Saturday, April 17, 2010

The game... continued

I started responding to a comment on my last post "Like a game, but not." when I realized I was breaking into another post... well more of a sequel or update.

I think at best we get about a week of "stability" from time to time.  It's been a while since we've gone 72 hours without a correction.   I went into our last appointment convinced that he was going to be well out of range and he was spot-on center (for 4 years old, they targeted his A1c at 9.0%, and he was exactly that).  But again now I see numbers bouncing around with an overall upward trend.

We made the adjustment to the long acting last night (only 1/2 unit, thank God) and he was sent off to bed at 6.7 (120) 2 hours after dinner.   Most often at that level he trends up; not last night.  At dinner +4 hours he was 4.0 (72) - juiced him (13g) and he was 8.1 by 11:00 and a smidgen higher at 3:00, 8.3 (150)... beautiful!  7:30 this morning, back to 4.1.  *Insert multiple expletives here*

Jonathan's been really into oatmeal for breakfast lately, not bad, healthy choice.  He also like a little chocolate syrup in his milk - OK not so great, but he eats well over all.  Now back to 4.1, kid needs to eat NOW.  I do the math: oatmeal + milk + chocolate = 52g @ 1:13....4 units.... Hmmm... Let me think about this for exactly 4.1 seconds, because I can't make him wait too long, but I need to decide what to do about this.  The cheat sheet says "if less than 4, dose after meal with 1 unit less".  So at 3.9 it's 3 units after, and at 4.1 it's 4 units before.  That seems like a huge gap for a 0.2 mmol/L (3.6 mg/dL) difference.  Hmmmm....

Being that he's with me all morning, I go for the 4 and test him 2 hours later at snack time: 19.1 (344) *Insert multiple expletives here*

On one hand I'm glad I didn't short change him after all, but on the other it could have gone the other way too.  On weekends I'm a little more apt to be on the aggressive side with insulin; school days I do a 180 and go conservative.  Today it seems I did the right thing so far.

Next stop on the glucoaster, Lunch!


  1. I wanted to comment because I love your word, "Glucoaster." And because You are spot on with your analogy. I hate the guessing doses when the boys wake up low. Now that they have pumps, the pumps do all the calculating for me which is a relief. Still get nervous though...had to send my husband to my youngest kindergarten class just one hour into school yesterday to make sure things were a ok.

  2. Thanks Meri! I go nuts some days, but I could never imagine being in your shoes; you're amazing!