What’s for dinner? Or lunch? Or breakfast? Oh my…

 

Planning meals can be the bane of a mother’s or father’s existence and if your child has juvenile diabetes it can seem more daunting. You are probably asking yourself: does my child’s diet need to change?

Type 1 Diabetes and Food

As long as your child’s blood sugar readings are kept in normal range, meaning they get the insulin they needs to process the carbohydrates they takes in, they can eat anything.

Blood sugar tests and Food

However, you might need to determine how your child reacts to different foods.  We’re all different and we react in different ways to foods and food ingredients.

You might want to substitute foods that cause blood glucose instability with others that have less impact on insulin needs.   An example is substituting milk or water for juice or sugary sodas. Other drinks that contain sucralose or agave nectar are also good substitutes.

Snacks like cheese and/or peanut butter and celery are great because they also don’t require as much insulin to cover them.

You may be giving insulin that matches the carb level and your child’s blood sugar spikes anyway.  This is because we all metabolize foods at different rates.   Using blood sugar test strips to figure out what foods spike or even cause lows is the only way.   Recording your child’s blood sugar test strip results in a food chart is a great strategy.  Sometimes you need only substitute based on the amount of sweeteners in the brands you usually buy:  look for sugar, honey, high fructose and corn syrup in the ingredients list.

However, your child may be able to eat foods with these ingredients in them…it depends on what the other ingredients are in the product and how your child metabolizes them.  Similarly certain preservatives, starches and fillers can impact your child blood sugar level.  It’s all trial and error.

Don’t eliminate all sugar

But don’t try to eliminate all sugar from your child’s diet.  This isn’t a good idea because it is impossible to keep tabs on all your child’s food intake.   It’s not emotionally healthy for a child to have mom and dad hovering over every bite.  In fact, banishing sugar can backfire.  The child hides treats from parents and parents try to second-guess their child.  Uncontrolled blood sugar levels result.

Giving your child sugars can actually help to train your child in appropriate sugar consumption.  For example, you can teach your child to pair something sugary with protein, like nuts, cheese or meats.  Additionally teach your child that treats are for after meals.  And be sure that your child with type one diabetes isn’t singled out in the family.  Keep your whole family on the same sugar consumption rules.  Look for foods made with xylitol, agave nectar, coconut crystals and stevia leaf are all natural sweeteners that are less likely to increase blood sugar levels.

So life goes on…with a few adjustments.  So what’s for dinner?

“We’re losing our connection…you’re breaking up” :Type 1 diabetes and Insulin resistance

When you are on a cell phone call you want to stay connected but sometimes you lose your connection.  In a way, the cell phone is like something that can happen in the body between your cells and insulin.  Making a connection and keeping a connection between your cells and insulin is essential to the process of glucose absorption.  A break in that connection is called insulin resistance or impaired insulin sensitivity.

What is insulin resistance?

When your body’s cells don’t respond to insulin, the condition is called insulin resistance.  To understand insulin resistance you have to look at a person whose pancreas and other body cells are connected or functioning properly.   As that person eats, their blood glucose rises and causes their pancreas to produce insulin.  Insulin passes through the bloodstream persuading fat and muscle cells to take up blood glucose.  It also tells the liver to hold onto its glucose stores.

The fat and muscle cells in a person with insulin resistance don’t respond to the presence of insulin and this lack of response leaves glucose in the blood stream.

Human growth hormone, blood sugar readings and insulin resistance

Going back to the cell phone analogy, imagine you lose the connection, you keep driving, you get back into range and get reconnected.  That’s what happens when your child has a growth spurt.

You may have noticed that there are times when your child has a series of high blood sugar readings.  Then later they return to normal.  As your child goes through growth spurts, larger amounts of human growth hormone are present in the body.  Human growth hormone causes insulin resistance in your child.  When the period of intense growth slows, the connection returns and the child’s insulin resistance disappears.  This type of insulin resistance is normal in growing children.

When insulin resistance is a problem with juvenile diabetes

For someone with type 1 diabetes, long term extremes in glucose highs and lows can increase the likelihood of developing insulin resistance.  Years of poor control and imbalance in food intake, insulin intake and exercise greatly increase the risk of insulin resistance.

Balance is the Key with Type 1 diabetes

Your job is to teach your child balance.  Encourage your child to exercise 30 minutes –moderate exercise like walking or biking:  three or four times a week will suffice, although more is OK.  Teaching proper eating habits like balancing carbs with protein intake to reduce glucose highs and lows is the other part of the key to balancing glucose levels.  Reviewing blood glucose readings and insulin doses to determine patterns is also part of what you should do and what you should train your child to do as they mature.

Finally, you have heard this before, but it bears repeating.  Cut yourself some slack!  It’s not easy being a surrogate pancreas.

Tight control? Say what?

Commercials for pantyhose or perhaps the turning radius of that fancy car you always dreamed of owning?

No, tight control, in this case, means keeping your blood glucose levels within a limited range.   Specifically it means maintaining period A1c readings at around 7% for an extended period.

What is an A1c test and what does it tell me about my child’s type one Diabetes?

An A1c test or HbA1c test is a blood test that measures the amount of glycohemoglobin in the blood.  Glycohemoglobin is the protein that forms when hemoglobin (the blood protein that carries oxygen) binds with glucose.  In a person who doesn’t have diabetes, glycohemoglobin levels are around 5 to 6% of the total hemoglobin in the blood.  The more glucose there is in the blood, the higher the level of glycohemoglobin in the blood.  Someone with juvenile diabetes who has higher than normal levels of glucose in the blood will have more glycohemoglobin in their blood.

The hemoglobin in your blood remains in circulation for 60 to 90 days.  The amount of glycohemoglobin in your blood represents the average amount glucose in the blood over the last 2 to 3 months.   The A1c test gives your medical team a pretty good measure of where you child’s blood sugars have been over the last 2 or 3 months.

If a person’s A1c test is 7%, that means that their average blood glucose levels have been at 150 mg/dL.    It the reading is 8% that means that their blood glucose levels have averaged to around 180 mg/dL.  Anything higher than this and the team will probably review their treatment regimen.

A high reading on this test doesn’t mean that parents aren’t keeping a close eye on their child’s diabetes.  Generally it means that there needs to be a change in insulin, probably because your child has grown.

Should you try to keep “tight control” of juvenile diabetes?

Keeping tight control with children is difficult because there are many variables that are affecting their blood sugar levels, like the fact that they are growing.  However, the goal of tight control can help you to instill some good habits that will help your child in the future.

Regular mealtimes and blood glucose tests

Making sure your child eats three meals with a balance of proteins, carbohydrates and fats is key to good regulation.  If it is possible, keep grazing to a minimum but instead provide timely snacks, keeping 3 hours between eating.  To stave off over night low, have your child eat protein, like peanut butter crackers and milk before bed.

Review blood sugar and insulin doses to see patterns.

Keep a log of activities, carb intake and insulin dosages.  If you miss, don’t fret because blood glucose meters and insulin pumps have memory functions.  Review you log and try to figure out your child’s patterns.

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Look at the ratio of basal insulin to bolus insulin

Basal insulin should be at least 40% of the insulin your child receives in a day.  Generally it should not be more that 50%.  If it is less than 40% or more than 50% your child’s blood sugar readings are not stable.

You can’t imitate a healthy pancreas perfectly

So don’t go crazy over this.  Part of your job as a parent of a child with type one diabetes is loving your child.  Moderation is key.  Overdoing and obsessing over blood sugar readings and carbs counts to the exclusion of fun and love does nothing but alienate your child.

That Old Sweet Tooth: Sweets and Type 2 Diabetes

 

You have  a sweet tooth and you have type two diabetes…do you have to give up sweets?  NO.

Okay. End of post.  NOT—

Denying yourself sweets will not help you with your type two diabetes.  What it could lead to is craving and then gorging…not a great way to keep your blood sugars in the right range.

Also, having a moderate level of fat, between 30 and 35 percent of your calorie intake, can help to slow down digestion and paces the amount of glucose entering the bloodstream.  Of course, the fats that are the healthiest and most heart protective are omega-3 fats and monounsaturated fats found in nuts, olive oils, canola oils, flax seed and fishy fish.

So, what to do?

Sweets, as well as white bread and other carbs will raise your blood sugar.  However, if you eat them correctly you can definitely have them in your diet plan.  One of the most important words in your vocabulary now is moderation.

Pay attention to serving sizes

Eating a whole package of cookies isn’t eating in moderation.  But if you eat the cookies in its serving size and note the carbs you are eating, you’ll be able to keep cookies in your diet.

Pair your sweets with a meal

One way to help you keep your blood sugar under control is to eat your sweets as dessert.

Substitute

Instead of having a baked potato and a dessert, substitute the sweet for that high carb food in your meal plan.  Having both can not only raise your blood sugar but it  can also increase your calorie intake.

Monitor your blood sugar and keep a log

One of the most important parts of your life with type two diabetes is blood sugar monitoring.  Use your Dario glucose monitoring system to help keep you on track.  A quick blood sugar reading 2 hours after eating can give you an idea of how you are doing with keeping control of your type two diabetes.

Exercise

After eating your meal with a dessert, take a brisk walk.  It will help you burn calories, help you increase your muscle mass and in the long run, increase your metabolic rate and help decrease your blood sugar levels.

So moderation in all things is the way to go with sweets.  Keep up the good work and remember, being a pancreas isn’t easy…you’re doing the best you can.

Sick child? What should you know about Juvenile Diabetes and illness?

 

Mary was at church with her mom on Sunday when she felt nauseous.  “Mommy, I think I’m going to throw up!”  Her mother told her, “I want you to run outside as fast as you can.  Go behind the bushes, you can throw up there and nobody will see you.”  So Mary ran for the door but less than a minute later, she was back in her seat next to mom.  “Did you make it to the bushes that fast Mary?” she asked.  “I didn’t have to go that far, Mommy, Just as I got to the front door, I found a box that had a sign on it:  FOR THE SICK.”

 

When your child is sick, it’s not a laughing matter.  This is especially true if your child has Type 1 diabetes.  What do you need to know?

First, when someone is sick, their body requires extra energy to help the immune system fight off infection.   Juvenile diabetics are at particular risk when sick of not keeping enough glucose in their system to fight their infections.

Sick kids are often not interested in eating—this decrease in food intake can lead to lower blood sugar.  Your main concern as a parent of a child with diabetes is that your child takes in enough food and insulin to prevent her body from burning fat for energy.  Fat burning leads to ketone production: ketoacidosis is a serious, life-threatening condition.

Be Watchful! Take blood sugar readings…

       and watch for ketones

Second, take blood sugar readings more frequently.   Remember, ketoacidosis can occur in a sick child with normal blood sugar readings.  Monitor ketones every 6 to 8 hours, especially if your child is dealing with low blood glucose and poor appetite.

Fluids

Third, offer your child lots of fluids with simple, easy to digest carbohydrates in them.  This is true for stomach illness as well as for respiratory infections since extra fluids help to thin mucus.   Ginger ale, apple or pear juices are all good choices.  Avoid milk and caffeine…however, if your child won’t take anything else, give them that.

In winter, warm beverages like mint or ginger tea with sugar or honey sweetening work well.  Popsicles or frozen ice cubes of apple juice, or a slushy of frozen juice put through a blender will sooth the throat.

Stay Vigilant:  Monitor those Blood Sugar Test Strips

Of course, every child’s reaction to illness is different and may actually differ for every illness.  But if you remain vigilant, you can manage your child’s blood sugar and help them fight off infections.

Some Signs or Symptoms of Low Blood Sugar

Be aware of some signs or symptoms of low blood sugar.

Ø  Irritability, confusion, or anxiety

Ø  Trembling, weakness, palpitations and sweating

Ø  Hunger, sugar cravings

Ø  Headache

Extremely low blood sugar can result in seizures or coma.

Stay Healthy Yourself

Finally, it is important to stay healthy yourself.  So keep washing your hands and don’t lose your sense of humor.  Laughter is the best medicine and it can help you stay healthy.

Just a spoon full of sugar…Signs of Hypoglycemia in Juvenile Diabetes

Yeah,…you probably hate that song but it is true…it can help you if

if you are hypoglycemic.  What is hypoglycemia anyway?

Low blood sugar is called hypoglycemia.  This occurs when there is too much insulin in your blood and not enough sugar or glucose.    For those who have Type 1 diabetes, it can be dangerous and even life threatening.  So listen up.

It’s important to plan ahead for low blood sugar.  And to know the early symptoms of hypoglycemia.

Early symptoms of low blood sugar

Ø  Sweating

Ø  Pale skin

Ø  Shaking

Ø  Pounding heart

Ø  Hunger

Ø  Headache

Ø  Dizziness

Ø  Irritability

Ø  Weakness

Ø  Frequent sighing

Ø  Nausea or vomiting

Late symptoms can make you seem to be drunk or violent and it is very serious.

Late symptoms of low blood sugar

Ø  Confusion

Ø  Blurred vision

Ø  Impaired coordination

Ø  Personality change

Ø  Numbness in the mouth

Ø  Seizures

Ø  Fainting

Ø  Agitation

How does hypoglycemia happen?

Hypoglycemia can happen if you overestimate the amount of insulin you need and take too much of it or if you don’t eat enough food to compensate for the amount of insulin you took.   It also happens if you get more exercise than usual or if you eat later than usual or miss a meal or snack.

Strategies to raise your blood sugar level

If your blood sugar is too low (less than 70 mg/dl), it’s important to bring your level up immediately.  Drink half a cup of orange juice or half a cup of apple juice.  You can also take a tablespoon of honey, molasses or corn syrup.  Another option is to buy 5mg tabs of glucose and take 3 of those.  Or you can even follow the advice of the song and take a rounded tablespoon full of sugar to help. (emphasis added for cliché effect) Wait fifteen minutes and then take a blood sugar reading.

Hypoglycemia Unawareness

Believe it or not, there is a condition called hypoglycemia unawareness.  It happens when you don’t experience or feel the symptoms of hypoglycemia.  Around 20% of people with diabetes have this condition.  It is more likely in people who have had diabetes for a long time or who have had many episodes of hypoglycemia.

Coping

Strategies for coping with hypoglycemia unawareness include setting your target blood sugar levels higher so that you have only a couple of low sugar episodes in a week.  Discuss this with your physician.  Another strategy is to test your blood sugar levels before doing an activity that requires full attention, like driving.   Reducing the frequency of low blood sugars can help bring your awareness of hypoglycemia back.

With a little planning you can do anything

So that is the scoop on low blood sugar.  Planning ahead and carrying glucose tablets or even hard candy is key.  Then you can do anything with Type 1 diabetes!

Disorganization and Type One Diabetes Burnout: SMH (Shake My Head)

Disorganization and Type One Diabetes Burnout:  SMH (Shake My Head)

Being a teen isn’t easy and being a teen with type one diabetes is even harder.   Being a teen with juvenile diabetes and being disorganized makes it worse.

Are You Disorganized?

Are your diabetes supplies spread across three rooms?  When you open a cabinet with your supplies, do boxes of blood sugar test strips, lancets or broken glucose meters come pouring out? If this sounds like you, then read on!

Disorganization and Burnout

Disorganization can increase your likelihood of burnout.  Burnout is the feeling you get when you try your hardest, doing the same things over and over again to keep your type one diabetes in check and you feel as though you’re not getting anywhere.  You’re frustrated, annoyed and you stop taking care of yourself.   Lots of people with type one diabetes have gone through this.

Getting organized can help you feel as though you have more control over your life.

How do you beat back disorganization?

Beating back Type one Diabetes Disorganization:  Simplify

Simplify?

Easy to say, not so easy to do.  How do you simplify caring for your type one diabetes when there are so many steps and so much gear to deal with it?

Put tasks together

One way is to put tasks together.

For example:

·      Put your insulin, syringes and glucose meter together in the same place.

·      Take you blood sugar test every time you give yourself an injection.

·      Connect the time you inject your long acting insulin with a chore or task you already do every day

·      Before you leave the house, check that you have all your diabetes supplies with you

Set specific plans or goals

Another way is to have a specific plan or goal

For example, if you are having trouble remembering to take your blood sugar, instead of saying “I’ll be better about checking my blood sugar.”  Make a specific, easy to reach goal like:  “I’ll do a  blood sugar test before going out to the movies with friends and after I get home.”

Small, steps are much easier to take than giant steps.  Making small, achievable goals will really help to get you organized.

Ask for help

Again this is not an easy thing to do but it will take the pressure off you to get a little aid.  For example, maybe you could ask your parents to take your blood sugar reading in the morning when you wake up.

One item that can really help you out is an alarm.  This could be on your cell phone or your watch.  When you are busy with living, sometimes you can forget to take care of things like checking blood sugar levels.

Use your Dario Glucose Monitoring System

 

And don’t forget, the Dario glucose monitoring system for mobile phones can keep you on track:  reminding you to take your blood sugar readings, injections and alerting you if you are hypoglycemic.  It can help you figure out your carbs and the amount of insulin you need.  Since the meter and lancets and test strips are in one place, it can be so much easier to be organized.  Check your event chart for clues to help your blood sugar stay on track.

So don’t let yourself get burned out.  It’s tough being a pancreas but you are up to the challenge!

Figuring out the Carbs for Type One Diabetes

Figuring out the Carbs for Type One Diabetes

So you’re trying to figure out the carbohydrate count of the food you or your child with juvenile diabetes is about to consume.  So, the very first question you need to know the answer to is:

What are carbohydrates and their relationship with type one diabetes?

Carbohydrates can be loosely defined as the sugars and starches found in food.  Just to make things more complicated, however, not all carbohydrates are the same.  There are simple carbohydrates, like potatoes, juice or white flour or sugar and there are complex carbohydrates, like whole grains, vegetables and raw fruit.  The simple carbohydrates become converted into blood glucose at a faster rate than the complex carbohydrates.

The amount of insulin that is needed at mealtimes depends on the amount of carbohydrates that are taken into the body.   Having said that, the elimination of carbohydrates is definitely not a smart idea because you and your child need fresh fruits, vegetables and whole grains.  In fact, as a general rule to keep in mind, carbohydrates should make up about half of all the food that you eat.

What you need to know

So—just what do you need to know to figure out how many carbohydrates are being eaten by your child with type one diabetes?

Food labeling

Food labeling makes it simple in some respects.   There are three things that you need to know:

1)   Look for the carbohydrates per serving entry

2)   Find out the serving size

3)   Determine how many servings you or your child are going to eat

In this example there are 31 grams of carbohydrates per serving.  There are 2 servings in this container.  It is a good idea to avoid foods where the first five ingredients include white flour, sugar or high fructose syrup.

What about other foods?

But how do you handle restaurant foods, or home cooked foods and fruits and vegetables?  What constitutes a serving?  How many servings are being consumed and how many carbohydrates do those servings translate into?

Here are a few carbohydrate counts:  An 8 oz glass of milk contains about 12 g of carbohydrates, a whole wheat bread slice is about 20 g, a slice of American cheese is 1 to 2 g.  Still, you will need some sort of reference to give you carbs per serving.

There are books and online tables available. Additionally, your Darios glucose monitoring system also provides carb counts.

How much is a serving when you are out at a restaurant?

Guestimate by Using Your Hand

Your thumb from the first knuckle to the fingertip is about the size of one ounce of food.   The palm of an average size woman is about the size of three ounces of food; for a man it is about four ounces.   Your closed fist represents about one cup of food.

So it may seem like a lot

But it is a matter of habit.  And remember:  imitating a healthy pancreas perfectly is not possible.  Doing your best is!

Getting that drop of blood: Dario Blood glucose monitoring

 

 Sticking your fingers is intimidating, to say the least.   But getting that all important drop of blood is lifesaving for people with type one and type two diabetes.

Choosing the site for blood glucose testing

Changing the sites that you use often will help you avoid bruising or scarring.

Finger sticks

Either side of your 8 fingers is okay for drawing blood to get a blood sugar reading. It is best to take blood from above the first knuckle and try to avoid the nail bed.

  Alternate sites

If you play guitar or work with your hands, you may have tough fingertips.  Other sites can be used to test blood sugar.  These include your upper forearms, thigh and calves, the outside edge of your hand or the thumb at the bottom joint (ball of the thumb).

Check the alternate site with a finger stick site to be sure that these match.

Prepare the site for blood glucose testing

There are two ways to prepare the site.  First wash with soap, rinse thoroughly and dry completely.  Second , get the blood moving in the area that you are pricking.  For a finger stick, ball up your hand into a fist, lower your hand below the waist and or put your hand under warm water.  The warmer your site is the better.  For alternative sites, massage or rub the area for a bit.

The stick

To get the blood flowing, take a deep breath.  This will relax your hands and fingers and reduce constriction of your blood vessels.  Hold your hand down to get the blood flowing.  If you try an alternate site, remember that it will take longer to get blood than with a finger stick test.   Work quickly.

 

Maintaining the site for future use

It is important not to overuse one site so rotate sites as much as you can.  In addition, exercise will help keep your blood moving.  Using lotions can help to keep your skin supple.  Smoking is a no-no.  Not only is it bad for your health in so many ways, it also harms your circulation making blood glucose monitoring even more difficult.

Other ways to keep fingers in good shape is to use gloves for household duties like dishwashing or cleaning.  Gardening or work gloves should be used for outdoor work.

 

Nothing Holds You Back

Be proud of yourself and keep testing your blood sugar regularly.  It’s simple, easy and even elegant with your Dario Blood Glucose monitoring system.  With the lancets and blood glucose test strips that come with your Dario, you can get your readings in a hurry.  It will also keep up with events, what you eat, your physical activity…everything you need.  And it can keep your physician up-to-date as well.

 

Remember being a pancreas is hard.  You’re doing the best you can and doing it better with Dario.

What to do if…

Juvenile Diabetes and your child

Sometimes your child will eat food that hasn’t been covered with insulin. The reasons vary…it could be that your child ate something that you didn’t know about, or perhaps you could not give insulin when your child did eat.

Life happens…so don’t be surprised if you find yourself in this situation. Every parent whose child has diabetes type one will experience this. So…here are some choices for dealing with the situation.

Know what your child ate
If you know what your child ate and how much insulin is needed, go ahead and give your child a bolus of insulin. The important thing to remember is that you need to wait to take a blood sugar reading at least 2 to 3 hours after you have given the bolus. It takes this long for the insulin to be processed. If you take the reading earlier than 2 hours, you will likely get a high blood glucose reading. It is a false reading because not all of the glucose that was injected has gotten into the system.

Don’t know what your child ate
If you don’t know what your child ate or don’t know how much insulin to give, wait two hours, take a blood sugar reading and then correct the high glucose reading with an injection of insulin.

It takes about 2 hours for carbohydrates in foods, in the form of glucose, to enter the bloodstream. Foods high in proteins or fats take 3 to 3 ½ hours to get to the bloodstream.

So don’t panic
This happens to every child with type 1 diabetes and so it happens to their parents. The most important thing to do is not to panic.

And don’t forget, the Dario glucose monitoring system for mobile phones can give you and your child’s physician important insights in monitoring your child’s blood sugar readings. It eases your mind by helping you determine the amount of insulin your child needs, provides reminders and alerts regarding hypoglycemia and general testing and you can always take a look at the event charts for clues to help you keep your child’s blood sugar on track.

So take a deep breath. You are not alone. Consider your choices and you’ll be okay. Remember, being a surrogate pancreas is not an easy task. You’re doing the best you can.

Can My Child with Type One Diabetes Do the Things Other Kids Can Do?

YES! Your child can do anything other kids can do. It is important that you encourage them. Diabetes is not your child and shouldn’t be the center of your child’s life. It is just one facet of your child that needs to be addressed.

Children with Type One Diabetes Can Do Anything

Children with juvenile diabetes have become inventors, musicians and celebrities.

Nick Jonas — The Jonas Brothers
Thomas Edison
Justice Sonya Sotomayor—Supreme Court Justice
Mary Tyler Moore—actress

Most parents worry about having their child participate in sports. However, children with diabetes have become Olympians, pitchers in Major League Baseball, Professional Hockey and Football players. Here are a few examples:

Gary Hall Jr. — US Olympic Gold Medalist, Swimming
Mike Sinclair — NFL – Philadelphia Eagles
Kris Freeman — Olympic and National Champion Cross-Country Skier
Walt Frazier — ­ NBA – New York Knicks
Arthur Ashe — Tennis – Wimbledon winner
Chris Dudley— NBA
Nick Boynton — Philadelphia Flyer
Kris Freeman— Olympic cross-country skier
Missy Foy— ultramarathoner

Being Prepared with Juvenile Diabetes
Children with type one diabetes play, shop, dance, learn to drive and do everything other children do. The main difference is that they and you have to be prepared. They have to take special precautions and always have 2 or 3 bottles of insulin, 2 or 3 syringes, a blood glucose meter, blood glucose test strips, and a source of carbs with them.

Participation in group activities like sports or band will probably require meetings with school officials, coaches and teachers prior to school starting and every year your child is in school.
Blood Sugar Management
There are also important pre-activity, blood sugar management measures that can help.
1) Check your child’s blood glucose and ketone levels prior to competitive sports
2) Check your child’s blood sugar levels at regular intervals throughout the event
3) Have extra water available
4) Keep a record of blood sugar, water and carb needs. Your Dario blood glucose management system can help you keep those records.
5) Find out from your child’s physician if s/he should have a slightly higher than normal blood sugar range so there is less danger of going low during the extreme activity
6) Don’t leave diabetes management to the coach, staff or your child
7) Watch your child’s performance and praise their efforts

If there is a sports injury it is important to check blood sugar levels. This is because our bodies react to injury by becoming more insulin resistant and by releasing glycogen from the liver. Be sure that your child is wearing a medical ID bracelet or necklace.

And let them do anything that the other kids do.

Being a Pancreas: Basal and Bolus Insulin and Juvenile Diabetes

So: as a surrogate pancreas you’ve got to get familiarize yourself with what one does. That’s how you’ll understand the difference between basal and bolus insulin.
Typical Pancreatic Activity

When we sleep (and are not eating), the liver releases some of its stores of glycogen into the bloodstream, to give the brain the energy it needs. In a normal pancreas, insulin is released slowly and continuously. It does this to keep blood glucose levels in balance. Blood glucose levels would rise without this continuous supply of insulin.

When a meal is eaten, the pancreas emits a larger amount of insulin to keep pace with the blood glucose that is being released into the bloodstream from the process of digestion.

All of this activity keeps the person without type one diabetes and without insulin resistance at blood glucose levels that range from 65 mg/DL to 150 mg/DL.

To Treat Type One Diabetes

You’ve got to imitate the pancreas. Your child will have two types of insulin. Basal insulin is like the continuous supply of insulin while bolus is what happens around eating. Basal is “extended release” insulin while bolus is “fast-acting” insulin.

Basal insulin starts working within an hour of injection and will has a12 to 24 hour activity duration in the body. Bolus insulin starts to work within 15 minutes of injection and lasts about 4 hours. It is at its peak at around 1 1/2 to 2 hours after injection. Bolus insulin is given when your child has eaten anything with carbohydrates or when his/her insulin level is high.

How much?
Basal insulin

Your endocrinologist will prescribe the amount of basal insulin your child receives based on your child’s age and weight. It will also be based on a week’s worth of multiple night-time blood glucose readings. The basal levels will be adjusted so that your child’s blood sugar readings don’t get too high or too low at night. Your team will also review and change basal insulin levels based on your child’s rate of growth or if your child gets sick.

Bolus insulin
Figuring out the amount of bolus insulin is a little tricky. This is because every person metabolizes food a little differently and needs can change based on exercise levels, food intake, overall health and even the amount of sleep your child has.

Record keeping is part of the challenge here and seeing patterns in your child’s blood sugar readings before eating is also important. Also, if you need help, call your child’s physician.

The things that go into the calculations of how much insulin your child gets in a bolus is:
1) Blood sugar reading prior to injection
2) Amount of carbs about to be eaten
3) Amount of time since last injection of insulin
4) Environmental factors: sickness, activity levels, weather (warm or cold)

The Dario glucose monitoring system can help you keep track of all of this and even calculate the amount of bolus insulin that your child needs.

Remember, it’s not easy being a surrogate pancreas. You are doing the best you can!