We're battling highs today, as well. William has been over 200 every BG check since yesterday afternoon, and corrections aren't bringing him down like they usually do. He doesn't seem to be getting sick, not eating like he's having a growth spurt. I opened a new vial, but that didn't change anything. Time to review his numbers the past few days and make an adjustment...again.
We're all there with you. We all get frustrated and scared. We all have times when we just break down and cry for our kids. We're all doing our best with what we've been handed. Hang in there.
We should be experts by now. Cassie was diagnosed over 15 years ago. Yet we STILL have days like this where high BGs drive us crazy/stupid/worried (www.daddybetes.com/.../dont-mess-with-zofran.html).
The fear and worry are magnified when you're newly diagnosed. You feel like a failure for not being able to take away the pain/hurt/danger from your child. If even an old pro like me still has problems managing T1 diabetes, you can bet that you're probably doing more good than you give yourself credit for.
How old is your daughter? is she on pump?
p,s: I like your bright smile on the photo
Highs happen, don't overstress.
My A1c was 14-15 high for my teen years and beyond (I skipped shots, didn't test) and I'm complication free after over 3 decades with D.
Think everyone who boluses/shoots up after a meal is smart. Know it's not ideal, but I'm almost 40 and still do that because I can't always predict how much I'll eat. There's no way you can predict accurately with a child.
Jen - You are doing a GREAT job with managing a 3 year old on shots. I couldn't get really predictable blood sugars until I started using a pump. The long acting insulins are difficult to time and there's no way they can match a person's basal needs.
T1 since 1977 Minimed pump since 2002
Sorry you are having a hard time. We all understand how you feel.
We went to hospital January 3rd and the doctor was pleased my son's A1C came down a bit (still hight but getting there 8.9).
Then out of the blue as of last Sunday his sugars are running high again and now we will probably have to readjust everything.
I can only think that maybe the pre-teen and teen years offer a challenge b/c of puberty.
That being said, you never know where life will take you.
My dad is diabetic 70 out of 71 years and is doing well considering how long he has been diabetic (one of the longest living diabetics in Canada IMAGINE having diabetes for 70 years!!!
My older brother was diagnosed at age 12 and is now 45 and is doing well (some minor neuropathy in his legs).
Myself, diabetic only 10 years and I have gastroparesis.
My point is you cannot worry as you never know what will happen.
Do you best (which I know you are doing) and I believe that once puberty has passed (I know, that is a long time away) things will settle.
As my Dad always says, "That is the nature of diabetes...if your sugars did not go up and down, you would not be a diabetic..." He is truly inspirational!!!
do kids develop some kind of defense system in their body if they get diabetes from young age? if it is the case, maybe it is good to let them stay on MDI, and switch after the puberty
I don't know for certain, Weide, but our diabetes team has told me that it seems that for some unknown reason, children dx before puberty seem to be protected from the effects of highs until after puberty. That is why they apparently allow the "normal" range for young kids (ie my 3yr old) to fall b/w 6-12mmol. Once they hit puberty, I was told that tighter control is much more critical. Not sure if that answers your question.
To all the parents on this thread, I have a general observation to mention. Everyone seems to be talking about out of control numbers, with very few answers as to why they are occurring. Ever since my daughter was dxd over five years ago (now age 14), I have made it my 100% priority to understand cause-and-effect, and to take precise measures each time there is a high or a low. The one key factor no one seems to be mentioning, is the types of food your children are eating. Without question, the single most important factor for us has been to understand the glycemic index of every food which she eats. This has enabled us to understand, with some trial-and-error, precisely how her numbers will be influenced by the types of foods she eats (e.g. apples vs. strawberries, pasta vs. rice, bread vs. pizza, etc.) We've got it figured out for every meal she eats, when to pre-bolus, when to use the extended bolus feature of the Medtronic pump and for which foods, and also what to do if she gets our of her range. Her basal/bolus ratio is always at 50/50%.
This did not happen overnight, but when you understand the glycemic indexes of foods, you might kick yourselves (as I did to myself) when you realize that what they are eating, is often the main cause of the problems. The second part is what you are doing when trying to make corrections to get the numbers into range. Also, how to check the insertion/injection site, amount of exercise, even the temperature of your refrigerator where your insulin is stored. If anyone wants more input from me, I am happy to share my thoughts. We are now almost 20 consecutive days in a row without a high or a low of any significance. That's a record for us, and her A1C's have never been higher than 6.7%. For the last few years, she has had no problems in school, and overall lives a pretty normal life with low stress in the household. It wasn't always that way, so I am happy to help others if I can.
This may be a bit off topic, but I'm going to say it anyway.
Generally speaking, kids are resilient. Their bodies are programmed to repair damage on a daily (or nightly) basis, mostly while they sleep. They bounce back, and their bodies seem to pretty quickly fix stuff that would knock "mature adults” on their keesters.
I once read a pretty graphic description of what a high BG does to the tiny little vessels throughout the body. It was really disturbing to think of that happening to my son every time he had a high, and I got myself into a tizzzy just thinking about what was happening every time *I* did not keep my son's BG in range.
But then I thought about how INCREDIBLE a child's body is at fixing all those little booboo's that occur throughout the day. My (non-D) 7-year old can rip his foot open on a garden implement today ('cause that's how he rocks), and a few days from now it's barely visible, because he heals *that quickly*. All night long, his little body is on overdrive spewing out new cells in every corner of his little body, and in the morning he's all beefed up and ready to tackle a new day. That's what kids' bodies do.
My D-Kid is no different. I know that he can have a couple of days (or nights) of highs, but as long as we work on keeping his BG as stable as possible, make sure he gets as much sleep as he needs, and good nutrition during the day, his body will be able to deal with those occasional spats of highs. Overall, he's the healthiest of our three kids...always the last to get the flu and the first to recover.
It's really easy to get caught up in EVERY high or low and feel like you're not doing your job. But the fact is, we're attempting to perform an impossible job. We cannot "be" a pancreas. We can only do our best to mimic the incredibly phenomenal, mind-blowinging complex thing that a pancreas is. Every hour of every day.
Try to keep in mind the "milestones". Quarterly A1c numbers are a good start. We have annual bloodwork that gives us a bigger picture on all of the body functions that *may* be affected by D. Annual eye exams that let us know IF there have been any changes to the vascular system. On a more intimate, weekly-ish basis, I check his feet to be sure that all those little bumps, bruises and boo-boos are healing normally. "Big Picture" is what I, personally, aim for with our son's health. I just can’t do any better than that.
I am not a pancreas. I am not an endocrinologist. I am not a doctor. I am not a nurse. I am "just" a mom who loves her D-kid, who was unexpectedly shoved into all of those roles in an Earth-shattering one-hour period of time about 2.5 years ago. I'm doing my best, just as you are. Just as we all are.
Take a deep breath. Look to the horizon. Stay in touch with the D-community (here at Juvenation, in the blog world, by e-mail, and in person through local groups).
Take another deep breath. Don't get yourself overly wound up in the details. You're going great.
Well said Mo. Thanks for that, I know I needed to hear it.
could you elaborate? It certainly sounds hopeful, but how exactly do you
calculate the glycemic index? Let's say you're having spaghetti with meat
sauce. How do you know how much protein is in the sauce? And what if you put
parmesian on it. Does that change it? And even if you knew it, how does that
translate into timing? Does a food with the same glycemic index get
metabolized faster if you excercise? Or slower at night (which we have found
with our son)? It seems dauntingly complex, but maybe you have found some
simplification that captures the important time constants?
It's even more complex than that - but don't get frustrated. For my daughter, the important thing that we learned is that pasta releases carbs for six hours. It might release faster if it is cooked more, but most of the time, she will eat two servings, and we will do a dual wave bolus for 6-hours at about 100-120 carbs. That includes our assessment of the sauce and any vegetables in the sauce like carrots or peas perhaps. For us, it works like a charm, every time. But, it took us a while to figure it out, and tweaking her pump to get it right. We don't factor carbs for parmesan or any proteins in the sauce.
Another example for us is fresh pizza (we never, ever eat frozen pizza or chain restaurant pizza). Pizza for us requires a 1 1/2 hour bolus for two slices. Two servings of vegetable or chicken fried rice is usually three hours.
And yes, the exercise will cause the insulin to work faster, but we found the carbs then will release faster as well, so we still do the same bolus but keep an eye on her numbers later on to see if there is a drop. If there is a low, we treat it with 15 carbs, set the timer, and test again in 15 minutes to see if she has stabilized. We test again in an hour.
If there is a high, we discuss the possible causes of the high (forgot to bolus, didn't count the right carbs, possible site congestion, etc., then we do a correction, and test again in an hour. Absolutely no carbs when she is high! If she is still high again, we automatically give her a shot, check her site again, or change it, go for a walk, then test again in an hour.
We have lots of basic rules which we always follow and which keeps us out of trouble. We always pre-bolus for meals, at least 15 minutes (unless she is low). If you don't know the exact carb intake before the meal, then we pre-bolus for 1/2 the meal at least 15-30 minutes, then do the rest after she finishes.
We avoid all cereals, pretzels, some fast-acting fruits like watermelon and pineapple, and stick with slower acting foods like, flour wraps with eggs for breakfast, pancakes, strawberries, apples and bananas, popcorn, rice, pasta, pizza, etc. Do a Google search on Glycemic Index and look for a pyramid illustration, then test for yourself what works best on each of your favorite foods.
Everyone should do what's right for them, but my best advice is educate yourselves as much as possible over the Internet. Don't depend 100% on your doctor. The more time you put into this, the better your results will be.
Hope that helps!
thank you for your great insight!
I could understand we can intense manage while we are with our kids, but how are we going to manage them while they are in school?
My daughter is 14, so we do everything diabetes-related together. She understands as much as I do, so really my job now is to help remind her of things. We collaborate every time she eats something to make sure we have the right bolus. When she is at school now, we know what she eats for lunch - again no fast acting carbs, which helps her get through her day without any spikes. She also tests, then pre-boluses about 20 minutes before lunch. She is getting better every day, and taking on more responsibility. It's actually quite bonding for us. We make mistakes, but we try never to make the same mistakes twice. Very rarely does she experience a high or a low without a reason. We always try to understand what caused it, so we don't repeat it again.
By the way, I highly recommend that everyone attend this annual conference at least one time - there is so much information there, it will change your lives - www.childrenwithdiabetes.com/.../orlando2012.
Hope that helps - please keep the questions coming!
I am glad you have such tight control over your daugther's sugars. I think everyone needs to do what works best for them. I agree that it helps to know the GI of foods. Here is where I take issue. I made a promise to myself and my 3yr old that diabetes would not single her out. I would never send her to a birthday party and tell her she couldn't have cake because the icing had too much fast acting carbs. If she asked for cereal for breakfast, I won't tell her it is taboo. There is nothing better on a hot summer day than a slice of juicy watermelon, diabetes or not. If that means having a high or breaking a streak, so be it. She is a child, and a young one, with a life full of diabetic challenges ahead. I am determined to make diabetes fit into her life, not the other way around. I am committed to teaching her adaptability, flexiblity, and diligence where diabetes management is concerned. I will learn how the insulin works so that she can enjoy what she wants (at least once in a while). As an adult, I want her to be able to handle the curve balls, and to do that I need to teach her how, not to avoid certain things because its too hard to figure out. I don't want her to grow up thinking that this thing that has made her different means she can't have or do what all of her friends do. It may just take a bit extra planning/figuring. If as an adult she chooses to avoid certain foods, then great, whatever works, but my goal is for her to learn that she can do this, and anything else she desires. I don't mean that I will let her eat a pile of sugar loaded garbage, just as I wouldn't have pre-diagnosis. I mean absolutely no offence, Micheal, and I commend you on the tremedous job you are doing with your daughter... 20 days is truely amazing. I strive for such a great run. I just do it different, a different school of thought is all. Finding balance is not easy, but I will.... for her. Everyday I do it for her.