James has forever been perfectly happy for me to do pretty much everything related to the management of his type 1 diabetes. While I have long wondered if he’d ever “get the itch” to try to do things for himself, he’s always resisted. “James, would you like to learn to test yourself?” The response is always, “No.” Which, frankly, has always been just fine with me. I figure that he’ll have the rest of his life to learn; I’m not going to rush him.
The last couple of months, though, things have been different. He is now actually doing quite a lot for himself. First he learned to test himself. While he probably still prefers me to do it, he will happily test himself many times throughout the day if I ask. This comes in handy, I will freely admit.
He’s also figured out how to give himself a bolus dose of insulin for his meals. His math skills are getting stronger at this age, and I think he really likes the way that the pump computes his insulin dose. I’ll holler to him to “give yourself 15 carbs” (diabetes-ese for “input into your pump that you consumed 15 grams of carbohydrates”), and he’ll yell back, “I just gave myself .8 units.” It’s just kind of fun.
On the other hand, he’s NOT that practiced at counting carbs. I just figure, baby steps. So it was with mild surprise that I met James at the close of one of his recent activities. This activity is once a week for an hour. I’m perfectly comfortable dropping James off. I always bring his testing kit and some low blood sugar supplies “just in case,” though the reality is that I check before and after the meeting, and he’s always been just fine. This time around, evidently they had a snack in the middle of the hour as part of a game they were playing. So, newly confident James decided he’d just give himself insulin for it. He tried his hand at label reading. It was kind of a disaster.
At pickup he told me he bolused for his snack. I asked how many carbs. He answered, “I ate 13 pretzels and gave myself 150 carbs.” Now, for someone unfamiliar with carb counts, this may sound just fine. But I’m guessing that you, dear reader, are aware that for those 13 pretzels to be worth 150 carbs, they would pretty much have to be the size of saucers. I took a look at the label. I’m still not sure how he calculated it, but I probably would have given him insulin for 15 grams of carbs, not 150!
So this is where “mommy stoic face” comes in handy. I realized immediately that I needed to NOT FREAK OUT. But the reality is that he gave himself insulin for 150 grams worth of carbohydrates so he needs to consume roughly that amount or he will end up with low blood sugar. And he needs to do it quickly. Yikes.
Well, first things first. Luckily, I got most of the carbs into him in the form of juice. Five juice boxes to be exact. And I threw in a couple of squeeze-y yogurts for good measure. It was crucial to get a lot of carbs into him fast! Our fix seemed to work out just perfectly.
But, there is also that worrisome aspect of how to prevent another such episode. While I don’t want to frighten James or cause him to lose interest in managing diabetes, I also need to let him know how to avoid a similar instance. And really, I’m working on it. I’ve made a vow to teach him better carb counting, and I’m definitely going to talk to the activity leaders to make sure they are aware of what he is doing with his pump. But it’s just such a fine line between stressing the importance of accurate insulin dosing and causing him to be afraid or to lose confidence. Honestly, I’m still trying to figure out the right approach.
Disclaimer: The experiences and suggestions recounted in these articles are not intended as medical advice, and they are not necessarily the “typical” experiences of families with a child who has type 1 diabetes. These situations are unique to the families depicted. Families should check with their healthcare professionals regarding the treatment of type 1 diabetes and the frequency of blood glucose monitoring. Jen and Kim are real moms of kids with type 1 diabetes and have been compensated for their contributions to this site.