Preparing My 10 Year Old Daughter with Type 1 Diabetes to Manage her Disease Independently

We did it! My 10 year old daughter, Madison, who has type one diabetes went to the movies, the park and out for pizza without anyone educated or trained (just prepped) in her disease for the very first time! And I learned a lot from this experience.

First, I learned that Madison needs to understand that when she eats, it takes about 2 hours before her blood glucose will start to go down. Of course there are exceptions to this rule such as she is running around. Typically when a child with type 1 diabetes eats, their blood glucose will go up and peak about 2 hours later and then start to go down and stabilize.

Yesterday, Madison called me after the movie to let me know that her blood glucose was 323. She had eaten lunch at Noon. Then she ate candy at 1:30 pm with a blood glucose of 256. Her blood glucose still hadn't peaked from lunch. So eating more sugar with a higher blood glucose will make her blood sugar go up higher. The 323 was expected. I told her give it an hour and her blood sugar will start to go down. She felt a lot better after she called me.

Second, I should have educated her friend's dad on who to call for an emergency such as 911 and me! I think it's also important to be aware of the Glucagon pen. It's like an Epipen and used if a person with type one diabetes experiences hypoglycemia and passes out.

The following is how my husband and I are preparing our daughter to become more independent. This is a life threatening disease and it isn't easy for us to let her go out an entire day without us.  For me to feel comfortable, I need to know that she is responsible enough to take care of a disease that has life threatening results if not managed properly.

• Prepare her medical / diabetes bag. In Madison's bag, we always have the following:
• Meter including finger pricker and test strips
• CGM (if she's not wearing it)
• Two 4 oz juices
• Container of Ritz peanut butter crackers
• Wipes to clean her fingers for an accurate testing
• Glucagon pen (for emergencies)
• Ketone strips
• Parents and doctors (endocrinologist) numbers
• and sometimes Glucose tablets. These don't work as fast for Madison, so we hardly use them.
• Check her blood glucose using a finger pricker, test strips and meter
• Administer insulin using a wireless meter, her pump and/or shots. We've just required Madison to know how to administer insulin using her pump because that is all she uses.
• Understand what to do (and how it feels) if their blood glucose is low (hypoglycemia). Every child is different, but when Madison is low - below 80 - she needs a 4 oz juice and a few peanut butter crackers. 
• Know what to do (and how it feels) if their blood sugar is too high (hyperglycemia). 
• Be able to test for ketones using ketone strips.
• Know that when their blood sugar is too high they shouldn't be eating carbs. They can still eat non-carbs (cheese, meat, celery, cucumbers, pickles). Once their blood sugar goes down to a good number (we like 180), they can have a carb again.
• Have a phone readily available. We let Madison borrow her brother's phone so she didn't have to keep asking her friend's dad. She texted me a few times and then called three times. It gave her peace of mind that I was there if she needed me. When we spoke, I had her answer her own questions versus me giving her the answers.

I would love to hear other ideas or suggestions for how to continue helping my daughter become more independent!

Other posts:

• Overprotective Mom Did It! My Type 1 Diabetes Girl Is Out At The Movies Without Me
• Managing Your Child's Type 1 Diabetes During Sports Tournament
• Diabetes - Differences Between Type 1 and Type 2 (Sept, 2013)Back to School Type 1 Diabetes Survival Tips for Parents (Aug, 2013)

Dexcom G4 CGM for Type 1 Diabetes Review

I love the Dexcom G4 CGM! But I also am not the one with type 1 diabetes, or the one wearing it. It's my 9 year old daughter who is testing it and we've had some not so great moments with it. But the pros are outweighing the cons.


My daughters Dexcom is pink.

Madison was diagnosed 2 1/2 years ago with type 1 diabetes. Within 8 weeks we had her on an insulin pump, which made our lives easier (not great, but easier), with managing her type 1 diabetes. Last summer, I started to suggest that she try a continuous glucose monitor (CGM). She wasn't excited for several reasons:

1. It's another attachment. My daughter is an insulin pump user, which requires an inset to be attached to her body so insulin can flow from the insulin pump into her body. The CGM sensor attaches to your body and then wirelessly sends your blood sugar readings to a device that interprets and shows them in graph format.
2. With the Dexcom G4 CGM, you have another device to be responsible for. And they are pretty pricey to replace!

The reason I was pushing her to try it was because she started to experience loss of hypoglycemia sensitivity. She wasn't feeling her lows. A month ago, after having quite a few blood sugar lows of 60 and then one at 41 where she didn't feel the lows very well, she decided to give the Dexcom G4 Pediatric CGM a try.

Why we chose Dexcom G4 CGM:
I chose the Dexcom because it was a smaller and a less bulky attachment compared to the Medtronic CGM. It also had a separate receiver, allowing my husband and I to quickly see Madison's blood sugar readings. And from the reviews I had read, it was more accurate.

It arrived in three boxes. One box was the receiver. Another was the transmitter. And the third was four sensors.

 

Our positive and not so positive experience the first week:

• The CGM sensor/transmitter attachment was a lot bigger and bulkier on my daughter than it was on the adult we saw it on. 
   
  
• Having another attachment really was a downer for my daughter and I. She already had her insulin inset attached to her. This one took up so much space on her belly and made me sad that her baby skin was being pricked again.
   
  
• First day blood sugar readings weren't accurate at all. I learned why. The CGM is reading bodily fluids and not blood sugar. As such, we have to teach it that what it reads for a bodily fluid number equals the blood sugar reading. It really is cool. In fact, on day two, the results were amazingly accurate and have been since.
• On day two, my daughters sensor came off. We had it attached to an area just above her butt. It wasn't the best location, because I had attached it right where the top of her pants was. When she went to the bathroom, her pants got hooked on the sensor and ripped half of it off. The company replaced the sensor for us, which we were so happy about!
• The 2nd sensor lasted us seven days! I loved it! But my daughter didn't.
• First, why I loved it. It gave me accurate readings of her blood sugar, allowing me to prepare for her highs and lows. It also allowed us to not prick her fingers so much.
• She loved the fact that it gave her more accurate blood sugar readings, but hated that she had another attachment. The spot on her belly bothered her. It got in the way when she was sitting and felt awkward. We also had to put another piece of adhesive on it to make sure it didn't come off this time. She said it really itched. When we took off the CGM sensor on day seven, she had a rash that looked like it was irritated.
• It ended without allowing a grace period. I was so pissed! So, on day seven, the CGM sensor had reached it's life at 8:15 am - 45 minutes before we had to head to an all day fastpitch tournament. Later, I found out that it does give you an advance warning, which must have happened when we were all sleeping. Going back to 8:15 am.  I heard this beep coming from the CGM and then saw an image that looked like a red light / stop light. I pressed the button and it turned off. I was so pissed. We were heading out of the house to a softball tournament and the stupid thing ended. I called Dexcom. 45 minutes later they called me back. By that time, I had already changed my daughters sensor. Not without tears though. She shed a few tears because she needs a little more time than a few minutes to plan for stuff like this. She hates needles. She hates doing this. And removing the sensor attachment and putting another one one just wasn't something she was excited to do. But she did it at 8:55 am. Then we had to wait two hours before we got a blood sugar reading. Timing sucked. Exactly when her game started, the CGM receiver beeped asking us to enter two blood sugar readings. Thank heavens she was 5th at bat. We hurried and pricked her finger twice and then entered the blood sugar readings. From that moment on, the CGM was such a benefit. It gave us the most accurate blood sugar readings and we didn't have to prick her fingers during the tournament, except for lunch.

So, we are still in the testing period. As a mom, I love it because I don't have to prick her fingers as much and when she is running around, I get a quick snapshot if her blood sugar is starting to go down. But as a mom, I also hate it, because it covers a large part of her belly and she has to lug around a device so she can get a glimpse of her blood sugar results. She said this sensor attachment doesn't bother her as much. We put it higher so it doesn't interfere with her insulin pump fanny pack type bag. She also likes knowing her blood sugar more often.

My Type 1 Daughter Treated Herself For Wrong Blood Sugar

This morning, as I was getting the kids ready for school, I noticed I hadn't filled out Madison's type 1 diabetes sheet that lists her blood sugar for breakfast, total carbs she ate, and the carb count for her snack and lunch. I nonchalantly asked her what her blood sugar was. She told me 156. As I was writing the number on the sheet, she then told me that she might have changed it on her meter and given herself insulin for a blood sugar of 212. My eyes basically popped out of my head.

I really thought Madison was joking, but then I checked her meter and she did treat herself for a blood sugar of 212. All I thought was, when the heck is this disease going to become less stressful?

I actually left her as is and didn't give her anything to eat because I wasn't sure of the numbers. Even though Madison said she increased her blood sugar reading on the meter to 212, I wasn't 100% sure she really did. It just didn't seem realistic that she would have done that. Yet, she was so sure that she did. And there was no history or log that I could find within the meter that showed otherwise.

Instead, I emailed her teacher and the nurse to give them a heads up on what had happened and to watch her. If she would have given herself too much insulin, her blood sugar would have been lower than normal in the morning. It's 12:30 pm, and I guess everything must be fine because no emergency texts have come my way.

The more freedom I give my nine year old daughter to check her blood sugar and give herself insulin, the more I realize how easy it is to make mistakes using her current meter and insulin pump. She can easily change her blood sugar reading result. She can easily change her settings without a parents approval or password. She can easily give herself more insulin or less insulin. And she can easily prime the insulin pump, which could kill her.

I'm disappointed in the lack of safety protocols on my daughters insulin pump. Mistakes like this shouldn't easily happen. I know the technology has significantly advanced, since the 50's. But as a mom, wanting to give her daughter more freedom and control in managing her blood sugar, her current meter and pump doesn't give me the confidence that she will be safe.

Madison presently uses the Animas One Ping. I love it because of it's wireless ability. You can bolus your child wireless using the meter. It's heaven, especially when you are out in public. You don't have to pull out her insulin pump to give her insulin. Instead, you do it straight from the meter. But there are downsides like the meter not communicating with the insulin pump and only partial insulin delivery goes.

I'm sure every meter and insulin pump has it's positive and negatives. I'd love to hear your experiences with your meter and insulin pump. Right now we're looking into the Dexcom G4 CGM (continuous glucose monitor) and Medtronic.

How To Manage Your Child's Type 1 Diabetes During A Basketball Tournament

We won! My nine year old daughter's U10 Girls Basketball Team won their tournament! They are the Charlotte Mecklenburg champions! And my daughter made two amazing baskets, which looked easy during the game, but truthfully hadn't been easy during the season because of her type 1 diabetes.

 

 

Figuring out her best blood sugar level for each of my daughter's sports hasn't been easy. For softball her blood sugar level seemed to work well in the low 200's. Soccer the same. And, I actually thought it was also a perfect number for basketball. But yesterday's basketball championship game proved me wrong.

Every game this basketball season, Madison's blood sugar has stayed steady in the low 200's. Usually around 211 - 226. And we worked hard to get it to that level by making sure she didn't eat certain foods such as pizza, meatball sub, pasta, rice, or a bagel before a game. Those foods keep her blood sugar high for a longer period of time, where she has a harder time focusing and concentrating.

During the game's, Madison appeared fine, blocking shots and trying to make shots. Every so often she would have a delayed response or a puzzled look on her face. I wondered if it was due to her blood sugar (type 1 diabetes) or her not understanding the play. But after yesterday's game, where her blood sugar was 126 at the start of the game, I'm starting to think her puzzled looks and inability to think quick on the basketball court had to do with her blood sugar being too high for this sport.

Madison was like a totally new basketball player on the court yesterday. She was leaping out of no where for the ball. She took shots and even got two in. I was so proud of her, yet so disappointed in myself that she played the entire basketball season with a blood sugar that was too high for her to really perform at her best. My husband and I have kept it higher, fearing it would drop fast and then she'd crash. I hate seeing her shake and her face turn pale when her blood sugar is low. It's scary for her and me. So keeping it higher is a much more comfortable zone for us. At least, I thought. But now I know differently.

Fastpitch U10 softball tryouts are this weekend. And I'm coaching, which gives me the opportunity to be hands on with her type 1 diabetes and do some trial and error. I'm going to try to keep her blood sugar around 130 - 150 for all games. I know that won't be possible all the time; especially because she always seems to go through growth spurts during the spring season and the heat causes her blood sugar to increase, forcing me to make lots of changes to her insulin levels. But I'm not giving up! And I hope every parent who has a child with type 1 diabetes doesn't give up too!

We as parents of children living with type 1 diabetes have a responsibility to teach your child how to eat properly and manage their disease so they can perform at their best academically, intellectually, and athletically now and continue into their adult age.

What I learned:

• Don't feed the disease.
• High carb foods like pizza, fried rice, pasta, and a bagel keep my daughters blood sugar high too long, causing her to not be able to perform at her best in school and sports.
• A blood sugar of 126 worked amazing for my daughter during her basketball tournament. Of course, I was nervous the entire time, wondering if her blood sugar was dipping below 100. It didn't!
• After a sports game, parents need to keep a close eye on their child's blood sugar because it takes hours for it to become stable again. In fact, last night, after my daughters basketball game (4:30 pm), we checked her blood sugar and it was 90, so we fed her dinner. At 8:15 pm it was 227.  I knew it was going to drop a little more, so I didn't treat it. At 11:00 pm, my husband checked her blood sugar and it was 60. He had to wake her up and give her a juice and a few peanut butter crackers.

FDA approves pediatric use of Dexcom’s G4 Platinum continuous glucose monitoring system

Press Announcements FDA approves pediatric use of Dexcom’s G4 Platinum continuous glucose monitoring system

Five Ways To Make Type 1 Diabetes Fun For Your Child | Working Mother

Every parent who has a child with type 1 diabetes knows this is not a fun disease to live with. You have to prick your fingers eight to twelve times a day. You have to count every carbohydrate that you eat. You have to be careful for blood sugar highs and lows because they can cause hypoglycemia (blurry vision, hunger, irritability, shakiness, fast heartbeat, fatigue, and headache and possibly even passing out) and hyperglycemia (increased thirst, frequent urination, headache, stupor, inability to focus).

As a parent with a nine year old daughter who has had this disease for two years, I've become an expert on managing her blood sugar highs and lows, making sure the tips of her fingers don't turn black because she pricks one more than the other, and teaching her how to take care of herself so she grows up to be a healthy confident adult. But this isn't the only thing that I'm teaching her. I'm also teaching her how to find ways to have fun in between the not so fun moments.

Below are five fun ways to make living with type 1 diabetes fun! The little things such as the below has truly made a difference in my daughter's life. And the smile I get when I do one of them is so worth it!

1. For dinner, eat dessert first. Then eat the meal.
2. For breakfast have a piece of birthday cake or a slice of pizza. My daughter has been invited to late night birthday parties and has been unable to eat the cake because of the time of day. So instead, we wrap it up, take it home, and she eats it for breakfast.
3. When changing her inset, I let her take the pump off for an hour and a half, and without any inset or tape on her behind (that's where we have to attach the inset) she can run around and have some freedom.
4. Give a lollipop after your child's plays baseball, basketball, or other extracurricular competitive game. After every softball, basketball, and soccer game, I surprise my daughter with a different colored lollipop. This keeps her blood sugar from dropping fast and also puts the sweetest smile on her face. It's her special treat after the game.
5. Sneak two pieces of hershey kisses into your type 1 child's lunch box. I usually try to sneak two pieces of chocolate because it doesn't affect my daughter's blood sugar as much as other treats. And she loves chocolate! Two Hershey kisses are only 5 carbs.

I would love to hear how other parents make their type 1 diabetic child's life fun! I plan on writing a children's chapter book about an elementary aged girl finds out she has type 1 diabetes. It will be one in my Wunderkind Family series.

Type 1 diabetes (T1D) is an autoimmune disease in which a person’s pancreas stops producing insulin, a hormone that enables people to get energy from food. It occurs when the body’s immune system attacks and destroys the insulin-producing cells in the pancreas, called beta cells. While its causes are not yet entirely understood, scientists believe that both genetic factors and environmental triggers are involved. Its onset has nothing to do with diet or lifestyle. There is nothing you can do to prevent T1D, and—at present—nothing you can do to get rid of it.

Type 1 Diabetes Triggers Anxiety Attacks During Soccer Game

I know every family has their worries and concerns, especially when it comes to their children. But parenting a child with type 1 diabetes is so much more complex then anyone realizes. It was this past weekend that I accepted the fact that Madison's type 1 diabetes disease is also triggering anxiety attacks and causing her difficulty breathing when her blood sugar is too low (below 80) or too high (above 225).

It all became apparent for me on the soccer field. As her soccer coach and mom, I constantly worry that she's not going to be able to play up to her potential because of her disease. And the past three soccer games she hasn't been able to. In fact, for three games in a row, she has taken herself out of the game because she wasn't able breathe. The last game she walked off the field when all the kids were still running around. She didn't even yell to me that she needed to be substituted. Her blood sugar made her feel so bad that she just couldn't even yell. She said, "I thought I was going to pass out and you would have to call 911."  I tried so hard to hide my emotions. But I was angry and frustrated. I have really come to hate this disease.

From the sidelines, parents have mentioned how great she's doing. She scores and she's able to make a few good plays. She even gives them the impression that she's running just as much as the other girls. But as her mom and her soccer coach, she hasn't been herself. And she's walking and standing so much more than she has in the past.

Madison was born to run. If she could run all day long, she would. But lately, for unknown reasons, her blood sugar has stayed above 250 during our soccer games, causing her to have a real difficult time breathing if she runs to much. I've tried moving her to defense and even goalie where she can calm down and not run as much. But she feels even worse when she's just standing around. The reason she feels worse is because her blood sugar is already high and when she stands around, she's not burning it off, making it go higher.

Seeing my daughter take herself out of the game is heartbreaking. Tears filled her eyes last game. And the only words that entered my mind was hers. When she was five years old she said, "Mommy, I want to be an Olympic soccer player." And ever since she was diagnosed (November 4, 2011), I feel as if her dream may not become reality. I'm not giving up and I hope she doesn't too. But boy this disease has really been the greatest challenge she and I have ever had to face.

Many of you may be thinking, Just change her diet. Wish it was that simple. This past Saturday, the morning of her game, she had eggs, bacon and a half of banana. I wanted her to have some carbs (the banana) so her blood sugar wouldn't drop so fast. But it didn't matter that she had a low carb breakfast. Her adrenaline and stress kept her blood sugar above 260 the entire game. After the game it went up to 300. Then within 30 minutes it dropped to 80. I was angry that her blood sugar was outsmarting me. I literally have a competition going with her blood sugar and I'm going to win!

We have two games left in the season and then our tournament starts the weekend of November 9th. This disease isn't going to control us or win! I truly believe there has to be a way to help my daughter do the things she loves to do at her potential.

The following is what I'm going to try this week.
This week I'm going to have her visualize seeing herself running and scoring and playing up to her potential. I'm going to work with her on breathing techniques. And then on Saturday, I'm going to eliminate the banana from her breakfast and have her eat a bowl of cereal (1/2 of a cup of Honey Nut Cheerios) along with eggs and bacon.

I'm keeping my fingers crossed that the above will work. If you have had any experience with type 1 diabetes and anxiety, I would love to hear how you have been able to manage anxiety and difficult breathing for a type 1 diabetic.

Thanks so much for your support!

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Back to School Type 1 Diabetes Survival Tips for Parents

Back to school is right around the corner, and school shopping isn’t the only thing that a mom and dad of a type 1 diabetes child needs to plan and prepare for. They also have to make sure the staff at their child’s school is trained and educated on how to take care of their child’s highs and lows; They need to ensure their type 1 child has enough supplies (medical, food and drink) on hand at school; And they need to plan for the unexpected. 

Below are some tips and strategies to help parents of type 1 children get ready for back to school. Please feel free to share any that you have too in the comments section!

• Get the class and activity schedule before your type 1 diabetes son or daughter starts school. This helped me with trying to set-up my daughter’s insulin pump basal rates during the day. For instance, before she got on the school bus, I lowered her basal enough where her blood sugar wouldn’t drop to where she was at risk of a seizure or passing out. We also worked out a plan for recess where my type 1 daughter would take off her pump and leave it on her desk. This way when recess was finished, she would see her pump on her desk which reminded her to put it back on.
• Schedule a training with the teacher and nurse prior to school starting. I went in a few days before school started and trained my daughter’s teacher on how to manage my type 1 child's diabetes at school. We discussed lows, highs and the unexpected such as how to handle rain days and substitute teachers.
• Provide your teacher with a bullet list of what if scenarios. The information I included were things like what if it rains and what if she drops food on the floor during lunch and what if there is a substitute teacher and what if she has a test after lunch. I also included things like how to tell if my daughter was low or high symptoms and how to treat them. 
• Create a daily log sheet that is sent home every day. Every morning before my daughter goes to school, I fill out the date, what her morning bg was, how many carbs she ate for breakfast and how much insulin I gave her. I also list what her snack carb will be and breakout her lunch items along with carb count. My daughter takes this to school with her and the teacher fills it out every time my daughter checks her blood sugar and administers insulin. The daily log sheet went home with my daughter every day. This helped me in making the necessary basal rate changes to her pump.
• Exchange cell phone numbers and email addresses if you can. My type 1 daughter’s teacher was awesome! She would text or call me whenever she had a question or wasn’t sure how to handle a situation (and there were many!). The most challenging part during last year’s school year was trying to get my type 1 diabetes daughter’s blood sugar low enough so she could participate in PE. She ate breakfast an hour before PE, which always caused her blood sugar to be right around 300 at that time. Our school will not allow a type 1 diabetic to participate in PE if their blood sugar is over 300. They also will not allow them to get on the school bus if their blood sugar is over 300 or too low.
• Create a type 1 diabetes at school supplies container. I bought a plastic container with a cover from Target which I filled with sugar tablets, 8 pack of juicy juice boxes, peanut butter crackers (protein), an extra glucose meter and ketone strips. Whenever my type 1 daughters supplies started to run low, the teacher would make note of it on the daily log sheet she sent home.
• Have your child carry a diabetes bag filled with sugar tablets, a juice box, protein, and meter (and test strips/lancets/finger pricker). They will need to take this everywhere they go.
• Discuss with your child's teacher and your child where they will check their blood sugar in class. For my daughter, the teacher set-up a table in the room where she could check her blood sugar. This is where my daughter kept her diabetes bag, daily log sheet and whatever else she needed.
• Determine how and if your type 1 child will share their disease with the students. We had my daughter take one of her type 1 diabetes books in for the teacher to read to the class. Then the teacher opened it up for discussion.
• Make sure your child's classroom is not an allergy classroom or has peanut allergy restrictions. Protein is a must for keeping a type 1 child's blood sugar stable. And peanuts and peanut butter work great!
• Fill out proper medical and school paper work, and know your legal rights! We have my type 1 daughters endocrinologist fill out diabetes medical management plan detailing my daughters insulin levels and what range her blood sugar should be kept at. In addition, we completed a 504 Plan which allows my daughter to take an exam at different times if her blood sugar is too low or too high. It also allows her to be excused from class during an exam if she needs to go to the bathroom.
• Know your legal rights.

Other tips for dealing with seemingly small problems that can depress children about having type 1 diabetes(e.g. all the good cafeteria seats being taken by the time a child returns from the nurse at lunch or having to carry their supplies around with them all the time).

• Try to invest in a diabetes bag that your child likes. My type 1 daughter picks out everything herself. She likes using a mini backpack. We also got her an insulin pump sports waist band from Pump Wear, Inc. that has cheetah prints on it and some fun things from Pumptastic. 
  
• Have someone reserve a seat at lunch or during a school event for your type 1 child. My daughter’s twin brother tries to hold a seat for her at lunch, while she’s in the classroom checking her blood sugar. I would talk to the teacher about helping make the diabetic child comfortable, where they can ensure the type 1 child gets to sit next to their good friend.


• Plan ahead for a celebration or party. There have been many occasions where my type 1 daughter hasn’t been able to eat during a celebration because her blood sugar is too high or it’s 30 minutes prior to the bus leaving. When that happens, I have the teacher wrap it up and let her take it home. In fact, there were quite a few times where they wouldn’t allow her to take the bus home because her blood sugar was over 300 bg. I have three kids at the elementary school. When my daughter unexpectedly couldn’t ride the school bus, the school staff would have to frantically run around and get my other two off the bus so I could pick up all three together. After a couple instances like the above, we put a plan in place where if there was a birthday celebration or treat up to one hour before my daughter got on the bus, then she would take the treat home.


• When a substitute teacher is in her class, my type 1 daughter has to go to the nurse to have her blood sugar checked. There always has to be someone with my daughter when she checks her blood and administers insulin. It’s a protocol her elementary school has. At my daughters school, the nurse is only there three days a week. On the days the nurse is not there, another diabetes trained school staff member sits with my daughter when she checks her blood sugar or administers insulin.


• Like I mentioned above, my type 1 daughter has missed part of PE or all of PE at least half of last year because of the time it’s held for her specific grade class. I have her color or play a game. I try to have her do things she likes to do during that time because she can’t run around and play.


• Your type 1 child drops food onto the floor or spills their drink. You’ll find that the teacher will panic more than your child. Try to estimate how many carbs your type 1 child dropped on the floor. Then supplement with something else. We always had extra peanut butter crackers on hand to supplement what fell onto the floor. And this definitely happens!


• It rained or snowed. If your child doesn’t take their pump off during recess than most likely your child’s blood sugar will be higher. If you are able to send in a note that informs the teacher to give your child a little more insulin at that time, you’ll be able to manage these highs better.


•  No nurse at the school! The nurse at my daughter’s elementary school is only there three days a week. It is required that a trained diabetes adult has to give, help or observe my type 1 daughter when she check’s her blood glucose and bolus’s herself (bolus means give insulin). For insulin shots, two trained diabetes adults MUST verify dosage and be in the room while administering insulin at my daughter’s school. Mistakes happen. I love that my type 1 daughters school has such strict rules.
  
  

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Safety Preparation for a Type 1 Diabetic Child

Last week, we experienced severe weather storm warnings, which encouraged everyone in Union County, NC to get to the lowest level of their home in case of an unexpected Tornado. After the Oklahoma tragedy, we took this warning seriously. My kids and I ran around frantically, gathering and lugging down the following to our basement bathroom - food, water, diapers, baby wipes, toilet paper, towels, and type 1 diabetic supplies.

Once everything was in place, we sat near the bathroom, doing homework and waiting to see if the storm would bring the unexpected-a tornado. It didn't! Thank heavens. But what if it would have? What if a tornado did form just before we were able to gather my daughters type 1 diabetes supplies or diapers for my baby?

That one warning made me realize that I needed to prepare for such possible events now. The following is what I would recommend keeping near the place you plan to hide if a possible tornado did form. I also shared a list of things you should always have with you in your car, just in case your car breaks down, you are stuck in traffic, or you got into an accident. We've been stuck in traffic for hours at a time, unable to get off the road. Being prepared is a must when you have a type 1 diabetic child.

Severe  weather warning:

1. Always have your child's type 1 diabetic bag with them during a severe storm warning filled with at least one juice, the Glucagon pen, sugar tablets, meter, test strips, batteries for meter and insulin pump, and protein (such as peanut butter crackers or Slim Jim). We also have frosting in my daughters bag, along with syringes.
2. Store a package of juice (8 juice boxes per pack), case of water, sugar tablets and a box of peanut butter crackers in your basement where you will be hiding.
3. Keep an extra meter kit.
4. Keep an extra unopened insulin pen if you are able too.
5. Make sure you keep extra batteries in their diabetic bag or in this area. Your child's meter or insulin pump's battery could die.
6. Store a pad of paper and a few pencils for the kids to draw and doodle. If you have an extra card set, store that too.

Automobile:

1. Always have your child's type 1 diabetic bag with your child.
2. Have an extra finger pricking device in your glove compartment. We've broken ours when we have been out and about. We were lucky we had stashed an extra in our glove compartment.
3. Keep extra waters and juice in your car. If it's too hot to keep them in there all the time, then make an auto diabetes bag (in addition to your child's type 1 diabetes bag) that you take with you whenever you are in the car. I have a Thirty-one bag that I store water, juice, sugar tablets, baby wipes, and box of peanut butter Ritz crackers that I take with me whenever I drive.

I would love to hear any additional supplies or tips that you may have!

Learning Lessons for Managing Type 1 Diabetes with Sports

I love playing sports, especially softball and soccer! And I feel blessed that my daughter Madison loves playing them just as much as I do. But managing Madison's blood sugar during and after a game is like a weather person trying to predict which direction a hurricane will go in. There are so many variables (weather, meal, emotional state, growth spurt) that can trigger it to go in a direction you just wouldn't have thought possible. And last night, Madison's blood sugar dropped way below her norm while she was sleeping all because of playing in a tournament fastpitch softball game, which they won.

For an hour and a half, every kid and parent was on a high, including Madison's blood sugar, which stayed around 230, even after I gave her insulin during the game. I had hoped it was closer to 150 for several reasons. When Madison's blood sugar is above 250, she has a harder time hitting the ball. She also starts getting fidgety out in the field where she's moving and wiggling a lot more than normal. And she also starts getting more emotional.

But last night, no matter what I tried (giving her insulin and having her do jumping jacks) her blood sugar decided to just maintain itself around 230 a result of being ecstatic from hitting a home run, sad from striking out, pitching to a new team, and anxious for the next play. After the game, I let her have a lollipop and decided not to have her check her blood sugar. From past experience, I've found it's not worth having her check her blood sugar immediately after a game unless she feels really low. Usually after she's played a game, her blood sugar will continue to drop for at least 20 to 40 minutes afterward.

When we got home, I had her get ready for bed and then we checked her blood sugar at 8:27 pm. The meter said her blood sugar was 125, a number that is perfect. But something inside me thought she may still drop, so I gave her four Ritz peanut butter crackers, hoping that would keep her blood sugar around 125 throughout the night. But it didn't.

Usually, we don't check her blood again until my husband goes to bed which is around 11:00 pm. But last night, I had this urge to check her one hour later and my jaw dropped and eyes bugged out of my head when the meter showed the number 53. I immediately woke her up and had her drink two juice boxes and eat five Ritz peanut butter crackers. From there, we went into prevention mode and implemented the 15:15 rule. This is a rule where we have to check her blood sugar 15 minutes later, and if it hasn't gone up, then we need to give her 15 carbs and recheck it 15 minutes after that. Basically at this point we're feeding her disease. This is what I hate about the disease. Our endocrinologist said that usually type 1 diabetics will wake up from a nightmare when their blood sugar drops too low. And if they don't, they end up in a coma. 53 was way too low for me.

I've learned a lot about what to do and what not to do with controlling Madison's blood sugar during and after a soccer, basketball and softball game. I hope the following provides a guideline for other parents of type 1 diabetic children.

• For high active sports like soccer and basketball, we've found it's better to take Madison's insulin pump off. Soccer and basketball are two highly active sports, allowing Madison to run around enough for us to take off her insulin pump during the game and practice.
• For low active sports, we've had to keep Madison's insulin pump on. We've found baseball and softball to be low active sports. Madison isn't as active during a softball game, requiring us to keep her pump on.
• During a high active game, we've consistently had to check Madison's blood sugar half way through. We've found that we've needed to give Madison at least a 15 carb juice 30 minutes after the game has started.
• During a low active sport, we haven't had to check Madison's blood sugar as much, if at all. Madison is usually good with feeling her highs and lows. And because she's not running around as much, I haven't been concernd with her blood sugar dropping. In fact, I've been more worried with it going high because she is nervous and not active. 
• Because of last night, after a tournament game, I plan to take Madison's pump off for one hour. This will eliminate basal insulin from entering her body. The excitement and stess during last nights fast pitch tournament game caused Madison's blood sugar to be unpredictable.
• Madison's blood sugar has to be in the 100's for her to play at her best for softball. We've found that if she eats a high protein meal with measurable carbs, we're better able to manage her blood sugar.
• Pizza and pasta an hour or two before a soccer game works well for Madison. But it doesn't for softball. In fact, we've found it's best not to have Madison eat a high starchy carb before a softball game, because she's not active enough to burn it off quickly.
• After a game or practice, a parent should check their type 1 diabetic child's blood sugar an hour after they go to bed, because that is the time period where their body is relaxing and blood sugar is trying to stabilize. In addition, I highly recommend checking it again one to two hours later.
• Always share your child's disease with the umpire, referree and coach. We've had several instances where I've had to call timeout to give Madison a sugar tablet.

I hope you will also share your learning lessons!

Highs and Lows of Raising a Child with Type 1 Diabetes | workingmother.com

Highs and Lows of Raising a Child with Type 1 Diabetes | workingmother.com

A Mother's Nightmare - Learning Her Seven Year Old Has Type 1 Diabetes

We all know that life can change in a split second. I experienced three such changes in less than one year, two which brought the greatest joy to my life—the pregnancy and birth of my fourth child! And a third that brought great sadness. The night of November 4, 2011 shockingly was a tragic time for me and my family. It's the night that my 7 year old daughter was rushed in an ambulance to downtown Charlotte Hemby Children’s Hospital, because the doctors at an Urgent Care Clinic found sugar in her urine. Within hours, she was diagnosed with Type 1 Diabetes-a disease I was ignorant of, a disease my prophetic logical mind could not predict.

Ironically, the signs were there a month prior. But I didn’t recognize the signs and messages; or should I say, I was too exhausted from being a new mom to pay attention to them or think they were anything serious.

Going back in time, one month earlier, my daughter, Madison, (after participating in a diabetes lecture at school) asked me if she could catch diabetes. I chuckled and paused for a split moment, wondering why she would ask me such a bizarre question. Her eyes filled with water, knowing there was something going on within her body that I wasn’t ready to face. I gazed into her big, glossy hazel eyes and said, “No, you can’t catch diabetes.” I then went on to share that my grandfather had Type 2 Diabetes when he was older, but it was because he didn’t take care of himself. She looked at me and said, “I think I have diabetes." Madison’s comment left me dumb-founded, unsure what was going to happen and to whom. I actually thought perhaps one of my parents may come down with diabetes. Never did I expect my daughter to be diagnosed not even a month later.

But that was only the beginning of the signs and messages. Madison had also started to wet her bed, urinate constantly, and drink more than usual. My husband even asked me once if I thought Madison had diabetes. My mind just couldn’t wrap itself around her all of a sudden getting diabetes. She was thin. She ate well. How in the world could she get it? So instead, I attributed all the changes to her adjusting to me having a baby and then taking care of the baby. I was pregnant and delivered October 7, 2011—the day I thanked God for being blessed with four healthy children, not knowing that one of my children wasn’t healthy.

Weeks went on, and Madison continued wetting her bed, and drinking and urinating more than usual. I was consumed with being a new mom, trying to catch up on sleep and doing the necessities when my kids got home from school that I chalked up her behavior to simply adjusting to having a newborn sister. But on November 4th, I couldn’t ignore the signs and messages any longer. She was thin. She was weak. She was stupor.

That afternoon, Madison stepped off the school bus, floating in her clothes. I thought perhaps I had purchased her the wrong size, because she looked anorexic. I checked the inner tag of her pants which said size 8, the size she had been wearing for several months. I followed her into the house, confused with what I was witnessing. She sat on the couch, leaned back and just stared out into the room in this dazed look. Thinking she may be anorexic, I asked her a simple question, “Did you eat your lunch today?” She just continued to stare in this stupor state, never responding. She looked like she was on drugs. Then I thought perhaps she had mono because my neighbor’s two girls just had mono a couple weeks back. I had my husband take Madison to Urgent Care, thinking they would be back home within an hour and a half. But instead, I received a text from my emotionally shocked husband around 6:10 pm stating Madison was being rushed to the hospital because they found sugar in her urine. My body and mind became numb from the words I read. How on Earth could I have missed all the signs? Within seconds tears flooded down my face and didn’t stop for weeks.

For four days, with my newborn baby in tow, I spent twelve hours by Madison's side in the hospital, learning everything I could to be able to take care of her. I tried so hard to be emotionally strong, but my hormones were everywhere, having just given birth four weeks earlier. Every time I cried, she would cry which broke my heart even more. But I was able to bring a smile to her face when I would say, “Princess, the reason I’m crying is because I'm so happy you are healthy again and you will be able to run around and play like you always have.” But down deep inside, I was mourning. I was angry. I was sad. I was in shock, especially when the endocrinologist said her Type 1 Diabetes was triggered by a virus and it was just pure bad luck. Words I really had a hard time wrapping my mind around.

After two days in ICU and a total of five nights in the hospital (where the first three days my husband, nurses, doctor and I spent begging Madison to allow us to give her shots, always resulting in us holding her arms and legs while she screamed and cried so we could give her the insulin that was keeping her alive), we were able to take her home. But with it came an enormous responsibility and change in lifestyle. We were now responsible for checking her blood sugar by pricking her finger every couple of hours, even throughout the night. We also were responsible for administering her insulin by giving her four to six shots a day. And we were responsible for keeping track and calculating every carbohydrate she ate at every meal. We now were responsible for making sure she didn’t go into a stupor state again, and for that matter, coma.

Things aren’t simple in our lives, but whose life is really simple. The good thing is our life is becoming more manageable. As of Christmas (2011), we were able to transition Madison to a pump, giving her and me a little more freedom and control. It’s not picture perfect, but its allowed her to have less shots and to eat snacks.

I’ve learned and grown a great deal over the past nine weeks. What I've come to realize is that when tragedy happens, there are people ready and willing to help you, if you open up your heart and life to them. Those people were my family, friends and neighbors. I wouldn’t have been able to get through this rough period without them, especially Tracy (a mother of a type 1 diabetic daughter who has become a great friend and mentor)! Madison’s diagnosis has truly made me stop and appreciate my family, friends and neighbors.

Yes, I still have moments of crying, experiencing disbelief, and getting angry. But in the same breath, I'm very grateful that her disease is manageable and she can still run around, play and be her silly sassy self.

Blessings,

Melissa
www.melissaproductions.com