Summer. School’s out and summer’s here. Are you thinking what I’m thinking? Sleeping late, summer nights, ice cream, swimming, and basal changes. Wait. What?
As the carefree days of summer approach us there are many things that undeniably shout ‘Summer!’ The sound of the ice cream truck, the smell of the beach, picnics, jumping off the diving board, and for a kid living with Type 1 diabetes it also means basal rate testing and basal rate changes.
Basal insulin is the background insulin that is coursing through the body 24 hours a day. Basal insulin is either given through a shot once every 24 hours or through multiple rates throughout the day via an insulin pump. My son wears an insulin pump, and he currently has 8 different basal rates set. His total amount of basal insulin over a 24 hour period is 9.25 units. That means over a 24 hour period his body needs 9.25 units to live. Some hours during the day he needs more insulin, like at night, and some hours during the day he needs less insulin, like in the morning, hence the 8 different rates. His body needs more and less insulin all different times of day.
With summer here, and no school schedule to follow my son’s basal needs will change. You may ask yourself, how is this possible? What does summer and school have to do with insulin needs? Unfortunately the answer is everything.
During the school year my son goes to sleep at 7:30pm. His body requires much more insulin from the moment he falls asleep until about midnight, when his insulin needs slowly taper off until about 5:00am. I am not a doctor (I just play one on TV), but it just makes sense then that in the summer when his bedtime moves to 9:00 there would be a difference in his insulin needs. The difference between 7:30 and 9:00pm is an hour and a half that he may (or may not) need less insulin. The only way to tell is to watch his numbers at that particular time of day and test more often for a few days. If he drops too low during or immediately after that time frame then I know some changes in insulin output need to take place, he may need less insulin.
On the opposite end of the night, the morning, there are sure to be some changes there too. On a school day my son has to wake up and eat breakfast almost immediately. Now that summer is here, he can sleep in and eat breakfast when he wants. Two things, sleeping late and eating off schedule, that may or may not change his insulin needs at that time.
Confused? Imagine how I feel.
While I am ecstatic that school is out, I am apprehensive with what the next few weeks are going to bring with my son’s numbers. I have no idea how his school basal rates are going to fit into his summer needs. I have to be more diligent, if that’s even possible, with testing his sugar. While I already test him over 10 times a day, I may have to cluster some of the testing during certain times of the day to determine specific insulin needs for the summer months.
It will all get done, hopefully quickly and smoothly, so that my son can enjoy summer just as any other child. I want him to have memories of ice cream trucks, swimming and just being a kid. Testing blood glucose levels, treating lows, and correcting highs should not overshadow all the good things we have going on.
Summer is one of my favorite time of year…I just want the same for my son.