The Curve Ball

From Danielle:

Even after 12 ½ years of waltzing the diabetes dragon, I’m still amazed to see the affect that exercise has on my son’s blood sugar!! This particular time though, it seemed especially crazy (probably because my child went from doing NOTHING all winter to then “giving it all he’s got” to make the school badminton team). Meteorologists show the winter of 2014 to be one of the most miserable on record and that translates to “sitting inside on your butt because no matter how warm you dress it’s just too cold (and no fun) to be outside”. Paul is usually “that kid” who can’t sit still and is out either tobogganing, building snow forts or mastering snowboarding but that’s hard to do with temperatures of -40° C most of the winter. So when he “unleashed his wrath” on the badminton birdie during try-outs, it became evident very quickly that we were in for a hold-on-to-your-hats-blood-sugar-ride.

One thing you discover about diabetes over the years is that it’s predictably unpredictable. Certain things set off crazy blood sugars more than others…illness, fatty foods (like pizza), and activity to name a few; all these things when they happen, alert you to “be on guard”. But over the years we’ve armed ourselves with knowledge that comes from seeing patterns in the midst of the “unpredictable”. It’s from realizing those patterns that we have put systems in place to make all the appropriate adjustments prior to things getting “out-of-control”. So that’s what we did in this case, we gave him less insulin knowing that he is more likely to go low up to 24 hours after exercise. We not only gave him less insulin with his next few meals but because he has a pump, we also turned down his basal rate (background insulin) by 30% for the next 8 hours. But this is where the unpredictable part comes in because he STILL went low. Not just a little low but a BIG, WHOPPING, GIVE 60 CARBS TO TREAT OVER 45 MINUTES low. And of course this all happens at close to midnight which makes it feel so much worse (caution: caregiver fatigue and diabetes do not mix).

So to all of us taking care of a child with type 1 diabetes…Stay alert! If your child has a day of intense exercise, make sure you test their BG more often, make sure that you get up that night to check them and make sure you have a plan to deal with exercise (see Exercise Affects BG). After all, you never know when the “predictably unpredictable” will become the “unpredictably unpredictable”.