Tag Archives: Blood Sugar Checks

Surprise! A Ketone All-Nighter

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Evie came home yesterday from school with a headache and an upset stomach. She gets headaches pretty frequently and for a variety of reasons, diabetes being one of them. Sometimes with nausea, sometimes not.

Her blood sugar had been pretty high at bedtime the night before, over 500, but she came back down with two overnight corrections, so I figured she had just missed a bolus, as opposed to having pump problems. Her blood sugar had not been especially high yesterday at school, or at home in the afternoon….200’s, not great, but not that unusual for her.

She had the headache all day, and had a mediocre appetite at dinner. When I checked her at bedtime her blood sugar was over 500 again, and…..surprise! her blood ketone level was 2.3 mmol/L (red light zone!). I had her test with a urine ketone strip for comparison, and she tested out with Large ketones.

(Neither Evie nor Luke have been especially prone to developing ketones in the past, and we’ve gotten out of the habit of checking regularly. In fact, we check so rarely that I had to open a new bottle of urine ketone strips for Evie to test. Time to get back in the habit.) 

So I changed out her infusion set and insulin reservoir and did a correction bolus, had her drink a huge glass of water, and pushed her basal insulin rate to 175%. And then checked her blood sugar and ketone levels about a million times throughout the night.

By about 3:00 am she had negative blood ketones and her BG was below 100. I checked her again an hour or so later and she was 75, so she drank 4 oz of juice and went back to sleep. She woke up this morning at 65.

I figured she was in the clear until she texted me her blood sugar number from school this morning: 451 at 10: 30 am. Way too high for 2.5 hours after a carefully carb-counted breakfast. Sigh. Her dad brought some freshly opened insulin to school and changed out her pump reservoir again, and she bottomed out at 43 two-hours after lunch.

So the front-runners for probable causes are: bad infusion site, degraded insulin, stealthy illness, or maybe even hormonal insulin resistance?  I wish it was more clear, but, frustratingly, nothing about diabetes is ever cut and dry. Sometimes it just sucks.

Diabetes….Run With It!

I’ve had such fun running with my kids this spring!

Will and Luke both surprised and humbled me by finishing a 5K fun run with me a few weeks ago, the longest distance either of them has run before outside of soccer practice. They enjoyed the attention they got by being the two youngest runners, and I was insanely proud of them!

I knew beforehand that Will could run the distance, but I wasn’t sure about Luke. In fact, I hadn’t even planned to have him run, but he stepped up for his bib number without a second thought. I tucked the business parts of his blood sugar meter into his SPIbelt (which is how he wears his insulin pump), along with some glucose gel and meter strips, and we took off! 

Both boys ran about a mile before we had to slow to a walk for a bit. We all stopped again after the second mile for a quick blood sugar check (a little elevated but not worrisome), but Will took off on his own after that. Luke started to struggle a little in the third mile, but always managed to turn on the heat when someone was cheering him on or there was a photographer taking his picture!

Will finished his run in just over 30 minutes; Luke and I crossed the finish line after about 45 minutes. We checked his blood sugar one more time and then bolused for his post-run snack. There’s always a worry during exercise that Luke’s body will chew through his blood glucose too fast and he’ll have a low. Having the tools with us to check for and treat a low blood sugar is non-negotiable!

It was not only amazing to see my two small boys run a distance race, but to witness the pride and accomplishment that they felt within themselves at the finish line! And as icing on the cake, they won 1st and 2nd place in their age group (which I’m pretty sure was created on the spot).

It’s so important to me that all three of my kids feel confidence in their physicality, whether they happen to have diabetes (Evie and Luke) or they don’t (Will). Running a distance race was a perfect way for them to safely feel what it’s like to push themselves towards a physical goal, and to learn that they can do more than they can imagine! This is a lesson that I learned late in life, and it pleases me to no end to see them learning how to enjoy being active now, when it can become a lifelong habit.

A Hypo Mystery

I'm going to need to restock the juice box supply.

So many juice boxes this week….

If Luke is coming up on a site change and it’s close to bedtime, he usually asks me to wait until he’s asleep. No problem. I can pull off his old infusion set and place his new one and he doesn’t even bat an eye.

So last Wednesday night that’s what I did. I also took the liberty to place his new set on a little used place on his body, his upper thigh, for the sake of good rotation.

His BG the next morning was 48, which sometimes happens after a site change, so he downed a juice box to start his day. Pre-lunch BG was 270, he ate about a cup of ziti noodles with red sauce, we bolused for a small BG correction and 45 grams of carbohydrate, and I sent him off to school. An hour later he was 47.

What the….what?

The next day he had nearly the same scenario at school, plus a couple more low-40’s hypos at home. So I pulled his thigh site that night and placed a new one on the back of his arm, the old tried-and-true standby.

Incidentally, both days he was uncharacteristically irritable and aggressive at school and found himself in time out several times. He typically gets spacey and whiny when he’s low, but he doesn’t usually have so much trouble controlling his behavior.

My (loose) theory is that the thigh site was too close to the muscle (this skinny little boy is pretty short on adipose tissue) which caused a too-rapid uptake of his meal boluses. And then the resulting quick drop in his blood glucose caused extra irritability and crazy-boy behavior.

Either that or his pancreas has rebooted.

(Kidding, kidding….)

Hole-y Swim Fingers!

Hole-y diabetic swim fingers Batman!

Extended periods of time in the pool give everyone wrinkly fingers, but time after time I’m shocked by what happens to fingers that have been pricked hundreds and hundreds of times.

Normally they just have small marks, like polkadots, on their finger tips. But when the skin shrinks up and gets wrinkly they look like tiny little sponges!

The kids gets a kick out of it, for now.

These are Luke’s fingers, after 4 years of blood glucose checks. I wonder what they will look like in 10 more years. Does this ever go away?

The Disappearing Gingerbread House

Evie made a spectacular gingerbread house in her class on Wednesday! It was great fifth grade Christmas fun. She brought it home carefully and put it on top of her dresser.

Evie and her gingerbread house

Note the presence of a roof. And the copious amount of candy decorating the roof and yard.

This….is the same house, this evening:

Pilfered gingerbread house

I was perplexed why her blood sugar was 476 mg/dL at 1:00am, but I think I have a pretty good idea now of what happened!

Anyone else have a T1D with a massive sweet tooth?

Common Unity

com·mu·ni·ty    kǝ-‘myü-nǝ-tē\  n.   
            1. A unified body of individuals.

We were blessed to spend our Thanksgiving this year with a wonderful group of new friends. This group of people has been working together, living together, and celebrating together throughout the evolution of life over the past ten-plus years. They are singles, couples, parents and children, and soon-to-be-parents. The group has shifted and changed over time, but their core values persevere:

Love. Compassion. Support. Joy. Family.

Put into practice, these values result in acceptance, generosity, genuine interest in the lives and hearts of other people, true emotional connection, and gatherings that are dang fun.

Something new that my brood and I bring to the group is diabetes. Insulin, pumping, finger sticks, hypos, infusion sets, middle-of-the-night alarms, carbohydrate counting–these are things that are now so pervasive in our lives that I’ve almost completely lost the perspective of life without diabetes. Spending extended time like this with new friends makes me more aware of just how burdensome and strange it all can be.

For example, another mom in the group offered to take Luke home with her from the park we were all at to play with her son, and it took me nearly a full 60 seconds of silent internal deliberation, calculation, and trouble-shooting to even answer her. And then I had to give The Plan. And then I made mental notes about absolute times when I was going to need to call and check-in. Would 1 hour be too long? I’m sure I seemed like a crazy person.

And did I wake anyone when I was shuffling through the house, barely conscious at 3 o’clock in the morning, to maneuver through a pile of sleeping kids and check blood sugars? Did anyone notice the vacant stare I adopt when my kids sit down with a plate of food and I’m mentally analyzing and calculating the carbohydrate content? That fleeting look of panic when someone starts to cut up pie?

Evie learns to make pecan pie from scratch. Score!

Evie learns to make pecan pie from scratch. Score!

The great thing about this cohesive group was their acceptance and attendant willingness to learn about what makes our world go ’round. People asked questions. They talked to my kids about their experiences and were interested in the answers. They watched me change infusion sets and dial in boluses, asked me about food and routines, and just genuinely cared about us.

And that’s what is so valuable about being part of a community. Whether it’s a small group of friends and family, a church or social circle, a local support group, or the larger cultural or medical communities, it’s valuable and vital to be able to share your struggles, burdens, accomplishments and joys with people who share some common thread. A common unity.

Everyone needs a community.

Kids have a remarkable ability to meld into relatively cohesive groups within hours of meeting each other.

Kids have a remarkable ability to meld into relatively cohesive groups within hours of meeting each other.

An Amusing 2 am Blood Sugar Check

Things like this remind me that the fingers I’m poking belong to a six-year-old boy. Luke rocked his beloved new skate gloves all through the night. Good thing they are fingerless!