AUGUST 2024 - 3 Years Old child, Type1 Diabetes, Insulin Hypoglycemia, Intermittent, Bloating 1 Month
PATIENT DATA LOG OF AUGUST - 2024
01/08/24
Patient Advocate: 01/08/24
7.30am nuts and dates
7.45am milk and puffed rice
9.45am 2u lispro insulin
9.55am rice with papaya, chayote, pumpkin, long beans, pointed gourd, tometo, paneer and salad
1.45pm blood suger 259
1.45pm 3u lispro insulin
1.55pm lunch with same previous dish
5.45pm sour curd
7.00pm oats
9.45pm 2u lispro insulin
9.55pm dinner with as same as lunch dish and include fish
03/08/24
Patient Advocate: 02/08/24
7.30am blood suger 94
7.30am nuts and e
7.45am milk and puffed rice
9.45am 2u lispro insulin
9.55am rice with papaya, spiny gourd, pumpkin, chayote, green banana, pointed gourd, egg and salad
1.45pm 3u lispro insulin
1.55pm lunch with same previous dish except egg and include paneer
4.00pm blood suger 88
5.30pm sour curd
7.00pm oats
9.45pm 2u lispro insulin
9.55pm dinner with as same as lunch dish except paneer and include fish
10.40pm 4u lantus insulin
04/08/24
Patient Advocate: 3/08/24
7.30am nuts and dates
7.45am milk and puffed rice
9.45am 2u lispro insulin
9.55am rice with pointed gourd, tometo, pumpkin, papaya, sponge gourd, ribbed gourd, bitter gourd and salad
12.00noon mousambi
1.45pm 3u lispro insulin
1.55pm lunch with same previous dish and paneer
4.00pm blood sugar, 243
5.30pm sour curd
7.00pm banana
9.45pm 2u lispro insulin
9.55pm dinner with as same as lunch dish
10..40pm 5u lantus insulin
9.45pm blood sugar before dinner 199
05/08/24
Patient Advocate: 4/08/24
7.30am nuts and dates
7.45am milk and puffed rice
9.45am 2u lispro insulin
9.55am rice with papaya, chayote, sponge gourd, bitter gourd, tomato, pointed gourd, and salad
12.00noon blood suger 247
12.00noon mousambi
1.45pm 3u lispro insulin
1.55pm lunch with same previous dish and fish
5.30pm sour curd
7.00pm banana
9.45pm blood sugar 163
9.45pm 2u lispro insulin
9.55pm dinner with as same as lunch dish
10.40pm 5u lantus insulin
06/08/24
Patient Advocate: 05/08/24
7.30am blood suger 98
7.30am nuts and dates
7.45am milk and puffed rice
9.45am 2u lispro insulin
9.55am rice with pointed gourd, bitter gourd, pumpkin, papaya, chayote, green banana,
12.00noon mousambi
1.45pm 3u lispro insulin
1.55pm lunch with same previous dish and paneer
4.00pm blood sugar 126
5.30pm sour curd
7.45pm oats
9.45pm 2u lispro insulin
9.55pm dinner with as same as lunch dish
10.40pm 5u lantus insulin
6/08/24
7.30am nuts and dates
7.45am milk and puffed rice
9.45am 2u lispro insulin
9.55am rice with papaya, chayote, green banana, pointed gourd, bitter gourd, tomato, egg and salad
12.00noon blood sugar 137
12.00noon mousambi
1.45pm 3u lispro insulin
1.55pm lunch with same previous dish except egg and include fish
5.30pm sour curd
7.00pm oats
9.45pm blood suger 233
9.45pm 3u lispro insulin
9.55pm dinner with as same as previous
10.40pm 5u lantus insulin
07/08/24
Patient Advocate: 12.00night blood sugar two hours later of dinner 99
PaJR PHR Moderator: 👍
Patient Advocate: 07/08/24
7.30am nuts and dates
7.45am milk and puffed rice
9.45am 2u lispro insulin
9.55am rice with pointed gourd, chayote, papaya, green banana, sponge gourd, tomato egg and salad
12.00noon mousambi
1.45pm blood sugar 93
1.45pm 2u lispro insulin
1.55pm lunch with same previous dish except egg and include fish
5.30om sour curd
7.00pm oats
9.45pm 2u lispro insulin
9.55pm dinner with as same as previous dish
10.40pm 5u lantus insulin
08/08/24
Patient Advocate: 12.10am blood suger after dinner 213
8/08/24
7.30am blood suger 52
No symptoms at all
7.30am nuts, dates and 1/2 cream roll biscuit
7.45am milk
9.45am 2u lispro insulin
9.55am rice with papaya, chayote, ribbed gourd, tomato, green banana, egg and salad
12.00noon mousambi
1.45pm 2u lispro insulin
1.55pm lunch with same previous dish except egg and include fish
5.30pm sour curd
7.00pm banana
9.45pm blood suger 120
9.45pm 2u lispro insulin
9.55pm dinner with as same as lunch dish
10.40pm 4u lantus insulin
09/08/24
Patient Advoacte: 09/08/24
7.30am nuts and dates
7.45am milk and puffed rice
9.45am 2u lispro insulin
9.55am rice with pointed gourd, tometo, green banana, chayote, papaya, ribbed gourd, egg and salad
12.00noon mousambi
1.45pm blood sugar 190
1.45pm 2u lispro insulin
1.55pm lunch with same previous dish except egg and include fish
5.30pm sour curd
7.15pm banana
9.45pm 2u lispro insulin
9.55pm dinner with as same as lunch dish
10.40pm 4u lantus insulin
10/08/24
Patient Advocate: 12.00night blood suger after dinner 150
10/08/24
7.30am nuts and dates
7.45am milk and puffed rice
9.45am 2u lispro insulin
9.55am rice with papaya, chayote, bitter gourd, tomato, pointed gourd, green banana, egg and salad
12.00noon mousambi
1.45pm 2u lispro insulin
1.55pm lunch with same previous dish except egg
5.38pm sour curd
7.00pm banana
9.45pm blood suger 258
9.45pm 2u lispro insulin
9.55pm dinner with as same as previous dish
10.40pm 5u lantus insulin
11/08/24
Patient Advocate: 11/08/24
7.30am blood suger 136
7.30am nuts
7.45am milk and puffed rice
9.45am 2u lispro insulin
9.55am rice with pointed gourd, chayote, papaya, green banana, tomato, egg and salad ( cucumber and lemon)
12.00noon moumita l
12.00noon mousambi
1.45pm 2u lispro insulin
1.55pm lunch with same previous dish except egg
4.00pm blood suger 96
5.30pm sour curd
7.00pm oats
9.45pm 2u lispro insulin
9.55pm dinner with as same as lunch dish
10.40pm 5u lantus insulin
12/08/24
PaJR PHR Moderator: 👍
Patient Advocate: 12/08/24
7.30am nuts
7.45am milk and puffed rice
9.45am 2u lispro insulin
9.55am rice with pointed gourd, bitter gourd, tomato, chayote, papaya, green banana, egg and salad
12.00noon blood suger 176
12.00noon mosambi
1.45pm 2u lispro insulin
1.55pm lunch with same previous dish except egg
5.30pm sour curd
7.00pm banana
9.45pm blood sugar 134
9.45pm 2u lispro insulin
9.55pm dinner with as same as lunch dish
10.40pm 5u lantus insulin
13/08/24
Patient Advocate: 13/08/24
7.30am nuts
7.45am milk and puffed rice
9.45am 2u lispro insulin
9.55am rice with pointed gourd, chayote, papaya, green banana, bitter truth, egg and salad
12.00noon mosambi
1.45pm 2u lispro insulin
1.55am lunch with same previous dish
5.30pm sour curd
7.00pm oats
9.45pm 2u lispro insulin
9.55pm dinner with as same as lunch dish except egg
10.40pm 5u lantus insulin
PaJR PHR Moderator: Any symptoms at 6:30AM?
Patiet Advocate: No Sir
16/08/24
Patient Advocate: 15/08/24
7.30am nuts
7.45am milk and puffed rice
9.45am 2u lispro insulin
9.55am rice with pointed gourd, chayote, brinjal Spiny guard, long beans, papaya, egg and salad
12.00noon mosambi
1.45pm 2u lispro insulin
1.55pm lunch with same previous dish except egg and include fish
5.30pm sour curd
7.00pm oats
9.45pm 2u lispro insulin
9.55pm dinner with as same as lunch dish
10.40pm 5u lantus insulin
16.08.24
7.30am blood suger 64
7.30am nuts
7.45am milk and puffed rice
9.45am 2u lispro insulin
9.55am rice with pointed gourd, tometo, long beans, papaya,, chayote , green banana, bitter gourd, egg and salad
12.00noon mosambi
1.45pm 2u lispro insulin
1.55pm lunch with same previous dish except egg and include fish
4.00pm blood sugar 113
5.30pm sour curd
7.00pm banana
9.45pm 2u lispro insulin
9.55pm dinner with as same as lunch with
10.40pm 5u lantus insulin
17/08/24
PaJR PHR Moderator: Reduce lantus dose to 3U
Patient Advocate: Ok sir
18/08/24
Patient Advocate: 17/08/24
7.30am blood suger 67
7.30am nuts
7.45am milk and puffed rice
9.45am 2u lispro insulin
9.55am rice with pointed gourd, bitter gourd, tomato, long beans, papaya, chayote, egg and salad
12.00noon mosambi
1.45pm 2u lispro insulin
1.55pm lunch with same previous dish except egg
5.30pm sour curd
7.00pm oats
7.15pm 1pc sweet (sandesh)
9.45pm blood sugar 290
9.45pm 2u lispro insulin
9.55pm dinner with as same as lunch dish
10.40pm 4u lantus
Dinner er age sugar onek ta high chhilo tai 2u na kamiye 1u kamano hoyechhe
PaJR PHR Moderator: The sugar before dinner gets worked on primarily by the lispro she's given while the lantus works on the basal sugar levels as reflected in her fasting levels which was still hypoglycemic as lantus wasn't reduced well enough!
রাতের খাবারের আগে চিনিটি প্রাথমিকভাবে তার দেওয়া লিসপ্রো দ্বারা কাজ করে.
ল্যান্টাস বেসাল চিনির মাত্রায় কাজ করে যা তার উপবাসের মাত্রায় প্রতিফলিত হয় যা তখনও হাইপোগ্লাইসেমিক ছিল কারণ ল্যান্টাস যথেষ্ট পরিমাণে হ্রাস পায়নি!
Patient Advocate: 18/08/24
7.45am milk and puffed rice
9.45am 2u lispro insulin
9.55am rice with papaya, chayote, green banana, pointed gourd, tometo, long beans, egg and salad
12.00noon blood sugar 105
12.00noon mosambi
1.45pm 2u lispro insulin
155pm lunch with same previous dish except egg and include fish
5.30pm sour curd
7.00pm banana
9.45pm blood sugar 167
9.45pm 2u lispro insulin
9.55pm dinner with as same as lunch dish
10.40pm 3u lantus insulin
20/08/24
Patient Advocate: 19/08/24
7.30am nuts and dates
7.45am milk and puffed rice
9.45am 2u lispro insulin
9.55am rice with pointed gourd, tometo, long beans, papaya, chayote, green banana, bitter gourd, egg and salad
12.00noon mosambi
1.45pm blood sugar 302
1.45pm 2u lispro insulin
1.55pm lunch with same previous dish except egg
5.30pm sour curd
7.00pm banana
9.45pm 2u lispro insulin
9.55pm dinner with as same as previous dish
10.40pm 3u lantus insulin
20/08/24
7.30am fasting blood sugar 180
7.30am nuts and dates
7.45am milk with puffed rice
PaJR PHR Moderator: Increase lantus today to 4U
Patient Advocate: Ok Sir, I also think that
PaJR PHR Moderator: Wish we had the 0.5U kids pens easily available (link was shared earlier and is it archived in @Narmeen Shah 's case report?)to make the process of pediatrics insulin dose titration easier and better controlled
Patient Advocate: Eta pray shesher dike, porer Lantus ta 0.5u kids pen khoj karbo
Narmeen Shah: https://m.indiamart.com/proddetail/humalog-junior-kwikpen-2850841647288.html
Sir these links? Yes, they are archived in the case report.
Patient Advocate: 9.45am 2u lispro insulin
9.55am rice with papaya, chayote, green banana, long beans, sponge gourd, pumpkin, egg and salad
12.00noon mosambi
2.30pm 2u lispro insulin
2.45pm lunch with same previous dish except egg and include fish
5.00pm blood sugar 216
6.30pm sour curd
7.30pm oats
9.45pm blood sugar 276
9.45pm 2u lispro insulin
9.55pm dinner with as same as lunch dish
10.45pm 4u lantus insulin
22/08/24
Patient Advocate: 21/08/24
7.30am nuts and dates
7.45am milk with puffed rice
9.45am 2u lispro insulin
9.55am rice with papaya, spiny gourd, sponge gourd, long beans, pointed gourd, bitter gourd, tomato, green banana , egg and salad
12.00noon blood sugar 176
12.00noon mosambi
1.45pm 2u lispro insulin
1.55pm lunch with same previous dish
5.30pm sour curd
7.00pm oats
9.45pm blood suger 175
9.45pm 2u lispro insulin
9.55pm dinner with as same as lunch dish except egg
10.40pm 4u lantus insulin
23/08/24
Patient Advocate: 22/08/24
7.30am nuts and dates
7.45am milk and puffed rice
9.45am 2u lispro insulin
9.55am rice with papaya, spiny gourd, sponge gourd long beans, pumpkin, egg and salad
12.00noon mosambi
1.45pm 2u lispro insulin
1.55pm lunch with same previous dish except egg and include fish
5.30pm sour curd
7.00pm oats
9.45pm 2u lispro insulin
9.55pm dinner with as same as lunch dish
10.40pm 4u lantus insulin
12.. 00night blood suger 114
23/08/24
7.30am blood sugar 144
7.30am nuts and dates
7.45am milk and puffed rice
9.45am 2u lispro insulin
9.55am rice with papaya, chayote, green banana, long beans, egg and salad
12.00noon mosambi
1.45pm 2u lispro insulin
1.55pm lunch with same previous dish except egg and include fish
4.00pm blood suger 248
5.30pm sour curd
Sir Aaj ke ki lantus 1u barano jabe ?
PaJR PHR Moderator: Lantus barano komano tar jonye either amader puro diner 7 point sugar profile dorkar 2-3 days jabot are nahole at least 2-3 diner por por fasting ta dekha proyojon
4PM er sugar ta depend korche 1:45 PM a newa lispro r upore
Patient Advocate: Thik achhe
7.00pm oats
9.45pm 2u lispro insulin
9.55pm dinner with as same as lunch dish
10.40pm 4u lantus insulin
24/08/24
Patient Advocate: 24/08/24
7.30am nuts and dates
7.45am milk and puffed rice
9.45am 2u lispro insulin
9.55am rice with papaya, chayote, green banana, long beans, sponge gourd, egg and salad
12.00noon apple and guava
1.45pm 2u lispro insulin
1.55pm lunch with same previous dish except egg
4.00pm blood sugar 244
5.30pm sour curd
7.00pm banana
9.45pm 2u lispro insulin
9.55pm dinner with as same as lunch dish
10.40pm 4u lantus insulin
26/08/24
Patient Advocate: 25/08/24
7.30am nuts and dates
7.45am milk and puffed rice
9.45am 2u lispro insulin
9.55am rice with pointed gourd, chayote, green banana, bitter gourd, tomato and salad
12.00noon blood sugar 217
12.00noon mosambi
1.45pm 2u lispro insulin
1.55pm lunch with same previous dish and fish
5.30pm sour curd
7.00pm banana
8.30pk one pc cream cake
9.45pm blood sugar 379
9.45pm lispro insulin 3u
9.55pm dinner with as same as lunch dish
10.40pm 4u lantus insulin
12.00night blood sugar 201
PaJR PHR Moderator: Today's fasting sugars?
Patient Advocate: Fasting 95
PaJR PHR Moderator: Better not increase lantus now
Yesterday's higher post meal sugars may need dose titration of her short acting lispro insulin just before her meals
27/08/24
Patient Advocate: 26/08/24
7.45am blood sugar 95
9.45am 2u lispro insulin
9.55am rice with pointed gourd, chayote, brinjal, tomato, spiny guard, pumpkin, egg and salad
12.00noon mosambi
1.45pm 2u lispro insulin
1.55pm lunch with same previous dish except egg and include fish
5.30pm sour curd
7.00pm banana
9.45pm blood suger 157
9.45pm 2u lispro insulin
9.55pm dinner with as same as lunch dish except fish
10.40pm lantus insulin 4u
PaJR PHR Moderator: The above data driven fact that her high post meal blood sugars since two days resolved without any changes of insulin dose suggests that diet and activities factors are involved in the previous highs and current lows.
@Patient Advocate can you share details about her diet and or activities that you feel may have made a difference to her sugars?
@Narmeen Shah thanks for updating her EHR case report till 23/8/24!
29/08/24
Patient Advocate: 27/08/24
Ei din amra barir baire thakar janya test Kara hoy ni
Insulin lispro 3 times before meal by 2u each
Aar lantus 4u at night
28/0824
7.30am blood suger 69
7.30am nuts and dates
7.45am milk and puffed rice
9.45am 2u lispro insulin
9.55am rice with pointed gourd, chayote, green banana, papaya, spiny guard, bitter gourd, egg and salad
12.00noon mosambi
1.45pm 2u lispro insulin
1.55pm lunch with same previous dish except egg and include fish
4.00pm blood sugar 119
5.30pm sour curd
7.00pm oats
8.15pm amul kool 3/4 bottle
9.45pm 2u lispro insulin
9.55pm dinner with as same as lunch dish
10.40pm 4u lantus insulin
PaJR PHR Moderator: Lantus aabar 3U kore dewa bhalo keno ki ota abar dangerous hypoglycemia r pothe niye choleche.
0.5U dose titration korte parle bhalo hoto
Patient Advocate: Ok Sir, ajke sugar level ta dekhe apnake janabo
PaJR PHR Moderator: Gotokal er fasting dekhe uporer montobbo korechilam.
Aajker fasting ta jaante parle bhalo hoto
Patient Advocate: 29/08/24
7.30am nuts and dates
7.45am milk and puffed rice
9.45am 2u lispro insulin
9.55am rice with pointed gourd, chayote, papaya, green banana, long beans, egg and salad
12.00noon blood sugar 319
12.00noon mosambi
1.45pm 3u lispro insulin
1.55pm lunch with same previous dish except egg and include fish
4.00pm blood sugar 199
30/08/24
Patient Advocate: 5.30pm sour curd
7.00pm banana
9.45pm blood sugar 210
9.45pm 2u lispro insulin
9.55pm dinner with as same as lunch dish
10.40pm 4u lantus insulin
PaJR PHR Moderator: Lispro should have been 3 units before breakfast yesterday and 2 units before lunch
Lantus should have been 3 units
Patient Advocate: 30/08/24
7.30am nuts and dates
7.45am milk and puffed rice
9.45am 2u lispro insulin
9.55am rice with pointed gourd, chayote, papaya, long beans, tomato and salad
12.00noon mosambi
1.45pm blood suger 275
1.45pm 2u lispro insulin
1.55pm lunch with same previous dish
5.30pm sour curd
7.45pm oats
9.45pm 2u lispro insulin
9.55pm dinner with as same as lunch dish
10.40pm 4u lantus insulin
31/08/24
Patient Advocate: 12.00night blood suger 210
01/09/24
Patient Advocate: 31/08/24
7.30am nuts and dates
7.45am milk and puffed rice
9.45am 2u lispro insulin
9.55am rice with pointed gourd, tometo, pumpkin, chayote, papaya, long beans, and salad
12.00noon mosambi
1.30pm 2u lispro insulin
1.40pm lunch with same previous dish and paneer
5.00pm prasad (fruits and mix of flour, milk, banana palm fruit, raisins)
7.00pm blood suger 253
7.30pm sugar free icecream
9.45pm 2u lispro insulin
9.55pm khichudi and previous vegetable
10.40pm 4u lantus insulin
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