I am an engineer and I love to solve problems. Having said that, diabetes is not a fun thing to troubleshoot. I design and build equipment that is used for testing parts. Each time I build something it is different than the time before. I do spend time trying to figure out why something is not working or why it is not working correctly. I have drawn from my experience of trouble shooting machines and use some of those principles to make the decisions for the changes that I make in William's care.
I never make a change based on one number. I want to see a trend before I make a change. I want to see many numbers above or below to make an informed decision. I also want to see a trend after a change. I want to see things move in the direction that I made the change for. If he was running high I want to see him come down. If I get one high number I can see that it could be many things that have caused the number so do not over react. You will find that you chase your tail when you do. William's numbers for basel rates and carb ratios have been same numbers for the most part for the last few years. I make small adjustments when a number starts to drift high but he has been the same for the last few years. I do expect that he will need more insulin as he gets older. If you are making changes all of the time something is not right. I spend a lot of time studying William's numbers to see if I need to change his bolus number or the basel rate.
One other thing that I have found was the his carb sensitivity was originally 100 to 1. I noticed that after a big correction dose that William would always go low. When I bumped it up to 200 to 1 the doctor originally told me this was a bad idea but after this change his numbers were so much better. A few years later we are at 180 to 1 and William is still doing great.
If you are just starting out you might also find that when you give your young person 15 grams of carbs like the doctor says when he is low that they now shoot high and end up at 500 which is just as bad. One thing that I have found is correcting a low or a high takes a little time. If I give William candy to correct a low it might take an hour to see the real change in his number. When they say check and give more carbs after 15 minutes if you are correcting a low can cause you to over correct. In 15 minutes you might just start to see the beginning of the correction take place. I also find that it really depends on what his number is as to how many carbs that you need to give your diabetic. I have written a paper for William that instructs his school on how many pieces of candy to give him when his blood sugar is at an interval below 100. You must also keep in mind that if your diabetic is active you may need to give him a little more than normal. When the office does call for advice I always ask what William's schedule looks like for the rest of the day so I know if I need to add more candy to a normal correction. After he is given a correction I check in 30 minutes to make sure that he is heading in the right direction. It will take a little time to figure out what your diabetic will need in their lives but it will vary on how far off you are and many other factors.
Night time checks have made a big difference. Some people do them and some don't. I check William every night at 11PM and 2AM. Immediately after I started doing this night time checks Williams A1C dropped significantly. It is worth the lost sleep to make sure that I give him the best chance at a healthy life as I can.
William has had A1C's well below the doctors ranges for almost two years straight now. You need to pay attention to everything that you do and the result of what you did. Look for the things that cause your diabetic to go out and try to understand what happened. Try not to over analyze things but pay attention to what is happening. The doctor is there for advice, but you are the one that lives with the disease every day.
Looking for trends and making changes,
His Loving Dad
I never make a change based on one number. I want to see a trend before I make a change. I want to see many numbers above or below to make an informed decision. I also want to see a trend after a change. I want to see things move in the direction that I made the change for. If he was running high I want to see him come down. If I get one high number I can see that it could be many things that have caused the number so do not over react. You will find that you chase your tail when you do. William's numbers for basel rates and carb ratios have been same numbers for the most part for the last few years. I make small adjustments when a number starts to drift high but he has been the same for the last few years. I do expect that he will need more insulin as he gets older. If you are making changes all of the time something is not right. I spend a lot of time studying William's numbers to see if I need to change his bolus number or the basel rate.
One other thing that I have found was the his carb sensitivity was originally 100 to 1. I noticed that after a big correction dose that William would always go low. When I bumped it up to 200 to 1 the doctor originally told me this was a bad idea but after this change his numbers were so much better. A few years later we are at 180 to 1 and William is still doing great.
If you are just starting out you might also find that when you give your young person 15 grams of carbs like the doctor says when he is low that they now shoot high and end up at 500 which is just as bad. One thing that I have found is correcting a low or a high takes a little time. If I give William candy to correct a low it might take an hour to see the real change in his number. When they say check and give more carbs after 15 minutes if you are correcting a low can cause you to over correct. In 15 minutes you might just start to see the beginning of the correction take place. I also find that it really depends on what his number is as to how many carbs that you need to give your diabetic. I have written a paper for William that instructs his school on how many pieces of candy to give him when his blood sugar is at an interval below 100. You must also keep in mind that if your diabetic is active you may need to give him a little more than normal. When the office does call for advice I always ask what William's schedule looks like for the rest of the day so I know if I need to add more candy to a normal correction. After he is given a correction I check in 30 minutes to make sure that he is heading in the right direction. It will take a little time to figure out what your diabetic will need in their lives but it will vary on how far off you are and many other factors.
Night time checks have made a big difference. Some people do them and some don't. I check William every night at 11PM and 2AM. Immediately after I started doing this night time checks Williams A1C dropped significantly. It is worth the lost sleep to make sure that I give him the best chance at a healthy life as I can.
William has had A1C's well below the doctors ranges for almost two years straight now. You need to pay attention to everything that you do and the result of what you did. Look for the things that cause your diabetic to go out and try to understand what happened. Try not to over analyze things but pay attention to what is happening. The doctor is there for advice, but you are the one that lives with the disease every day.
Looking for trends and making changes,
His Loving Dad
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