Hi All, Kennedy is 11 and im middle school, omnipod, still in honeymoon, 9 months out from diagnosis,
she is having lots of trouble in her math class, which is right when her blood sugar peaks after lunch. We do have in her 504 plan an upper limit she must be below to test. So she missed lots of her tests due to high blood sugars, and then also there is just the regular work daily s=when she doesn't test, that also she is having a hard time with.
Her teacher has been completely not helpful with her and we have been working with the pricipal to make special arrangements to get her work done outside of class time. But she is missing key concepts, due to hyperglycemia and partially due to being out of school for illness ( last week she wiped out in gym and got a contusion on her foot BS 330, btw) and had to miss math that day.
I guess I thought having the 504 would make everything easy to make up, but there is still that problem of the HYPERGLYCEMIA which is persistent and really keeping her from learning...
we do pod changes every third day in the morning before school, so every third day there is a decent chance of a spike right during the class. Lunch is a problem, as we have been unable to figure out how to bolus enough time for her insulin to kick in, so her peak is even higher than it should be.
To top it off her teacher has type two and makes comments to her like " are you sure you're going to eat that" in front of her peers.
Kennedy is just starting to be able to tell her highs and starts to feel bad upwards of 200 now.
Ideas? I'm toying with the idea of a carb free lunch, that is about the only thing that will probably work here, but the poor kid, she's already restricted so much... ( celiac too)
you know, after Caleb grows up... you should be a cde you know!! SERIOUSLY! I read a little more on your blag about what your endo said about a 200 post meal spike " that's diabetes" I feel like that all the time with them!! The tech is changing perhaps too fast for them to keep up... Is Caleb interested in doing an AP trial?
:) You are very kind. For the most part, Caleb doesn't think about D all that much and therefore is completely indifferent to a trial. But I sure would love to see him doing it! Can't wait for that to be available. :)
Oh - I forgot to mention - no the endo did nor recommend the super bolus. Just something we experimented with.
Is she bolusing 15-30 min. before eating? That might help. But I think pretty much there will *always* be spikes in BG after eating lunch (w/carbs). Unless she has gym directly afterwards, perhaps. I have type 1 and I can see how I shouldn't take a test if I'm low, since my brain is not working properly, but why not high? The brain is getting plenty of sugar. Maybe she is different, but I can't say highs affect me like lows do. My brain still works, I just may be thirstier and have to pee more. (maybe she is more sensitive being newly diagnosed?) If the hyperglycemia is "persistent" in that it doesn't come down all afternoon, then she needs a higher lunch bolus. But if it spikes after lunch then comes down, that is normal. Anytime you check right after a meal, it will probably be high. It is going to take a few hours for BG to come down after eating, any meal, that is just how "rapid acting" insulin works-- it's not all that rapid. She may be just missing too much class, too many tests, even unnecessarily... and high blood sugar after meals is basically a fact of life in type 1. Maybe they can switch her to gym or an easier class after lunch? How high is her sugar, by the way, after lunch? Maybe just raising the upper limit for a test, knowing it will tend to be high after eating? Say, to 300? (I don't know what it is now, but it's tough to prevent a spike into the 200s after meals, IMO).
I hadn't read the other comments when I wrote the above--
can she bolus before lunch? (sounds like she waits till lunch to bolus, then waits to eat, why not bolus during the class before lunch?) I don't know, I haven't had a middle schooler w/type 1, only a younger kid. I do agree that it's probably affected the whole relationship w/the teacher at this point and switching would be good if possible. Or at least next year.
And I just don't notice being in the 200s but maybe others do!
that's what I was thinking!! test and bolus in the class BEFORE lunch then just swing by the nurses office to let her know her numbers and carb count, it is actually on the way... it's just lately ( switched to apidra) and her numbers are overall better, that she notices being in the 200's...
maybe we should increase the testing limit? what number does everyone else use? maybe 250? our endo said anywhere between 200 to 250 would be ok
We don't use the POD but my dd we change her every two days and we do it after dinner but before bed time. This way if her sugar spikes during the night we know it is the pump malfunctioning and there is a good chance we can correct the problem. Also if the pump is working she does tend to be a little lower for those first few hours and it gives us a chance to fix that as well. She usually sleeps through the checks at night so that doesn't seem to be a problem. It works for us.
So sorry to hear all this, diabetes is hard enough without the added pressures you all are experiencing.
Both of our boys are on the OmniPod, and we do see highs after pod changes. We have started to bolus a tiny bit before the pod change, and that seems to help head off the highs later on. Our endo also has them extending their bolus an extra hour after a meal which works pretty well.
I would definitely check with your endo and see if there are any changes you can make to her basal rate at that time. Also, what is the insulin duration set for in her pod? That might be a factor as well.
My favorite sentence in their 504 plan is as follows: It is important that even though people around (name) may be frustrated, or blame the highs or lows on something or someone, realize that these feeling may be projected to (name) and makes him feel badly about himself.
As a side note, there is a terrific site for all sorts of subjects, but we use it for math. www.khanacademy.org
I have started splitting my son's bolus with meals especially if it's pizza or something higher in fat, or if he's higher. I seem to split more than not regardless of what he come to think of it. I usually do a 40/60% split and extend it over 1.5-2 hours. (usually 1.5) This seems to help him from getting too high or dumping a whole lot of insulin all at once if he's high.