It’s late at night as I’m writing this.
The reason I’m up is because of Type 1 Diabetes. One of our kids has it, and we have to check her blood sugar (or blood glucose — the terms are pretty interchangeable unless you’re working to educated someone that no, there’s not granulated sugar inside someone’s veins) at a certain time tonight.
The reason we have to check it is because she has insulin in her system right now and we have to make sure that her blood glucose is at a good over-night level and won’t dip low while she’s sleeping. Having low blood glucose can be dangerous, and we want to avoid that.
The reason she has insulin in her system is because as we were getting into jammies and reading bedtime books, her blood glucose (BG for short) was not in her target range — it was too high. That required an injection (we use syringes and are just now beginning to look into the insulin pump system of delivering insulin) of fast acting insulin. That insulin stays active a certain amount of time, and we have to make sure she’s at a certain BG so she’s safe from experiencing lows overnight.
In true Give-a-mouse-a-cookie form, we’ve got reasons all over the place up there but none of them can tell us why exactly her levels were high or, for that matter, why our daughter even has T1D.
Many people learn to discern when they are having a low. Some people are irritable, some feel shaky, others get super hungry or tired. These are things our daughter is learning to recognize, but it’s pretty hard to tell when you’re asleep.
The thing is, there was every indicator to believe that tonight our daughter would have a lower BG at bedtime than on some other nights since she had a bath. [‘Once a month whether you need it or not’ my dad used to joke.] Baths tend to send her low. So when we checked her and discovered she was high, it put us in a tricky spot.
- Based on prior experience and information we know baths send her BG low.
- She still had active insulin in her system when she had the bath. In theory, this should have sent her lower rather than higher.
- Now that’s she’s high, if we give her insulin, will it hit all at once and send her low?
- If we don’t give her insulin, will her BG stay at this high level or even climb higher overnight?
- Can we cheat and just give her a little bit and check on her when it wears off and give her more if she needs it?
Lots of factors in that one decision.
What I’m learning is that this is the nature of the beast when it comes to T1D. We can follow the guidelines and ratios exactly two days in a row and get different results on each of those days. People’s BGs are so variable for so many reasons, many of which are unseen, that it feels like being at that tea party in the Alice in Wonderland story, constantly swapping seats and people shouting out new rules and then changing them or not following along. This doesn’t mean we’re doing anything wrong, even though it’s easy to second guess every decision you make when you’re managing someone’s T1D. The stakes feel very high. Every decision feels like it carries implications for her overall health and welfare. I already felt that pressure as a parent before our diagnosis. It’s only amplified now.
Knowing that we can do what we can do when it comes to managing Type 1 Diabetes helps release me from its grip. Knowing that we can never completely factor in stress, growth spurts, hormone changes, outdoor temperatures, excitement, activity lets me realize that I’ve placed unrealistic expectations on myself. We can keep her safe, we can be as prepared as possible, but we’re not going to stay within that target BG range constantly. That’s just the way it is with BG, with T1D. It doesn’t mean we’ve done anything wrong, or overlooked something we should have caught.
It’s just the way it is.