Wednesday, September 10, 2008

Wow, it's been a while.

Summer happened and I haven't written in over a month.  Wow.

Lot's of things going on in our household for the last few months.  Cadence continues to grow at a furious pace which of course brings mass sugar roller coaster sessions.  We actually made a bunch of basal changes with her, mostly increases with timing tweaks, to accomodate her not breastfeeding any longer, and a ravenous appetite of a 22 month old.  I would like to say that we carefully and deliberately made incremental basal changes armed with the knowledge of hour by hour basal testing...but that would be bullshit.

We guessed.  Her sugars and basals were going along so great, so stable, then all of sudden it was like the pump turned off.  She had massive ongoing highs, sometimes taking 2-3 corrections to restore and horrible night time lows to boot.  All of this while Nic and Cadence were on the road in Windsor.  What's been interesting in our experience with a baby, now toddler with Type 1 diabetes is that it's a road less travelled and one that's even less maintained.  Almost no one, barring a few parents we've met online, have a clue how to manage a very young child with diabetes.  We're essentially blazing new trail.  So, after reading all the books, manuals, papers, guides, and websites we could about establishing insulin to carb ratios, Insulin sensitivity factors, correction factors, basal calculators....We took a W.A.G. , clinical lingo for a "Wild Ass Guess".  We doubled her breakfast basal, 30% increase to her afternoon, 15% dinner, 10% lower nighttime.  Guess what...it worked, she's doing way better now.

Now while I don't recommend anyone use this clinical approach for managing their diabetes, there's alot to be said about instinct.  I've talked to many diabetics who can tell you to within a few points, what their blood sugar is.  Certainly more accurate than the "acceptable 20% error" of traditional blood glucose meters.  It once again highlights one of the famous acronyms used in diabetes, which is: "YDMV" - Your Diabetes May Vary.  

The moral is that despite the rules and guidelines that are meant to help make decisions for people with or associated with this disease, asking questions and using your gut can be one of the finest tools of measurement at your disposal, certainly not one to be overlooked.  

Here's an experiment for all you type 1's out there, if an endo asks you how you feel...don't tell them your blood sugar first, answer the question.  It may change the approach to your care.

b.