a day in the life . . with diabetes (day 1 of dbw)

Today is the first day of Diabetes Blog Week, launched by Karen at Bitter-Sweet, so here's what yesterday looked like for our family. (For those of you just joining us, my daughter L is 10, was diagnosed 8 months ago, and has been on a MiniMed insulin pump for about 6 weeks.)

(Apologies for the length and inexplicable tense changes.)

11:06 pm (Saturday night) - 218 BG. Slightly higher than the 183 she was just an hour before, so I bolus .8 units. I was a little sleep-deprived from a recent rock 'n roll roadtrip, which is why I made the mistake of correcting her. Why was that a mistake, you wonder? Because when I checked her three hours later...

2:12 am - 76. Not so good, Al. I suspend her basal (thanks to Meri's suggestion, but have the feeling it won't be enough, so I hang out in L's room for 15 minutes and test her again. But I fall asleep on her floor and wake up a half hour later and she's...

2:40 am - 58. Well that wakes me up. Run downstairs, grab an orange juice from the fridge and race back to L's room to try to get her to wake up and drink some OJ. She slurps on the straw, half-asleep, until I determine she's had about half of the mini-bottle (approximately 15 grams of carbs). She rolls over and goes back to sleep. But I am too amped up from the excitement. I check her in 15 minutes and she's...

3:01 am - 112. Now that's a number I can go to sleep on. Phew. But just in case, I set my alarm for two hours, instead of the recommended three. Everything is still so new with the pump, and we just changed her basal rate a few days earlier, so since she's already had one instance of an overnight low, I feel more comfortable checking her sooner rather than later.

5:01 am - 97. This is well within the target range, but she's not supposed to go to sleep if she's under 100, so the number makes me a bit anxious. I decide to check her again in 15 minutes.

5:16 am - 95. Taking the meter's margin of error into account, she is holding steady. But I am still feeling nervous, so I decide to test her again in a little bit. I get into bed with her and doze off.

6:01 am - 98. I am encouraged that she continues to hold steady. I feel comfortable enough to get back into my own bed. Luckily she has slept through all of the testing, and only had to wake up once to chug some OJ. She wakes up at about 9 am, but since it's Mother's Day, I get to sleep in. Yay!

9:14 am - 149. She's not hungry right away, so she waits to correct her BG until she has some breakfast, about an hour later. She has 52 carbs (two bowls of Lucky Charms) and the pump says that she needs 3.6 units of insulin to cover her breakfast and her high BG. She spends the morning hanging out with her dad, watching Mythbusters. She learns that redheads have a higher tolerance for pain than their blonde and brunette counterparts, and women can deal with pain better than men. As a red-headed girl, she concludes that she can handle more pain than a substantial percentage of the rest of the world. I cannot disagree.

1:27 pm - 249. Her CHECK BG alarm goes off, as it had been three hours since her last bolus. I am surprised that her number is so high, but I don't think much of it, and she follows the pump's calculation of a 1.8 correction. We head out to see a movie, and plan on having snacks there and an early dinner afterward.  We settle into our seats in the theater and she grabs for her tester. She's feeling low.

3:08 pm - 42. WHAT.  Did we overcorrect for her high BG an hour and a half ago? Maybe it was an inaccurate reading? WHO KNOWS. She pops 15 jelly beans and then digs into her hot dogs. Low blood sugars always make her super hungry. She has no problem polishing off two hot dogs and a small bag of popcorn all by herself. John boluses her for the hot dogs at 3:17 pm (1.2 units for 20 carbs) and at 3:39 he programs a square bolus for the 44 grams of carbs in her popcorn. We have only recently begun experimenting with the extended bolus features of the pump, and we still don't quite have the hang of it. (For those of you who do not eat and breathe diabetes every day, a square bolus simply means that instead of injecting the 2.7 units of insulin all at once, the pump will deliver it over a longer period of time based on a percentage/time equation that you program into it. This is especially helpful when L is eating things that take longer to process, such as popcorn, pasta, or ice cream. Phew. Are you still reading?  Only 9 more hours to cover in this post!) After the movie, we go to the bookstore and make good use of some gift cards. Then we go to dinner. L is still full from her movie food, so she doesn't have anything to eat. It's probably for the best since the restaurant we chose does not have nutritional info, so we would have been guessing the carb count of her dinner anyway.


6:57 pm - 294. She still has a small amount of active insulin on board (.5) because of the square bolus earlier, so the pump corrects her BG with 1.9 units. We get some ice cream for dessert and we are fully stoked because they DO have nutritional info. Her small order of chocolate fudge ice cream with rainbow sprinkles is 49 carbs. John decides to program her pump with a dual wave bolus due to the dairy content. Like the square bolus mentioned above, a dual wave bolus is designed to extend the delivery of insulin over time, rather than delivering it all at once, since the body takes longer to process certain foods. In the past, when she was on multiple daily injections, which does not allow for delayed insulin delivery, she would experience a low BG right after some meals, followed by a wicked high BG a few hours later, depending on how much fat or protein was in the meal vs. carbs.  Are you still with me?? I'm still learning all this myself, so I don't feel that I'm doing the best job explaining it, but basically, in this instance, John told the pump to give L 10% of the insulin right now (.4) and spread the other 90% (2.8) out over the next hour. Okay. So. We head home after ice cream and settle in to watch the season finale of The Amazing Race (Go Cowboys!). We wouldn't normally let L stay up late on a school night, but it happens to be time to change her infusion set (we have to do so every 2-3 days), and we have to give the numbing cream an hour to work, so as soon as we walk in the door, John puts the EMLA cream on her belly so it can start working its magic. As we watch the show, John loads a new insulin reservoir into her pump. After an hour has passed, during a commercial break, he inserts the new set into her belly and hooks up the freshly refilled pump. She rubs some baby oil on the old site and pulls it out. It's time for her to go to bed.


11:32 pm - 289. I test her for the last time of the day on my way to bed. A little high, possibly from the infusion set change. I worry that there's an air bubble or a kink in the tubing that is interfering with the insulin delivery. I bolus 1.4 units and hope for the best. I set my alarm for 2:30 am and get in bed, so we can do it all again tomorrow.

(In case you're on the edge of your seat wondering, she was 263 at 2:38 this morning, so I corrected her with 1.1 units.   When I checked her again at 5:41, she was down to 116. Much better. So, on we go...)

Tune in tomorrow for Day 2 of Diabetes Blog Week. I promise it won't be this long and boring! ;)