As you may or may not know from my new signature, November 14 is World Diabetes Day (so if AT ALL possible, and if I'm not asking too much, could you please wear blue that day to raise awareness/show support for Juvenile Diabetes).
Also, November is National Diabetes Awareness Month. Every World Diabetes Day is meant to raise awareness and think about people with the disease. This WDD will be the same as others, yet very different.
I have been a member of this forum for quite some time now, but I am also a member of other forums (all Type 1 Diabetes related) the DOC (Diabetic Online Community) is very small...they become your family.
"Alec, Jesse, Trent, Chantal, Madeline, Breanne, and Mary Kathryn are names I type with a heavy heart. They are a small collection of names that belong to a larger list of children who have lost their lives to Type 1 Diabetes. On October 20, it was with great sadness that I add the name of another beautiful child...Eilish.
I cannot begin to fathom the emptiness that must exist. The heartache. The grief. The news that day knocked the wind out of me...and reminded me, once again, of how quickly everything can change. My immediate thoughts turn to Eilish's parents...parents who were vigilant and educated, parents who embraced the challenge of Type 1 Diabetes and were sacrificially willing to do whatever necessary to ensure their daughter's well being. Parents who, on October 19, feared this potential complication int eh back of their mind - and woke up on Oct. 20 to realize it firsthand. This family will FOREVER be in my thoughts."
OH, and just because it's SAE Day (Support - Advocate - Educate) I give you one of many blog posts...
So I am dedicating this post to people who don't understand Type 1 Diabetes. Especially for those who figuratively roll their eyes at Type 1 and for those who have uttered, "How is it that big of a deal?" or have lectured, "At least it's not cancer!"
Well, for you my dear friends, I am putting you in charge of bolusing my son for lunch today. (Bolusing means giving Billy insulin. There is a whole new language that comes with this disease.) Come on...it's ONE time. Fix Billy up for lunch. It's no big deal, right? Give it a whirl!
Here is your scenario: (and I promise this is a VERY typical one. And don't worry, this is a boy with the easiest ratios). Billy calls you at 12:15pm. He has just eaten his lunch and wants to know how much insulin to give himself. Some information you need to know:
-His blood sugar number was 130 before he ate lunch at 11:50am
-He ate 1/2 an apple, most of his pretzels, his yogurt and his entire sandwich. He also ate an Oreo that his friend gave him.
-He gets 1 unit of insulin for ever 20 grams of carbs he eats.
-One unit of insulin brings his blood sugar, (or BG) down 100 points. His blood sugar goal for this time of day is 110.
Ready to calculate?
-Correction = 0.2 units. To bring his sugar down the twenty points needed.
-Carb bolus = 10g for the 1/2 apple, 10g for the mostly eaten 15 carbs of pretzels, 40g for the sandwich, 15g for the yogurt and 5g for the cookie. This is 80g of carbs. 80g Carbs is 4 units of insulin.
So what would you give him? 4.2 units of insulin? You would be totally wrong. You don't have all the information! Yes, his pre lunch BG was 130. But he had a snack 1 hour and 40 minutes before that. He had a banana (30g). So at 10:15 he got 1.5 units of insulin. Insulin stays in your ssytem for 2 hours. My boy had approximately 0.7 units that is still in his system from the 4.2 units you were planning on giving him. That means you are now going to give him 3.5 units...STOP! DON'T DO IT! More information needed!
He has PE after lunch today. They are doing relay races. Exercise DROPS his blood sugar like a rock. Better take away a unit of insulin for good measure! (How do I know 1 unit? You learn. Instincts are a big part of taking care of a child with diabetes.)
So now, how much insulin are you going to inject into my little boy? 2.5 units. Better...but um...sorry. There is yet another small bit of information you need to take into account. We have been adjusting Billy's basal rates (Basal: The underlying insulin that his pump delivers to him in small puffs ever few minutes throughout the day.) Billy has just ended a growth spurt and has been suddenly, for the last two days, dropping like crazy between 1 o'clock and 3 o'clock. Since we wait 5 dyas to establish a pattern, we need to leave his basal's as is..and at this moment, we need to adjust for these potentially scary lows. Better take off another 1/2 unit to keep him safe. (Yeah, because I said so!)
Final answer: 2 units of insulin needs to be delivered. And you were going to give him how much? 4.2?!?!
That is 2.2 units of insulin too much. That amount of insulin would have brought his blood sugar down 220 points. Which, with all that running around he was doing, would have put his blood sugar number at a negative number. Yeah, you can't be alive with a negative number.
But don't worry! We get to do this again for his afternoon snack! And again at dinner! And again before bed! And again at 11pm! And again at 1am, and again at breakfast tomorrow! LOTS AND LOTS OF PRACTICE!! YAY!
And the variables are never ending. A meal eaten with high fat changes everything. A meal eaten a couple hours earlier with high fat changes everything. A big test at school changes things. A substitute teacher changest things. A small cold changes everything! A growth spurt, field trip, or night of unexplainable highs changes everything. The weather sometimes changes everything. EVERYTHING CHANGES EVERYTHING!
I couldn't even write it down if I tried. And hey, I just tried. Worst part is...I don't know everythign there is to know about this disease. Because, I'm not a pancreas. I am a human being. Unfortunately.
So when you think you are ready to judge even one second of my split second decision about my little boy's health...think again. Because this disease is impossibly complicated. Billy will spend the rest of his life trying to hit a moving target.
And that is all I have to SAE!
Thank you for listening (reading)...
And now PICTURES!!
Also, November is National Diabetes Awareness Month. Every World Diabetes Day is meant to raise awareness and think about people with the disease. This WDD will be the same as others, yet very different.
I have been a member of this forum for quite some time now, but I am also a member of other forums (all Type 1 Diabetes related) the DOC (Diabetic Online Community) is very small...they become your family.
"Alec, Jesse, Trent, Chantal, Madeline, Breanne, and Mary Kathryn are names I type with a heavy heart. They are a small collection of names that belong to a larger list of children who have lost their lives to Type 1 Diabetes. On October 20, it was with great sadness that I add the name of another beautiful child...Eilish.
I cannot begin to fathom the emptiness that must exist. The heartache. The grief. The news that day knocked the wind out of me...and reminded me, once again, of how quickly everything can change. My immediate thoughts turn to Eilish's parents...parents who were vigilant and educated, parents who embraced the challenge of Type 1 Diabetes and were sacrificially willing to do whatever necessary to ensure their daughter's well being. Parents who, on October 19, feared this potential complication int eh back of their mind - and woke up on Oct. 20 to realize it firsthand. This family will FOREVER be in my thoughts."
OH, and just because it's SAE Day (Support - Advocate - Educate) I give you one of many blog posts...
So I am dedicating this post to people who don't understand Type 1 Diabetes. Especially for those who figuratively roll their eyes at Type 1 and for those who have uttered, "How is it that big of a deal?" or have lectured, "At least it's not cancer!"
Well, for you my dear friends, I am putting you in charge of bolusing my son for lunch today. (Bolusing means giving Billy insulin. There is a whole new language that comes with this disease.) Come on...it's ONE time. Fix Billy up for lunch. It's no big deal, right? Give it a whirl!
Here is your scenario: (and I promise this is a VERY typical one. And don't worry, this is a boy with the easiest ratios). Billy calls you at 12:15pm. He has just eaten his lunch and wants to know how much insulin to give himself. Some information you need to know:
-His blood sugar number was 130 before he ate lunch at 11:50am
-He ate 1/2 an apple, most of his pretzels, his yogurt and his entire sandwich. He also ate an Oreo that his friend gave him.
-He gets 1 unit of insulin for ever 20 grams of carbs he eats.
-One unit of insulin brings his blood sugar, (or BG) down 100 points. His blood sugar goal for this time of day is 110.
Ready to calculate?
-Correction = 0.2 units. To bring his sugar down the twenty points needed.
-Carb bolus = 10g for the 1/2 apple, 10g for the mostly eaten 15 carbs of pretzels, 40g for the sandwich, 15g for the yogurt and 5g for the cookie. This is 80g of carbs. 80g Carbs is 4 units of insulin.
So what would you give him? 4.2 units of insulin? You would be totally wrong. You don't have all the information! Yes, his pre lunch BG was 130. But he had a snack 1 hour and 40 minutes before that. He had a banana (30g). So at 10:15 he got 1.5 units of insulin. Insulin stays in your ssytem for 2 hours. My boy had approximately 0.7 units that is still in his system from the 4.2 units you were planning on giving him. That means you are now going to give him 3.5 units...STOP! DON'T DO IT! More information needed!
He has PE after lunch today. They are doing relay races. Exercise DROPS his blood sugar like a rock. Better take away a unit of insulin for good measure! (How do I know 1 unit? You learn. Instincts are a big part of taking care of a child with diabetes.)
So now, how much insulin are you going to inject into my little boy? 2.5 units. Better...but um...sorry. There is yet another small bit of information you need to take into account. We have been adjusting Billy's basal rates (Basal: The underlying insulin that his pump delivers to him in small puffs ever few minutes throughout the day.) Billy has just ended a growth spurt and has been suddenly, for the last two days, dropping like crazy between 1 o'clock and 3 o'clock. Since we wait 5 dyas to establish a pattern, we need to leave his basal's as is..and at this moment, we need to adjust for these potentially scary lows. Better take off another 1/2 unit to keep him safe. (Yeah, because I said so!)
Final answer: 2 units of insulin needs to be delivered. And you were going to give him how much? 4.2?!?!
That is 2.2 units of insulin too much. That amount of insulin would have brought his blood sugar down 220 points. Which, with all that running around he was doing, would have put his blood sugar number at a negative number. Yeah, you can't be alive with a negative number.
But don't worry! We get to do this again for his afternoon snack! And again at dinner! And again before bed! And again at 11pm! And again at 1am, and again at breakfast tomorrow! LOTS AND LOTS OF PRACTICE!! YAY!
And the variables are never ending. A meal eaten with high fat changes everything. A meal eaten a couple hours earlier with high fat changes everything. A big test at school changes things. A substitute teacher changest things. A small cold changes everything! A growth spurt, field trip, or night of unexplainable highs changes everything. The weather sometimes changes everything. EVERYTHING CHANGES EVERYTHING!
I couldn't even write it down if I tried. And hey, I just tried. Worst part is...I don't know everythign there is to know about this disease. Because, I'm not a pancreas. I am a human being. Unfortunately.
So when you think you are ready to judge even one second of my split second decision about my little boy's health...think again. Because this disease is impossibly complicated. Billy will spend the rest of his life trying to hit a moving target.
And that is all I have to SAE!
Thank you for listening (reading)...
And now PICTURES!!