One of the keys to managing diabetes is checking blood sugar levels. As I’ve explained before here, it’s usually done by pricking a finger then using a test strip and a meter to get a number. There’s usually a range of blood sugar levels your doctor gives that’s right for you. Too high and you need more insulin. Too low and you need more glucose, or sugar. Very simple explanation of a fairly complicated matter.
You can see what a meter looks like and how you check glucose levels in a pretty good presentation at Medline Plus: http://www.nlm.nih.gov/medlineplus/ency/presentations/100220_1.htm
In the short term, it’s much more dangerous to be low than to be high. Low blood sugar means your brain is deprived of glucose. Symptoms start out with trembling and sweating and at dangerous levels can result in seizures or coma or even death. High blood sugar is more dangerous over a long period of time; it can lead to eye, kidney, nerve and blood vessel damage.
Our job, as parents of a two year old with diabetes, is to keep Benny as close to a blood sugar level of 80 to 150 as we can. We check about 6 times a day. My five year old, Lea, treats the meter like it’s part of game show. Once you put the test strip in, it counts down from five and she’s always rooting for a good number (no whammies!!). So far, I think we’ve done pretty well, but there have been two instances that stand out.
The very first came less than a month after Benny’s diagnosis. We were on a long-planned vacation, at my parents’ house in Florida. Along with my sister and her kids, we went to a sort of indoor amusement park. Benny had eaten a relatively normal lunch and it was already past nap time. We were thinking about hitting the road, when Slade noticed Benny, while still running around and having fun, seemed slightly uncoordinated. He was getting sort of clumsy. We scooped him up and took him to a quiet place to check his blood sugar. As I was holding him, he kept falling asleep. Since it was way past nap time, I wasn’t that worried. Well, after we checked him, you bet I was scared. His blood sugar was at 32. He wasn’t trying to sleep – he was about to pass out!
Luckily, he was lucid enough to suck down a quick juice box, which we always carry. Slade ran to a nearby snack stand and threw a 10-dollar bill at the guy for another bottle of juice. (He gave us the change later. Thanks!). Meantime, I had coaxed Benny into eating a fruit snack, which we also always carry, and he was coming around. By the time we got into the parking lot he was back up to a safe 95 and half an hour later he was chatting away, eating chicken nuggets and happy as could be. It took me two days and several conversations with our doctor to calm down!
The second incident was yesterday. Benny woke up for his afternoon nap sweaty and pale. He was happy to see me but put his head right down on my shoulder when I picked him up. We always check him after a nap and the magic number was…. 54. He’s been that low before, but usually 4 ounces of apple juice (15 carbs) is enough to bring him right back up, in about 5 minutes (we follow that with another 15 carb/protein snack, like peanut butter crackers). This time, it took a longer and it was pretty scary. That pale, shaky appearance lasted almost half an hour. In fact, I gave him some more sugar (sweet-tarts, a favorite) just in case. Of course, then a while later, his sugar was through the roof with one of the highest readings we’ve had in a while. We gave him a reasonable amount of insulin, a good dinner and lots of water (that helps). His next set of numbers were great.
What amazes me is how good he seems to feel after just a little bit of sugar or a little bit of insulin. 15 grams of carbohydrate isn’t really that much and you should see the teeny units of insulin, it’s really just a couple of drops (granted, Benny only weighs 30 pounds). We’re also in what’s called the honeymoon period of diabetes, when Benny’s pancreas still has 15-20% function. We don’t know how long that will last; it could be weeks or maybe even a year or two.
We’re told the end of the “honeymoon” won’t really mean a change in how we check or treat Benny, though. We’ll still be watching that little countdown, cheering for a winning number.
Labels: Juvenile Diabetes
Having many relatives that have to deal with what we call in our family “the heavy D” … your insight, candor on the topic — especially condiering how personal — are certainly comforting to those of us who have this issue as part of our daily lives.
Stacey, miracles do happen. I am 57, 4 kids all with their Masters Degrees and all non diabetic. I am not so lucky. However in 2005 a miracle drug came out, BYETTA. It is in fact a miracle drug that gets injected 2 times a day. It helps rebuild pancreatic cells. Theoretically it is for Type 2s. However many Type 1s are currently on it and are actually getting off of insulin. Other Pre Diabetics are taking it as an extreme precaution. I don’t know if Benny is a candidate but I would get MULTIPLE opinions from many Endochronologists and see if it could be for him. I’ve been on it for a year and it is magic. Please get the opinions of true experts, I think it could work for you. Craig McCracken # 336 337 8275 or email@example.com, Thanks Craig, Pilot Mountain, NC on 150 acres of paradise in the Blue Ridge !
Stacey, thanks for opening up and talking about your experiences with Benny. It’s always nice to hear a patient’s perspective. Because there may be many families dealing with diabetes who read your blog, I’d like to take a minute to respond to Mr. McCracken.
Byetta is a miracle drug. It has really helped many people with type 2 diabetes get better control of their disease. Byetta works by binding to the GLP-1 receptor, and encouraging the pancreas to release more insulin.
However, in patients who have type 1 diabetes, their pancreases do not have any ability to produce insulin. Therefore, Byetta would not be an option for someone with Type 1 diabetes, because they can’t produce any natural insulin with or without stimulation at the GLP-1 receptor.
There is a somewhat similar product named Symlin that does have a beneficial effect in patients with Type 1 diabetes. Symlin works by decreasing glucagon secretion and limiting glucose production by the liver.
Both Byetta (for type 2) and Symlin (for type 1) are wonderful drugs, but NEITHER is a replacement for insulin. However, both could potentially decrease insulin needs, and in a type 2 patient, could get them off from insulin. In a type 1 patient, insulin will still be necessary.
Mark Vanderwel, MD
Pediatric Endocrinology and Diabetes Specialists
It is comforting to read and relate to the experiences that you and your family are having with Benny. I read your stories of confusion about the math problems that you have to do every 2-3 hours, the terror of seeing your child during a hypoglycemic episode and the joy of several “good” readings in one day and my wife and I definitely understand. Our 2 year old daughter was diagnosed last October. (Very shortly after, many friends were asking me, “Do you listen to WBT and Stacey Simms in the morning?”) You and I spoke briefly at the JDRF Family Fun Day and we have experienced many of the same things that you describe here. We have submitted our paperwork for the pump (Cozmo) – I think that you were trying to decide which one. I’ll let you know how that goes.
Thank you for sharing your experiences. It does help others dealing with the same things to feel that we aren’t the only ones…
Alan – firstname.lastname@example.org
Alan, Lindsay & Craig – wow, thanks so much for writing here! I sometimes can’t believe the response I’ve received from families with Type I. I’m thrilled Dr. V took the time to respond as well. We’ll see about publishing posts that seem to give out medical information, although I’m reluctant to edit. However, I’m not a doctor and this column is certianly not meant to be a source of medical information. We’ll see how it goes.