It is something we Dmoms don’t talk about very often, but it really struck me tonight. We make judgement calls every day that have the potential of
1 keeping our kids in range
2 allowing them to go dangerously low
3 allowing them to go dangerously high.
Every day! Sometimes multiple times a day. Here’s the problem. Blood sugars are affected by a plethora of factors: carbs, fat, stress, temperature, activity, illness, temper tantrums, and sometimes it seems even to be effected by the way the wind blows or rainbows.
Night time is hardest for most of us, we all need sleep which means no one is aware of what any or all of those factors are doing to our sugar babies blood sugars.
Even with a Dexcom we only know what his blood sugar is doing at that moment (or maybe just a few minutes earlier) we don’t know where it’s headed. Dexcom can tell us if he’s going up or down or if he’s been low or high. What Dex can’t tell us is if the 69 with a straight down arrow is suddenly going to curve back up to a double up arrow in 10-20 minutes because of the ice cream he ate after dinner.
This was my dilemma tonight. Dex read below 55 straight down arrow, finger poke said 69, pump said 2.2 units of insulin still active in his system. Thats a lot of insulin on board for a 69 blood sugar! What we are told to do by the Drs and nurses is give 15 carbs and wait 15 minutes to check again. With 2.2 units of insulin still in his system, it sounds like a good idea! But! I knew he had ice cream tonight, which is high in fat and can delay the carbs kicking in. The straight down arrow still freaks me out, so I gave him 2 glucose tabs (8 carbs) to stop the crash (hopefully without causing him to go high when the ice cream kicks in). That 2.2 units could bring his blood sugar low enough to kill him if he doesn’t have carbs counteracting it.
It’s a fine line we walk. There is no right answer, no rule that will tell us the right thing to do. We have to trust our gut and pray that we guessed right. Tonight I guessed right, the ice cream kicked in after the 2 glucose tabs leveled him off and that 2.w units of insulin kept him from going over 250. He’s at a good number for the night and hopefully will stay in range so we can all get some sleep tonight.