Tag Archives: insulin

Happy Anniversary!

Seems odd to think of an anniversary of being diagnosed with type 1 diabetes as “happy”, but we have real reason to celebrate today!  No, we didn’t discover the cure, and no, I didn’t figure out a way to turn back the clock to a time when Medium didn’t have diabetes.  But our lives have been altered, the path of our journey has changed course and we have a new normal, so different things make me happy now. Like Medium having an A1C of 6.8.  Oh yeah baby, sweet! The hemoglobin A1C test is the litmus test for diabetics to make sure they are staying in range.  A diabetic only knows what their blood sugar is when they test it and who knows what it is doing the rest of the time.  The life of a red blood cell is 90 days, so the test is able to look back and tell you what your average blood glucose was over the last 3 months.  A healthy, “normal” A1C is between 4-6.  When Medium was diagnosed and in the hospital his A1C was 11.4 which told us that his average blood sugar for the 3 months before diagnosis was in the low 300’s.  I bought a home A1C kit which had two tests in it and we took one at his one month mark and it had gone down to 8.6 and now at  the 2 month mark it is 6.8.  Now, I don’t know how accurate the home kits are, but most research I have done says they are accurate within 20%.  We will get an official A1C at the endocrinologists office when he goes for his 3 month follow up.  I will probably do a home test before we go to compare it to the doctor’s office test and check for accuracy.  But none the less, I am so excited that his A1C is so good.  It is almost in normal range and that is even with one month of pre-diagnosis, non-medicated blood cells on board!  So basically we are kicking diabetes’ ass, even without a pump!

And speaking of the pump…..that leads me to my next reason to celebrate today.  I found out yesterday that the insurance company paid the claim for the pump! They denied the claim for the continuous glucose monitor but after a few phone calls, I am fairly certain that will be paid, too.  (They only cover the CGM for one diagnosis code and they must have overlooked the code on his script because it was on there).  So we are spending this weekend going through the all the instruction manuals and taking the online lessons so I can call on Monday and we can schedule our pump training.  Woohoo!

We spent the evening with some of my oldest friends (they aren’t old, I have just known them for a LONG time).  One of the families lives out of town and the other family lives about 25 minutes away and we just don’t get together very often.  There are 8 kids between us and they are all between the ages of 5 and 12, all boys except one girl.  The kids all had a great time together and Medium was right in the mix, hoopin’ it up having a great time.  And I couldn’t help but get a little choked up watching him.  Because while we still have a long road ahead of us and a lifetime of managing this disease, I took comfort in seeing just how far we have come in 2 months and watching Medium having a normal, happy Saturday night with friends.

But I still hate diabetes.

Me and "My Savior".

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Uninvited Evil Twin

If you want to try and understand the highs and lows of diabetes, this might help.

Medium’s BG’s on Monday:

7:18 am-116 Good morning perfect number!

10:18 am-120  Hello outstanding after breakfast number, nice to see you!

12:17 pm-102  Time for lunch, who wants a perfect blood sugar number?  Not me, I already am one!

2:48 pm-75  Ok, so we played outside, but still within range. We’re doing great!

4:39 pm-118  Perfect number after a free snack!  (woohoo, we love “free” snacks!)

6:19 pm-73  Yep, more playing outside, it’s the last day of Spring Break, but we are still in range, we are golden.

9:32 pm-103  How about another “free” 10 carb snack, just for good measure to keep us up during the night?  And our 4 units of Lantus, of course.

11:56 pm-271 WHAT???  Two-hundred and seventy-one!!!!  WTH??? It was 10 carbs of honey roasted peanuts for God’s sake!  And we just had Lantus!

2:57 am-217  Really?  Only 54 points in 3 hours?  Why so stubborn?

7:39 am-109  Oh, good morning  perfect blood sugar, where were you last night?  Your evil twin, hyperglycemia stopped by, uninvited.

And this is just a little snapshot of what really goes on.  Every day is a rollercoaster filled with either squashing highs or chasing lows, or, if you are really lucky, BOTH!  Diabetics (or their caregivers) have to think about their every move when deciding insulin delivery.  What am I going to eat?  When am I going to eat it?  How long will it take me to eat it?  What is my BG now?  Will I be exercising later?  Is it bedtime?  Am I stressed or nervous about something?  Do I have a cold?

Aren’t you glad your body just does what it’s supposed to?  I know I am.

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It has been two months since Medium’s diagnosis of T1D and my husband and I thought we could go out for a quick dinner by ourselves.  Medium’s brother, Large is a very responsible seventh grader and Medium is all over this diabetes stuff.  So we felt okay to leave them all for a quick bite to eat down the street.

Medium’s BG at 6:30 was 113.  He ate a 54 carb dinner and was bolused two units of insulin. (He is on a 1:30 carb ratio.  Meaning for every 30 carbs he eats, he gets one unit of insulin. So in this example he was just a teeny bit overdosed, he should have eaten 60 carbs to make it a perfect 1:30 ratio.)

We left the house at 7:00 after Medium had finished eating and gave them explicit instructions to check his BG again at 7:30 since the drug peaks at 81 minutes and he was just barely overdosed and it was a new insulin pen (new insulin tends to have a bit of a “kick”).  Plus Medium and Small were on their way down to the basement to play a rousing game of indoor basketball when we left so we knew with all of those factors, he could go a little low.  And we told them that if he is low at 7:30 when he checks that he should then have a snack.  Medium is well-versed in snacks.  He is very insulin sensitive and very active and tends to run on the lower side more often than on the higher side.  So he gets “free” (meaning he doesn’t have to dose for them) snacks all the time.  In fact, we rarely ever dose for snacks.  He doses for his three meals a day, and that is usually it.  If we do dose him for a snack, it tends to send his BG’s all out of whack so we try to just give small snacks without dosing when he is lower throughout the day.

So here we are, thinking we are so smart and thinking we have thought it all through and have all angles covered, and we have a plan and everyone knows the plan and so we are leaving for date night.

So much for having a plan.

We hadn’t been gone 5 minutes when Large calls and says, “Medium is thirty-one”.

ME: “I’m sorry, what did you say?  One thirty-one?”

LARGE:  “No, thirty-one.”

ME:  “Shit!”

Medium gets on the phone and asks what he should have.  I tell him he should have 4 glucose tabs and then some peanut butter crackers and we turned the car around and headed back home.  By the time we got there he was on the couch, pale and sweating.  I got him a cold wash cloth and Brian and I sat with him and watched him eat.  We retested him and he was up to 76 ten minutes later.  Thirty minutes after that he was 132 and an hour and a half after that he was 210.  Brian just checked him again, five hours after he was 31 and with nothing else to eat other than the 4 glucose tabs, peanut butter crackers and several pieces of cheese and he is now at 319.  From 31 to 319.

Tonight’s score: Diabetes-1, Rawlings family-0

I hate diabetes.

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Lesson #1: Type 1 Has Nothing To Do With Eating Sugar

Admittedly I have become somewhat of an expert in the field of “parenting a child with type 1 diabetes”, out of necessity, of course.  But it still amazes me how misunderstood type 1 is.  I can’t believe how many people make comments about how Medium can’t eat sugar anymore, or how much healthier we are going to be eating now.  But my personal favorite is the person who said, “Medium always did have a sweet tooth”, as if to imply that Medium did this to himself by eating too much sugar.  It is hard not to get angry. I so wish that I could have prevented this somehow or that I could take it away from him or turn back the clock, but I can’t.  No one can.  Medium got this because he was genetically predisposed to it (his aunt has it, too).  Then one day, while his immune system was busy fighting off some kind of cold/virus, it decided to also attack the islet cells that live on his pancreas and produce insulin. Type 1 (also called juvenile diabetes, but not as much anymore because adults can also get type 1) is an autoimmune disease.  So, now he has hardly any islet cells left that are producing insulin.  Without insulin, the carbohydrates that he eats (which turn into sugar) cannot get out of the bloodstream and into his cells where they can then be used for energy.  The carbohydrates (sugars) stay in his blood and makes his blood sugar levels too high.  Without sugar to use as energy, his body burns fat.  As fat is burned it produces toxic acids called ketones which poison the body when present in large amounts.  What happens next is bad, real bad.  It is called diabetic ketoacidosis or DKA for short.  DKA is a medical emergency.  So, type 1 diabetics have to give themselves the insulin that their bodies do not produce.  They give themselves fast-acting insulin with every meal based on how many grams of carbohydrates they are eating, (this is called a bolus) and they give themselves a slow-acting insulin once a day so they always have some insulin working in their body (this is called basal insulin).  They constantly have to check their blood glucose levels to make sure they are in a safe range, because the wonderful, amazing bodies that God gave us know exactly how much insulin to produce to cover the foods we eat, but diabetics can only guess.  So if a diabetic is managing his or her disease very closely, they are logging their blood sugars before and after meals and activity and logging how much insulin they are taking so they can find the right balance.  And the extra fun thing about kids (*sarcasm warning*) is that as soon as you find a good balance, they have a growth spurt, or get sick or go through puberty (all things that affect blood sugar levels) and then you are back at square one, making adjustments.  And a type 1 diabetic has to do this everyday, for the rest of their lives or until my prayers are answered and a cure is discovered.

Type 2 diabetes (also called non-insulin dependent or adult-onset diabetes) is very different.  Type 2 diabetics still produce insulin, their bodies just do not use it correctly/efficiently, this is called insulin resistance.  This is the most common form of diabetes and thus more people have heard of it and thus, thus people innocently confuse type 1 and type 2.  Low activity level, poor diet and excess weight are risk factors, so in some type 2’s this was preventable.  One of the biggest differences between type 1 and type 2 is that with a change in diet and exercise and lifestyle, type 2 can sometimes be curable.  Type 1 has no cure.  Type 2 diabetics can also sometimes manage their disease with just diet and exercise or a pill, no injections.

Whew!  That was kind of long and boring.  But while you are now half asleep, I feel better that I am doing my part to educate people.  And after all, it’s all about me!  Hee, hee.  And, believe it or not, I have oh-so-much more that I could tell you about, but boring people with long-winded stories about sugar is actually my dad’s department. (Sorry dad!  I just couldn’t resist!  Love you!) (My dad has worked for a sugar company for more than 25 years and he likes to tell detailed stories about beets vs. cane sugar……zzzzzzz).

So if each of you would take what you learned here today and tell 2 people and then they each told 2 people, and so on and so on, then everyone in the world would understand what type 1 diabetes is and then I don’t have to get angry at anyone. Plus that would get us closer to a cure, too!  Could you do that for me, please?

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