How to Drive Me MDI Mad

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For the past several months we have been struggling with Marcus’s numbers.  So much that CHEO removed him from the pump because his A1c kept climbing.  It was no longer safe to keep him on the pump.  Little did they know in September that he would still be uncontrolled in January while on MDI.

His past Endo appointment in January showed he was due for blood work and his doc noticed that his thyroid is a bit enlarged.  We have yet to get him in for his blood draws but reading up on thyroid issues showed that IF he has hyperthyroidism that it would explain his lack of weight gain and his resistance to insulin.

Another autoimmune disease has not yet been determined but it MAY be a reason as to why he needs 150 units a day at 11 years old.  In January the doc asked us to try him on Humalog again because the first time he tried it he got instantly red, hot and hard at the injection site.  I was reluctant but we did it anyway because, well, we need to figure out what is going on.

We haven’t been able to identify what has been happening with him to the point that the doctor even requested that home care nurses come to monitor meal time.  Every nurse that came said that we didn’t need them and that we are doing everything that we are supposed to.  What can you do when you have been living with this disease for 5 years? Start over and try again.  At least, that is what we are trying.

He even had an iPro put on by the Medtronic rep and that showed that his Humalog is working.  Maybe a little too well, he is now having lows.  While lows are never good, I will take more close to being “in range” numbers rather than being in the 20’s (360’s).

jan-27-sensor-data

Marcus’ lows now have gotten so bad that the day after the above graph was captured, he was at CJ’s birthday sleepover at his moms house and was low all night and on the 29th at lunch, he was low so often that he had 79 uncovered carbs.  That is not like Marcus.  When he got home that afternoon he went up to 11 but then dropped back down without any insulin.  We changed his food ratio to give less insulin but had to come back to our regular one after a few days of higher numbers.

We have taken to making sure we give him his Lantus at night as well as bolus him ourselves to make sure all the insulin makes it in.  We have switched my skin and bones kid to 5mm long needles to see if that would help.  The pen tips seem to really make a difference.  Maybe “thick skin” is true after all. Who knew?

I am actually in disbelief but the graph shows that he is mostly in range.  The first high yesterday can be explained by him eating before blousing and we (I) didn’t bolus him at all.  Oops.  This is what happens on snow days.  One more reason I love the new Ascensia Contour Next One app is that it allows for notes to be easily added otherwise I would completely forget why he was high.   The second high was after he went out and shovelled the driveway and we corrected off that number after.

feb-13-readings

I am so confused.  When we change his ratio to give him less insulin he skyrockets into the high teens early twenties but when we have it at his current regular ratio, he drops too far.  He REALLY needs to get back on the pump.  This MDI is driving me mad.

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