Friday, November 14, 2008

A typical day

In honor of World Diabetes Day, I thought I'd post what a typical day for a Type 1 diabetic (or parent of a Type 1 diabetic) is like. Of course, the irony is that there isn't a typical day - there are so many variables and factors that go into a diabetic's blood sugar, that normal doesn't happen, but here we go:

7:00am - Emma gets up. We check her blood sugar first thing. Recently she has either been waking up in range (70-150) or low. If she's low, we have to give her juice before she eats
7:30am - Emma eats breakfast. Every meal she has needs to have a protein in addition to carbs. Protein slows down the absorption of carbs and paces it better with the action of the insulin. She is given insulin through her pump for her breakfast.
9:30am - Check Emma's blood sugar. Her morning numbers have been a little crazy so we have to do a 2-hour post-meal check. These days, she is in the low end of range at this time, which means more testing. If she's below 100, we give her 2 ounces of juice because the insulin is still working in her body and she'll go even lower if we don't.
11:00am - Check Emma's blood sugar. If she's below 80, we give her between 1 and 2 ounces of juice

12:00pm - Check Emma's blood sugar and feed her lunch. These days she has started arguing with me about what she wants to eat. So, I can't give her insulin before she eats, because there's no guarantee she will eat it. So, she eats (or doesn't eat) and then we give her insulin based on what she ate.
12:30pm - Emma goes to take a nap - sometimes she goes right to sleep and sometimes she's awake for a long time.
3:00pm - Check Emma's blood sugar. Whether she's awake or not, we need to check her reading. There is just no telling whether she's going to be low, high, or in between, so we need to check. The good news is that we only have 4-5 combinations of food that she eats for lunch, so we are pretty confident in the carb counts that we are using.
5:00pm - Check Emma's blood sugar. This is a crazy time of day for Emma. During sports seasons, we are often heading out to baseball or soccer so she's running around a lot, which makes her readings drop. If we are at home, she's a lot calmer, so her readings will go up. Obviously, its not steady so we need to check.

Evening and Overnight
6:30pm - Check Emma's blood sugar for dinner. Dinner time varies a lot based on what activities the kids have and what time Mike is getting home from work. Dinner also introduces the most variability in carb counts as we have more variety for dinner than any other meal. Its often a meal with a higher fat content too, which affects Emma's blood sugars.
8:00pm - Bedtime for Emma.
8:30 - 9:00pm - Check Emma's blood sugar. Based on what we ate, how confident we are in the carb counts that we did, and what Emma's reading was before dinner, we check her between 2 and 2 1/2 hours after dinner. She's often not been in her room for long, so she's often not asleep or just going to sleep. But we have to disturb her to check her and sometimes give her juice if she's low.
10:00pm, 11:00pm, midnight, 2am, 3am, 4am - any of those times overnight, we have to check Emma's blood sugar. Each night we have to make a decision based on what she ate, what her 8:30pm reading was, what else is going on, whether she went right to sleep, etc. There are many variables that factor into the decision each night.

Each time we check Emma and she is low (below 80), we have to give her juice. Usually that means a re-check in 30-60 minutes to make sure she really DID go back up. If she's high enough that we need to give her a correction with insulin, we have to check her in 2 hours to make sure she came down, and didn't come down too low.

The other variable is the unknown. Since Emma cannot tell when she's high or low, we have to try to read the symptoms. If she's fussy or cranky, we have to test to see if she's low or high. But, lets not forget that she's 3. She can be fussy or cranky because she's 3, or because she's low or high. We hate that we have to test because we don't know.

Every 3-4 days, we have to change the location of her pump site. After a period of time, the tissues of your body become saturated with insulin and you need a new site. We rotate from time to time between her rump and her belly. Over the past 2 1/2 months we have found that her insulin needs are a lot lower when her site is on her belly. Which means we've had to adjust all of her insulin doses to accommodate. Which means more testing. We have also found that after we change her site, her body is so excited to have fresh insulin in a fresh site that it goes nuts and she drops low - really low. So, we are often fighting low readings for 6-12 hours after a site change - luckily its only every 3-4 days.

So as you see, you tend to be "time driven" when you have Type 1 diabetes. Its always about when the next time is to test, when you ate last, how much insulin is still working in your body, whether the fat in your food is going to make you spike later, whether a new site is going to make you go low, whether the exercise you did in the afternoon will make you go low, or the adrenalin in your system will make you go high, whether you looked at your mother wrong, whether the moon is in a strange cycle, or Jupiter and Mars are visible at sundown.

There are just so many factors that the best you can do is have discipline and structure and test often - keep them from going too low or too high and have as normal a life as possible and you've succeeded.


Jacque said...
This comment has been removed by the author.
Jacque said...

Tiring to just read about it. God bless you and the whole family - you need all the help and blessing you can get. (removed prior comment because of error - didn't preview)