Thursday, March 25, 2010

Pizza assault

My last few posts have been a bit of history, but today some current events.  Anyone that knows me knows that I can, on occasion, have a bit of a short fuse.  Be it a combination of a few nights of 2am BG checks mixed with a generous amount of caffeine today and some completely out-to-lunch customers, or simply the planets not aligned in my celestial house, or something a little more realistic in between.  Whatever the case, I was on a hair trigger today.

Jonathan seemed to have a similar day.  Now, I did wake up in a fairly good mood and I believe I left the house in a pleasant demeanor, but there is still the possibility that my bad vibes wore off on the little guy.  Then again, as I look at his numbers for the last 24 hours I start to wonder if there is a connection.

He had good numbers through the night.  Yesterday he was 6.0 at dinner + 4 hours which was a bit of a drop from his bed-time check hence the "2am" (or 2:22 after hitting the snooze button twice and ticking off the wife) but that was 12.6 so I rested easy the remainder of the night.  Breakfast was 8.2 (this is all mmol/L btw) which is nice to see, but today is an occasion and that's where things seem to have started to go off track.

About once every 5-6 weeks the school does a "pizza day".  The full day students get pizza, cinnamon sticks, and juice for lunch (depending if and what you order).  I have no clue how many carbs are in a "cinnamon stick", but I have about a half a year before we get there.  The morning kids however, aka Jonathan, can order a slice of pizza for AM snack.  In keeping with our "let the kid be a kid" philosophy, we let him participate in pizza day since it's not frequent thing.  When we have pizza, we usually count it at 15g-carb and this works ok.  A "slice" as we all know can vary wildly, but back to my point.

Since "pizza day" for Jonathan happens about an hour later than normal snack (and an hour closer to lunch), we send a note in his lunch log to reduce corrections by 1 unit since we don't want a slice of pizza eaten 45 minutes or so earlier to trick the nurse into giving him more insulin than he needs.  Again, this is all rough estimation, but has been successful previously.  His lunch BG was 18.0, so his insulin was 2.5+1-1=2.5 units.  When we checked him at dinner he was 17.6, so it may be safe to say he was high all afternoon.

Here's where it gets weird.  Jonathan is usually a really laid back and loving/lovable guy.  He's the sweetest kid, but not today.  When I arrived at latchkey to pick him up, he was sitting down and Miss. Deb informed me that Jonathan had something to tell me.  Jonathan immediately started crying, so I took him aside and tried to get him to talk about what had happened.  I managed to gather that he had hurt one of his closest friends.  He had thrown a dinky car in his face, and roughed him up a bit on the carpet.  I was really surprised.  Jonathan is not an aggressive kid, at least not that we've observed so far, so this brought two questions to mind.  The non-D question was, is this the beginning of some sort of behaviour that we need to get a handle on now (and I guess regardless of the answer to the second question, that would be a yes)?  But, the D question I pose now is, can/do high BGs prompt or exacerbate aggressive tendencies?

It's the second question I'm wondering if anyone out there has some insight on.  With rare exception, I am not one to accept inappropriate behaviour and excuse it on the basis of "an influencing factor".  It's my opinion that if highs = aggression that he needs to learn how to deal with it properly (I can't throw dinky cars at my customers, as much as I'd sometimes like to).  I'm just trying to find out if there could be a link between the two to help me better understand the relationship and help him learn to manage that.

Any thoughts?


  1. This comment has been removed by the author.

  2. High bg's(and low for that matter) can ABSOLUTELY cause them to do things. I was SO stressed with the way Justin was acting before dx. And I can tell a difference in his demeanor when his numbers are running a little higher now.

    Believe me... I agree 100% that they need to learn how to deal properly. But having said that... I don't think they can help it sometimes.
    I do get on to him, but I always make him check his bg before I decide consequences.

    This is just MY take on it...I hope it helps a little.

  3. We are just starting to see Elise's personality being affected by high BG. Up until now, we never saw a change, but lately we've been seeing some crankiness. I have heard stories of crazy temper tantrums from other Moms, so I know it happens. I think that Elise is still pretty young (and maybe also being a girl it manifests itself differently), so we haven't had to many issues.

    Sorry I'm not any help, hopefully the more seasoned veterans will chime in soon!

  4. HI,

    YES, the BGs I believe do effect their behavior. Joe can get very hyper when high and if in the right circumstances, I could totally see him throwing a "dinky" car at someone when he was 4years old AND high.

    You are right, I do think they need to learn how to handle it...with that being said, when they are so young I think it is pretty hard. Like Lora, I always check Joe if the behavior is questionable and then decide how I am going to proceed with consequences.

    On a side note...Pizza is our nemesis. We usually have to spread out insulin delivery for it or he will go low within 2 hours after the insulin dose and then he will be sky-high for 4-6 hours after that.

  5. Thanks to all of you. This is good info!

    Definitely the circumstances help guide the consequences. No doubt this will be on the bumpier side of the ride. I see some Wii free days in his future though.

    Reyna's comment brings up another thing I've been contemplating: Carb absorption….
    I've noticed from time to time that after a meal / proportional insulin he will be in range, but at +4 to 6 hours later he will skyrocket. This is easiest to observe in the evening as he has no carb intake after dinner unless to correct a low. I asked the nurses and dietician at the clinic and was told that carbs are absorbed in less than two hours, but I still wonder sometimes if either certain foods or certain circumstances make a meal more of a "time release" type thing where the sugars aren't getting into his blood until hours later. Chinese food is another wacky deal.

    Just one of my crazy theories I try to research from time to time.

  6. You are onto something my friend. I think each child/individual is different. But I have found time and time again that Joe can tolerate Pizza in the middle of the day...(I use a special setting on his give 60% of the insulin up front and then to spread out like 40% over a few hours). He will stay in the 100s to low 200s (not sure of the conversion to your measurements).

    If he eats foods like pizza or mac and cheese at night...well forget about it. All bets are off (he, no matter what I do, will skyrocket and it takes several corrections to get his number down). I have played with his pump settings, but don't like to "crank" up the insulin while he, and we, are sleeping. It makes me nervous. We haven't EVEN ventured to Chinese...haha...Joe has had D for 3 1/2 years and still hasn't had Chinese food. I've been meaning to tackle that one. haha.