Toes in the Sand and Pumpers

Its summer time and most of us are heading out for a vacation. Some to big cities, some to forested mountains, some to lakes and camping. And then there are those of us headed to warm sun, sand and ocean! Think of it, seeing to the bottom of the ocean and the fish swimming and surfing, sailing, and sand castles! But wait….

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….There is insulin and insulin pumps and strips and all that fun stuff to figure out! Hot weather and taking the pump off to play in the water and then putting it back on every two hours and trying not to get sand in everything!!! Here are some tips to save the sand everywhere (and if you are at a beach, have been at any time in your life then you know sand just sticks to everything!):

1. If your child or self uses an insulin pump. always put the site cap back on. If sand gets into the site then it is site change time.

2. Have a dedicated cooler for only insulin supplies, (insulin, strips, sugar etc )that is large enough sand will have a hard time jumping in!

3. Consider going back to shots for the time you will be at the beach. No pump, only glucometer, and strips to worry about.  If doing this connect with you Diabetic educator and review what basal insulin and an insulinshot schedule.

Our book has all of the equations to determine correction factor and insulin needs for food as an easy resource for your beach travels!

While at the beach have fun and keep you r toes in the sand for those of us by the Rocky Mountains

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The Type 1 Teen

Type 1 Teens

Teenager. Merriam-Webster define a teenager as “being or related to a people in their teens [13-19 years of age]”. Parents understand a “teenager” is more than a age.  It is a time for growth towards adulthood. How each teenager manages this growth can and will be vastly different. Some teenagers need constant guidance and supervision. Others appear to be born ready to launch into adulthood. Either way this time in a person’s life is exciting, challenging, and rewarding.

Now add the daily challenge of diabetes to the teen years. As parents we want to give our children wings to fly. But when daily our children’s lives can be at risk, letting go may become a challenge.  How do we allow our type 1 children to thrive and still be healthy and alive in the end? I think this is a question daily we ask our selves.

Consider where your teen is at in their own care now. Are they able to recognize low blood sugars? treat for them accurately? testing and understanding what to do with their blood sugar?

Basically start small. Teach them what to do with a low blood sugar, because lets face it a low blood sugar is the most immediately dangerous aspect of type 1 diabetes. Then move on to what to do with the blood sugar number at meals and allowing them to take the time to research their own carbohydrate counts. See small steps. The smaller the step the easier the mastery.

Also enlist the help of the endocrinologist and educator. Let them tell your child what to do and how to do it. Some times in those teen years guidance from a different adult followed better.

Below are some resources for helping teens become independent in their diabetes.

-WHEN YOUR TEEN JUST QUITS: DIABETES AND TEEN YEARS http://www.diabetesselfmanagement.com/about-diabetes/kids-diabetes/when-your-teen-just-quits/

-TEEN TOOLKIT  http://www.jdrf.org/wp-content/uploads/2013/10/JDRFTEENTOOLKIT.pdf

-PARENTING A TEEN WITH TYPE 1 DIABETES https://diatribe.org/parenting-your-teen-type-1-diabetes

Also look forward to our book that will help your teen take ownership and control of their diabetes in a reasonable way!

 

 

 

 

 

 


Your Child with Type 1 Diabetes is Starting School

 Type 1 Diabetics First School Year

The first year of school is approaching for your child. Going to school is such a joyous milestone for you and your child. And for the diabetic family it can also become very overwhelming for the parents. As a parent you have been in control over all the blood sugars, injections, food intake, and what to do during exercise (recess). Now it is time to start school, kindergarten is right around the corner and what do you need to do? To start you need to talk to your diabetic educator and gather information and orders from the doctor.

Getting Prepared

First you want orders from the endocrinologist. Those orders will come need to go to the school nurse about 2 weeks before school starts. Then you will meet the school nurse. At that time she will review the orders and talk to you about your child. This helps the nurse make a care plan (this will be the same for what you do for your child at home-our book can help keep all of this information sorted easily to discuss with the nurse) for your diabetic. The next meeting will be with the teachers and nurse. Before this meeting you will want to make individual care packages for each teacher. Things to have in this package is a description of your childs hypoglycemia and rescue medications like juice or smartees.

This is to ensure when your child has a low blood sugar during class then the teacher can treat in the class room if needed. Also your child should have some kind of sugar in his or her pocket and know what to do with it. Sometimes walking to the nurse is not appropriate especially with an extreme low blood sugar. Also specify that your child is never to walk to the school nurse unattended with a low or high blood sugar. The child needs accompaniment by another adult, not another student.

Next  is important to know what your services your school[provides. Some schools have a full-time nurses or a health aid directed by a nurse.  Some aids are able to give shots and some are not able to give shots (this will depend on the state and city in which you live). Most schools will have a diabetic plan in place at the beginning of each school year to help guide your childs care. If you child will at school over the lunch hour you will need to decide if your type 1 diabetic will eat sack lunch or school lunch. If you decide on the school lunch the school can provide the carbohydrate count for the meals served. With sack lunches you should send the carbohydrate count with lunch. Writing on a plastic sandwich bag or disposable container (I know it is not green to use disposable but very easy for carb counting) for each object in the lunch. Assigning carbohydrate counts on each food piece allows your child some flexibility with what he or she will eat.

504 Plans

Finally, there is the 504 plan. A 504 plan is a legal plan put in place for diabetics (or other medical reasons). As a parent of a type 1 diabetic it is your right to use a 504 plan for the treatment of you diabetic child during tests, standardized tests, during class period so they are not unfairly treated when it comes to school work and missing class time. 504 plans are not always necessary during the first few years of elementary school. As your child progresses through school this may become more important with standardized testing. The school sets up the 504 plan and you will meet with the school consoler, nurse, and any teachers you deem important.  During this meeting you will decide what incluison criteria and all party to the meeting will agree upon the academic plan.

All of this feels like more than enough to remember for the first year of school. Once you do this it gets easier (Diabetics will go through the same process each year).  Most schools have had a type 1 diabetic before and will navigate you through this process. If you hare having issues with the school enlist your diabetic educator or endocrinologist for help. They will either help you directly or get the right person to help you with the school. Once all of the medical details straightened out, then as a parent you can enjoy sending your child to kindergarten for the first and last time. Those milestones are precious.


Low blood sugars or hypoglycemia in type 1 diabetes is an immediate concern. Hypoglycemia is a blood sugar below a child’s predetermined range; for example less than 70mg/dl. Low blood sugar symptoms are shaky; sweaty; dizzy; weak; irritable; extreme hunger; drowsy; confused; headache; pale, grey, or flushed; restless sleeping or nightmares.

Low blood sugars require immediate treatment.

To start the child should test his or her blood sugar.
Then treat the blood sugar with 15 grams of a simple sugar.
Simple sugars are 4 oz of regular soda or juice, glucose tablets, 2 packages of smartees.
Simple sugar is not a cookie, ice cream, chocolate or the like.
Then wait 10-15 minutes and have the child retest his or her blood sugar.
When the blood sugar is within an acceptable range then have the child eat a 15 gram carbohydrate snack with protein.

Things that cause low blood sugars are: exercise, more insulin than carbohydrates, to much basal insulin. For frequent low blood sugars a review of a child’s blood sugars and potential causes examined to rectify the low blood sugars.

Hypoglycemia and Type 1 Diabetes



Magic Disappearing Peanut Butter cookies

I am not sure who gave me this recipe years ago. But when my son’s sweet tooth hits these are perfect (and an easy snack in the summer)! Secretly I love the extra protein I get when I munch on them also. Very diabetic friendly!

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1 cup creamy or crunchy peanut butter
1 1/3 cups granular Splenda or equivalent liquid Splenda
1 egg
1 teaspoon vanilla.
Extra granular Splenda for fork

Line a large baking sheet with parchment paper. Combine all of the ingredients in a small mixing bowl; beat well with a spoon until it becomes a thick dough. Gently roll into 20 balls and place on a baking sheet. Or, use a 2-teaspoon cookie scoop to evenly measure the dough. Dip a fork in granular Splenda and make a criss-cross design by gently pressing into the balls of dough in alternating directions. Be gentle and dip the fork into Splenda frequently because the dough is very sticky. Bake at 350º for 12-15 minutes. Cool before removing from the baking sheet. Store in the freezer and do not thaw before eating.

Makes 20 small cookies
Can be frozen

With granular Splenda:
Per Cookie: 81 Calories; 6g Fat; 3g Protein; 4g Carbohydrate; 1g Dietary Fiber; 3g Net Carbs
Per 2 Cookies: 162 Calories; 12g Fat; 7g Protein; 8g Carbohydrate; 1g Dietary Fiber; 7g Net Carbs


The ins and outs of insurance

3a118a835fd0d6d253f49acc9ed5697aA Bedtime Story: Insurance Heartache and Stress.

Knowing what the insurance will pay for and what they won’t and when the insurance covers everything.

My lesson the hard way.

Recently my son’s continous glucose monitor (CGM) stopped working.  And my descriptions of  stopped working is it would not charge, blink or the OK green light.  So of course I went about calling our CGM company for the arduous process of replacing the CGM.  After a long conversation we decided (the company rep and myself) that it was truly dead. With this fabulous information the next step was to await the doctors new prescription. Obtaing this elusive prescription seemed far reaching. First I had asked for the company to acquire the needed paperwork form the physician and not the diabetic educator, as we had not visited with her recently. However the company decided to go about this in their own way. They proceeded to contact the educator and she would not fill out the paperwork because she had not seen him. Now The educator we have seen in the past is FABULOUS; simply my son really prefers the male doctor. Because of this we then played a waiting game from November to January. And so the story continues.

While we are in waiting questions such as does a CGM make or break a diabetic day? Really, why not just go old school and just test all day long? But for my son it can make or break his day and week and month. His blood sugars tend to be wildly all over the place causing him to test his sugars more than the 8-10 times a day. Also he has recently started in a running club and driving.  So having a CGM that will shut off if he cannot detect a low blood sugar is a life saver, literally.  Besides saving his fingers from repeated testing. Moreover, he is able to simply look at his pump prior to sitting behind the steering wheel, at schimagesool, or before running. His CGM can make or break his daily management of his diabetes causing us to miss it horribly.

With the passing of months of mourning we have finally heard from the company!YAY! There is no paperwork form the physician. UGH. The holidays are here! I have called the physician’s office, they already have the paperwork done and faxed back; and we finally have the prescription to the company, creating a no out of pocket payment with our insurance. SIGH–calm and relief set begin to take over. Or so we thought! A few weeks pass. Mind you we are in mid-January, and the company calls me and states they just received the fax from the doctors office. Huh, you mean the one that was faxed in December? (You thought this tirade was complete and our family’s stress was finalized.) This then lead to a 2 hour phone conversation with the company. Me stating and restating that I was informed by the doctors office they had confirmation recite from the fax before the new year began. The representative and manager stated their paperwork demonstrate otherwise. What is a family to do!

The End of the Story

The company did not have the paperwork in hand before the end of the year so it is to be billed on 2016 insurance! UGHHH. Lesson learned (The financial lesson). Don’t wait for the company call and harass everyone until its done right! He has his CGM and all is now going smoothly and with lots of basal rate changes, very few lows and a green light indicating all is well with our CGM.

Moral of the story

Know your insurance and the companies you are working with. you can save money in the end and the ability to maintain a full head of  hair at the end! Happy New Insurance Year!

 


Children and Type 1 Diabetes: New Year, New Resolutions

Type 1 and the upcoming New Year

Last week as we approached midnight we all made some sort of resolution. You may have kept the resolution quiet but it is still there lingering in the back of your mind. It may to be more organized, be in better shape, eat healthier, or simply not to make a resolution. How do your resolutions apply to helping your child with his/her diabetes? Is it to learn a new skill? to improve on an A1C? to encourage and actually get your child to camp? To not be a helicopter parent as much? So no matter what your personal diabetes related resolution is I have included a list of things that may help ease the daily diabetes burden in your lives.

          Things you can do:

1)Make a resolution to download that CGM to get quality data at least once a month. This will help with A1C management and improved glucose control.

2) Keep a food diary quarterly with sugars and carbohydrate counts to determine if your child’s insulin sensitivity is correct. Some foods cause spikes in blood sugars and may require a dual wave or increased insulin to combat the high. Alternatively some foods may not need as much insulin because your child uses those foods better.

3) Try to have your child eat at schedule times. Fore example breakfast at 8 a.m., lunch at 12 p.m., and dinner at 6 p.m.. In our house I limit food intake to every two hours so my son does not stack his insulin.

 

I hope these guidelines find you and your child well in the new year. Check out our book for more tips on when you are not with your child and another adult is caring for your child.

Stacey Smith-Bradfield



Hypoglycemia Treatment

15482946_sOne Smartie, 2 Smarties, 3 or 4…What is your child’s preferred treatment for a low blood sugar?  There are so many treatment options to choose from.  There is a small tube of cake gel, 4 ounces of OJ, 4 ounces of regular juice,, a package of fruit chews, or glucose tablets.  Some children like to change up what they use, sometimes Smarties or juice or sometimes regular soda.  The key is to keep it around 15 grams of carbohydrates, and then follow up with a 15 gram of carbohydrate snack with protein.  For example a slice of bread with peanut butter on it.

Our book helps a babysitter, grandparent, or another adult to determine these things.


What to Expect When Flying

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Flying and Diabetes

Flying with diabetes the first time is an overwhelming activity. Flying is overwhelming because of security. There are so many rules to fly in a plane these days. In these rules how does a parent of a type 1 diabetic prepare?

Flying with diabetes does not need to be overwhelming! Following some basic rules getting through security should be easy.

 

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The basics:

Medications:

Keep medications separate from the other carry on items and ensure they are clearly labeled.  As you enter security, declare that you have liquid medications, needles, etc (including the ice packs) to the security officer. A side note the ice pack must be completely frozen not soft or slushy. The TSA website indicates this can be confiscated and tested more thoroughly.

Pumps:

Declare that you or your child uses an insulin pump and the pump cannot be safely removed from your child’s body. Likely the pump will be checked and like phones you will be asked to make the screen change.

You can also ask for a pat down instead of the x-ray machine so it does not interfere with you device.

We have traveled may times with my son and have never had an issue with security. Most times he is stream lined trough security because of his age and medical condition.

 

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For full information visit the TSA web page for traveling with medications:

http://www.tsa.gov/travel/special-procedures

 

Happy Holiday Travels

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