People with Type 1 diabetes are constantly predicting, guessing, second-guessing, and evaluating blood glucose numbers. Nothing is ever written in stone.
Someone once told me that Type 1 diabetes is the thinking man’s disease, and that is because you are constantly thinking about numbers: blood glucose numbers, carbohydrate numbers, highs, lows, and the in-betweens. Some days are predictable, but even those are not predictable before hand. You only know it was a good day for numbers after you look back and see what kind of numbers there were. You can’t predict a day where every check will be in range, they just happen. They are great days when they do happen, but you never know when they will occur.
Then there are the days that seem like they are going to be predictable, and they make a u-turn and flip the other way. Those u-turn days are where the thinking, guessing, second-guessing, and evaluating come into play. Let me walk you through our day at the water park including my thoughts (IN BOLD) about the day. Be warned, you may get tired reading through my thoughts if you haven’t had your morning coffee yet.
Wake up the day of the water park, great number 103. Great, good start to the day, maybe our day will stay on track. Let me pack extra candy because with all the activity at the water park we may have some lows.
Arrive at the water park less than 2 hours after breakfast, great number 161. Great, still a good start. Let’s have a free snack to build up strength without adding any carbs and insulin. Snack on hard boiled eggs (it was the day after Easter after all).
Getting ready to swim almost 2 hours after last check. Long lines at the water park. Great number again, 148. That number is actually a little high for 4 hours after breakfast, but with the extra activity he may need the tiny bit higher number to hold him steady while he is playing so hard.
About 1 1/2 hours later check sugar again getting ready to eat lunch, ut oh, number not so good, 228. Ok, we are going up, maybe it’s basal? Maybe he needs an adjustment tomorrow when we are not here with his basal rate, should not be going up for no reason, especially with so much activity?
Correct the number and pre-bolus for pizza. Pizza is 75 carbs. I already looked it up on the internet the day before so I knew ahead of time what he was going to eat and how much insulin he would need.
About 1 hour after eating, not a time one usually checks sugar, and his number is 242. I’m ok with that number, he has over 1 unit of insulin working and he is going to be really active with his favorite cousin. Let that number go and check in while and see what is going on.
Another 1 1/2 hours go by, he must be going low by now. He is crazy active, running around, jumping, going down water slides, let me grab him and check to see if he needs some sugar. Check sugar, 385!!! Ok, this is not good. Not good at all. What is going on? Could it be basal? Did I under bolus for that pizza? Maybe the nutritional information on the website was wrong, maybe I didn’t give enough insulin for the pizza. Correct, double check that he is feeling ok otherwise and move on.
Another 1 1/2 hours go by, he has to be in range by now, the boy has over 2 units of insulin coursing through his tiny body and he is having the time of his life. Expelling so much energy, climbing 5 flights of steps over and over to get to the highest water slide. Check sugar, 355!!!! Ok, this is awful. What is going on? Maybe his site is coming loose with all the water and I can’t see that it is not in correctly? Maybe it is basal? Maybe his adrenaline is keeping him up? Maybe he is getting sick, sometimes we see highs before he gets sick. Maybe this, maybe that? Ugh!!!
Ok, quickly go and take a shower, will reconnect pump after shower after I get a good look at the site. Check site out, it is coming up on the edges, but doesn’t appear to be affecting the actual cannula (part where insulin goes in). Change the site immediately and reconnect quickly. Do a big correction for that 355. Also, prebolus for dinner.
Check again in 1 1/2 hours, number down to 263. Ok, good sign. Insulin definitely working now, he’s even lower than before he ate dinner, so that original number is on it’s way down. Great!!
Check again in 1 1/2 hours, number down to 113. Looking good. Possibly a little too low, but not much insulin from the bolus working anymore, going straight on basal. Should remain pretty steady at this point.
Check again 45 minutes later, just had a feeling. Number down to 89. Aahh, not so good. Numbers below 100 at night (10:46 pm) scare me a little. Let me give him a glucose tab (4 carbs) just to turn this around. Maybe dinner insulin worked a little longer than normal? Maybe the correction was a little too much? Maybe the activity from today is catching up with him?
Check again 45 minutes later, another feeling. NUMBER DOWN TO 33!!!!!!! CRAP!! TREAT! Get this number up! Treat with 32 carbs.
Check again 1 hour later (12:30am), great number 136. Whew!
Check again a couple of hours later, great number 127. Thank goodness basal held steady like it does most nights. Guess his night time basals are good. Now what was up with the day? Better check today to make sure basals and ratios are good.
This is one day in the life of living with Type 1 diabetes. Now you can plainly see the thinking man’s disease statement, you never stop thinking when you are dealing with type 1 diabetes. It is like Type 1 diabetes holds the key to a puzzle that you can never possibly solve, yet you wake up everyday ready to play the game.