Sneaky Sneaky

Having diabetes stinks and I think it does even more so for a kid.  For the most part Alyssa manages her diabetes very well, knowing that she needs to check if she can have something before she puts it in her mouth.  I try not to keep the joys of sweets from her, my theory is anything in moderation.  She knows that even if she can't have a sweet at the moment she asks, she can save it for later when she can.  This decision is based on her glucose level, how soon it is to a mealtime, her activity level, and the amount of time before she goes to bed.

Yesterday with dinner she asked if she could have a low-sugar Klondike ice cream bar.  The dessert has 25 grams of carbohydrates and so I said that she could have it for desert after she ate her dinner.  With the ice cream, her dinner total came to 75 grams of carbohydrates (Normally 60).  Before dinner her blood glucose level was 144 (good).  Her insulin ratio is 1 unit for every 20 grams of carbohydrates, and because her bg's were good, no correction was needed.  So I gave her 3 1/2 units of Novolog.  All was good. 

At her bedtime glucose check her level was 166 and if they are under 200, she has a night time snack that is 15 grams of carbohydrates to balance her blood sugar level through the night.  She normally handles this on her own, and I'll call out to her, "What's your sugar?" she usually tells me what it is and I tell her if she needs a snack or not.  Well, I told her to get herself a snack (she has her own cabinet full of snacks all that are 15 grams of carbs or less)  However, miss flossy decided that she wanted to have another ice cream bar.  So, I'm in my room on my laptop and I hear my husband ask Alyssa if mom said she could have this ice cream?  "Alyssa!!" She had taken one bite.  Anyway, I had her wrap it up, promising she could have it the next day.  Diabetes is tricky and nights can produce dangerous lows or highs depending on her level of activity and pattern of bg's for the day.  That is why I choose to give her 15 grams of complex carbohydrate snacks that include protein before bedtime instead of sugary treats that can cause spikes and morning highs.  

I know it's tough to not be able to eat what she wants anytime she wants, and trust me, she didn't forget what I told her as she had her ice cream bar with her lunch this afternoon.

Math skills needed....

After dinner last night, Alyssa went in her room to work on a puzzle.  About an hour later, I went into check on her because she was too quiet and she was fast asleep in her bed....7:30p and way early for her?  I pricked her finger (she doesn't wake anymore) and the meter read 434...wth!!  recheck....413!  I calculated the carbs, she had eaten something she had eaten many times before and had gotten her insulin.  I woke her up and had her get in the shower while I made another injection.  Here is where math skills come in handy....

Oddly, Alyssa usually drops about 100 pts during the night...I'm not sure what crazy girl does in her sleep....but normally I try to make sure her levels are between 180-200 when she goes to bed.  Alyssa's correction rate is .5 units for every 50 over 150, but since her bedtime goal is around 200 and I wanted her to drop about 200 pts., I gave her 2.0 units.  Another problem, sometimes the insulin brings her down too quickly and she feels the affects of a low even if she is not (and if she doesn't eat as well).  So, I also gave her a 15 g carb snack.  I estimated with the insulin and the snack that she would wake up with a bg of about 150.  This morning....the meter read 136... pretty darn close!!

I'm not sure where this spike came from (I searched for evidence of a secret snack, but didn't find any??) I think its instinct to want to find the culprit, although there may not be a tangible one.  I mean really, there is no known cause for this disease so it's understandable that there is no known cause for occasional spikes or lows.   I try not to stress too much when situations like this happen, but its hard not to when your a control freak like me :-/