Saturday, November 24, 2007

Highs ... and Highs

I have posted a few times about Emma's sling-shotting Highs and Lows. Well, for the past few days, its been basically Highs. And not small highs, big highs. I corrected a 476 at 3 hours after dinner last night. She didn't even eat enough food to spike her that high. That has been the case for the past few days.

I have checked her ketones over and over and she had none, so I'm confident she was getting insulin. And with corrections, she eventually comes down. So, I think we need to change some meal ratios. But gosh, I hate to do that right as we are going on vacation - talk about screwed up. We're probably gonna be so out of whack by the time we return.

Now I'm just waiting to hear back from the nurse about my proposed changes and then I'll be making some. This is just so frustrating.

Monday, November 12, 2007

LO!

As much as the parent of a diabetic doesn't like the blood glucose meter to greet you with a HI (meaning blood sugar ABOVE 600), you REALLY don't want to see LO.

LO means less than 20. Many diabetics have had seizures with blood sugar levels higher than that.

We got a LO on the meter yesterday. It was during a time that Emma typically goes a little low, so we were checking her. We got a LO on the meter! So, while I was checking it again, Mike got Emma some juice. My 2nd reading was 24 - so that LO was pretty accurate.

Emma's only symptom of a problem with a bit of stumbling disoirentation. She doesn't know when she's low - or if she does, she doesn't know how to explain how she is feeling.

So, after quite a few days of degrees of lows around dinner, I lowered Emma's basal rate during that time. Not that I can check it today, as she has been running high all day so its tough to tell how effective a change in treatment is.

Tuesday, November 6, 2007

Finally, someone in respected media agrees with us

Reputed doctors are finally saying that Halle Berry's "miracle cure" of Type 1 diabetes was probably an initial misdiagnosis of Type 1 instead of Type 2.

ABC News Report

Well, Duh

Monday, November 5, 2007

PSA: Yes, my child can eat sugar

I'm a pretty trusting person. I also give most people the benefit of the doubt. So, I don't get as spun up as others do when "well meaning" people make assumptions about their children because they have Type 1 Diabetes.

A common one is this: Your child has diabetes; they can't have sugar.

Well, that USED to be true. Kinda. The older regimens of diabetic care (NPH and NNR) had insulins that "peaked" at certain times. So, you had to eat at certain times to avoid a low. And you had to eat just a certain amount to avoid a high. And you avoided sugary things because, well, they just weren't well managed with the older regimens.

Take the old regimens, old ways of thinking, and combine it with a media blitz talking about childhood obesity and diabetes (that would be Type TWO), and many "well meaning" people will assume your child should not or cannot have sugar

Not true.

Now, I don't stuff Emma full of sugar. But, then again, I don't stuff my other two children full of sugar either. Emma probably gets the same amount of "Refined sugar treats" as my other two children did at this age - not much. This was our first Halloween since diagnosis and its been the same for her as the other two - a couple of pieces after trick-or-treating and then one piece a day as dessert with a meal since then. It hasn't been every day that she's had a piece of candy after lunch or dinner, but we've had it when she asked (and when she ate the rest of her regular food, which is always a requirement).

I have stayed away from the "pure sugar" candy, such as sweet tarts. They will do nothing but spike her and then drop her. We'll save those to treat lows! But, she's had chocolate and has quite enjoyed it. We just add the carbs from the candy into her meal and give her a dose of insulin to cover it all. It works best that way, as the candy has a high glycemic index and putting it with some protein and lower glycemic index foods helps to slow the absorption and avoid the peak.

So, thanks for caring - but she can have sugar. We just regulate it just like we do with our other kids, because we don't want THREE of them bouncing off the walls!

Friday, November 2, 2007

67 and 545!

I saw both of those numbers today - yes, I did.

We have many days where we rarely see over 200 - except at breakfast(which I'll discuss in a minute), so to see 67 and 545 in the same day was quite a feat.

Now that Emma has finally kicked her bug, she has a couple of trends that I want to address. The first was the SPIKE that she has after breakfast - she can easily hit 350 to 400 at the 2-hour or even the 3-hour mark after breakfast (she has a 5 hour IOB). So, I wanted to try what so many on the Children With Diabetes board suggest - pre-bolusing. I had discussed it with the CDE and a couple of different approaches. Today, I wanted to just be simple. Estimate her carbs and then dose her when she sits down to eat (instead of after). That will give the insulin a 20 minute head start.

So, we do that and her 2-hour reading was 250 - not bad. But, then I realized that might not be good at all. A quick IM to Mike confirmed that she had NO protein at breakfast. Without protein, she SPIKES really high and then PLUMMETS to a low because the insulin can't catch the food. I don't know WHY Mike thought we could leave out the protein, but oh well. So, today wasn't a good test of the pre-bolus. That's where the 67 came from - at lunch.

So, I gave her some juice and then her lunch, did a slight negative correction and she went down for her nap. I set her a temporary basal rate of +20% when she goes down for a nap because she always goes HIGH. Well, definitely she did that today. She woke up at 545! Turns out we were at the full 3-day mark for her site - and her sites don't last 3 days. So, I did a quick site change (if I don't have to reload the cartridge or prime new tubing, I can do it very quickly) and gave her a correction to handle the 545.

But, the 2nd trend I wanted to treat today was perpetual lows right before dinner. Its usually between 4:30pm and 6pm that she drops - just about every day - whether she has a nap or not. Mainly because that is our running around time and she is often running down the sidewalk at Tae Kwon Do, or on the soccer field. So, I decreased her basal rate at 4pm (my first change in basal on my own without asking the CDE). But, I couldn't test it because of the 545 at 4pm that had to be treated.

So, two changes tried and none able to test the result. We'll try again tomorrow.

See, I'm not the only one who agrees

PerezHilton

Another Diabetes Blog