Your Child with Type 1 Diabetes is Starting School

Leave a comment August 15, 2016 Stacey

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

Aside Leave a comment July 25, 2016 Stacey

Diabetic funnies

Magic Disappearing Peanut Butter cookies

The ins and outs of insurance

A 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 sch images ool, 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!

My youngest child, a non-diabetic child, is allowed to stay home at a younger age than my older diabetic child. She does not have a chronic illness to attend to while alone. But my type 1 child was not allowed that privilege until after he was 13 years old. Call it helicopter parenting, but he was not quite ready to attend to his low blood sugars without a responsible adult around. My main concern was that he needed to have very good awareness of his low blood sugars and how to treat them properly. He has always been able to notice a change in his blood sugars, but being able to treat his low blood sugars is a whole different animal. Once I started to feel that he had a solid grasp on this I began to let him stay home alone for short periods of time. I would run an errand, or stop by the grocery store. As I began to be more confident, my husband and I would venture out to the local restaurant for dinner. Now that he has earned our trust to stay home during the day without adults, he calls or texts me with issues with his blood sugar. He is now able to treat and care for his blood sugars for short periods of time. In turn this will eventually help him grow into an adult.

Each child is different. Some questions to help you determine when he or she can stay home are:

1. How mature is your child?

2. How does he or she recognize low blood sugars?

3. Is your child able to treat low blood sugars and follow up with a snack?

4. How far away will you be from the home?

Once you are satisfied with these key points, start with short trips from home. You should have a successful transition to leaving your child at home while feeling comfortable about the blood sugars.

Type 1 Diabetes and Staying Home Alone: When is the Right Time?

Aside Leave a comment November 14, 2015 Stacey

All Work and No Play

How is life going? Have you found yourself recently trying to do all diabetes all day and night? Has your child been ill, leaving no room for anything (even a shower)? Or are you just trying to be the best parent/caregiver you know how and that means an A1c less than 7! images

This can mean living with too much stress and creating a more clinical environment for your type 1 child. What has your family done recently that has been fun and not structured around diabetes (at least to the best of your parental abilities)? Or structured around diabetes as a learning experience or game?

Here are some Ideas to try for a week

Diabetes is never fun, but sometimes it’s good to change things up a bit. For example, only do the basic things for meals like carbohydrate counting and giving insulin.

The whole family checks their blood sugar – new lancets!

Everyone does a site or CGM insertion

Different treatment, see post on treatments

Low-key approach to lows and highs, be calm

The other parent takes charge: spa day!

All Work and No Play Can Make Diabetes Unbearable

Aside Leave a comment August 14, 2015 Stacey

The “Weekend Away”

The Weekend

Here it is our first real out-of-state vacation without the kids. My mother-in-law took them for us while we scooted off to Seattle, WA for five days. This would mark our first “BIG” trip without the kids. We have had others: to the mountains for a night or they have scooted over to friends’ houses overnight. But to go out-of-state without me being in complete control of Quincy’s diabetes for five days (and he was not at camp)? My feelings: excited, scared, curious to see if I could do it and not go psycho crazy and need to control everything! So I plotted my obsessive need to control all the details. spaceneddle

The details

Five days at grandma’s house. She had a mini-trips planned with the kids. This meant I needed to plan and discuss what is expected for Quincy when you are more than 30 minutes from home, staying in a hotel, and then going on a fabulous train ride (which was way more exciting for my kids than going to some silly city!). I, of course, have the “travel overnight” and not being at a hotel down to a “T” with skiing. But I actually had to think my steps through and decided what a non-routine caregiver would need to do for a fun-filled grandparent weekend.

The steps

We do use our book for our son. Now that he is a young teenager he does quite a bit on his own with lots of supervision. He needs his travel bag and then several smaller bags for the train ride. The travel bag consists of several pump site changes, insertion device (it is never fun to leave this at home), insulin, Lantus (just in case the pump fails all together), syringes, test strips, glucagon (in every pocket imaginable), alcohol wipes, sugar, and an extra glucometer. That is the big bag. Now experience has taught my family that taking one to two extra glucometers is a must, and keeping things in several places is a must. So my mother-in-law had a baggie with a glucometer and sugar for her purse, and my son took the site change (only one) in his diabetic bag on the train. Then came special training about keeping all diabetic supplies from being too hot or too cold in the event they may not function right.

The result

We had an exceptional time in Seattle. The kids had fun with my mother-in-law. Mobile phone communication was mostly about our trips and very little about blood sugars until the last day and that will be the next post. My mother-in-law utilized the book when she needed to and it kept everything running smoothly. It’s amazing how a full scope of knowledge helps care for your child! Everything she needed to take care of Quincy was right in the our book, “Type 1 Diabetes and Babysitting: A Parent’s Toolkit”.

Diabetes educators: Who are they and what do they do?

Likely every type 1 child and their families have seen an educator: at the hospital, for insulin management, to start on a pump, or for school paperwork. But what do you really know about your diabetes educator and what are their backgrounds?

The Definition

According to the American Association of Diabetes Educators (AADE):

A certified diabetes educator (CDE) is a healthcare professional for diabetes or people at risk for diabetes with behavioral goals to achieve better clinical outcomes. So what exactly does that mean? The idea is an educator helps a child with diabetes (or family members, in the case of children) with eating habits, exercise habits, insulin dosing, sick day management, and basically the day-to-day activities for a child that affects blood sugars and A1c levels. A diabetes educator’s background is varied. He or she may have a background as a registered nurse, a nutritionist, a pharmacist, a physician, or a mental health professional, to name a few. He or she must take a certification exam to become an educator. The basis for their education revolves around what the AADE calls the 7 self-care behaviors: healthy eating, being active, monitoring and taking medications, problem-solving, healthy coping, and reducing risks.

Who Pays to See a CDE

Typically a person with diabetes can see an educator more often than the endocrinologist; however, this is based on insurance coverage. Insurance coverage for an educator will differ between plans (so check your insurance plan out). Usually you need a referral from the endocrinologist. After the referral is made you can typically see the educator more often than the endocrinologist depending on the reason for seeing the educator.

How do you use your educator in your community? Is he or she helpful or is the endocrinologist you see more helpful? Have you seen your educator lately?

Here is the link to the American Association of Diabetes Educators with a full-page on what an educator is:

http://www.diabeteseducator.org/export/sites/aade/_resources/pdf/Definition_Diabetes_Educator.pdf

What Exactly Does a Certified Diabetes Educator Do?

Aside Leave a comment July 11, 2015 Stacey

Type 1 Diabetes and Growth Spurts

Growing children seem to eat parents out of house and home. There is never enough food for them! For example, my type 1 13-year-old is eating me out of house and home! And the result is a three-inch growth spurt about every three months. The problem (beyond the obvious sugar control!) is that he wants to eat all day long. Waiting until the next meal might as well be giving him a “death sentence”. The recommendations we received was to eat every two hours. He is able to have an entire meal every two hours. I thought what a great compromise! But he still wants to graze all day long like a cow in pasture! So I try to help him eat good food and sometimes fun foods to encourage eating well.

So why is it a big deal for him to eat constantly? It has to do with insulin, whether via shot or pump. Eating more often requires insulin. Each time he takes insulin he is stacking it on the last dose and essentially giving himself mega doses of insulin, setting himself up for a low. Rapid insulin like Novolog or Humalog have about a 3-4 hour active time in the body. The insulin works quickly but does not leave the body quickly. It basically means we can expect many and frequent lows. Eating every two hours helps with this but does not necessarily eliminate stacking of insulin. But for us it works.

Growing and grazing. Eat, beef up and grow taller. Type 1’s can navigate this easily without negative consequences. Go forth and chow down!

Growing and Grazing

Aside Leave a comment June 24, 2015 Stacey

Type 1 Diabetes

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A 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.

The End of the Story

Moral of the story

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All Work and No Play

Here are some Ideas to try for a week

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The Weekend

The details

The steps

The result

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Type 1 Diabetes and Growth Spurts

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