Tuesday, 21 July 2009

Adjusting insulin is a big part of diabetes management for type-1 diabetics

Adjusting insulin is a big part of diabetes management for type-1 diabetics, so I would definitely encourage you to flesh that conversation out w/his nurse. However if his diagnosis is not that old, he may indeed be in that honey moon phase where his body is still producing insulin and/or glucagon. I know for me, I use a sliding scale w/my Novolog (the sliding scale is based on insulin-to-carb ratio). On a sedentary day my scale is 1 unit of Novolog per 5 grahams of Carbohydrates. On a day after I've played a soccer match, my scale is about 1 unit of Novolog per 10 grahams of carbohydrates, but that is me as a person whose body/BS is greatly influenced by exercise. It is truly a God-sent that your son can feel his hypoglycemia. I've also
been one of the lucky ones who is able to notice physically, when I go low. My mom always knew by saying "your eyes are at half-mast" or "you're looking pale and peeked, time to test!" To answer your question, I always test my BS after a 15-minute interval. Sometimes I test 20 or 30 minutes after my initial low BS b/c the body needs time to digest the food and break down the sugar. Usually the fast-acting stuff, OJ, Starburst etc. is enough to propel me to a decent number that I will maintain for the rest of the day. However, if it is a day full of exercise (like heavy walking), I often follow a quick fix (two to three starbursts) with a protein-filled snack, like a Reese's Peanut butter cup, a nutty granola bar, or just straight almonds or peanuts b/c the carb count is lower w/nuts and they are a great source of protein.

Lastly I wanted to say that there is definitely a sort of "mental" component. One where even though the BS is on the rebound, the body still "feels" low. I know in these cases I have sometimes over-treated. For example I'd have a bad low of say 45 mg/dl, I'd drink my OJ and still feel very "shaky." I tested fifteen minutes later only to be at 55 mg/dl. More OJ. Another fifteen minutes go by and I'm only at 65 mg/dl, so more OJ. By the time I test 45-minutes after my initial low of 45 mg/dl I'm at 128 mg/dl, GREAT I'm finally in-range. Then I test an hour later and I'm at 280 mg/dl. It was the adverse effect of too much fast-acting sugar. So you have to watch out for that. Although I wouldn't be too worried, as it sounds like your son is going more hypo than hyperglycemic. Overall it sounds like you have a great handle on the situation and are a strong mom who is doing everything she can for her kid. Hope you get to enjoy the rides w/all this information being thrown at you!

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