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

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9876051_sMy 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?

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All Work3a118a835fd0d6d253f49acc9ed5697a 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!images

All Work and No Play Can Make Diabetes Unbearable

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

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?

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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.

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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!

Portrait of a boy holding fruits

Growing and Grazing

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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

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