I May Owe Him My Daughter’s Life

As a parent of a child (ok multiple children) with diabetes there are times when I have missed small hour alarms and slept through the night after some major correction bolus at bedtime only to wake in a startled panic holding my breath until I see my child breathing the next morning.

I haven’t ever met a parent of a child with diabetes that hasn’t experienced the above scenario.

Thankfully ‘dead in bed’ is not as common as we train ourselves to believe. Fear is insidious. In the early years after diagnosis we micromanage as much as we can to keep our kids safe. It is normal for us to do so. When my kids were younger I wouldn’t tell them the hours of sleep I missed to keep them safe. I still don’t tell them. Once my youngest overheard me talking about how tired I was after getting up or staying up (I can’t remember which, but I think I wrote about it a few years ago). My poor little man heard me say I was exhausted because of misbehaving diabetes and it broke his wee little heart. Then my heart broke into a bazillion little pieces.

Enter Dexcom. Even the first Dexcom CGMs were the bomb. Dexcom made my kids safer. Granted the early devices didn’t connect with bluetooth on their phones and they couldn’t share their numbers with me but it was a start. Dexcom is all about innovation and improving the lives of people and children with diabetes and by default improving my life as a parent of children with diabetes.

The most recent Dexcom device is the Dexcom G5. No longer do my kids have to carry a special receiver. Their numbers go directly to their iPhones and then the numbers are shared remotely with me on my phone. I can always know their numbers and sometimes my adult friends who use Dexcom G5 share their numbers with me too, especially if they are traveling alone and want a safety net.

So this last July while at Children With Diabetes Friends for Life my teens met other teens and had the best week ever. One of those teens became close with my oldest child and my daughter decided to share her Dexcom G5 numbers with him. That means he always knows her number and receives alerts if she is going dangerously low. At the time I thought it was sweet. I loved that she had a friend she could trust and confide in and count on.

I don’t require my kids to share their numbers with me although they do. That is to say I don’t provide consequences if they don’t share but sharing is highly encouraged.

Some teens might be concerned that sharing constant numbers with their parents would increase the “nagging” or micromanaging. I haven’t found that to be true with my kids but it is a common concern of teens with CGMs. <<<<this is important because maybe your teen won’t wear a Dexcom G5 because they don’t want a parent always watching, but what if they would wear it if say instead of a parent (or in my case in addition to) another friend received the numbers and low blood sugar alerts? That friend doesn’t have to have diabetes. It can be a Bff that doesn’t know the first thing about diabetes but would happily be a safety net for their best friend.

So anyway – my daughter shares her Dexcom numbers with this new FFL friend, who incidentally lives an entire continent away – 3000 miles. This friend would occasionally see low blood sugar alerts and text my daughter to be sure she is doing something about it. That’s cool and helpful. Less nagging from me.

A few weeks ago I went to bed with my phone on silent unknowingly.

The next morning I saw a number of notifications from Dexcom on my phone. A quick glance at my daughters Dexcom graph showed me that around 3am she had dipped below 30.

I didn’t know. I didn’t hear an alert since my phone was silenced.

The Dexcom graph showed that she was in a safe range at the time I woke up. Thank goodness but what about the middle of the night? Did she wake up and treat? Did her body release enough glucagon naturally to keep her safe?

No.

She didn’t wake up to her multiple low alarms. Her body was likely frantically pushing natural glucagon but probably not enough to keep her safe or alive.

It was her friend.

Her friend 3000 miles away heard the alarms at 3am alerting to my daughters severe low blood sugar. The Dexcom didn’t even give a number just “Low Glucose”.

This friend called my daughter no less than a dozen times until she woke up and treated the low.

This friend may have saved my daughter’s life.

Dexcom is the only CGM that allows blood sugars to be shared between devices across continents and around the world.

I may very likely owe my daughter’s life to a teenager and Dexcom.

Am I being dramatic?

Yes.

But is it warranted?

Yes.

I do not work for, get paid by, and I wasn’t asked by Dexcom to share this story.

I am sharing it because I believe in Dexcom, I believe in the power of friendships, and I believe that sometimes as parents we should consider the best ways to keep our kids safe while allowing them the freedom they so desperately desire. If your child is not enthusiastic about using a CGM that would broadcast his/her numbers 24/7 to you consider compromising by inviting them to find a friend to share with. There are also settings on the Dexcom application that your child can set which limits the visibility of numbers to those he/she shares with. For example the application can be set to hide graphs and numbers but send alerts for lows or extreme highs.

Talk to your child about using Dexcom and how it opens doors for increased freedom and peace of mind while also improving diabetes care, including less blood sugar checks.

oh – and after that event I made sure that my daughters friend had contact numbers for me in case he is unable to reach her.

It really does take a village to raise a child. Sometimes that village extends over 3000 miles.

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My daughter (blue hair) with some of her FFL including the young man who caught the low. Incidentally they are wrapped in blankets provided by Dexcom at the family movie night. Literally wrapped in the warm fuzzies Dexcom CGM provides.

 

I Get It Wrong Often

Last night my Middles, (13 year old teen boy) was over 400 before going to bed.

He was 238 before dinner and bolused (used his insulin pump to deliver insulin into his body) for dinner with extra insulin to correct the high.

That was 4 hours before he was going to bed.

He was surprised by the high blood sugar before going to bed.

The infusion site he had on was only 36 hours old.

I chose not to drill him regarding what he might have eaten after dinner that could have resulted in the high but I did assume he had eaten something or somethings.

I just told him to correct (bolus insulin for the high) and to go to bed.

I set alarms (two) on my phone to wake up and check his blood sugar around midnight.

I don’t remember hearing the first alarm.

I do remember hearing the second alarm and I remember silencing it.

I awoke with a start at 4:11am realizing my neglectfulness.

In the moments walking between my bedroom and my sons bedroom my heart pounded against my ribs. The fear parents of children with diabetes experience when we know there is the slightest possibility our kids could have experienced a sever low at night can be monstrous. The relief when we see our child sleeping peacefully while their chest slowly rises and falls with each breath is equally as immense.

My boy was sleeping soundly and breathing normally. Exhale.

I checked his blood sugar.

403.

Fuck.

My assumption that he had eaten some rogue food between dinner and bed was incorrect. Instead the high before he went to bed was very likely due to a failed infusion site (place that insulin from his pump is infused into his body). The site needs to be replaced a minimum of every 3 days – his most recent site was only 36 hours old and shouldn’t have failed.

I had to wake the child and ask him to come downstairs to replace the site and insulin in his pump.

He didn’t complain. He felt like crud and he knew that insulin was the only way he would feel better.

Ok he whined a little. It was 4:15am and he didn’t sleep as soundly as I had first imagined.

New site, new insulin in his pump and a large bolus to correct his blood sugar.

We don’t own a ketone meter (a small device similar to a glucometer that checks the amount of ketones are in the blood via a finger stick/drop of blood), ketones are often present during periods of extreme high blood sugars. Ketones are produced when the body burns fat for energy, excessive ketones poison the body and when combined with dehydration can result in ketoacidosis, a life threatening condition.

Before he came into the kitchen to get his new site and insulin I heard him in the bathroom. It was too late to ask him to use the ketostix (paper strips with a small patch on the end that is chemically treated to change color if ketones are present). The ketostix are not a very accurate way to test for ketones – because the paper sticks check the urine for ketones the result is about 4 hours delayed, meaning not the most accurate ketone level, but at least it is an indication of what was happening in this body. Alas – he used up all his urine so no ketone check.

Sent the boy back to bed.

He will need to go to school regardless today. I am scheduled to work.

In the hour since I awoke with a panic I have been berating myself for yet another fail.

We own Dexcom CGMs (continuous glucose monitors). CGMs check a person’s blood sugar every 5 minutes and have alarms that can alert the wearer and others that blood sugars are high or low. Had he been wearing his CGM we likely wouldn’t have ever got to be in the 400s last night and certainly wouldn’t have stayed in the 400s all night as I slept through phone alarms.

Had I done the nagging parent thing at bedtime to determine if he had actually eaten between dinner and bed I might have been able to determine that the high was in fact due to a failed infusion site rather than by a teen that likes to snack and forgets to bolus.

Had I just stayed up between 10pm and midnight I would have not been sleeping at midnight and I would have been able to replace the failed infusion site 5 hours ago vs. letting my son sleep with such dangerous numbers.

Like I said, I get it wrong often.

I’m sorry middles.

Ps. In the 40 minutes since I wrote this and went to take a shower for work I spoke with my husband. He confirmed that he observed Middles eating multiple tangerines before checking his bedtime blood sugar. Thus, it is likely he was high before eating the tangerines but also likely he forgot to bolus for the tangerines. Suggesting that while he bolused for the high before bed he neglected to take insulin to cover the tangerines.

Sigh……

Whack A Mole

When my kids were younger I would take them to Chuck E Cheese often. We lived in Texas and the summers were hot so the days we didn’t hang by the pool we would hang out with the mouse. Yes it was a petri dish of germs. No I didn’t take hand sanitizer, might not have even required the kids to wash hands before eating. A favorite game was always Whack A Mole. All three of my kids loved whacking the mechanical moles and often we would race since there were two games right next to each other. There was something therapeutic about whacking those plastic heads repeatedly always trying to beat the game.

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It is no longer therapeutic. The moles are no longer cute plastic rodents with hard hats and a grin.

The moles are highs and lows, the game never ends and I don’t get any tickets to trade in for trinkets.

Also I am now playing three games at once. Are you imagining me dashing between three arcade machines with a mallet whacking heads? Oh and the mallet – it is always attached to a single machine with a short cord so often I forget which mallet I’m holding and find myself flat on my ass because I tried whacking a mole with the wrong mallet. (giggling yet? It’s ok – I find humor in it too because if I didn’t I’d need to be drunk off the cheap beer)

My kids are 15, 13, and 11. Hormones, puberty, outside play, missed boluses, sports participation, lazy day electronics, lack of any meal schedule, late nights, endless snacking, and more make the whack a blood sugar game all that more difficult.

Yesterday on a FB page for parents of kids with diabetes another mom was waging war on a stubborn high with her 14-year-old son. Multiple highs and multiple corrections with different insulin (MDI) and she and her son likely felt they were using a 19th century flintlock pistol to lay siege on an enemy using 21st century armor. At least that is how I felt between 10pm and now at 6:30am. In the FB feed when she first posted her concerns of repeated highs despite corrections I, like others, had said if it’s a pump it may be a bad site. If it is MDI it may be bad insulin. Any chance the child was sneaking food? This exchange took place long before my 13-year-old returned home from a babysitting gig and learned of his 432.

Of course he isn’t currently wearing his Dexcom so he didn’t realize. He had checked his blood sugar at 7pm and was in the upper 200s. He and the boys he was watching ate pizza (yes part of the issue I’m sure) and he bolused and corrected. I called him a bit before 9 and asked him how he was. He checked BS and was in the 400s. He corrected.  He returned home a bit after 10 and checked, still in the 400s. He corrected again with his pump thinking it was pizza related and went off to bed, well he is a 13-year-old boy and it was a Saturday during the summer so he corrected and went off to veg in front of his Xbox. A bit after 11 I was going to bed and asked him to check again, 512. What? New pump site, new insulin, correction, kisses good night, alarm set for 1am for me. 1am – 355 not a big drop for 2 hours. Another correction. 3am 279. 6:30am 224. Stubborn ass high for sure. A losing battle of Whack A Mole or laying siege to a heavily armored enemy with a flintlock. Either way I am left feeling defeated.

Every person and child with diabetes reacts differently to insulin – oh and there are different brands of insulin that work better in some than others. Teens have raging hormones that seem to taunt the best offensive line of diabetes management.

I think I may have strayed from my original intention of this post which was to describe what it is like trying to help 3 kids of different ages and genders manage diabetes. Different games of Whack A mole – trying to use the same mallet on all three games, etc. It is true – corrections like the ones my middle son completed would have likely corrected my youngest son with little difficulty – less hormones. The corrections would have also corrected my daughter easily on most days. Why is correcting highs in my 13-year-old son more difficult? Perhaps his pump settings such as his correction factor (how much insulin he gets to correct out of range blood sugars) needs adjusting – although we had increased the ratios just a few weeks ago.

I’m not sure this post has any redeeming qualities. I think I was mostly venting. But if you ever feel like you are playing an endless game of Whack A Mole perhaps you will find solace in knowing it is a game we all play at times and if you are a parent of a teen and the game is getting harder, it is normal. I hope you won’t make the same mistakes I have made and accuse your teen of sneaking snacks (although mine really does often sneak snacks but nearly always boluses for them). I have found the less I trust my teen to be doing the right things (how do we define the right things in a teen that wants to be normal?) the more difficult it becomes to help him manage his diabetes. When he is high and I try to help discover why he immediately goes on the defensive. That isn’t helpful to either of us. I have never punished my kids for high blood sugars and I’ve never rewarded them for in-range numbers. I commend them for checking and bolusing but that is about it. Still the temptation, especially towards my middle child, for me to say “what did you eat?” is a strong one. I have said it many times and accusing him (whether I was correct in my assumption or not) has built a wall of defense. I don’t need an additional wall of defense to negotiate while trying to battle the actual blood sugar.

Sigh. 3 kids with diabetes, two teens and one right on their heels.

Thank goodness for coffee, cookie dough ice-cream and the diabetes online community.

Purple Because Aliens Don’t Wear Hats

If you accidentally bolus 25 units of insulin when only 3.5 units were needed and each unit of insulin will reduce blood sugar by 50 points while every 10 grams of carbs would normally require 1 unit of insulin and your blood sugar was 300, keeping in mind fast acting insulin takes approximately 20 minutes to be active and remains in the body 3-7 hours with a peek between the 2nd and 4th hour, how many carbohydrates should be consumed and over what period of time should said carbohydrates be consumed in order to avoid convulsions, coma and death?

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The facts:

At approximately 10:30 pm PST my daughter checked her blood sugar. The result was 300.

She wears a t:slim insulin pump. She input the data (the blood sugar of 300) into the pump.

The pump completed the required calculations to determine the amount of insulin needed to lower my daughters blood sugar.

My daughter pushed the required buttons (really its a touch screen pump so there are no buttons) to deliver the required amount of insulin.

The t:slim pump delivers insulin very slowly – in (I believe) 0.3 unit increments. They say it is a safety feature – and honestly it would have been had my daughter noticed her nearly deadly mistake early enough.

After approving the suggested bolus on the pump my daughter clipped her pump back to her pajama bottoms and tucked in for a good nights rest.

Minutes later her insulin pump alerted her to a problem. Basically it had delivered 25 of the 30 units of insulin that was required to complete the suggested (and approved) bolus.

I am 100% certain my daughter had a total WTF moment although I wasn’t there to witness it. I just know she came downstairs saying “Mom Mom Mom Mommy Mommy Mom”

Her pump is programmed to never give more than 25 units of insulin at one time (meaning for one bolus). The suggested bolus was 30 units of insulin – thus the pump gave 25 and then asked the user (my daughter) if she wanted to give the remaining 5 units. Clearly we need to reduce the number of units that can be given at one time to perhaps 15 units but that is just one lesson we learned in the small hours of last night. 

What happened? 

Well technically exactly what the endocrinologist at my daughters last appointment said could happen and why she (the endo) refuses to prescribe the Tandem t:slim pump to children (including and possibly especially teens). BTW – my daughter didn’t care for me reminding her of that conversation with that endo. She (my daughter) doesn’t like it when others may have a valid point (I’m not sure where she gets that from).

Basically – my daughter input the 300 blood sugar as carbohydrates rather than as a blood sugar. Her pump is programmed to calculate insulin needs based on blood sugars and total carbs consumed. The amount of insulin needed by my daughter to lower a blood sugar of 300 to 150 is 3.5 units. Had she input the 300 blood sugar as a blood sugar all would have been well. However, she put the 300 in as carbs. Her pump is programmed to bolus (that means inject) 1 unit of insulin for every 10 grams of carbohydrates; which is why her pump wanted to bolus 30 units of insulin.

There are a number of screens on the pump a user has to go through in order to initiate insulin delivery. Each screen provides the user with some information such as how the pump calculated the suggested bolus, confirmation that the calculations appear correct, confirmation that the user wants to deliver the suggested amount of insulin, an opportunity to change the suggested amount, again a confirmation before it will deliver and finally a screen showing what t:slim calls the ‘Bolus Splash’ which also displays the amount of insulin being delivered.

So just as the endo suggested could happen with kids and teens (and likely adults too) – my daughter put in the 300 blood sugar as carbs and then in a matter of less than seconds tapped: ‘DONE’, ‘NEXT’, ‘YES’, ‘DELIVER’ – and voila! the pump initiated the delivery of enough insulin to kill my daughter within just a couple of hours whilst we all slumbered away.

*quick side note for those that may not be familiar with how diabetes can kill a person – people with type 1 diabetes (my kids) must take insulin to stay alive because their pancreases don’t produce it. There must always be a balance between the amount of insulin taken and the amount of carbohydrates consumed (carbohydrates are not just sugar – they are potatoes, rice, bread, fruit, milk, yogurt, pasta, etc). Too much insulin will lower a persons blood sugar and cause hypoglycemia which is typically anytime a blood sugar is below 70. A normal blood sugar is between 70 and 145 for people who do not have diabetes. The lower the blood sugar the more danger a person is in. Most people will lose consciousness, convulse, and possibly die with a blood sugar less than 20 but some people can be symptomatic long before a blood sugar of 20 or less.  If my daughter had not alerted us to the accidental overdose her blood sugar would have dropped to less than 20 within the first hour or so. It would have dropped so quickly based on the amount of insulin she delivered she may not have become aware of the drop in time to take action. 

What did we do?

Well for starters this…

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Banana, Teddy Grams, 2 juice boxes, mini butterfinger, mini 100 grand, full peanut butter and jelly sandwich (she was eating the other half)

The above picture shows approx. 125 grams of carbohydrates. She really needed a minimum of 200 grams but the child could not consume another bite.

She was exhausted. I sent her to bed and told her I would wake her if she needed to consume more. (IF?!?! – of course she would but I didn’t want to alarm her)

I checked her after 30 min. (11:00pm)

She was still in the upper 200s. Insulin isn’t really active until after 20 – 30 min so that was expected. She had eaten a number of fast and long acting carbohydrates (referring to how fast the body absorbs the sugar and/or converts carbohydrates into sugar) so I wasn’t sure what her blood sugar was going to do. I mean I knew it was going to go down but I didn’t know by how much or how fast.

11:30pm – blood sugar 118, woke her and had her drink 30 grams of juice.

It was at this check that I realized I had let slide a very important step in preventing an insulin overdose from ending tragically. I forgot to suspend basal insulin delivery. Basal insulin is insulin that is almost continuously delivered – a small drip basically to mimic what a functioning pancreas does for people without diabetes. Obviously my daughter did not need her basal insulin delivery at that time. Thus, I suspended all basal insulin for the next 4 hours – that should have been done at 10:30pm when my daughter made us aware of the accident. (BTW – this is only valid for people/kids who wear insulin pumps – those that get their basal insulin via an injection have no way of suspending the basal insulin)

dammit.

At 12:00am – blood sugar 124, gave 30 more grams of juice. She did not want to drink the juice this time and I actually had the first of two ‘drink the juice Shelby’ moments. That sucked.

12:30am – blood sugar 131, gave 15 more grams of juice.

1:10am – blood sugar 108, 15 more grams of juice. The second ‘drink the juice Shelby moment’

1:45am – blood sugar 145 – hallelujah she was going up. At this point the majority of the insulin, if not all of it was out of her system. I was still nervous though. It isn’t really an exact science when it comes to how long insulin is active. Each body is different. Thus I grabbed a pillow from the couch and climbed into bed with her. I felt safe enough to close my eyes at that point but I didn’t want to be far off. Prior to that I had watched a number of DVRd shoes afraid to close my eyes even for an instant.

My alarm woke me at 2:30am – blood sugar 162. Fine.

I stayed in her bed until my alarm at 6:00am.

Her blood sugar this morning 274. I think perhaps I could have turned her basal insulin back on at 2:30am but would you have?

She doesn’t remember any of the juices although she saw the juice box carnage on her desk. She woke with a slight stomach ache – well duh she drank 6 juice boxes in the middle of the night.

As a side note – it dawned on me sometime around 1:00am that I could have possibly used small injections of glucagon rather than juice boxes. I have never used the ‘mini-glucagon’ before – never had a reason to. Clearly I need to school myself on mini glucagon doses. (Glucagon is a hormone naturally produced in a persons liver as a last natural defense against hypoglycemia but it has also been synthesized and is typically used in emergency situations when a person experiencing severe hypoglycemia is not conscious. It has also been used in situations similar to ours last night or during periods of illness when carbohydrates can’t be consumed.)

Had it not been for the alert that the pump still had 5 units of the suggested bolus to deliver, or had my daughter ignored the alert this story would not be being told with sarcasm and purple hat wearing alien jokes. This story wouldn’t be being written the morning after while I wait for my youngest to finish getting ready for school. Had the pump not alarmed or had she ignored the alarm when it did alarm, this morning would be a huge black hole that no amount of expletives, sarcasm, tears or cyber hugs would bring me back from.

Diabetes is hard. I know sometimes many of us in the diabetes community make it look easy. We share pictures of bolus worthy food, laugh at the word ‘high’, share random silly moments with diabetes humor, climb mountains, run across Canada, win pageants, Nascar races, Indy races and Ninja Warrior challenges, send our kids off to college and sleepovers, walk, run, and bike. Oh and then there are these folks over at Connected in Motion who are just all kinds of awesome. We do all of these things and often we make it look easy peasy, but diabetes is hard. It is 24/7/52 FOREVER. Yes, I believe there will be a cure and there are always new treatments and tools being developed that make managing diabetes easier. But for right now it is forever, it is frustrating, it is dangerous, and it is damn hard.

I get a lot of kudos from friends, relatives and strangers who stumble on my blog posts. My kids get a lot of kudos too. It’s always nice to hear ‘you are a strong mom’, ‘you are so brave’, ‘your kids are so lucky’, ‘your kids are amazing’, etc. But I have to be honest – last night rocked my world. I was scared – more scared than I’ve ever been. With all my involvement in the diabetes online community, with all the books and blogs I’ve read, with all the conversations with Dfriends  – I forgot some of the basics – suspend the pump, give mini-glucagon. 

I am not sure how I feel about Tandem and t:slim right now. I don’t blame them or the pump but I also don’t blame my daughter. I can understand anyone doing just as she did. It was an easy mistake and even I’ve jumped through the multiple screens when I’ve given my daughter a correction bolus in the middle of the night. The danger is due to the exact reason the pump is so wonderful – ease of use. My daughter loves her t:slim pump and I want her to have the tools she deems best – it’s her diabetes. But honestly this event – it never would have happened with an Animas pump. Animas pumps will do the calculations to determine the proper insulin dose but prior to delivery the user must ‘scroll’ up using arrow keys to match the suggested bolus amount to the amount being input. Thus, the user can’t simply tap buttons without paying attention to the calculations and suggested bolus amounts like they can do with t:slim. I’m not sure about Medtronic or OmniPod pumps. Medtronic pumps don’t require the user to input the suggested bolus like Animas pumps do but the steps needed to get to the point of delivery are longer and more cumbersome than with t:slim. We’ve never used OmniPod or played with one so I have no idea how their system works.

When considering an insulin pump do research, find a way to get your hands on a pump to play with it, don’t just go with what your doctor wants you to go with. I still recommend the Tandem t:slim pump. I believe in it. It is the easiest pump to use, has the smallest profile of any tubbed pumps, has a rechargeable battery which is better for the environment IMHO (although stay tuned for the latest in a serious I think I might call ‘oops she did it again’), and holds 300 units of insulin which is important to many. I do not recommend the t:slim for younger kids. It is sooooooo easy to use and clearly at times too easy that I personally don’t believe it is the best pump choice for kids under 12. AGAIN MY HUMBLE OPINION.

I also fully support and recommend Animas pumps. Currently my boys both use the Animas Pings. Fabulous pump for all ages. There is a rumor the Animas Vibe will make its debut in the USA very very soon – the VIBE combines the Dexcom CGM (continuous glucose monitor) with the Animas pump so that the CGM results can be seen on the pump screen versus carrying a separate receiver. Sadly it means no more ping technology (the ability to program a bolus using the ping meter remote without touching the insulin pump – comes in handy for blood sugar corrections on small children after the witching hours).

Hug your kids. Hug your spouses. Love fiercely. Stock up on juice. Eat chocolate. Laugh as often as you can.

Oh hey also maybe do me a solid and go like the Stick With It Sugar Facebook page.

Size Matters

Last night around midnight I woke to check Sugarboy’s blood sugar.

He uses the Animas Ping pump with Ping meter. The Ping meter uses the One Touch Ultra test strips.

We have been using the Ping and One Touch Ultra meters for over 7 years. We love the Ping and feel pretty good about the Ping meter although it isn’t our favorite meter. We prefer the One Touch VerioIQ meter because of the color screen, smaller blood sample size and the very appreciated light at the test strip port. My two older kids both use the VerioIQ – one also uses Ping pump but doesn’t wish to use the Ping Meter. My oldest uses the TSlim pump so there would be no reason for her to use the Ping meter.

I don’t know exactly when the change was made – I can’t remember what I had for breakfast yesterday so remembering when One Touch made the change would be ridiculous. I believe it has been within the last year though.

When the change was made I was initially excited – yea for having more strips in a container. Other test strips manufacturers had been putting 50 per container for some time.

It took only a few days for the change to seriously frustrate my son. He is only 10 and has tiny fingers but still had a hard time retrieving a test strip from a freshly opened canister. The frustration continued until he had used about 20 test strips. To combat his frustration (and mine) we began just putting half the strips from a new canister into the nearly empty or empty canister he was using. This worked fine albeit annoying. The problem of course would be if we ever had issues with the test strips there would be no way of knowing if the test strips were truly part of the LOT number listed on the canister. Not really an issue since we never had a quality issue to report.

So last night like I said, I woke up to check my son’s blood sugar. He had just replaced his canister of test strips at his last check. He didn’t just reload his empty canister – he put a whole new canister in his diabetes bag. That meant it had 49 test strips in it.

Considering my 10-year-old with tiny fingers has trouble getting a new strip out of a new canister of strips you can imagine my frustration at midnight with my 40-year-old fingers that aren’t nearly as cute and slim as my sons. After my third attempt at pulling up a single test strip I had to shake them half way out of the canister to retrieve one. This resulted in a half-dozen strips falling into the bed-clothes. Since the Ping meter doesn’t have a light like the Verio I was doing this with only the dim light of the hallway. Since test strips are costly and not to be wasted I had to turn on the bedroom light to find the renegade strips. I watched my boy squeeze his eyes tighter shut as the light flooded the room. I found more than a half-dozen within the bedding. Realizing that some might be used (my boy puts his used strips back into his Dbag and opening the Dbag sometimes allows the used strips to slip out) I had to then peer at each strip with my sleep deprived eyes to determine if it already held DNA or if was an unused strip.

This whole process took about 7-10 minutes. Not a ton of time but those 7-10 minutes felt like a lifetime in the middle of the night.

Frustrated and more than a bit angry I sent a tweet to One Touch. I think I sent multiple tweets. But one tweet got the attention of One Touch.

strip2photoToday One Touch responded to my tweet. They asked me to DM them. Here’s my issue with sending a DM. Trying to express my frustration in 140 characters is like stuffing 50 test strips into a canister made to hold 25. Although I appreciate they reached out.

Here is the problem via pictures:

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We have both Verio and Ultra in our home – different kids with diabetes means different preferences for diabetes tools.

The Verio canister is the same size as the Ultra canister and both contain 50 test strips.

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Notice the the difference in ‘free space’ between the two types of test strips – both are new canisters containing 50 strips each. There is no issue retrieving a Verio test strip. Retrieving an Ultra test strip from a new canister is close to impossible unless they are shaken loose (often resulting in spills).

Why the difficulties with one and not the other? Well if you can’t see the difference in the size of the strips from the above photo look here…

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Size matters people. The Ultra test strip is thicker. BTW it also requires more blood but that’s off topic.

One Touch in their response to my tweet said they wanted to help.

Dear One Touch – Im not sure how you can help. It means a lot that you responded at all. We have been loyal One Touch customers for many years. Not that we haven’t tried other meters but we always return to you. I’ve already said how much we like the VerioIQ. Anyway – my youngest likes using his ping meter to remote bolus. How can you help – work with (if you’re not already) Animas to get the VerioIQ to have the same technology as the Ping meter so it can remote bolus. That would be the best solution. Might be out of your hands though. I appreciate any attempt made to reduce waste and make managing diabetes easier and I believe those were likely the contributing factors that lead to putting 50 Ultra strips into the same canister that used to hold 25. I actually applauded the decision initially because it meant half the waste and less time replacing canisters in my kids diabetes supply bags. But alas – the first two to three days of a new canister is really frustrating. Im just not sure there is anything you can do to remedy the problem without increasing the size of the canisters. I see a few problems with increasing the size of the canisters: a) it would seem counter productive since you would no longer be reducing the waste b) would leave more space then necessary in the Verio canisters, assuming you would still use the same canister for both types of strips c) no one wants to increase the amount of bulk their diabetes supplies create.

Thank you One Touch for responding to my middle-of-the-night exhausted Dmom slightly irrational tweet.

If you still wish to chat I can always be reached at stickwithitsugar@gmail.com.

 

 

Oh Be Careful Little Mouth What You Say

I am forcing myself to share this very very unflattering photo. It's my punishment for stupidity. You'll understand after.

I am forcing myself to share this very very unflattering photo. It’s my punishment for stupidity. You’ll understand after.

So last night. Wait I should start earlier. (quick warning – when I got to 1356 words I realized how long a post this would be. It is more than 1600 words. If you would like to skip the story and go straight to the moral feel free to scroll down – it’s an important lesson IMHO for all parents of kids with diabetes)

So yesterday afternoon I took Sugarboy up to Stanford to get started in a diabetes technology study. Since it’s a study I can’t/won’t share what he is wearing for the study or really any details. But I will say that his bedtime blood sugar needs to be under 260 for him to complete the study each night. The study is many nights long.

After the visit to Stanford he was starving. It was early, maybe 4pm. He wanted a personal pan pizza from Target (they sell Pizza Hut personal pan pizzas). While they are delicious they are also the antiChrist when it comes to diabetes management. Not only are they 80 grams of carbs but also loaded with thick gooey cheese and I’m certain they must use a good deal of butter/oil in the crust because multiple napkins are necessary. Of course he gets the pepperoni which adds an additional layer of fat.

A bit about carbs mixed with protein and fat. They (the carbs) are digested at a painfully slow rate. It takes a great deal of experience in the diabetes world to determine how best to dose insulin for meals that are what we call the triple threat (high carbs, high fat, high protein). Sometimes we are able to win the battle – extended doses of insulin over a 4-8 hour period after consumption usually does the trick. If you are a newbie to the diabetes world don’t fret about not figuring it out the first 27 dozen times – its something that takes time to figure out and every person with diabetes digests food differently – also not all pizza is created equal. Thick crust will take longer to digest than thin crispy. Veggie vs. Meat lovers – game changer.

Anyway – it was early enough in the day I thought all would be well. Eat at 4pm, do an extended bolus (insulin pump jargon for those taking multiple daily injections) and all should be well by bedtime in 5 hours.

I could not have been more wrong.

Bedtime blood sugar: 457 (see even those of us that have been dosing for pizza for over 7 years get it wrong and diabetes goes all wonky) (also note that we had neglected to check his blood sugar from 4pm to 9pm – not great after eating pizza)

I asked Sugarboy to dose for the elevated blood sugar (y’all do know that I don’t talk like that to my kids – that’s for y’alls benefit – what I actually say to my kids is “ok correct” but that wouldn’t make sense to some readers – then again most my readers are seasoned and would know so I could easily just type what I say and y’all would know but what if a newbie is here reading – imagine how “ok correct” would sound to them – holy crap I digress – also I might have used the word ‘y’all’ a few times and I’m not sure I took a breath while writing all this – can you say run-on)

Ok so Sugarboy dosed insulin to correct the high. He asked if he could sleep in my bed. With hubby away I love having him sleep in my bed. Also it makes for checking his blood sugar easier when he’s near me. (well it does but I still need to get up to check two other cwd so really thats a non-point)

He wanted me to go to bed with him. This is where mistake #1 was made.

I said I couldn’t because I would need to stay up and check his sugar in two hours so I could start the study computer.

His face dropped. He looked so sad. I thought because he wanted me to cuddle with him. I couldn’t cuddle – I would’ve fallen asleep – it wasn’t that I didn’t want to cuddle.

He then announced I could go to sleep. HE would stay up and check his sugar and start the study computer.

What? No. I tell him he needs to sleep and I have things to do so it’s all good.

It didn’t register right away. I mean it didn’t even register last night. It took till this morning to register what was happening. But Ill get to that in a second.

Two hours after he dosed insulin I checked his blood sugar. 431. #&@!

Ok so we likely didn’t screw up the dosing of the pizza. Clearly his infusion site (place where pump tubing attaches to body to deliver insulin) went bad. It was only at the tail end of day 2. The sites are normally good for 3 full days even longer sometimes if we forget to change it out.

Participating in the study last night was off the table. No big deal. Only it is since we are kinda on a time crunch since the study takes 3 months and we are moving at the end of 3 months. Each night we miss leaves us less of a window to finish the study.

Again no longer concerned about the study I focused on changing his infusion site. Sometimes I can get this done without waking him. Sadly we are out of the quickset infusion sets that are easiest to place IMHO. I had to use a different type of infusion site that I am not entirely familiar with.

I fumble around with placing the sensor in the applicator device for a good 7 minutes. I cock the device, remove the little plastic piece that protects the needle (or my fingers which ever), place it on his skin and press the release buttons that plunge the needle and flexible cannula into his skin. He woke up. He screamed in pain. He tried to grab at the applicator which I had not yet removed from his skin. I patted his hand and apologized. He went back to sleep. I gently lifted the applicator. @&#@

I had not removed the tiny pieces of paper that cover the adhesive parts of the infusion set. Thus the site came up with the applicator. I just punctured my kids skin for nothing. And worse, I’ll need to do it again.

Back downstairs. Another infusion set. Less time to place it in the application device this time around. Back up stairs. cock, remove paper, remove needle cover , place on skin, press, pull – Success – he did stir again but no scream this time. (I should note to any newbies or veterans considering a pump – very very rarely do my kids complain about pain when inserting a new infusion site. They agree it isn’t really painful and if it is, it only lasts a micro second. Now being lanced with a needle while in the middle of REM – well who the heck wouldn’t occasionally scream).

I fill the pump tubing with insulin then attach to his body. I dose him with insulin to correct the high. Keep in mind he has now likely been really really high (400+) for 7 hours.  The correction is a very large amount of insulin. If he had received any of the previously dosed insulin I could be putting him in danger. Thus I set an alarm to wake up in 2 hours.

At 1am my alarm goes off and I check his blood sugar. 301. I give him another correction. sometimes the longer a pwd is high the more difficult it is to correct. I don’t know the science behind it – I just knows it happens.

I set another alarm. 3am – 238. There is still a good deal of insulin working in his body so I do not do another correction.

This morning he is a very pretty 113. Of course he feels like crapola.

Meanwhile my other dear son is babbling (in his sweetest little voice) about a scooter he wants for Christmas. By this time I have heard about the scooter a dozen times in less than 24 hours. I’m fairly exhausted from the previous nights wompus with diabetes and I tell him so. I did this without thinking. I didn’t do it in an angry voice. I was sure to say “I’m sorry Middles I just can’t focus on the scooter right now because blah blah blah Im exhausted I didn’t get much rest can we talk later?” Middles understood and all was well, right?

No.

Sugarboy heard it all. He sat with his toast hanging limp in his hand half way to his mouth with a tear rolling down his cheek. He looked crushed.

He wiped his little tear, put down his toast and announced that he will stay up next time so I can go to bed.

Did you hear my heart break? I’m fairly certain it shattered on the floor.

I told him it wasn’t his fault. I told him diabetes is stupid. I told him I had things to do anyway. I told him I would nap later. I told him its not a big deal. I even lied and whispered to him that I was exaggerating because I didn’t want to hear more about a scooter. I told him anything I could think of to take the sadness and guilt off him.

So the moral – some unsolicited advice for other Dmoms and Ddads out there – be careful what you say in front of your little ones in regards to the hard times WE have helping manage diabetes. As much as we hurt for them they hurt for us. They see all we do, all we give up, how tired WE are and it makes them sad and makes them feel guilty. They have enough to worry about. We do this for them but they shouldn’t have to hear about it. They already know and if they don’t recognize it now they will when they grow and leave and have to spend a lifetime doing it for themselves. Just my two cents.

I love this kid.

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Sad, Happy, Screwed

So Middles received his first Humalog insulin pen yesterday. I must say I love Novalog but the Huma pen is Awesome looking.

He was beyond excited. Even Sweetstuff said she’d consider MDI again based on the Huma pen.

That is the part that makes me sad and happy at the same time.

It’s sad that my kids can get so excited about new diabetes tools. They shouldn’t have to be excited about them. I am grateful my kids all have such positive attitudes about diabetes management. Life would be so much harder for all of us if they despised it all and only saw what I sometimes see (a life sentence with diabetes, possible complications, added responsibility, the threat of death daily a different normal than others).

He was so excited to try it that he wanted to eat all the things just so he could inject.

His life with the Huma pen will be short-lived since his endo is already beginning the process to get him a pump. Thank goodness because have I said what a pain in the butt diabetes in school is here in CA?

He will be carrying his pen with him at school. He will have it in his backpack with his meter. The rotating nurse that is only at his school one day of week called me twice already (from another school) telling me he had to keep it in the office. I call bullshit.

I’m not having him be late for 1st period to drop it off, then late for the carpool after 8th period to pick it up and likely forget it frequently. He will carry it with him. (there are no lockers at his school, he carries his back pack with him everywhere regardless)

The nurse isn’t happy with me. She tried to insist. I basically said I would keep him home everyday unless she saw things my way. We will have a 504 review meeting early next week so its written in the 504. I have assured the nurse that he will not inject anywhere but the office (although honestly that’s silly since there is no one there to assist him regardless – I just don’t want him doing it in the bathroom and he isn’t comfortable doing it in front of other students).

Moving from a very very early diabetes diagnosis that only required a small dose of Lantus to the more difficult Honeymoon stage is well – total suckage.

His pancreas is still producing a good deal of insulin so dosing for highs and covering carbs can be tricky and treacherous. Last night he was 280 before bed. He was also very hungry. He ate a bowl of cereal and we dosed for the elevated blood sugar and the carbs. I checked his blood sugar two hours later while he slept.

67. Frick.

I’ve been spoiled. Sugarboy can down a 15 gram juice box in his sleep in less than a minute when he’s low. He doesn’t wake up. He feels the straw and smells the sweet nectar and simply drinks without ever opening his eyes.

Sweetstuff is a bit harder – I normally have to coax her awake just a bit and put the straw to her lips. She occasionally snaps at me “WHAAAT?” but mostly just sips the juice down, takes about 2 minutes.

Middles – holy difficult! I tried placing the straw on his lips while he was still sleeping, hoping that like Sugarboy he would simply drink it down. No go. He rolled over and rubbed his lips as if a loose pillow feather had landed on them.

I tapped his shoulder and said his name in a whisper. “Middles (I don’t actually call my kids by their blog names – that would be weird), middles honey you’re low, drink some juice”

Of course he moaned and rolled over. I try again, a bit heavier tapping and loader voice. “Middles you’re low drink the juice”

Fuck – now I have Shelby in my head “Drink the juice Shelby”

Still no response – well no helpful response from the boy. I place my hand behind him and pull him into a sitting position. He moans and says “ok”

Then falls back down.

Again I get him sitting. Again I put the straw to his lips. Again he says “ok” but remains sleeping sitting up.

5 more minutes of me trying to wake him enough to drink. When he does seem slightly conscious I tell him to drink the juice. He takes a tiny sip. Lays down and pulls his covers over him.

This is when I realize I’ve been spoiled and I am likely screwed.

Again I get him up. Again I put the straw to his lips. Drink Middles, Drink.

Another 5 minutes of slow painful sips.

He remembers nothing.

This morning he checks his meter and sees the 67. “Mom was I low, I saw a juice box on my night stand.”

Yes Middles you were low. It’s all good, I had your back.

Diabetes is stupid. My kids are awesome. I’m lucky.

 

 

Snorks and Demons Be Damned

It’s been awhile.

I’ve not posted.

That could mean a lot of things.

It could mean that nothing has gone wrong.

It could mean no one has required me to put on big girl panties.

It could mean that life is too busy being awesome for me to take the time to share.

It is all of these above and for that, I am thankful.

Of course we have experienced some bad pump sites (infusion sites where insulin pump infuses insulin into the body). It happens. We change sites, correct highs and move on.

We have also had some yucky low blood sugars – in all three kids. They drink juice, eat a fruit roll up and tell me they are STARVING for 15 minutes but again we move on.

Just another month with our unwanted house guest that refuses to leave, occasionally puts its feet on our coffee table (we don’t actually have a coffee table – technically its an ottoman but saying ‘puts its feet on our ottoman’ really doesn’t cause the visual cringe like a coffee table image does), it makes a ruckus at night, it messes with the kids homework like a poorly trained dog, and in general gets annoying.

That is until last night. My littlest, my Sugarboy was 268 at bedtime which meant no cookie. For those not overly familiar with type 1 diabetes – normally he can have a cookie and take insulin but when he is already high I turn into the soup nazi and its “no cookie for you” only I say it with a hug and an apology. We dosed insulin, read stories and kissed good night. He was tired and his head hurt from the high blood sugar and I was sad for my son.

I plugged into my phone, hit play and listened to Percy Jackson battle a number of monsters in a labyrinth while I tidied up the kitchen, folded laundry and moped a floor. An hour later I was relaxing on the couch with my new John Irving book. An hour after that I checked blood sugars.

Kid #1 – all good.

Kid #2 – right as rain.

Kid #3 – Sugarboy – not so much, lower than he was before bed but not by much. I figured it was a stubborn high, dosed more insulin and returned to my comfy couch. Too sleepy to read I caught up on Big Bang Theory (oh that silly Sheldon), Modern Family (glad I’m not the Cam of the family), and Two and a Half Men (mmm Ashton).

At this point it is after 1am and I am fighting exhaustion myself. I check the boy. He is now higher than he was before bed. Insert a number of expletives here also insert a new infusion site. Luckily my boy did not wake up when I put a new infusion site on his backside, despite the needle that shoots through the skin to leave the flexible canula behind. When he has high blood sugars he sleeps more soundly than normal. His body is just exhausted from the additional glucose coursing through him and very likely some ketones (ketones are toxins produced when the body burns fat and fatty acids for fuel because it doesn’t have enough glucose available – the irony is the glucose is there for people with diabetes but the body is lacking the magic key (insulin) needed to use the glucose). Dose insulin. Kiss his forehead. Kiss his little hand that hugs his pillow and say a little wish that all will be well.

I set my alarm for 3am. I don’t always do a 3am check but with a new infusion site, high blood sugars and a large dose of insulin to correct a high blood sugar I do need to recheck him.

Fast forward to 6:05am when my normal alarm goes off. Great song playing ‘Demons’ by Imagine Dragons. It’s kind of a dark song but has a catchy tune and I take the lyrics as a warning not to let my demons rule my days. Sorry – digressed.

Demons – In case you don’t know the song.

As the song played on I realized I didn’t hear my 3am alarm. This is the scene where I leap from bed and down the hall in less than a blink of an eye. Crash into the boys room and pause for a half second to watch his chest rise and fall. He is alive. I didn’t overdose him with insulin. (Just FYI – I am not the only parent who watches for the rise and fall of a child’s chest when the child has Type 1 diabetes – trust me on that.)

I check his blood sugar. Insert more expletives. His blood sugar 468. He wakes up, tells me his head hurts, tells me his chest hurts, tells me his stomach hurts. Then he goes potty – you know that scene in Austin Powers  – the Wiz – yea it was like that.

Don’t know the scene – click here >>> The Wiz

I tell him about the late night highs and the new infusion site. I tell him it likely failed.

He took the one I put in at 1am off – thankfully without much complaint. Sometimes those suckers stick on pretty good and removing them can be as uncomfortable as getting a new one.

The reason the new site and correction dose of insulin at 1am didn’t work.

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Friggen snorks. Shakes fist in air.

The infusion set I put in at 1am didn’t take. The canula (flexible tube that stays under his skin) bent and therefore was not infusing insulin into his body. We here in the diabetes world call that a snork. (remember the cartoon with odd sea creatures with the bent snork on their heads – google it if you don’t and don’t be fooled by their cuteness – they are pesky little a**holes).

Put on a new infusion set and dosed insulin. Checked ketones – LARGE. He ate toast and a yogurt (yes he was high but the only way to clear ketones is to eat carbs, dose insulin and drink lots and lots of water).

His blood sugar at 9am – 270. He was going down which meant the new infusion site was working. Still had a long way to go plus he still had moderate ketones.

He stayed home from school. It wouldn’t have been safe to send him to school with a severe high blood sugar, large ketones and a wallop of an insulin dose. Not to mention he felt miserable.

It’s eleven now. His sugars are down to 180. Ketones are small. He is still home playing xbox and relaxing. I’ll let him veg the rest of the day – he’s earned it.

Meanwhile I was writing this in an attempt to clear my head and keep the demons (anger, frustration, fear) at bay. I like it better when I don’t have much to say. Take time to hug a diabetic today.

PS. was not my intention to rhyme so much – clearly I’m feeling lyrical.

She Did It Herself

There was a recent post on Diabetes Mine by Will. You can read it and all the great comments in response to it HERE (Link removed because I am suspicious the post was written only to generate page views and put money in Will’s pocket. Basically Will called our kids ‘spoiled brats’ because we do our best to keep them alive including checking blood sugars at night. If I’m wrong Will is welcome to leave his thoughts as a comment on this post.)

So last night I tucked my kids in with kisses and hugs and went off to read in my bed while I waited for my hubby to get home from Denver. He was due home within the hour. I hadn’t brought glucose meters upstairs with me since I’d planned to get up and visit with my hubby. Instead I fell asleep reading. (Not the books fault – I had been up till 2am the night before so I was exhausted.)

I woke up around 2am to find my dear husband asleep beside me. I realized my mistake and got up to get glucose meters. Both kids were slightly high at bedtime and I had corrected them before sending them off to bed. I had that panicky feeling that maybe the correction was too much. Checked kids – Sugarboy was within range. Sweetstuff was still a bit high so I gave another correction.

That panicky feeling usually keeps me awake for sometime and last night was no exception. I went back downstairs and played on pinterest for a half hour (I love the Geek category – those are my people) after being amused regarding all things Dr. Who I fell asleep on the couch.

Around 4am (I think) my dear daughter came down and gently woke me to tell me her pump was out of insulin and she was gonna fill it. I vaguely remember this.

Chad woke me when he came down to leave for work around 7am but I remained on the couch listening to his footsteps and wishing him a good day.

This is what I found on the table when I got up around 7:30am.

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That additional correction I tried to give in the middle of the night – she didn’t get all of it and I didn’t hear the alarm on the pump alerting me. Turns out her pump didn’t have enough insulin to give her the entire correction or basal insulin for the rest of the night. It took 2 hours of alarms to wake my daughter so she could fix the problem.

She not only filled her pump with insulin, she checked her blood sugar and gave a correction. Score one for my beautiful daughter.

This was her at 8am.

1photoLook I know not all parents of CWD check sugars at night. I don’t do it every night. Maybe I would do it every night if I went to bed when my kids do but I’m up till midnight most nights. I check them before I go to bed and the alarms I set to wake me are dependent on what their numbers are when I go to bed.

Below are my numbers and plans but honestly its like Bennet of YDMV says – Your Diabetes May Vary. My  guidelines may not (and likely would not) work for all CWD – some kids react faster than others to corrections, some react slower to fast carbs, some go high/low depending on the cartoon print on their pjs. Please don’t use my numbers as your own guide. Now I’m worried I shouldn’t even share them. Shoot. Ok just promise you will not use my guidelines – mine are specific for my kids and how I know they will most often react. Seriously – these are kid specific – I don’t even use the same guidelines for both of my kids.

Sweetstuff –

Between 85-150 with no working insulin (no insulin given 2-3 hours prior) – do nothing, sleep soundly.

Under 85 – treat with fast 15 fast carbs – wait. check. repeat if necessary. If within range with no working insulin – I sleep soundly, if there is insulin still working I wait it out if less than 1 hour worth of insulin or set an alarm if longer.

Between 150-250 – check working insulin, if there is IOB (that’s ‘insulin on board’ – it’s a pump thing) I do the math – 1 unit will generally reduce my daughters BS by 50 points. If the working IOB will bring her into range I sleep soundly. If not I give additional insulin and sleep soundly (even with no IOB the amount of the correction is small enough I still sleep soundly).

Above 250 – check IOB and give correction if needed – I set an alarm. Anytime I give a correction of more than 2 units I get up. Insulin/hormones/the phase of the moon – these can all toy with diabetes and larger corrections make me more nervous at night.

Sugarboy is similar but I’m more cautious/conservative with him. He is more sensitive to insulin and 1 unit can drop him at minimum 100 points. He is also more active than my daughter, always on the go. He spends upwards of 2 hours a day on the trampoline and a good deal of that time is within hours of bed.

Also something to note – I recheck any reading over 300. You may have heard about the Strip Safely campaign. Basically current glucose meters can have a 20% variable. That might not mean much if a PWD number is within range – a 100 could be a 90 or a 110. However once those numbers are upwards of 300 that variable can be scary. 300 could really be 240 to 360 – Considering those 120  points mean 1.2 units of insulin and my boy drops 100 points per 1 unit – well it can get scary once the BS gets really high and I am dosing insulin based on a number that could be WAY off.

Click HERE to find out more about how you can help with the Strip Safely campaign – your support can help us all stay safe.

Ok that last bit about Strip Safely got me a bit off track but its an important message.

My message this morning is don’t let anyone tell you that night-time blood sugar checks are unnecessary or that you are taking on too much or that you are spoiling your child. Night time blood sugar checks are a personal family decision. Of course you should talk to your child’s doctor about night-time checks but also follow your gut. My son’s endo told us we only needed to check at night for the first two weeks after diagnosis. My son was 2. He was using Lantus for his basal insulin. Every night for over 4 months he would be in the 40s by 2am – despite decreasing his Lantus dose multiple times. It was not the fault of the Lantus – he was just very sensitive to insulin and still is. What if I had stopped at the two-week mark?

When our daughter was diagnosed we were told the same thing, she too dropped low every night.

The other side of the coin – don’t let anyone scare you into doing night-time checks if not doing them is working for you. Trust your instincts. I have yet to meet a parent that normally doesn’t do night-time checks that would send their kid off to bed after a huge correction without either staying up or getting up to check. Do what works for your family and trust your kids too. We’ve been lucky that my daughter will normally feel a low and get up. My son has never woken up when he was low to alert us.

I am very proud of my daughter for being so independent last night. It is a great relief (but not a surprise) that she is able and willing to do what she needs to do to take care of herself even in the wee hours of the night/morning. I will tell her this as soon as she gets out of bed – it after 11am and yes she is still in bed – yea teen years and summertime.

Thanks for getting through all the babbling and long stints of text. Here is cute cat picture as a reward.

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PS- I really hope the FDA approves the Dexcom G4 CGM for kids soon. My kids both participated in a study with the Dex G4 and it was the best week of sleep I’ve gotten in over 7 years. I’m not saying I didn’t have to get up – but when I did get up it was because the Dex alerted me. I slept soundly otherwise. Our current  insurance will not approve anything that the FDA has not approved thus no Dex for us until FDA says its ok for kids. (Although we all know it is as effective with kids as it is with adults and a great deal of kids use the Dex)