DITL: One day in our ordinary T1D life

Here is a glimpse into our life with T1D. Yesterday – 11/13/14 – was a pretty ordinary day. It could have started at 1:34 AM. 1:34 AM is a permanent setting on my alarm clock. Often my husband and/or I wake up to check V in the middle of the night. But yesterday there was no need for it, her BG was stable and in a reasonable range, so we just let it be.

Our morning started as usual around 7 AM. I had forgotten to take pictures right away, but typically we have breakfast at 7:30 and V checks her BG and gives herself insulin. Yesterday morning her breakfast number was awesome.

Here Victoria's PDM shows that she tested at 7:30 AM and had a BG of 131. This photo was taken at 8 AM after she had breakfast. Note the upward arrow on the CGM. Her BG is quickly taking off.

Here V’s PDM shows that she tested at 7:30 AM and had a BG of 131. This photo was taken at 8 AM after she had breakfast. Note the upward arrow on the CGM. Her BG is quickly taking off.

I finish packing kids’ lunches. On the menu today is quinoa with GF chicken nuggets. Everything has to be carefully measured and carbs accurately counted. Every day I send a note with an itemized list of all lunch items and their corresponding carb counts.

1/3 cup of quinoa = 15 g. 4 GF chicken nuggets = 14 g.

1/3 cup of quinoa = 15 g.
4 GF chicken nuggets = 14 g.

I am usually not privy to V’s BG at school but it is not necessary. If there are any concerns the nurse will call me. And when I pick V up from school I always check her PDM and her CGM to see what’s been going on.
Thursday is a short day so I pick up kids after lunch at school and we head to piano lesson. V wants a snack. I take a look at Dexcom and I do not like what I see.

282 and going up, which is typical after a meal. Also look at the graph and note that after breakfast BG went up and stayed up.

282 and going up, which is typical after a meal. Also look at the graph and note that after breakfast BG went up and stayed up.

Since she wants a snack anyway, she checks her BG and gives herself a bolus while her brother is starting with piano lesson.

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After piano we come home for an hour to rest and change, and then head over to YMCA for gymnastics. We always have to look at BG before class starts and decide what to do about her pump settings. In this case, CGM says that BG is 188 and holding steady. I think about it. V has been running high most of the day and I could leave everything as is and let her “burn off” her BG. On the other hand, she tends to drop quickly and drastically with physical activity. I mull it over, consider the fact that there is almost no active insulin in her body, and decide to reduce her basal rate for two hours. Another notable thing is that I decide to forgo checking actual BG. We are relying on Dexcom data alone. CGM has been pretty accurate and reliable so we feel comfortable making some decisions based on it from time to time.

CGM is shown that BG is holding stable in the high 100s

CGM is shown that BG is holding stable in the high 100s

We leave V’s kit outside in the hallway, she takes CGM into the gym with her, and I take a spin class across the hallway from the gym.

Ready for Gymnastics! Pod on one leg, CGM sensor on the other, CGM receiver in hand, she is ready to take on the world. Move over diabetes, you are not going to stop this girl from doing what she loves.

Ready for Gymnastics! Pod on one leg, CGM sensor on the other, CGM receiver in hand, she is ready to take on the world. Move over diabetes, you are not going to stop this girl from doing what she loves.

When I come out I notice that the kit was undisturbed, which means that V did not feel low/Dexcom did not alarm, so she did not need to test or treat her BG.

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V comes out 30 minutes later and we check. Did I make the right decision?

IMG_0541

Yep. Nailed it!

We head home for dinner. On the menu is meatloaf, potatoes, quinoa and salad. Once again everything is carefully measured and counted. You are looking at a 35g. carb dinner here.

Meatloaf slice = 10g. Little over 1/4 cup of potatoes = 10g. 1/3 cup of quinoa = 15g.  Salad = 0g.

Meatloaf slice = 10g.
Little over 1/4 cup of potatoes = 10g.
1/3 cup of quinoa = 15g.
Salad = 0g.

It is getting late but we need to change the pod. This is something we have to do every three days. While V is in the shower I start the prep.

IMG_0543

Once the new pod is on, V takes off the old pod. This is what her skin looks like immediately after pod removal. The marks usually disappear within a day or so, sometimes sooner. However, sometimes the cannula marks linger for a while, although they typically do not hurt or itch or bother her in any way.

The skin is a little red, and the bump is where the cannula was inserted.

The skin is a little red, and the bump is where the cannula was inserted.

V finally gets to sleep. Around 10 PM my husband checks on her before he goes to bed. She’s still a little high and he boluses her. I head to bed closer to 11 and do my final BG check. She sleeps through finger pokes and bolusing with the pump is non-invasive. We only need to wake her up if she is low and needs to take a fast acting sugar.

Still high

Still high

I look at the summary of the day on the PDM

Victoria checked her BG 8 times. The good news is that she did not have any lows. The bad news is that her BG was pretty high most of the day.

V checked her BG 8 times. The good news is that she did not have any lows. The bad news is that her BG was pretty high most of the day.

I mull over this data. V is still recovering form her cold, so the high BG is not surprising. But it would be great to get it down to a better range. I increase her temp basal overnight and set the alarm to 1:34 to get up and check on her. It only seems fitting to start 11/14/14 – World Diabetes Day – in the middle of the night with a BG check.

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