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.