Monday, November 5, 2012

Why people are Afraid of Type 1 Diabetes

I recently posted my thoughts on Why People so Afraid of Diabetes (see tab at the top of this page) and my thoughts included my experience of being on a Diabetes forum and being blasted as being a bad mother because I dont check my sons Blood Glucose (BG) during the night.

It's taken me a few days to think this through, but now I think I have an answer.

Almost all american children are immediately put onto Lantus insulin at diagnosis. Nothing wrong with that, but it means that the child is immediately thrust into the bolusing and carb counting and diabetic maths situation from day 1.

Also Lantus is a long term insulin. It runs for 24 hours. And then extra insulin is added at meal and snack times. This is called Bolusing. That is how the regime is supposed to work.

Lantus is listed in my Diabetes book as Onset is 2 - 4 hours, no peak and lasts 24 to 36 hours.

Many of the mothers on the forum mentioned giving their child a Lantus insulin injection at bedtime. Which means that it sits there inactive for 2 to 4 hours before it starts working. Of course the kid is going to have lows over night.

A better time to inject would be at breakfast time. If it is injected at breakfast time, then it will be active by lunch time and will stay active all evening and overnight. The child is far less likely to have lows. The morning bolus injection will cover the breakfast food eaten.

 As I also stated in my People Afraid of Diabetes page, I also stated that the reason why here in Ontario, we don't use Lantus. This is because we dont want newly diagnosed children being subjected to bolusing right from day 1. So in Ontario, we use intermediate acting insulin - called NPH. But the pronblem is that it is cloudy and for some reasons Americans have been conditioned to stay away from any insulin that is cloudy.

When I mentioned that I was using NPH (the intermediate insulin - the cloudy stuff), I was told, you need to get onto Lantus ASAP. Well, no I dont. In Ontario, kids dont go onto Lantus until they can inject themselves and until they can do carb counting and diabetic maths. And even then, the lantus is usually provided by the pump.  Children with Diabetes (CWD) have to keep their A1C's under 10 for 3 Endo visits in a row, in order to qualify for the pump.

Right now my sons shows no interest in injecting himself. Because I do it all for him. He is only 10 years old. So he won't be going onto a pump if he doesn't start taking care of himself. However, it is early days yet. Hopefully by the time he is 12 and 13 years old, he will be injecting himself.

Monday, October 1, 2012

Numbers going haywire....

Is this the end of the honeymoon period?

My son has had a bad cold and cough for the last 10 days - his BG numbers dropped for several days before going back to normal and then the cough started so I kept him home for the week while he coughed and generally acted sick. I did get some assignments from the teacher so that means he wont be too far behind.

But this weekend just ended, his BG numbers shot up high and stayed high. The book says that if the numbers stayed high for 3 days in a row, then to increase the insulin. It's only been 2 days but since it is across the board, then I will be increasing the NPH after just 2 days.

Am keeping the breakfast Rapide the same for now since the lunch time number is generally on target. And I increased the NPH, since the dinner and supper numbers have definitely increased so they need to be brought back under control.

Called the diabetes nurse this morning and explained what I was doing. She says I did the right thing.

Wednesday, September 5, 2012

Back to School

My son went back to school yesterday. September 4th. And it was HORRIBLE.


My first trip to the school was at 10 am so I could drop off 2 lots of juice boxes as his emergency stash. He needs to have 2 lots - one for the main school building and one for the annex where his classroom is.

I got the first phone call at lunch time. Did I forget to pack something in his bag? Yep - I forgot to pack his  blood glucose meter.  That was really silly, so I walked down to the school in the rain on my second trip of the day to poke his finger - only to discover that I had left the test strips at home. So I couldn't poke his finger. I just told him to have lunch and not to worry about the lunch time number.

At 2.30 pm I got another phone call. He had just had Gym class and was feeling shaky and again he had no blood glucose meter (I took it home with me after lunch). So back to school I went in the rain for the 3rd time - to poke his finger and give him permission to have a juice box. This time I remembered the test strips so we got a number. He said he was shaky but the number was not below 4. It was actually above 5 mmol/L - most unusual. But since he had just had a gym class, I allowed him to have a juice box.

He managed the rest of the day just fine.

Since the school board and therefore the school, do not currently have a Diabetes plicy, the school principal charged me with writing up a list of things I would like to see happen concerning my son's Diabetes, during the school day. This means I get to have some say in school policy.

Now, under Ontario teachers union rules, school teachers cannot inject Insulin or Glycogon, so neither of those will be part of the policy. Mostly I just to ensure that my son is allowed to eat his snacks when he is supposed to, in order to keep his sugar levels steady. He gets all his insulin shots at home before and after school.

Thursday, August 30, 2012

1st Post Diagnosis Clinic

Today my son and I went off to the Toronto Sick Kids Hospital for the first post diagnosis Clinic. These are usually held every 3 months, but this one was scheduled for August 30, so that he would be seen at the end of summer before school starts again.

We were in and out early. Got to the hospital at 0815, got the blood work done, was at the clinic by 0830, seen by the doctor before 9 AM and then by the diabetes nurse at 0930 and were on our way home by 10. We had left home at 0730 and we were back home by 1030. 

Just for the Record.
Today is Thursday August 30, 2012.
School starts next week on Tuesday September 4, 2012

I had 2 things I needed to find out for sure. One was the H1AC and the other was the anti-bodies issue. Does he or does he not have antibodies?

OK well about the antibodies issue. There were 2 antibodies tests done and one of them was positive and the other was negative. BUT, the doctor said that if you combine the positive antibodies test with the low level of insulin production he was measured at, then they are fairly sure that yes he has Type 1 Diabetes. The level of insulin, his body is producing is low enough to be normal for Type 1 Diabetes, and not high enough to be "normal" for Type 2.

Now the H1AC number. Back in mid June when my son was diagnosed, his H1AC was 13%.
I am very please to announce that today - just 2 and a half months after diagnosis - his H1AC is now 8.1%.
The doctor and the diabetes nurse were extremely impressed!!!!  They said this was an excellent result.

Hopefully in another 3 months, his H1AC will be down to 7%, and if we are very good, it may even be down to 6 point something.

Next Appointment is set for mid December - exactly 6 months after diagnosis.

Saturday, August 4, 2012

The A1C

What is the A1C test?

The A1C test is the best way to measure how controlled someone's diabetes is. It measures an average of Glygated Hemoglobin in the blood. Glygated Hemoglobin is the product after hemoglobin in the blood has combined with glucose. Since on average, blood cells last for 3 months, this gives an average level of glucose in the blood over the previous 3 months. It is now regarded as an excellent means of measure diabetes control.

My sons A1C in June was 13%. This is very high. It means that the average amount of blood sugar over the previous 3 months was 18 mmol/L.

In early March his blood sugar was measured at 5 mmol/L. (I saw that in his file - the doctor showed me).
And when he was diagnosed with type 1 diabetes less than 3 months later, his blood sugar was 25mmol/L.

In a non diabetic person, the normal blood sugar level would be between 4 and 6 mmol/L  The A1C would be around 5 to 6%.

In a diabetic with their blood sugar under control, the aim is to get your A1C down to 7%.

Last week, my husband (who has Type 2 diabetes but is also on insulin) told me that his A1C was 6% - which means he is keeping his diabetes under very good control.

My sons first post-diagnosis clinic is set for August 30, so we will get a new A1C number at that time. I hope it will it will be at least below 10%.  But if it's not then I will just have to try harder to keep my sons diabetes and blood sugar levels under better control.

Thursday, July 19, 2012

Adjusting Insulin for a normal day

I had another Diabetic class today - the last one I think. This one was about how to adjust the insulin dose.

The thing about Diabetes and Insulin is this.

Diabetes management is adjusting the Insulin for Reacting and and Preventing at the same time
Always keeping them in balance.

It's like a see-saw (or a teeter-totter) only this one is not just one dimensional.

This see-saw is a long plank of wood on a BALL and the ball goes all over the place and you are standing on the plank of  wood on top of the ball and trying to keep your balance in all directions. That's how I see it.

The  first thing you have to know and remember is how the insulin doses affects your BG numbers.

Breakfast Numbers are affected by the NPH Insulin dose from Bedtime the night before

Lunch Numbers are affected by the Rapid Insulin dose at Breakfast time

Dinner Numbers are affected by NPH Insulin dose at Breakfast time

Bedtime Numbers are affected by Rapid Insulin dose at Dinner time.

Now you need to know the 5 rules.

1 - If you have 3 highs in a row at the same time (3 days in a row) - you must INCREASE the insulin that will affect that time.

So for example, if you have High Blood sugar every day for 3 days at Breakfast time, you must increase the NPH insulin you give at bedtime.

If you have high Blood sugar every day for 3 days  at Lunch time, you must increase the Rapid insulin you give at Breakfast.

2 - If you have 2 Lows in a row at the same time of the day, you must reduce the insulin dose.

For example my son has been having low blood sugars every day at lunch time. And for most of the past 2 weeks, the diabetic nurse and I have been slowly reducing the amount of Rapid insulin he gets at Breakfast time.  

The reason he has lows at lunch time is because of all the activity he does at Day camp in the mornings - and when he is active, that uses up his sugars naturally, so he doesn't need as much insulin.

Remember when I said that exercise and insulin are in competition with each other. We are still looking for the right balance of exercise and insulin.

3 - If you have 3 highs in a row - again always at the same time, (for which you adjusted insulin), had a normal number and then had another high on the 5th day - you must still increase the insulin - same as you do after 3 highs in a row.

4 - Always adjust insulin by no more than 10% - and round up if you can only dose in full units rather than half units. My pens only allow me to adjust by 1 unit at a time. So far we are doing a pretty good job.

If you are giving less than 15 units of insulin, than the adjustment is by 1 unit only.
If you are giving more than 15 units of insulin, then the adjustment is by 2 units only.

5 - Only adjust 1 insulin dose per day. If you adjust 2 doses in the same day - you may cause a low the following day and we don't want that.

Lows are dangerous and need to be fixed up immediately. Highs are less dangerous and usually they come down on their own - unless they are super high then they need an adjustment of insulin.

There is a whole different regime of Insulin management when the diabetic child is SICK and NOT feeling well, but I will leave that for another post. 

Wednesday, July 11, 2012

The Honeymoon Period

Honeymoons are usually associated with weddings, not with Diabetes.

But guess what. There is a honeymoon period in the management of Diabetes.(first a little lecture - my apologies but I have to explain this).

As the pancreas shuts down and stop producing insulin, the beta cells (in the pancreas that produce the insulin) are destroyed. As they are destroyed, the blood sugar in the body rises because the sugar is not getting into the cells and the person because tired, fatigued, thirsty, pees a lot, etc etc - all the symptoms my son had when he was diagnosed almost 4 weeks ago.

So the patient is diagnosed, the insulin is started and the pancreas can take a break, which it does. But within a few weeks, it starts producing insulin again. Not all the beta cells have yet been destroyed at this point - because there are still some beta cells in the pancreas that are working. When the pancreas starts working again, this is called the honeymoon period - and it can start anywhere from 2 to 4 weeks after diagnosis and after the insulin injections start.

The Beta cells are still being destroyed by the body's immune system. But while they are working, they want to help. So they do. As the beta cells in the pancreas die off, the natural insulin that is produced by the body drops and the injected amount has to go up to cover the natural drop off. The pancreas can continue like this for anywhere from 3 months to a year and sometimes it even goes as long as 18 months (but that may be mostly due to less cells destroyed at the time the diagnosis was made). But eventually all the beta cells from the pancreas have been destroyed and the body becomes reliant on injected insulin for the rest of its life.

As to why I wrote all that, it was to explain the inexplicable number of low BG's my son had yesterday.

I wrote earlier that exercise and insulin are in competition - they compete for the same sugars in the blood. Too much insulin takes the blood sugars out of the blood and into the cells. As does exercise. So while I am injecting insulin into my sons body, he appears to also be getting insulin from his pancreas - all of which dumps the sugar from his blood into his cells and his BG level drops or goes low.

He had a total of 4 lows yesterday. The first one was at lunchtime - but that was due to the exercise they do every morning at camp. The other 3 lows were all over a 3 hour period around dinner and bed time.

Everytime he has a low, it must corrected by a Juicebox, or by chewing on Dex4 Glucose tablets.

Last night at home, we were out of juice boxes and Dex4 tablets, but we did have some large Rocket candies as an emergency stash.

When you have to give glucose, it is best to give the equivalent of 1 serving of carbohydrates - which is 15 grams of Carbs - always written as CHO

 The Dex 4 tablets each have 4 grams of CHO so you have to eat 4 of them to get one serving.
125 mls of Juice is one serving of CHO - thats one full junior box or half of a standard 225 ml box (roughly).

On the wrapping of the large rocket candies, it says - 6g CHO per 2 candies.

Now for some reason, I must have been slightly panicking last night because of me doing the maths and not figuring out that if 2 candies are 6 grams, then 1 candy must be 3 grams. Therefore 15 grams of CHO means he needs to eat 5 candies.

I was not giving my son 5 rocket candies as I should have done. I only gave him 2 because I was doing the maths like this - 6g CHO times 2 candies = 12 grams. Good he can have 2 candies and thats close enough to one serving. I must have been panicking to think that 1 rocket candy has 6 grams of carbs in it!!

This first low was around dinner time. I managed to get his BG level back up above 4 and then I gave him his dinner insulin and his dinner.

2 hours later at bedtime, he was shaky again. More pokes and again his BG is low. I could not understand why.  So once again I gave him 2 large rocket candies (still thinking that each candy had 6 grams of CHO).

We got his BG level back up above 4 mmol/L and so he had his bedtime insulin injection and his snack and off to bed.

 45 minutes later after going to bed, he said he was shaky yet again. And once again his BG level was below 4.

I was muttering to myself, I have to get his numbers up, I have to get his numbers up.

By this time my husband had been out and purchased another packet of Dex4 tablets, so this time, I gave my son 3 Dex 4 tablets. Each Dex tab has 4 grams of CHO so 4 grams times 3 tabs is 12 grams. After 15 minutes when his BG was still too low, I broke a granola bar in half and gave him that to eat. Granola bars are what he usually snacks on during the day. They have 22 grams of CHO so half a bar was roughly 11 grams. That plus the Dex4 tabs he has just taken, should put his BG numbers back into a safe range.

Sure they did. My meter reader said 24 mmol/L  WTF? My husband said - numbers would not rise that fast. My son simply said, you better test again mom. So I did.

 This time his BG was 13 - which is higher than his target, but at least it means he wont go too low, too fast. So finally my son got to sleep. It was now almost 10 pm.

I went to bed at 1 am and gave him a prick just to reassure myself. His 1 am number was perfect - 6.6 mmol/L - right in the middle of the target.

So my husband and I now believe that the honeymoon period is kicking in, for our son to have so many lows in the space of just a few hours. 

We need to reduce his insulin that is injected in order to help the body's natural insulin to do its job for the next few months.

When the beta cells in the pancreas eventually die altogether, then we will need to bring the amounts of insulin we inject back up again.

Monday, July 9, 2012

Insulin + Exercise = Low Sugars

Today my son went off to summer camp - it was his first day. The camp runs for the next 6 weeks, so it covers most of the summer.

This camp is an academic camp - which has a mix of academics and sports (mostly soccer and basketball) - as well as other special classes like Tae Kwae Do, Akido and science classes.

The kids will also do excursions to places around Toronto such as the Science Centre, the Museum (mostly to see the dinosaurs) and Centre Island.

I had thought they were going to do academics in the morning and sports in the afternoon, but it turned out to be the other way around. So he had sports in the morning and academics in the afternoon.

Now insulin and exercise do not complement each other - they actually compete. They both do the same thing. If you take insulin, it uses up the sugars and carbohydrates in your blood. If you exercise, it also uses up the sugars and carbohydrates in your blood. And if you have both - you end up with a rather LOW level of sugar in your blood.

So my son had a low blood sugar score before lunch today. A juice box took care of that and he was quickly back up into the target levels. I will have to discuss with the nurse about cutting down on the morning insulin.

There is also an overnight camping trip as part of the summer camp program as well. I am not sure if my son can go on the camping trip due to the insulin that must be injected, and most teachers are not trained to do that. I wonder if I can go on the camp too? I'm not sure if he will want me to come. I will have to discuss this with the staff.

Counting Carbs for Beginners

I had another Diabetic education session last week, and now I am supposed to be counting carbs for my son.Every bite that goes into his mouth has to be accounted for.

It kind of hard to keep to the rules when my husband - who has type 2 Diabetes, doesn't count carbs at all. He eats what he like when he likes and gives himself insulin to cover what he eats. Incredibly enough - 90%  of the time - his blood glucose level is within his target range.

My son cannot do that. We now have a specific amount of carbs he has to eat at each meal and snack so that we can keep the insulin on the same level.

On Saturday things went very well - I counted everything - and my sons numbers stayed in inside the BG target for the entire day.

On Sunday (yesterday) we went to the movies. We went to see The Amazing Spiderman - and my son was most upset to discover that he can no longer eat what he likes when he likes.

 Up until now, he has always had a JUMBO bag of popcorn at the movies. Popcorn has 6 carbs per air-popped cup. And Jumbo bags have at least 8 cups - possibly more.  So 6 x 8 is 48 carbs just in one jumbo bag alone. We have never added butter so that's ok. We always add cheese and cheese is a "free food"  Free foods have no carbs.

Yesterday we discovered that he can now only ever eat a SMALL bag of Popcorn - (and that's still at least 4 cups) but we can manage the 24 carbs. Still his BG went a little high but not too high.

Then after the movie we stopped at MacDonalds, and for the first time EVER, we asked for a nutritional fact sheet and sat down to decide what he could have before we purchased it.

So we settled on a double cheeseburger and small fries. We had to buy a Sprite Zero from another shop since MacD's do not sell Diet pop (other than coke and we never drink coke).

AS usual, my son wanted a MacFlurry - but with over 40 carbs, that's now a no-no!!

Again he was not happy.

"I'll never be allowed to eat at MacDonalds again" he sobbed.

Well that's not true, he can eat cheeseburgers and small fries, and salads, and the chicken nuggets, but he doesnt want to eat a healthy salad and he thinks that chicken nuggets are for babies.

Also at MacDonalds, I had to inject him with his dinner time insulin. Since I knew his BG numbers were a little high after the popcorn, I opted to give one extra unit of insulin to cover the high (of both the Popcorn and the Cheeseburger and Fries). This was the right decision to make because his bedtime BG was back down within the target range.

I am proud of myself for making a small decision that turned out to be correct.

Monday, July 2, 2012

And how to deal with High Blood Glucose levels

Today is July 2nd, 2012. We celebrated Canada Day today.

Canada day is usually celebrated on July 1st - but yesterday (July 1st) was a Sunday so today (Monday) is the statutory holiday.

The School year in Canada ended on Thursday June 28th.I mention this because my sons BG level went really high on Friday (June 29th). He had a meltdown temper tantrum right in front of me because I refused to give him anything more to eat. He stamped his feet and swore at me - using really foul language. When he gets mad like that - it usually means his BG is out of control. So I did a finger prick and sure enough - his BG was through the roof!!!

It was showing as 17.7 mmol/L. I was quite worried and wondering why it was so high. He had eaten one small chocolate bar 5 hours before dinner, and one cheese sandwish just 2 hours earlier. Dinner was due in less than 1 hour. 

Fortunately he gets some Rapide Insulin at dinner time, so that took care of his dinner and any other high sugar levels. By bed time his numbers was back down in the normal range. 

Then at 8.30pm (bed time), right when he was due for his last insulin dose of the day, he finally admitted to me that he had actually eaten 4 fig newton cookies at 5 pm while I was out of the apartment.

Each fig newton cookie has 14 grams of carbohydrates and he had eaten 4 of these within a few minutes. That was a whole extra 56 grams of carbohydrates - 1/3 of all the daily requirements. No wonder his BG went up so high.

 I told my husband to NEVER give our son any treats unless he checks with me first, and I told my son to never eat anything I have not approved of first. I do not want him to have another rude tantrum like that one.

The next 3 days of the long weekend (Saturday through Monday) his BG numbers were perfect.

Tomorrow (Tuesday July 3rd) he starts summer camp. I hope he behaves himself and does not overdo the food.

Tuesday, June 26, 2012

Low Blood Glucose Scare

I should have taken note of the low BG my son had yesterday after the walk to the 8th grade graduation ceremony. His BG was low, but not dangerously low.

 Today - well his BG  went REALLY low.

 I got a phone call from the school right on 3.30 pm today - thats when school gets out of the day..

The office lady says - My son is feeling shakey - what does he need to have?

My reply - He needs sugar ASAP.
Does anyone have any juice or pop?
Does he have a packet of dextrose 4 glucose tablets in his bag?
The answer to both those questions was NO.

So I rushed down to the school taking some juice boxes with me. He looked fine when I got there - the office gave him some small pastries because they have sugar. But they take a while to be digested. 

I measured his BG - it was 2.5 mmol/L - which is very low. The usual range for mmol/L is 4 -7 for adults and 4-10 for kids.

So I gave him 2 juice boxes. Within 5 minutes his BG was back up to 4.7 and by the time we got home, it was up to 6.2 mmol/L which is good.

He had been running around for the last hour before home time, from 2.30 recess until the home bell at 3.30pm which is why his BG went so low.

Now I will have to watch and see that he doesnt go too high before I can give him the next insulin which he usually gets at 6 - thats one hour from now.

We discovered the dextrose 4 glucose packet in his lunch bag which he had left at home.

I gave the left over juice boxes to the staff - there are only 2 more days of school left.

There is a meeting planned with the staff for diabetes education tomorrow and I was planning to tell them about all this - but at least now they have had a "practice situation".

I was telling my son he did exactly the right thing - to go to the office instead of trying to walk home. The only reason why I hadnt supplied the school with any emergency stuff is because we dont have any money to purchase it except the juice boxes that happened to be handy. We had purchased those for his lunch right before he was dx'd as type 1 - so they have never been used. Now he has milk for his drink rather than juice.

Now I know that he must have some carbs at 2.15 pm before the afternoon recess. The trouble is that we never know when the kids are going to be outside - its one of those things that cannot always be planned for. But more carbs before exercise sounds like a great idea.

Monday, June 25, 2012

Exercise and school meetings

My son's school had their grade 8 graduation ceremony this morning. So the whole school walks at least 7 blocks up to St Michael's Catholic Cathedral and then they walk back again - that's 14 city blocks total.

I was at the school waiting with my sons lunch when they got back. We did his finger poke and his BG was 4.4 mmol/L. Now that's the lowest I have seen it, but its not outside the target area (which is 4 to 10 mmol/L). But considering just how far he had walked, it is not surprising that his blood sugar was low.

He asked if he can have the juice - which I had also packed in his bag just in case.
"Only if you feel shakey" I said.

Since I still have not been able to speak to the teachers, I don't have any emergency supplies at the school yet. And because my son doesn't have permission to "prick himself" I have to come in and do it (or at least supervise him doing it) at lunch times. But there is a meeting set up for Wednesday 27th. 

I will let you know how it goes.

Sunday, June 24, 2012

Free foods

Free foods are foods that have either NO carbs at all, or such negligible amounts of carbohydrates that the carbs cannot be counted so the food is considered a free food. 

Technically you can have as much of these as you like of these foods, because they don't add to the blood sugars BUT you do have to consider the amounts of fat and protein that they have and take that into consideration when you are chowing down.

Take CHEESE for example. Cheese is a FREE food because it has no carbohydrates. But it does have fat and protein in it.

This is the list of FREE foods that the Hospital gave me.

Protein Foods 

Meat (all kinds - not smoked or preserved)
Peanut Butter


Salad Dressing
Sour Cream
Cream Cheese
Table Cream
Whipped Cream


Yelllow & Green Beans

Friday, June 22, 2012

Carb counts and diabetic maths - the first class

Well I had my first day of carb counting today. Actually I had 2 classes today. One from the dietician and the other from the diabetes education nurse.

From the dietician, I was told that on the nutrition facts section of every packet, there were 3 very important numbers.

1 - the serving size.
2 - the total carbohydrates
3 - the fibre count.

 Then I was told to ALWAYS SUBTRACT the fibre from the total carbohydrates.

That's because fibre does not increase or decrease the blood sugar.Why we do this, I don't know yet - I will probably learn this in a future class.  And then I learnt more about serving size - roughly how much it is for various foods and what one serving size looks like. 

In the next class - the nurse was explaining what the symptoms of T1D (Type 1 Diabetes) are,  how and where insulin is formed (in the pancreas), and why kids get T1D and how it develops. Lastly she spoke about the "honeymoon" period.

She explained about the genetic blueprint, (where kids need to have the genetic potential to have diabetes) but there is also the environmental factor as well.

Take a pair of identical twins for example. Both looking exactly identical, raised in the same family, eating the same food. And yet ONE of them gets T1D, and the other one does not. So they both have the genetic potential to have diabetes, but only one of them comes across the environmental trigger that sets off the symptoms for diabetes.

Because it takes time for the beta cells in the pancreas to be destroyed, it may take several years for a child to get to the point where symptoms start showing up. Usually at diagnosis, about 85 to 90% of the beta cells have been destroyed. The child or person is then hospitalized and stabilised.

Now that insulin is being injected, the remaining beta cells then take a vacation for a short time. Once they have rested, they come back and start working again. When this happens, the amount of insulin required from injections drops while the body is providing some of the insulin requirements. BUT because they are still be destroyed, eventually this extra insulin disappears, and the full amount of insulin must now be injected from outside the body. This is called the Honeymoon period and can last anywhere from 3 to 12 months.

Another important thing to remember is this.

More insulin causes blood sugar levels to drop - a low blood sugar level is called HYPOglycemia.

Less insulin causes blood sugar levels to rise - a high blood sugar level is called HYPERglycemia.

If you want to try and learn more about counting carbs and why fibre should or should not be subtracted - you can read this forum thread. It is very complex and full of jargon - most of which went over my head.

But I am sure in a few months I will be able to read this thread just like a newspaper without having to think about what I am reading. 

Wednesday, June 20, 2012

There is something called Diabetic Rages

I have Graves disease (that means I have a Hyperactive Thyroid) which has been under control for the last 2 years. This is an autoimmune disease, which means it is probably my fault that my son now has type 1 diabetes.

Before I was diagnosed with Graves, I used to become  rude, angry and upset at the slightest thing. These are called Graves Rages.

Tonight I have just witnessed a Diabetic Rage.

My son drank an extra glass of milk (several ounces of carbohydrate) before the dinner time insulin shot, and his Blood Glucose (BG) numbers shot up fast. His number at 6 pm was 26 mmol/L. Within an hour he was raging over something inconsequential, and my DH and I was flabbergasted as to where this rage and stubbornness came from.

So while he was raging, at 7pm I decide to take another reading. The first reading said that he was 33 mmol/L and to wash hands and try again. So I tried again. The second reading was much better - 21 mmol/L

An hour later at 8 pm after he had finally calmed down,  (and it was time for the second insulin shot), his Blood Glucose(BG) had dropped down to 18 mmol/L. A MUCH better number to have.

OTOH his BG numbers could just be high because he had a snack at 4 pm, barely 2 hours before, with no BG reading and that puts his numbers up high. Because his dinner time numbers have been high all week. 

Anyway, we will discuss this at the first education meeting with the diabetes team on Friday.

How Glucose is counted in Canada and USA

Most of the blogs I linked to in the previous post are American and for some reason the USA insists on measuring glucose differently from the rest of the world.

In Canada and many other places in the world, blood glucose is measured in units called millioles of glucose per litre of blood - mmol/L

In the USA, blood glucose is measured in units called milligrams per decilitre - mg/dL

1mmol/L = 18 mg/dL

So a blood glucose of 10 mmol/L  = a blood glucose of 180 mg/dL

In Canada, a normal reading for adults is between 4 and 7 mmol/L

My understanding is that a normal reading in the USA is between 80 and 120 mg/dL.

Source - When a Child Has Diabetes
By Daneman, Frank, Perlman
Sick Kids Hospital, Toronto, Canada
Third Edition, Key Porter Books, Toronto 2010

Type 1 Diabetes - posts around the net

These are some posts I found about Diabetic Maths.

He's got Diabetes!!!

Last week, on June 15, 2012, my 10 year old son was so lethargic and tired, he could not do anything. He could barely get out of bed. He also could not hold down what little food he was eating.

I did some research online and discovered that over the last few months and weeks, he had been exhibiting all the signs of Type 1 Diabetes, and neither myself, his father nor the staff from his school were recognizing the problem. They knew he was refusing to eat, but we all thought it was for self-image reasons. After all this boy is very tall and quite big for his age.

But anyway, once I figured out that he might have diabetes, I rushed him to the Toronto Sick Kids Hospital (yes we live in Toronto, Canada), to the ER  (Emergency Room), where it was discovered that his blood glucose level was high. It was 25 mmol/L. He also had ketoacidosis.

He was put on an insulin IV drip (as well as drips for sodium and potassium), and was admitted to the main hospital around 9 pm that same night.

The following day, when his blood glucose dropped to 10, his acidosis had gone and he was feeling and looking much better, he was released to go home at 6 pm.

The entire family had strict instructions to come back to the "Diabetic Daycare" the next day (Sunday) for the first of 2 days of intensive diabetic education.

The 2 days of diabetic education are now done. My son is back in school and looking and acting so much more like himself.  The change is amazing.

Starting on Friday (22nd June) we will begin 4 more weeks of diabetic education- but this is only 1 half day per week. This is where we will learn about counting carbs, taking insulin to match the carbs, how to recover from low and high blood sugar levels, and hopefully how to cook some fast but healthy meals for diabetics.

This is my son's glucose case - for doing finger pokes. The blue, white and gray item at top centre is the lancet for poking fingers. The white lancets on the right are the needles for the lancet. On the left is the Glucose metre reader and the round container at the bottom, holds the strips for testing blood. These strips go into the reader.

My husband is also diabetic, but he has type 2 which is NOT autoimmune.
Type 1 Diabetes is an autoimmiune disease, and I also happen to have an autoimmune disease as well.

I was never a fan of maths. It is the one subject I would always fail.

This blog will be a diary of my journey as I sally forth into the wonderful world of Diabetes, insulin, counting carbs and battling with DIABETIC MATHS.