Going Up

Last night was surprising. Tab was high. 400 city. All night we were:

MIDNIGHT: yarrrrgh he’s 400, what should I do?/we’re supposed to wait to see if he goes down. 1AM: are you sure he took his Lantus?/yeah, he took it with dinner and he bolused then too. 2AM: he’s still in the high 300’s; should I give him a unit?/no, it seems like he’s starting to go down now. 3AM: should I give him a something? he’s not going down anymore/no, the doctor said not to give corrections, and I don’t even know how to guess how much to give him. 4AM: should we give him something?/forget it, it’s almost time to wake up anyway.


So much double-ups for no good reason.

And then he was high all day today. Late this afternoon, I paged the on-call endo. It took me that long to realize he’s really not going downWhen she called back, I didn’t go into our whole story, for once. Instead I said, “I’m calling about my son and he’s high, and I don’t know how much background information you need.” She said she’d need to know the patient’s diagnosis (T1d), did he have ketones (no), age, and weight. She said based on that info, the correction would usually be 1:60, but as a precaution, we should use 1:75. Okay!

Of course, my next act was to admire myself for not telling her all about his diagnosis, his little brother, his high activity level, TrialNet, teplizumab, and why I imagined his endo recommended against corrections (my belief that she believes he might be more insulin sensitive than the imaginary person used in the correction formula, or that his pancreas might kick into action at any moment).

By the time I had the formula in hand, Tab was 300+ and going up, 4+ hours after lunch, and having spent the afternoon running around and shooting lacrosse balls.

Three hours post-correction, he’s down to 260. Reader, I am unimpressed by the efficacy of this treatment. I am assuming we should wait at least four? Five? Hours before attempting another correction. Because stacking.

He feels kind of sick. His head hurts. He’s lying under a fuzzy blanket, watching Homeland. He feels like I’m not hungry, but I just feel like I need to eat something because my body feels deprived of nutrients. It’s the behavior of a person who gets diagnosed with Type 1 diabetes a few weeks in the future, and you look back and say, “Remember how you were lying under that blanket and you had a headache and you didn’t feel like eating but you felt deprived of nutrients? I bet you had high blood sugar back then but golly, we just didn’t know.” BUT WE KNOW.

We know, we know, we know. But we don’t know how to make it go away.




  1. Larry Here · February 19, 2017

    Dang! I am not a doctor, and am not recommending this to you, but if I had a kid with T1, which of course I do, and had a few years of experience with said stupid disease, I would absolutely give more insulin and watch for lows. Maybe keep the kid home for a day and see how the experiment works out. That’s what I would do, because… insulin! Good luck and keep us posted. Dang.

    Liked by 2 people

    • Lucia Maya · February 20, 2017

      Though I don’t have a kid with diabetes, I have had type one for 40 years and I agree. It feels so yucky to be high (over 200 for me) If he does go low, and he’s on the Dexcom, you’ll both know and then he just needs to eat something. My guess is he might need an increase in his basal dose, if this stays like this for another day, but of course you’d need to check with the endo…

      Liked by 1 person

    • Katy · February 20, 2017

      Mm hmm. You are right. In retrospect, I can see this would have been a better course. I think I don’t know how to work with a medical team. I want to respect the professional advice, but I can’t tell when it’s based on an outsized fear of lows, and when it’s based on their knowledge and experience.


  2. shannon · February 20, 2017



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