The biggest difficulty of diabetes is that it can be so unpredictable. One small mistake in dosing or calculations can result in no sleep that night or a missed appointment or tae kwon do class. One exercise makes blood glucose plummet and another makes it go sky high. The same exercise can make one go high one day and low the next because of a little competitive spirit.
It takes awhile to see any patterns and to believe that the BG pattern isn't going to go back to what your previous month's experience taught you. Surely, this is just because he ____ (fill in the blank). We try to just adjust in the moment, adding insulin here and carbs there to minimize lows while still getting good results for the A1C and minimizing standard deviation.
The following analysis of his BG is done with Clarity and Dexcom G5, Note that the readings are not always consistent with finger pricks and a low of 60 may happen while I know he is actually 75 and not low in our book.) Our target BG for daytime is 100 mg/dL and 120 mg/dL for nights. I have made no changes to that in the past five months.
Two months ago, A1C was 6.1 which was consistent with his checkup 5 months ago. This was achieved with 2.5 % low readings. Last month, with my father ill, traveling, funeral, our concentration and attention wasn't always there and A1C rose to 6.4, still really good, and with 2.8% low. This past month, his A1C has lowered to 5.6 % but with 6.7% low. I'm not happy with that percentage of lows though he is nearly 85% in range. Though I'm lowering basal rates and adjusting carb ratios, I've not changed targets.
He should be far past the effects of low BG due to a gastrointestinal virus on April 22. He started using LDN (low dose naltrexone) on April 11th, ramping up from 0.5 mg to his present level of 3.5 mg. (Target 4.0 mg.) He is exercising no more than normal, We are using Sugar Surfing techniques, but were before.
In general, he trends low during the day and BG can be stubborn to bring up. In the evening, BG spikes quickly but comes down just as quickly sometimes when corrected. It's hard not to wonder if the LDN wears off by the evening. Perhaps giving some around dinner could ward off this daily spike? And of course, there is no way to know LDN has anything to do with anything.
I know a 6.7% low average can't be allowed to continue, but I'm reluctant to change my targets, rather want to change treatment. Yesterday, I put on a 25% reduction of basal all morning, which was too much and resulted in a higher than desirable BG at lunch. I know I'm going to have to change something: I was up until 4 a.m. after over-correcting his high BG at bedtime. I'm thankful we homeschool, because the frequent carbs and finger pricks tires him, too.
Note: Though 14 years old, son is of adult size and still growing
LDN was prescribed for thyroid condition not diabetes.
Disclaimer; Nothing you read on my blog is intended as medical advice. If you have questions about your medical care, please consult a doctor, I am not a medical professional and do not offer this as advice but only my own thoughts for our own situation.