Diabetes Awareness Month, Day 30

And just like that, it’s come to an end. Today is last day of diabetes awareness month, last time I’m spamming you with a post a day until next year. I am running out of steam and have nothing deep and profound to write today. Except that I wish I could put away our diabetes awareness until next year. But alas, that pesky thing is here to stay. If you got sick and tired of reading about it, imagine how sick and tired we get living with it every day. So please do me one favor: do what you can to keep raising diabetes awareness beyond November. If you learned something new about diabetes by reading my blog, please share it with others. If you hear a friend or family member giving out inaccurate information, please correct them. And if you meet another person with diabetes, be it child or adult, Type 1 or Type 2, please be kind to them. In this world where diabetics are always the butt of a joke, we can always use more kindness and understanding.

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Diabetes Awareness Month, Day 29

Today was the day I rage suspended. Yep, I’ve created a new diabetes term of endearment. Rage suspend is the opposite of rage bolus. It means cutting out insulin completely and for longer than one hour after relenting lows in an angry attempt to stabilize BG. It usually results in high BG a few hours afterwards.

We’ve had a few days on a low side. V has been complaining of some mild GI symptoms – tummy aches here and there, no appetite, feeling tired. When my child is not hungry you KNOW something is wrong. She is always hungry. And when she has any kind of GI upset her BG tends to crash hard. This time BG lows are mild and protracting, just like her GI symptoms. She’s been hovering around 60s and 70s, with a couple of dips into 50s and 40s. We’ve been having great difficulty bringing her above 90. We had her sip on Sprite quite a bit. Today Dexcom would.not.shut.up. It kept alerting and alerting and alerting. It’s set to alert at 75 so that we can be proactive about lows, even though we are perfectly comfortable letting her ride out the 70s as she feels quite good in the 70s range. But today she was dipping in and out of 70s so much, and Dexcom kept thinking she was mostly in the 60s. We made her drink more Sprite and eat more food. Good luck forcing food down V’s throat when she’s not hungry because she’s not feeling well. At around 4 PM I forced her to take a couple more bites and cried uncle. We suspended insulin delivery for 1 hr. After one hour was over she was still hovering in low 70s so I said what the hell, and suspended for another hour. BG finally started to climb up. So I guess mission accomplished? Except she’s still climbing up, 184 as of this exact moment. But I’m reluctant to give her insulin because I don’t want her to crash at night. Again. (Did I mention she was 40 last night at 11 PM?) Stupid diabetes. Damn if you do, damn if you don’t.

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Diabetes Awareness Month, Day 28

Today I’m going to re-post something from last year. It popped up on my Facebook newsfeed. First, I laughed. Then I realized that I posted it exclusively on the Facebook page. So I’m actually going to transfer it here instead of simply linking to the Facebook post.

Diabetes Awareness Month, Day 28. I think yesterday we discovered the devil of Diabetes, aka the T1D equivalent of 666. But we were unintimidated and taught it a good lesson. Story in pictures below:

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Dexcom alerted us to a high. It does not read BG above 400, so this was bound to be interesting

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Behold the T1D equivalent of 666
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The logical course of action – exorcism! Exorcism here being defined as expelling diabetes devil via exercise.
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And it started working quickly…

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An hour and a half later exorcism was proclaimed to have been successful. See ya, devil. You are not a match for us!

I should add that of course some insulin was required to finish beating diabeetus into submission and bringing V into a healthy BG range, which was accomplished in no more than another hour. Without strenuous exercise it could have taken double that time to get BG under control.

Diabetes Awareness Month, Day 27

I am pleased to report that this year we nailed Thanksgiving. It started with turkey. For so many years we kept over-cooking it. This year, with the help of a good meat thermometer, a LOT of butter, and more accurate info on when to pull the bird out of the oven, we ended up with a perfectly moist turkey cooked to perfection – dark meat and white meat. Nothing was over cooked and only a minuscule part was slightly over-cooked. Success!

But more importantly, we must have dialed up just enough magic to figure out carbs and insulin. It was very timely that I saw this article on diabetes and thanksgiving  in the morning and immediately decided that I was going to use the tips. Because we are not afraid of insulin, no we are not!

At the heart of Scott’s strategy was this philosophy:

I have two steadfast rules about managing my daughter’s type 1 diabetes. Read them, memorize them, live by them.

1. It is far easier to stop a low or falling blood glucose then it is to return a high blood sugar to a safe range. In my experience most low or falling BGs can be stopped and steadied in a short amount of time, maybe 15 minutes. A high BG can take 3 to 5 hours to return to a safe place. I’ll say it again. It is easier to stop a fall or a low then it is to effect a high. This thought guides everything I do with insulin.

I can’t stress enough how much it resonated with me. And yet times and times again we’ve found ourselves acting way too cautiously, fearing lows, not using our CGM to keep better tabs on BG trends. NO MORE.

Last night I checked V over an hour before dinner and gave her a correction to bring her to a lower range. Then I looked at our menu and honestly calculated carbs. In fact, I decided to round up and assume that high-fat things will be metabolized as glucose, so that virtually nothing was carb-free. I did the math and decided that 100 g. was a good ball-park number.

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I gave V her dinner bolus at least 3o min before dinner. She got 30% of insulin upfront and 70% spread out over 2 hrs, so that there would be active insulin in her system when all the delayed carb absorption started to happen.

The results were amazing. V’s BG stayed relatively steady. At some point after dinner and dessert I noticed that CGM was saying 91 and going down, so I let her have a small piece of candy. We had no lows and her BG topped at a little under 180! For us it is quite remarkable. Things were OK overnight, too. I gave V a small correction bolus before bedtime, and even though BG climbed up a little overnight, it again topped at 188. Typically, we’d be battling 200’s and 300’s and it was great to see V stay in a much better range.

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Now, this is definitely something to be thankful for!

Diabetes Awareness Month, Day 26

Today is Thanksgiving. Everyone is writing about what they are thankful for. I thought about it, but frankly I had already talked a lot about it. And don’t even get me started on what good things come from diabetes. Nothing good comes from diabetes. NOTHING. Yeah, you can adapt a healthier life style and blah blah blah, but I’d love to do it without diabetes thankyouverymuch.

That being said, I was pondering all this on my run this morning. This year I’m thankful for something we did not really have a year or two ago: little by little, we are getting our freedom back, despite diabetes. Now that we are 2.5 years into it, and are armed with experience, good support system, a pump, and a CGM, we can not only do more than before but relax into it. Last night V had a sleepover at a friend’s house. We were able to monitor her BG thanks to Dexcom Share and she had a perfect night and a great day. We barely had any contact with her, she managed diabetes on her own and did a wonderful job. V had sleepovers before but they were a lot more stressful and needed a lot more involvement from us. Same thing happened when V spent a couple of days and nights with her grandparents a couple of days ago. We stayed in frequent contact but things went much smoother than before, and it was a lot less stressful.

As I think about the past few months, more examples come to mind: V being able to have a run of the cruise ship without us…Getting away for a couple of days with my husband while V was in sleep-away camp…Letting V sleep in and rest home by herself when she had a cold and could not go to school, while I drove her brother to school in the morning…Being able to leave V home alone for a couple of hours and not drag her around with me when I had to run errands… Being able to let V stay home while I go for a run…

As I ran this morning, I remarked how wonderful it felt to enjoy our freedom. This is a win-win. Yes, it’s tremendously helpful to us, parents. But V is getting older and is at the age of wanting to be more and more independent, doing more things with friends and without parental supervision. I am grateful that we can make it happen and allow her to do all these normal things kids her age do. And I am grateful that we can breathe a little easier while letting her spread her wings.

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Diabetes Awareness Week, Day 25

The fallacy of carb-free turkey?

I’ve been reading a lot lately about how there may not be such a thing as carb-free turkey or steak. Basically, if you are going to eat a large portion of something that is high in fat, it will eventually metabolize as glucose. There is a particularly good piece on DiabetesMine about it. And Dr. Pettus talked about it at the TCOYD conference. And let me tell you, both of my kids can eat a hearty portion. So tomorrow I will conduct an experiment. I will not assume that turkey is carb-free. (Because you can be sure that it will involve a LOT of butter, so..umm..lots of fat. YUM.) I’m going to add some carbs to V’s bolus and see how the feast agrees with her. Heck, maybe I should assume that if she eats a metric ton of Brussel sprouts I should throw in a few carbs for them, too? And maybe  a couple of grams for deviled eggs? But excuse me, since when half a cup of mashed potatoes is 19 g? Isn’t it supposed to be 15 g.? Oh wait… There’s butter. Lots of butter. Better add those carbs in, I suppose… Hmm, I think tomorrow’s dinner will involve a lot of insulin.

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Diabetes Awareness Month, Day 24

I left you with a teaser yesterday. Today I will finish the story.

V has been at her grandparents’ house for a few days because of Thanksgiving break. When she is there, she is essentially flying solo with our support. We dropped her off on Sunday night and talked about night-time management. The challenging thing is that V is a deep sleeper and in the past has always slept through every single Dexcom alarm and through our phone calls. I would have to call grandparents and have them wake V up if she needed to do something in the middle of the night. This time, we took Dexcom out of its case and put it in a glass. We also made sure that V’s ringer volume was all the way up and chose a ringtone that she felt would wake her. We left hoping that it was a better system of communicating that would give V more independence and remove some of the stress and night-time burden off of her grandparents.

I woke up several times in the middle of the night to check Dexcom app and things were looking pretty good. Then at 4:53 AM I woke up to low alarm. 4:53-effin’-AM. I sat up and hesitated. Did V hear it? Is she waking up now and about to call me? Dexcom was showing a 74, so it was no reason to panic. I decided to give her a few minutes first (and to give myself a few minutes to wake up, get the brain going, and sneak into the bathroom.) V never called, so I picked up the phone and called her. Would she hear it?

Ring, ring, ring…

V: (very sleepy) Hi Mom

YES! She heard the phone. Success.

Me: Hi baby, did you hear Deckie?

Her: No.

So much for all those hacks. The child still can’t hear Dexcom alarm. Ugh.

Me: I’m so sorry to wake you up. Deck says you are low.

Her: (still very sleepy) OK

Me: I need  you to test now.

Her: OK

And then there was silence. For a few seconds I wondered if V went back to sleep. But then I heard some rustling and the familiar sounds of lancing and beeps of the strip in the meter. Whew, she was awake and following the plan. While she was testing, I was mulling over options. Glucose tabs? Gel? Decrease temp basal or leave it alone?

V: It’s a false alarm. I’m 134.

Me: You are what?!?

V: I am 134.

Me: (OMGWTF!) OK, please calibrate Deckie and you can go back to sleep.

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Because there is nothing more fun that waking up to a false low alarm at 4:53 AM.