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.