Blimey! A day in the life of a Type 1 Diabetic Child with Coeliac Disease! that was a long title. I’m exhausted already!
This is a typical day for my daughter but I have chosen to describe a day that covers all her medical needs.
Waking for school was not so easy today, Beth felt low, I could see she wasn’t wrong as her hand shook whilst she attempted to brush her hair. It’s times like this when you have to approach her as though she’s suffering with all the symptoms of a hangover, grumpy and irritable doesn’t cut it! She’s 3.7mmol (could be worse) of course her blood sugars (BS) will have been lower than that at just before dawn. That’s when the ‘Dawn Phenomenon‘ (DP) kicks in, we all get it, a little release of Glucagon in the blood to aid us with the natural waking up process. Beth’s DP can raise her BS by 3mmol, now my maths isn’t fantastic but that a potential low of 1.7 … hangover central!
3 Dextrose tablets and 10mins later Beth’s back, who was that other girl? Goodness knows, lets hope she doesn’t come back!
Breakfast time, let me think, will madam be wanting toast with Nutella, toast with Nutella, or …. toast with Nutella? It’s the one saving grace in this mayhem that Beth’s tastes are simple and she doesn’t want for much. Back in the early days I spent hours blood, sweat and tears (well, not blood) creating dishes from scratch so that Beth didn’t miss out on ‘normal’ food. Did she like any of them? Did she heck! I’ve learnt that these were my issues, not hers so chill Rebecca and spread Nutella!
Toast toasted in Beth’s personal Gluten Free toaster (no risk of sneaky crumbs contaminating her food), another prick test 5.6, three slices of toast (15g each) three generous slatherings of Nutella (10g each) and sugar free squash. So that’s 75g of carbohydrate in total to add to Beth’s Personal Diabetes Manager (PDM) which is basically a remote control – yes, my daughters a cyborg! The PDM sends a signal to the insulin Pod that’s attached to her with a diddy cannula that delivers insulin under the skin. Simply type in the carbs to the PDM, this in turn calculates what insulin Beth will need to cover her breakfast, point the PDM and press confirm – job done!
Now for the science bit, did you know that fatty foods slow down the digestion of carbohydrates which in turn slows down the release of sugar in the blood (ALL carbs turn to sugar). By slapping Nutella onto Beth’s toast, I’m slowing down the absorption of three pieces of toast into her system thus ensuring she’s a happy bunny until lunchtime.
The time is now 07:30 and the day has only just begun!
Lunchtime she tests 11.8, this is a bit high ideally she should be between 4.5 and 7.5 she did have an apple at break time to keep her going, these are generally 20g of carb but we tend not to bolus (that means give insulin) for snacks at school. Her packed lunch was lovingly prepared by myself and carb counted, today it’s 85g of carb in total … as indicated by the Post-It Note I’ve slipped into her test kit!
Afternoon lesson and it’s cookery. Beth makes Gluten Free biscuits (all ingredients supplied by her fabulous school) each one adorned with a glace cherry. Now I could be wrong but my guess is that one or two cherries may have inadvertently popped into Beth’s mouth because at 16:45 when she does a prick test before dinner she’s 20.2 … it’s just a hunch!
Quick dinner tonight, the kids have Karate. A bowl of tagliatelle with tomato and mascarpone sauce, that’s 80g of carb – point and fire!
18:15, soon be Karate, going on previous experience Beth will go low half way through her 2hr lesson so I reduce her basal on her PDM – this is the tiny droplet of insulin that she gets every 10 mins 24 hrs a day. Exercise can reduce your BS dramatically but your muscles will continue to work after extreme exercise, don’t quote me but I believe 30 mins of lane swimming will still effect your muscles 12hrs later. A reduction of 20% in her basal for the next 3 hrs should do it.
20:45, home again and Beth’s started beeping! time to change her Pod. The Pods last three days only to reduce the risk of infection at entry site. Old Pod deactivated and added to medical recycling box, new Pod filled with 200 units of insulin, primed to squeeze out any pesky bubbles, apply to Beth’s tummy, point and fire! Then we have the waiting game, it’s a bit like Russian Roulette you hear a quiet clicking sound as the mechanisms fire into action then ‘SNAP’ a sound not unlike a staple gun and the cannula is injected 3mm into the skin and the needle withdraws, all within 200ths of a second! Well done Beth, no need to do that again for three days unless we have one of those dreaded Pod failures that can happen every once in a while.
Suppertime consists of two biscuits (16g) and a 250ml glass of milk (10g) … did I just see her add a sneeky spoon of sugar to the milk? She denies it, I’ll give her the benefit of the doubt. Prick test and she’s 6.8 add 26g of carb to the PDM – point and fire!
My bedtime, it’s now 22:45, I was going to have an early night (I say this every night) one last ritual before I can settle into the land of sleep. Beth’s a heavy sleeper so doing a prick test rarely wakes her, she’s 12.2 … mmmm maybe she did add sugar to her milk after all! Do I bolus to correct her or do I leave it, decisions, decisions. Well her supper bolus was definitely right (sugargate aside) but she did have a hard session in karate tonight, do I, don’t I. Oh sod it, I’ll leave it this time…….good job I did…..
03:00 Beth comes into our room ‘Mum, I feel low’ – 3.2 and so begins a new day.
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