Diabetes is a constant balancing act between sugar and insulin. All food intake must be accompanied by insulin to flush out the digested food sugar from the bloodstream. How do we know how much insulin to give Adele?
First and foremost, we test Adele's blood sugar before she eats so we know where she's at. We currently aim for a sugar of 7 before meals. This means that if her sugar is lower than 7, we will give her a little less insulin and if her sugar is above 7, we will give her more insulin to hopefully bring it back down to 7. Our correction factor is currently 16. So, if her sugar is 3.6, we subtract 3.6 - 7 (target sugar) = -3.4 divided by 16 (correction factor) = -0.21 units.
Then we need to count carbs consumed. Basically we read food labels and calculate how many grams of carbs have been eaten. At home we use a scale to weigh Adele's food. We started this when Adele was younger and found that it gave us more precise numbers which usually (hopefully) leads to better sugars. With the weight of the food, all you need to do is multiply by the carb factor (you can find these factors on the web for pretty much all foods). For example, if Adele eats a toast that weighs 20 grams. This 20 multiplied by the carb factor (0.44) gives 8.8 grams of carbs for the toast. So before each meal, all food needs to be mesured. We write these values on Adele's Diabetes worksheet.
After the meal, we need to find total carbs consumed. We then divide total carbs by the scale for that particular meal. For example, if she ate 75 grams of carbs for supper divided by a scale of 37, it gives us 2.03 units of insulin. Scales are determined with the help of our Diabetes nurse and through trial and error.
I must now factor in the correction based on Adele's sugar before she ate (see calculation above). So, 2.03 units of insulin - 0.21 units = 1.82 units. We round this number and give her a bolus (immediate "shot" of fast-acting insulin) of 1.80 units of insulin to hopefully cover the food that she just ate. All this and there is absolutely no guarantee that this insulin amount will be the right dose. It's all part of the daily Type 1 gaming activities that we play...
**I apologize for the blurry photo :-)
1 comment:
We are living the same life. My daughter was diagnosed with type 1 this September and as I read it is my reality as well. I am finding really funny the photo of Adele's supper. That is also part of my reality...just eat something. It's comforting to see I don't have to feel bad about choc milk and ice cream at supper.
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