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, November 5, 2012
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.
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.
It RAINED HEAVILY ALL DAY.
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.
It RAINED HEAVILY ALL DAY.
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.
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.
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.
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.
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.
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