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Donuts…ugh.

Although people with Type 1 Diabetes can eat anything they want by covering food with insulin, some foods are not as friendly as we’d like them to be.

Chocolate covered donuts are a rare treat in this house. I don’t buy them too often so when they go on sale I surprise my family and buy a box. Everyone eats them, especially my 6 year old son with Type 1 diabetes.

We made a choice early on in his diagnosis that he would live like every other child, he is a kid first and diabetes comes second. We constantly figure out how to fit diabetes into our healthy, fun, everyday lifestyle. Whether it’s for playing sports, swimming or eating donuts, we figure out a way to make diabetes work with us, not against us.

In this house we count carbs two ways, we count the carbs directly off the packaging or we use something called carb factors. That is when you weigh the food in grams and then multiply that by the carb factor or the amount of carb in each gram of food. You can find out carb factor by using a list created by nutritionists or by dividing the carbs in grams by the weight in grams off the packaging. That tells you the amount of carbs in 1 gram of that particular food.

Anyway, I carb factored the chocolate donuts for my son last night and all was working perfectly. He went to bed his number was a perfect 140. However, through the night, the donuts’ goodness continued to give back to my son. As they are so high in fat, my son’s number continued to rise even though he had eaten donuts almost 5 hours earlier.

At 2:00am I checked my son, as I do most every early morning, and his number was well over 200. I initially thought it might be his site for his insulin pump, but then I remembered the donuts. They are the treat that just keep treating (or mistreating for that matter). I corrected with insulin.

At 6:00am I checked my son again, as I do most every morning, and his number was still well over 200. Now I really believed it must have been the new site. Not wanting to change the site while he was still sleeping, I attempted one more correction with insulin.

At 9:00am I checked my son as he woke up from his long chocolate-dream sleep and he was a perfect 120. Now I know it was not the site, just the donuts. They continued to rise my son’s blood sugar for a full 10 hours after eating them.

We love donuts in this house. We don’t love what they do to my son’s blood sugar. I won’t deny my son the donuts. I try not to deny anything because of diabetes. I will however, work my tail off the next time he eats donuts, by making temporary adjustments to his pump, to keep his blood sugar in range in the hours after eating them, when the donuts should be just a memory.

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Easy?

The phrase, “you make it all look so easy,” in reference to how we handle Type 1 diabetes is always met with mixed emotions.
While on the outside, “you make it all look so easy,” is a definite compliment, it does stir up some mixed emotions inside of me. I am proud that I have done what I have claimed to do since diagnosis day almost 2 years ago. I incorporated diabetes into OUR life as opposed to rearranging our lives around diabetes. Diabetes just became something that we dealt with. It didn’t determine if we went to the beach for the day, it just came along. Diabetes didn’t decide that we couldn’t go on playdates anymore, diabetes was just going to have to tag along. We did this, my son and me, and I am proud of both of us.

On the flip side of ‘you make it all look so easy,” I feel like my son is not getting the credit he deserves for living with this disease 24 hours a day every day of his life since diagnosis day. He does get his finger checked 10 times a day. He does have to stop playing in the pool even though he feels fine because sometimes lows can sneak up on you faster than you can say, “Mommy, I’m shaky.” He does have to wait to eat every single time he’s hungry to see if I need to check his sugar or to make sure all the carbs are counted already.

My son deserves credit for withstanding numerous blood glucose checks while he is sleeping, and then sometimes eating full snacks at 3:00am to raise his blood sugar, all with his eyes closed.

My son deserves credit for all the things he does to live with Type 1 diabetes. He withstands numerous questions about his pump, his meter, his candy that he carries for lows. While it’s nice that people are interested, some are not really interested, just intrusive, yet my son answers them all equally.

My daughter deserves credit for living with her brother’s chronic illness too. She has learned at a very young age that when her brother says he is low that mama has to run. She has learned that even during our quiet times together mama may be needed to go tend to something diabetes-related for the safety of her brother.

My parents, my son’s grandparents, deserve credit for learning all over again how to care for their grandson. They chose to go to Caregivers Camp to learn about how to handle diabetes during outings and sleepovers at Nannie and Papa’s house. My brother, my son’s Uncle, deserves the same credit. He has given up a few nights of his life to sleep over with my son at Nannie and Papa’s house to ensure there is one more adult there that can help if any issues arise.

My husband, my son’s daddy, deserves credit for giving up time with me. There are many times when we are out and about remembering why we fell in love over 17 years ago, when our ‘date’ is cut short because my son needs something that only I can provide.

I don’t say any of this for people to feel pity on us. That is why when someone says, “You make it all look so easy,” I smile and say thank you. No one needs to know the behind the scenes when it is not all so easy. We chose everyday to live our life exactly how we would live it if diabetes never reared it’s ugly head. We chose to ‘make it all look so easy’ so that we can go on living our lives as before. But I will tell you, it is nice when someone who says that also adds, “But I do know how hard you work to make it all look so easy.”

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No ‘getting off’ insulin for us.

A person with Type 1 diabetes can never ‘get off’ or stop using insulin regardless of exercise and diet.

A few months after my son was diagnosed we were at a family party. I was really not used to him having Type 1, so I was really unprepared to have an educated conversation about it. The farthest any conversation had gotten up until this point since our diagnosis consisted of, “How are you?” and “How is your son?” No one had ever asked any questions that I might not have known the answer, until this party two months after diagnosis.

A friend of my cousin who was a nurse started to ask me what I was feeding my son for breakfast. I told her pancakes, and stuff like that. I could tell by the look on her face that she disapproved. In an attempt to understand Type 1 diabetes better, I engaged in what I thought was going to be an enlightening conversation. Well, it was enlightening alright, but for all the wrong reasons.

She started to yell at me, yes yell at me, that I would never be able to get my son off insulin if I continued to feed him carbs such as pancakes. I must have looked confused, I never really thought that I had to get him off insulin, so she continued. She said I needed to change his diet, cut out all carbs, so that I could get him off insulin once and for all.

I was so stunned and angry that I couldn’t even formulate a sentence. I was not angry at her (yet) I was angry at the hospital nursing staff because they had led me to believe that he needed insulin and carbs to live and grow. I felt like I had been misled.

Well, I came home, after crying the whole hour ride home and immediately posted what had happened on www.type1parents.org. I cried and cried as I typed asking the parents that had become my support system exactly what I was doing wrong, should I be trying to get my son off insulin as this person had suggested (yelled) to me.

Do you know what they wrote back to me? A very simple statement, that still sticks in my thoughts today. They wrote, “Insulin is like air to your son, without it he will die.” Seriously, he will die without it. Could you imagine the consequences if I had believed this woman, and started to feed my 4 year old a carb free diet so that I could try to get him off insulin. First he would stop growing from lack of carbs, which give the body energy, then he would eventually die from lack of insulin.

Everyone needs insulin to live. People without Type 1 diabetes don’t have to think one second if their body is producing insulin. People without Type 1 have a steady stream of insulin flowing through their body keeping their blood sugar level automtatically. When the pancreas works, by providing insulin, it’s a very handy organ. The brain is even smart enough to tell a person’s pancreas without diabetes that a piece of very rich creamy chocolate cake is coming down the pipe soon, so insulin production is increased even before the first bite is swallowed to ensure the blood glucose levels remain consistent. Very nice system, when it works.

People with Type 1 diabetes don’t have the luxury of a working pancreas that puts out insulin. There is no insulin being produced…ever. Not for meals, and not for just simple living. Because of this people with Type 1 need to rely on two methods of insulin delivery every day. One type that gets taken every 24 hours is called a BASAL insulin. It takes the place of the BASE insulin that everyone else has coursing through their blood without any effort on their part. It keeps their blood glucose steady during times when they are not eating.

Now, the second method of insulin delivery that must be administered with every carb ingested is called the fast acting insulin, or BOLUS. This bolus (fast acting insulin) can be taken as many times a day as the person eats carbs. Some people take as few as 3 shots a day of fast acting, and some people can take as many as 10 shots a day. Let me explain. A four year old boy, as my son was at diagnosis, asks for milk. He has to get a shot to cover that milk. Then he asks for lunch, maybe a PB & J sandwich and some carrots. He has to get a shot to cover the carbs in the jelly and the bread, and even the carrots. Do you see where this is going? Think about another 4 or 5 year old that you may know. Eating and growing go hand in hand. Everytime my son eats, he has to get insulin. A bolus of insulin is also given if the blood glucose goes higher than the appropriate range for that particular person.

So, ‘getting off’ insulin is by no means any option for people with Type 1 diabetes. They have the basal insulin to keep them steady and the bolus of fast acting to cover their carbs when they eat and to treat high blood glucose. While a healty diet and exercise are wonderful ways of life, they will not cure Type 1 diabetes, and they will never replace the insulin that their bodies no longer make.

I look forward to the next family party when I may see this person again. Now I am ready to have that educated conversation. Except this time, it would be me doing the educating.