As a mom of a child living with Type 1 diabetes there are many times when I feel like a mad scientist when I make decisions regarding my son’s pump settings and insulin intake.
My son wears an insulin pump. This insulin pump holds one type of insulin, fast acting, but it is given to my son in two different ways. One way is the basal insulin, or background insulin, that is pumped through his pump every few seconds over a period of 24 hours.
For instance, my son uses 9 units of background/basal insulin a day. That 9 units has to be broken up over 24 hours to mimic the natural workings of a pancreas. There are times during the day when he receives one amount, say .325 units of insulin per hour with minuscule amounts of insulin being released every few seconds. Then there are other times of the day or night when his basal rate as we call it goes up to .775 units of insulin per hour with tiny amounts of insulin being released every few seconds.
This is what a working pancreas would do. It would release however much insulin a person needs to keep their blood glucose in the normal range. People without Type 1 diabetes do not go above a certain blood glucose number because their pancreas will not allow it. If a person without Type 1 diabetes needs extra insulin to combat growth hormones the working pancreas does it automatically. Or more insulin to combat an up and coming illness, no need to worry, the working pancreas is on the job. The person without Type 1 has no need to intervene or even know what the pancreas is doing. The working pancreas is a beautiful thing.
For my son there is no working pancreas. There is mom. The mad scientist.
It is up to me to evaluate all those thousands (yes thousands) of blood glucose checks to determine what would be the best basal setting for my son at any given time of day. Over a course of 10 blood glucose checks a day I can get a good picture of what my son’s insulin needs are. If he goes higher at certain times of day I can adjust the basal insulin or background insulin to keep his numbers steadier.
Once I have decided on a plan of action on how to adjust a basal rate the next step is to test his sugar several times in that time frame over several days to see if the results were achieved. Steady numbers mean it was a good move. Unsteady numbers, rising or dropping, mean that is was not the right decision. One snafu is if the basal rate was only moved up a tiny notch, say from .325 to .350, and then we begin to see lows there is no other move I can make. Or so you would think.
If the move up a .025 unit of insulin per hour did not do what I needed it to do, keep my son’s sugar steady, then I get to evaluate timing. If the previous basal rate ran from 7:00pm to 10:00pm and that was causing his sugar to rise, and by upping the basal rate caused him to drop too low, then maybe keeping the rate until 10:30pm would do the trick.
Now the only way to tell if that move worked is to test the next night, the next few nights, to see if the results were achieved. Steady numbers.
Confused?
Now you understand when you talk to me on the phone why I never know the day or the date. There is not enough room in my head for trivial things like that.
I am a mad scientist. I am a mom.