Wednesday, December 31, 2008
Tuesday, December 30, 2008
Anyway, after this sudden drop in Adele's blood sugars around midnight I didn't make any basal changes since I thought that it was due to her not eating her bedtime snack. But then after going through basically the same thing for the following 4 nights even if she did eat her snack, I'm not so sure that it had anything to do with it. Around midnight her sugar has suddenly begun to drop - she is now very sensitive to insulin at that time which was not the case before. I still have no clue why this is suddenly happening, but I have managed to stabalize things a bit more as of last night. I was even able to go to sleep at 10:30!!
So I think we're good until it changes again in a few days or a few weeks. The Type 1 game is rarely boring...
Wednesday, December 24, 2008
Friday, December 19, 2008
Monday, December 15, 2008
In a non-diabetic these 2 scenarios are avoided because our bodies are very, very efficient at monitoring insulin production and release from the pancreas, sugar absorption into bloodstream and blood sugar levels. For the Type 1 diabetic, not only does the pancreas no longer produce insulin, but all of this monitoring is gone also. Injecting insulin is the easy part of managing Type 1, the challenging part is all of this monitoring that non-diabetics take for granted...
Friday, December 12, 2008
We generally spend 1.5 to 2 hours per day physically doing tasks required to manage Adele's Diabetes. This includes checking blood sugar, calculating carbs consumed and insulin boluses, changing pump infusion sites... If all were equal, I would litterally find parenting so easy if Diabetes went away overnight. I'd probably get stressed and upset over other issues, but I'm just saying that initially it would be SOOOOO easy if it suddenly went away.
It's the only disease that I can think of (I do not have any medical training) where the patient (or caregiver) must decide the dose of medicine to administer. For other drugs, you simply follow what is prescribed on the medication (2 pills per day for example). With Type 1 Diabetes you must consider the quantity of food consumed, the blood sugar before eating and any remaining active insulin. It is never cut and dry.
Thursday, December 11, 2008
Tuesday, December 9, 2008
This past weekend I met Michele and Adele at the mall. They had not quite finished their shopping so we needed to go to one last store before leaving. As we were walking through the mall, Adele saw stuffed animals that she wanted to go see so Michele kept going and we would meet her at Sears once we were done. When we got to Sears, Adele and I could not find Michele. As we were waiting, Adele tells me that she feels low. I take a look at her and notice that she is very pale (sign that she is low, maybe even really low). Now, at that very moment I started to PANIC! We did not have her supplies backpack (Michele had it) and I had nothing to eat whatsoever. Even if I had a credit card (no cash) there may not be enough time to find something to eat and buy close by. She needed sugar NOW! As I was trying to calm myself and figure out how to get her some juice asap, I noticed Michele. Phew, close call!!!
I'm still not sure how low (or even if she was low), but I do know that she had never before felt a low in public like that. She had drank her juice by the time we found a comfortable spot to check her blood sugar (she was 7.4 at that time). Luckily we won this round of the Type 1 game... And the lesson learned was to ALWAYS have "the bag" with Adele. This also made me realize how true the message is on the Medicalert card inside the bag - "life-sustaining" really does mean life-sustaining!
Friday, December 5, 2008
Thursday, December 4, 2008
I have been struggling as of late with our chosen Diabetes management methodoloy. Are we testing Adele's blood sugar too much? How much is too much? There is no right or wrong answer to this, it's a personal thing. But I keep second guessing myself based on various opinions that I read or hear on the subject. I need to be confident in my decision and move forward...
I am pleased today that Adele's sugars are better than earlier in the week. The up and down cycle seems to have stabalized. Adele was low (3.4) this morning when she woke up. She told me she felt low which is good, because usually she doesn't feel her lows. As soon as she told me I felt panicky and gave her a bit of juice right away. I tried to calm down and talk to myself before I confirmed our assumptions with a blood glucose check.
Her sugar started to creep up after breakfast though (10.8 before dropping her off at school) and she would have been high for sure at snack time if I hadn't corrected with 0.6 units of insulin. She was 6.2 before her mid-morning snack and 6.5 before lunch (target is 7.0, so that was a very good). The extra blood glucose checks may be annoying, but it's what it takes to try to keep things in check.
Hopefully our Type 1 gaming luck will continue for the remainer of the week.
Wednesday, December 3, 2008
Adele is one of the lucky ones. She has 2 parents that love her very, very much and are commited to giving her the best possible care. We have medical insurance to cover the very expensive cost of her treatment. My job enables me (and my wife) to be on Diabetes call while at work. Because of my work as a computer analyst, I have experience working with numbers. Adele is an only child therefore we can put 100% of our focus on her care (I know families with 2 or more Type 1 children).
But then I often hear of families who do not have all these ressources. What about these Type 1 gamers? How long will they be able to stay in the game?
Tuesday, December 2, 2008
Adele was on shots for about 1 1/2 years before getting her pump. The pump has it's benefits and it's drawbacks, but for us we wouldn't go back to shots.
The pump is not an artificial pancreas. It will not automatically back off when blood sugar goes low or automatically give more insulin when blood sugar is high. It gives a very small amount of insulin every 3 minutes. This continuous insulin infusion is called your basal insulin. These basals are programmed in the pump by the user. A 24 hour clock enables you to program specific insulin amounts for the entire day.
Adele's basals are currently: 0.225 units/hour between midnight and 5 am, then 0.475 u/h until 9 am, then 0.225 u/h until 8:30 pm and 0.475 u/h until midnight. How did we come up with these? Through trial and error and with the help of the diabetes nurse.
Every time Adele eats she needs a "shot" of insulin to cover this food. The pump enables us to give her a "shot" of insulin at any time during the day without a needle. This is called a bolus. An infusion site (small flexible plastic tube inserted under the skin) is the doorway through which her body will receive the insulin.
Adele's pump is part of her now. It's an extension of her body since it is worn 24/7.
Monday, December 1, 2008
Friday, November 28, 2008
Please note that this is our personal management system. Each Type 1 diabetic manages their disease differently. No one approach is better than the next. The diabetic simply needs to find what works best for him/her.
Thursday, November 27, 2008
A mild cold or flu is like losing weeks of work adjusting insulin doses. You basically need to start over. Doses or scales that have been working are no longer enough, but you're not sure how much more insulin is needed to try to keep things in check.
For the past 2 days, Adele's blood glucose levels have shot up dramatically and I'm a bit lost as to how much insulin she needs to get them down again. Although her cold symptoms are minor (if she did not have diabetes, we wouldn't even know her immune system is fighting a cold).
Last night after a low (3.6) at 9 pm, Adele's sugar climbed to 11.5 at 1 am. We corrected with 0.2 units of insulin which would usually be enough. I had a feeling that this time it wasn't sufficient, but since we needed to sleep I wasn't too aggresive. This "feeling" caused me to wake up on my own at 4:30 am. I checked her sugar and she had gone up to 21.5! I gave her 1.1u and she woke up 2 hours later at 5.6.
Hopefully that the insulin scale guesstimates that I'm using today will be enough while not causing her sugars to drop too low...
Tuesday, November 25, 2008
In practice though, this is not the case. Our bodies are very complex. Stress, exercise, hormones or even your immune system fighting a virus will affect blood glucose. Highs and Lows are unavoidable. People often tell me that Adele's diabetes must be really bad since she gets her blood sugar tested many times per day (between 10 and 15+ times), but in reality this is what it takes to try to catch a low before it happens or correct a rising blood sugar before it gets too high.
Monday, November 24, 2008
Blood glucose less than 4.0 is called hypoglycemia. It is caused by too much insulin (or not enough food/sugar). Hypoglycemia is very dangerous. If the diabetic doesn't get any sugar asap he/she can become unconscious and even die.
Blood glucose greater than 8.0 is called hyperglycemia. It is caused by too little insulin (or too much food/sugar). If not treated, hyperglycemia can lead to ketoacidosis (diabetic coma). Frequent hyperglycemic episodes over time are what cause long term complications such as heart disease, blindness, kidney failure and amputation.
So, life for someone living with Type 1 Diabetes is a 24/7 balancing act between food/sugar and insulin to avoid hypoglycemia and hyperglycemia.
Friday, November 21, 2008
Unlike Type 2, Type 1 is not lifestyle related. A person cannot get Type 1 because of a poor diet, lack of exercise or eating too much sugar. Type 1 or Juvenile Diabetes is an autoimmune disorder that cannot be prevented or cured. A person develops Type 1 when their immune system mistakenly attacks the pancreas destroying it's ability to produce insulin. A Type 2 diabetic's pancreas is intact and still produces insulin, but his/her body can't utilize this insulin effectively.
Unlike Type 2, Type 1 cannot be controlled by diet and ALWAYS requires insulin therapy (mulitple daily insulin injections). Insulin is not a cure, it simply keeps the Type 1 diabetic alive by delaying complications.
Type 1 Diabetes cannot be outgrown. It's a life sentence.
Thursday, November 20, 2008
Mike LeBlanc (Adèle's dad)