Friday, November 28, 2008

Daily gaming

Here's how we play the Type 1 game on a daily basis...

Wake up @ 6:45 and test Adele's blood sugar. On weekends I need to backoff her morning basal insulin so she won't go low. Insulin basals are programmed in her pump. If she doesn't sleep in, she may wake up with a high blood glucose reading. I will correct right away if she's high by giving her an insulin bolus via her pump. After breakfast, I need to calculate how many grams of carbs she has taken in, do a bit of math and give her insulin via her pump.

If I have recently made changes to her insulin doses, I will test her blood sugar again before dropping her off at school @ 7:50.

Whoever is on call (either me or my wife) will then talk to Adele's teacher's aid again @ 8:45 and then 9:45 before her snack. If her sugars are dropping (or already low) I will tell the teacher's aid to give her a bit to eat. If her sugars are going up (or already high) I will tell the teacher's aid to give her insulin to bring them back down.

2 more blood glucose checks are done @ 10:45 and 11:45 before her lunch. She's checked again after lunch recess and before getting on the bus. In total, we are in contact with the teacher's aid about 8 or 9 times per workday.

We use the total grams of carbs consumed to calculate the amount of insulin that we give Adele each time she eats.

I usually check Adele's blood sugar 2 or 3 times after she is sleeping between 8:30 and 11:00 to give me a better idea of where her sugar is going. I can then make micro-adjustments to try and get a good reading when Michele checks her again between 1 and 2 am.

We use a log book to track blood glucose values and insulin throughout the day. This enables us to make better decisions and enables me to go back and look for tendancies in order to make adjustments.

This log book is from last summer, so the schedule is different from what's described above, but it still gives you an idea of the work required...

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

Flu season

Flu season is in full swing. Lots of kids are sneezing and coughing at Adele's daycare and school. Flus and colds almost always affect Adele's blood sugars. They tend to go up!

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

Highs and Lows

In theory, when you think about it, Type 1 Diabetes management seems quite simple. All you need to do is give the correct amount of insulin for the food (carbohydrates) taken in and the blood sugar levels should stay between 4.0 and 8.0 (in the normal range).

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.
No Type 1 diabetic is "worse" than another. Their pancreas doesn't produce any insulin.

Monday, November 24, 2008


In Canada, blood glucose level is measured in mmol/L. Normal values for blood glucose is between 4.0 mmol/L and 8.0 mmol/L.

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


What's the difference between Type 1 (Juvenile) and Type 2 Diabetes?

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


The purpose of this blog is to educate people about what it's like to live with Type 1 Diabetes. My daughter Adèle was diagnosed with Type 1 when she was 2 years old. She is now 8. All posts will explain the day-to-day adventures that we go through as a family to enable Adèle to stay alive.

Mike LeBlanc (Adèle's dad)