What Diabetes Apps Do You Use?

Technology is great! It allows us to keep connected with other people in our lives. For example, It allows my teenager to contact me always. So when he is over at a friends or out with school activities he texts me his blood sugar numbers when they are out of range. So my question is what apps for your smart phones do you use for your type 1 diabetic?

Type 1 Available apps

There are so many apps available for use. Some seem perfect for a type 2 diabetic because  they help with meals and weight loss. The few type 1 diabetic apps I have reviewed and looked at are ManageBGL, My care Connect, and Go Meals or Calorie King. ManageBGL website talks about real-time Blood sugars (a sitter/child enters it and it gets to the parents), predictive lows or highs, ans so much more. What a wonderful way for parents to help easy an overnight with others. Then there is My care Connect. This one allows information from school, child, parent to communicate back and for as well as with the endocrinologist. I have not had the chance to use either one but have look at both closely.

 

Then there is the applications that help you carb count:Calorie King, GO meals. We utilize apps and books. Usually just what we can get our hands on fastest. They have allowed my teenager to feel more comfortable counting carbs.

Pros and Cons

Apps help so much and in so many ways depending on which app you decide to use. Apps need good cell service or wi-fi to get the information live. Don’t get me wrong I utilize every thing I possibly can to help me with my sons diabetes management, but there are times a book or a phone call is easier or more reliable. So a mix of technology and old school paper is good.

Knowing when to tell your child or other adult if the app, phone call or consulting a book, like ours “type 1 Diabetes and Babysitting”, will be the fastest or safest method. We can rely on technology until it does not work then we need to rely on paper. Plus there are things that are tangible like having a flow chart right infornt of you to know management. Let me know which do you prefer: paper or a screen?

Type 1 Diabetic Apps


Ketones: What are they?

If you are familiar with Type 1 diabetes then you are familiar with ketones. If at least for the only reason that periodically you have needed to pee on a stick to see if you have them. But what are they really.

Ketones are the by-product of using protein as a main source of fuel for your body. Glucose is the main source of fuel for your body, it comes from foods such as sugar, carbohydrates, or fructose. In uncontrolled diabetes insulin cannot get glucose into your cells for fuel. This is from a lack of insulin or resistance toward insulin at the cellular level. When this happens your body starts to break down protein to use for fuel. During this process the body then creates an acid as a byproduct of breaking down protein. In small amounts occasionally you may not notice this. When uncontrolled diabetes and blood sugars are running high for long periods of time then the acid starts to build up in the blood causing ketones in your urine. This can eventually lead to coma and death without treatment and a myriad of other symptoms.

 

If you have ever had high ketones you know how awful you can feel. You get a headache, nausea, vomiting, and not really with it mentally. Treatment for ketones is insulin and fluids. Insulin controls blood sugars and the fluids to flush the ketones from your body If you have a hard time  keeping fluids down because of vomiting then you should see medical treatment. The act of vomiting alone can create more ketones as well as exercise. Treating ketones at home for a diabetic is difficult. Type 1 diabetes requires vigilance and drink plenty of fluids. and check you blood sugar and ketones at least every two hours. Until blood sugars and ketones are back to normal.  If you have not received a guide from your endocrinologist about a sick day guide then you should get one. It will spell out exactly how to treat your blood sugars and ketones when you are ill or your sugars are running to high. Type 1 diabetes can cause many issues and understanding what the underlying cause is to problems with diabetes, like ketones, will help you treat it better at home.


Symptoms of Type 1 Diabetes

I often had the question: How did you know your son had diabetes? I didn’t. Even as a healthcare provider Type 1 diabetes was not the first thing in my mind. Mostly because I am a mom before I am a nurse practitioner. Quincy did have most of the symptoms when I look back right before diagnosis. And because I am a practitioner I knew something was wrong and I had him into the clinic quickly. He was never in diabetic ketoacidosis upon diagnosis. So As a parent how do you know.

First If you think something is wrong with your child, take your child into your doctor. Nothing you can read here or anywhere else will substitute what a good provider can do when seeing your child and running some lab work.

Secondly the main symptoms of type 1 diabetes (or diabetes in general) is extreme thirst, extreme fatigue (more than you would see with a  growth spurt), extreme hunger but also weight loss, a fruity breath smell or loss of consciousness. The later are later symptoms and are indicative of diabetic ketoacidosis (DKA). DKA is when the body is breaking down large amounts of protein to make fuel and in turn makes the blood more acidic. This can render a person unconscious and without health care death.

If your child has any of the milder symptoms thirst or hunger that cannot be satisfied, fatigue or weight loss then take your child to the doctor. the symptoms could be diabetes or a number of other diagnoses.


Hyperglycemia and type 1 diabetes

Type 1 diabetes comes with many ups and downs. One such is hyperglycemia. Hyperglycemia or high blood sugars. High blood sugars are blood sugars above the range given for a particular child. A high blood sugar usually is defined as 150 mg/dl. If your child is on an insulin pump that number is above 250 mg/dl. Hyperglycemia is an issue when blood sugars run high for a long period of time, typically months. A periodic or a few days of a higher blood sugar is not a sever issue as long as the blood sugar becomes under control.

The symptoms of hyperglycemia are very thirsty, frequent urination, increase in hunger, ketones in urine tested by a ketone strip,and fatigue. Extremely high blood sugars are demonstrated as vomiting, unconscious, fruity smell of the breath, and loss of appetite. Ketones in the urine are made when a person has high blood sugars. Correcting blood sugars with insulin and drinking plenty of fluids will correct ketones and high blood sugars.

Causes for hyperglycemia in children is from a mismatch of insulin and carbohydrates counts. But other reasons are attributed to high blood sugars often due to child’s need for more basal insulin and or the child is growing.

To determine why a child has higher blood sugar it takes persistence to correct and know blood sugars are correctablef.


Type 1 Diabetes and Friends

Friends can be a tricky thing with your type 1 child. Children want so badly to fit in with others, to have a group of people who accept them unconditionally. Type 1 diabetes can make your child have the impression of being unaccepted. Now not all children feel this way. Many children have a self-confidence that is made of iron and other children determine their confidence based on others. And let’s face it: other kids can be mean and use diabetes as a way to pick on and bully your type 1 child.  As parents we want to embrace our children, keep them safe, and have them feel confident no matter what and make all of their ills disappear. If we, as parents, could do that we would wipe out diabetes all together with our wants and desires.

Since we cannot wipe out diabetes, how do we help our children to be comfortable with this lifelong disease?  I believe it depends of your child’s age. With a middle, elementary school and younger child, parents need to enter the classroom each year and talk to the class about type 1 diabetes. Joslin has a great handout to guide you as a parent through this at http://www.joslin.org/info/classroom_presentation_on_diabetes_for_elementary_school_age_children.html   Beyond talking to the class, you can also enlist the help of the friend’s parents. They will need to know about your child anyways so why not have them help talk to their child about childhood diabetes? The friend’s parent may know how to talk to their child about specific for their child.

Then with an older child,  he should start to learn to talk to their friends about Type 1 Diabetes. This will help two-fold. First, it helps your type 1 child learn about their disease a bit more because he or she needs to talk about Type 1. Secondly, I strongly believe that encouraging your child to discuss this makes them more confident about themselves. When a child becomes more confident they are more likely to advocate for themselves. With advocation less childhood bullying could occur. Kids don’t tend to pick on kids that are confident in themselves. Self-advocation is a lifelong habit.

All T1D kids need to eventually be able to discuss how their body works, why they need insulin, to carry sugar, eat often, and sometimes feel cruddy because of their sugars. Teaching your child while they are with you by talking to the classroom and their friend’s parents about type 1 diabetes will enhance your child’s ability to make lifelong habits to talk and discuss about their diabetes.


Brand New Type 1 Diabetic Parent

I first want to tell you to BREATHE!

Okay now we can talk. There is so much information that is getting told to you and you feel like you are drowning. Breathe again! You will become the next expert on your child and type 1 diabetes. But how do you get there and when will that happen?  Take small steps to get there. You will learn all of the information and will be that expert. Parents I have talked too say they really felt very comfortable around a year. Not that you won’t understand what to do until then; however, type 1 diabetes becomes second nature around then.

Not everyone is the same. Some parents are type A organized and have every paper ever given to us by the doctor to reference back too. And some of the parents have what is exactly needed and nothing more. Each has it merits. But what we do have in common is we keep all this stuff in one spot to find and reference. Usually all of the information is from a diabetic educator. Diabetic education is wonderful. They take you step by step through all things diabetes. So how could you break that up a little bit more for a not so structured person. Start with a list of how to focus on aspects of diabetic care. (And yes I am the type A personality, so planning is how I function. I recognize that planning is not everyone’s strength. And it is not a downfall). Start with a few weeks as a new diabetic parent and just get to know your child’s type 1 diabetes. As a parent of a newly diagnosed diabetic I learned my child; for example I learned that his legs were hungry when he was low. While you learn your child also spend time with a basic diabetic book to understand high blood sugars, low blood sugars. insulin, and carbohydrate counting. Then I would start to dive into each topic more in-depth.

A good example would be carbohydrate counting. To do this start to learn more about how to measure and weigh carbohydrates. The package carbohydrate counting is sometimes correct and sometimes way off. So measure with a good old-fashioned scale and use that carbohydrate counting book at diagnoses. If you have that book mark the pages you use most.If you don’t go buy one. If your preschooler will only eat macaroni and cheese then mark all of the pages. (We keep one of these books in a carry bag, in a kitchen draw, at grandmas house, in all the cars. One year we found older versions at the bookstore for a dollar a piece. You guessed it we bought every single one of them). Now that the pages are marked you will find it easier to start counting carbohydrates. Live with the carbohydrate counting and then move on to the next topic of your choice.

Over the next few weeks learn in-depth a certain aspect of the new diagnosis. With breaking it down into smaller steps it becomes easier.taking it step by step allows you to master your understanding of your child’s diabetes. Also remember you are still caring daily for your diabetic child.  The first year is the hardest because type 1 diabetes is not second nature. It will come it just takes time. But the thing that is most important to emphasize is a parent can become caught up in trying to do all of the diabetic stuff and burn out easily. So BREATHE often and frequently!

It is important to stay on top of it but you as a parent needs to know when you need a break even for a few hours. You can better help you child with their diabetes if you are not burnt out from care giving. to do this use all the resources you can, books, family, spouse, to make learning and caring easier for you and your family. Diabetes did not just

life-with-diabetes

impact your child, it has changed the whole family unit.

One place to start with a new diagnosis is with our book. It is for babysitters, but as authors we broke the book down in very basic topics to help people learn. The intended people are the sitters, but with a new diagnosed child the parent can also be that person to learn. And the plus side is that you will have all your kiddos information in one area. Diabetes is hard on the whole family and the primary parent tends to be the caregiver. You as a parent will learn it all and hopefully do so with as little stress as possible.



Type 1 Tween

As a parent caring for a child type 1 diabetic you have likely been living day-to-day with blood sugars, carbohydrate counting, insulin, and then adjusting basal rates and insulin to carbohydrate ratios. (of course this is if your child is not a new diagnosed type 1). Then one day you realized you have a tween. You know the 9/10-13 years of age trying to be a bit more independent from you as a parent. Naturally they need to learn independence slowly. In a tweens life Peers become the ruling influence and  the tween wants to make more of their own decisions. This is only the beginning as your child grows to adulthood. In a non diabetic life there is so much to consider. Diabetes then adds another layer for parents in raising a child to adulthood.

So how do you as a parent help your Type 1 child to navigate this  need for some independence and stay safe with diabetes. As in a non diabetic kids, life and learning and not linear. You give a child room to be independent and then they have a life lesson and have consequences. So how to begin independence and type 1 diabetes? The first thing to do it is to understand where your own child is at with their type 1 diabetes comfort level. Does he or she know how to count carbohydrates and does correctly with insulin? Can he or she give a shot? Are they aware of their blood sugars and able to test? Finally, can you trust your child to do those things and not be caught up in “life”? If you can then begin by trusting them to go to a friend’s house or other youth activities without you.Then do you get a phone or no phone and what age so to promote being able to be more independent, and what age is a phone given? We use a phone because I can parent from afar and my son is able to gain more independence.

I feel any of the above only happens in small steps. What works for one family may not work for another because kids are so different. Each child’s learning can be vastly different, but some basic truths apply to all type 1 children. One such truths is self-care in relation to their diabetes.  If this is satisfactory (able to test blood sugars, how to treat the blood sugar, and when to notify you as a parent) then I believe you let your child should be able to be away from the parent and grow gradually. For example we use our book, “Type 1 Diabetes and Babysitting: A Parent’s Toolkit” for my son to know what to do with his sugars. So when we are at a cross-road he looks up the basic steps and we always review it. If my son needs more training we discuss it with his educator. 

With slow training, I believe your type 1 child will grow to an independent adult. It is all a learning process for us as parents and for our children. In the end as parents we don’t only have the responsibility to prepare them to be adults but to also teach our Type 1 Diabetics how to manage their disease in a healthy way so they are able to without our help as parents. The tween years can be fun and challenging at the same time. Having a clear plan to guide your type 1 child into adulthood will decrease stress for the whole family at this time in their lives. 

 


The Type 1 Teen and Siblings

Somehow in the last few years, I felt as if I could escape the crazy periods of type one diabetes.  My son is all over with his sugars and keeping up with correcting and not allowing himself to go low.  I know, I know, you’re thinking “boy are you in for a big surprise!  Teens can be hard to manage at times!”  I am waiting for the hammer to fall, but in the meantime I had planned to participate in blissful ignorance.  And then it hit me as I am leaving the house to run an errand the other day.  I realized my younger child needs to be taught how to help her brother (who has been a babysitter for me).  Now Quincy is excellent at knowing if his sugars are not spot on, but what happens if he becomes distracted, or decides not to take care of something?  I began to think of a time when I sat my 10-year-old down and discussed what to do with her.  I think I assume she knows what to do because our house lives and breathes diabetes, highs and lows, in sickness and  in health.  So I started my mental list of what she does know: she knows to call 911, she knows to tell him to eat if he needs to and she knows how to call me when he is being completely unfair.  But if he is having an insulin reaction, waiting for 911 may be too late.

This enticed me to make another list of what she needs to learn and how.  She needs to learn how to give a glucagon shot, to test his blood sugar, what order does she need to take care of him and what he is like when he is low but still can argue (which he can do at a blood sugar of 20).

These thoughts lead to how to teach her. S he is only 10-years old. So my mental plan became:

  1. Talk to her about the responsibility of being alone and at home with him
  2. Ask her multiple questions on what she knows.  (I didn’t think teaching her what she already knows would work.)
  3. Show her where we keep the babysitting book (I keep it because it has everything she needs and I think she can understand it)
  4. Show her where we keep glucagon.
  5. Find the old glucagon.
  6. Practice with the old glucagon with an orange.
  7. Repeat so I know she is comfortable.
  8. Do a monthly check in with her to determine if she retained the information.

In the above plan she still needs to know how to check his blood sugar and suspend his pump and be able to read his pump.  But those are another teaching moment because teaching her everything makes me overwhelmed and I think it would make her overwhelmed.  So then the plan will be to start with his book.  I am a strong proponent of understanding the disease before dealing with the if, ands and buts.  This is another reason our book works so well.  Most people see the book and think my kid is beyond needing this, but I say anyone: siblings, other parents, grandparent, and the babysitter can read and use this book and that can be an advantage to having it.


Book Interest

When we started out writing our book as writers we knew how important a book about Type 1 diabetes and babysitting would be. We did  not plan for interest so fast.  Can you imagine our excitement when so many groups showed intersed quickly.

First, a few weeks ago I picked up a Colorado Springs Kids Magazine.  I started to look through it for things to do during October and there was an article about Type 1 Diabetes. And At the end of the article the physician mentioned our book. To be fair I work in the same large medical group with Dr. Garscadden, a pediatrician. What I did not know is he was going to mention our book in his article! And thank you Colorado Springs Health Partners and Dr. Garscadden for your support!Colorado_Springs_Kids_article Secondly,  JDRF reviews books twice a year for their online bookstore. They did contact us about a month ago to ask for a copy to review. So we sent on with fingers crossed! This week we found our book on their website! At JDRF’s bookstore you can find many helpful books for raising children with type 1 diabetes. Here is their website:  http://jdrf.org/life-with-tid/bookstore/