Wednesday, May 15, 2013

Inside Peek Into the Life of Type 1 Diabetes

While on paper it all looks pretty simple when it comes to type 1 diabetes management. You count your carbs before you eat, you inject insulin and this all should provide you with a stable blood sugar number right? Boy do I wish.

While giving insulin to cover the carbs the body will covert into glucose in the bloodstream is extremely important, it's not the only factor when it comes to Diabetes management. Exercise plays a huge role in blood sugar numbers, it's a great way to bring a higher number down, or help keep you in your target zone. Stress tends to increase one's blood sugar numbers, as well as illness, or puberty.

But the one way I've been kept on my toes throughout it all is during the night time. No matter the basal's that we put into place at night time it seems that there is no correct 'formula' for his night time insulin dosage. Clifford's body tends to be more sensitive to the insulin during the night time, I really do not know why this is, as I haven't really researched it as much. Add into play the dawn phenomenon, which typically happens for him at least around 2-3 am, his numbers are usually hit or miss. With his increased sensitivity, if he's high, it's a horrible guessing game for the correct dosage to bring him down to a nice number. I know I have to back off a good deal of what the pump suggests at night time, but just how much, well that's another story. There is no one set number, I can't just back off .5 units and hope for the best, because I get varied results either still high or too low. (Oh yeah, did I mention you must take into consideration also if they had any activity before bedtime, as it could take a few hours to take full effect?) Sounds fun right?

What I'm left with is the job that his once vital pancreas would do. The way the pancreas works is rather beautiful. You wouldn't know it but as a non diabetic you may still have a higher blood sugar from time to time if you checked yourself. That is because the body will secret your insulin at just the right time to bring you down, but not cause you to go too low. It's in no other words beautiful. It's hard to understand this when you don't have to see the other side of a non working organ in play. But here I am left playing the part of the dead organ floating inside his body and it's a bit stressful at times.

An example of my nightly guessing game when he's high is like last night he was over 300 ( which I honestly couldn't figure out why, so I busted out the ketone meter), the pump wanted to give him 3.3 units, but woah is that a large dose at night time for him. I backed off down to 1.9 units, because the particular number 1.4 units showed up in my head (to subtract), and well I went with my instincts. Because he's corrected, I must set an alarm to get up 2 hours later to make sure he's not coming down too fast, last night he happened to be 270 something I believe, and while typically that number comes down into a more stable or target number, something in my stomach said that we should still bolus for this one as well. In fact the pump wanted to give him 1.4 units and I only gave him 0.3. The nice side of this story is, he's is sitting currently at a 117! But there are times it could go either way, it's never perfect, and it's exhausting to be in my head during these few short moments.

This is diabetes. Not what you see in books, or on the internet. It's not black and white, and while it's manageable as they say, it's not easy. It's time consuming, it's a parasite that takes from you every single moment of the day, but it's worth all the hassle to see a healthy child wake up in the morning! Just a little inside view into the life of Type 1 diabetes!


  1. Bridget, I have the same problem that Clifford does, but I am able to see a pattern that helps me to correct the situation more easily. That is probably because my body has matured, and there is more stability in my control. I am sure that Clifford will reach that point in his life, and there will not be so much guesswork involved. I am much more sensitive to insulin starting about 9 PM, and throughout the night. I can depend on the IOB, if any, and the BG to determine the correct bolus if I have a high to correct. My highs at night are rarely more than 150, but it is easy to bring them down to about 100. Clifford will be able to do that too when his body has matured. I know that does not help you NOW, but it should be comforting to you to realize this.

    I do have occasional highs above 200 when I have scar tissue. I sometimes wish that scar tissue was visible on the skin's surface, but it isn't. If my infusion set is placed in scar tissue my BG will rise very fast, especially if I have a meal. The insulin is not being absorbed properly, so the BG rises very fast. I have to change sets and hope the next site does not also have scar tissue. After 67 years of T1D there are areas on my body that give me this problem. I hope you are using site rotation, keeping the sites at least 1 1/2 inches apart, and changing the sites every three days, or less. I did not know about site rotation and scar tissue while I was young, and this has become a problem for me. I have permanent scar tissue on parts of my body. You are fortunate that you live in a time that so much more is known about diabetes management. Clifford should do well in the future. He should have a long, healthy life like I have had. My good fortune may be due largely to good luck, but Clifford's longevity will be due to proper management, and very caring parents!

  2. Hi Richard thank you for your kind comment. I'm just now seeing it. I do not update my blog as much as I would like. To me there is only so much I can write about D before I feel like im repeating the same info to everyone. We definitely do site rotation, I've always been big on that. I'm trying to convince him to let me rotate to different areas. He seems to be more fond of using his stomach,and legs. I want to introduce his arms and bum into the rotation again, it makes it easier with him using a cgm too. He still has highs but I've noticed we typically can pin point a reason now. In his almost 4 years since dx his a1c has not gotten higher than 7.5 and that was only once. Since pumping he's been between 6.2 and 6.5, with 6.2 as his most recent. He does have lows that cause me concern in the 40s but usually those are after activity. Overall I think he's doing great. He's almost 10 and can self manage almost everything , except site insertion. He is learning more about counting carbs, how to treat a low before it causes concern. He will talk out what he should do, how many carbs are enough so he doesn't go too high.