Judgement call.

Much of parenting is about making judgement calls. You assess the situation and make the best decision you can at that time. It is the same with Type 1 diabetes. With Type 1 diabetes you assess, treat and hope it was the right decision.

While much of dealing with Type 1 diabetes is pretty cut and dry like giving insulin for carbs eaten, there are times when you have to make a decision based on the situation at hand and things are not so easy.

When my son has a low number while he is awake I know to treat with sugar and retest in 15 minutes. The problem arises when he is low and sound asleep. I can treat the low number and make him eat while he is sleeping, and then retest in 15 minutes.Then if the number is still too low, I can make him eat again while he is sleeping and then retest again in 15 minutes.

OR I can treat the number with more carbs then I usually do because if I got him eating while he is sleeping it may be easier to get it all in at once, and then retest in 15 minutes and possibly correct the number down a bit later.

OR I can treat the number with a normal amount of carbs used to treat a low, and put a temporary basal on him pump for an hour or so. What this means is I would stop the amount of insulin that is normally being put out from his pump at this particular time a day to give the sugar a chance to raise the low number. Of course, then test again in 15 minutes to see if I have turned the low around.

It seems like it shouldn’t be too difficult, as I have only laid out three different scenarios for treating a low while my son is sleeping. And choosing which plan of action is not the part that causes the most stress. The part that causes the most stress is after you have chosen a way to go, and the results are not at all what you expected.

After 15 carbs a person’s sugar is supposed to go up. Sometimes it doesn’t and sometimes it even goes lower. So when that happens to you one time it makes you question the next time. The one time when you check your child and his number is 65, treat with carbs, and then test 15 minutes later to see a 57 on the meter definitely changes your opinion about that plan of action. It is way harder to get a child to eat more carbs after you had already fed them not 15 minutes before all while they slept.

Diabetes is so unpredictable, that unpredictability is the only measurable factor. What works one day is not sure to work the next. It definitely makes judgement calls more difficult because there is no distinct pattern of when you’ve made the right call.

Experience helps you make the right decision, but even experience can not really tell whether you are making the right decision or not, that answer lies only in the next meter reading.