Grace has finally come out of her honeymoon period (the time after diagnosis when her pancreas still intermittently works. This time frame can last 6 months to a couple of years.) Now her body relys only on the insulin WE provide it to function.
As I see it, the honeymoon phase has some pros and some cons. The pros include needing less insulin to get through the day (her pancreas still provides the rest), being able to "guestimate" carbs more, since her body tended to pick up the slack where I guessed wrong, and periods of slightly more stable numbers (or so it seemed to me) due to her body's underlying output of insulin to smooth out the edges.
And then there's the one that I'm embarrassed to admit. I had the feeling that since Grace was on such a low daily dose of insulin, somehow that meant that she didn't "have it that bad" or at least, "not as bad as others." Believe me when I tell you, I KNOW how ridiculous that sounds. And my brain always knew how stupid it was to think that. But I think it was my brain's way of slowly accepting her diagnosis.
The cons of honeymooning mostly have to do with wack-a-doo numbers resulting from an unexpected surge of pancreas-produced insulin. Picture me bolusing Grace for dinner, and then her body kicking out insulin as well.
So here we are, a year and a half after diagnosis, fully out of her honeymoon. Grace is 100% at the mercy of the insulin her pump provides. I say that because I now know there's pros and cons to being OUT of her honeymoon. Take today, for example. Grace was high at snack (217). She was bolused to correct her high as well as to cover the food she ate. Then she went to PE, where they've been practicing for the mile run by running and/or walking around the track. Now, get that they've been practicing for the mile run since the beginning of the year, and I've never seen a correlation to low blood sugars after. Today, however, when she felt low after PE and went to the nurse she was 29.
Recheck - 32. The worst part is that she says she felt low, but not THAT low. Three glucose tabs and a healthy rebound output of glucose from her liver brought her up to 229 fifteen minutes later. She's been fine the rest of the day, but I realized that she never went low like this when she was honeymooning. Her body's natural output of insulin would shut off in situations like this preventing her from going too low. Now there's nothing more to shut off. If she's low and going lower, her pump still pumps out insulin it thinks she needs, thus taking her even lower.
To actually type the words, "it never occurred to me to lower her basal for a mile run," is humiliating, to say the least. If I was with her and saw that she was about to run/walk a mile I would've definitely lowered her basal. BUT THIS HAS NEVER HAPPENED AFTER P.E. CLASS! After she ran the mile last year she went right in for a blood sugar check and was fine. That's why I blame coming out of her honeymoon.
In a year and a half, I've never had to lower her basal for PE class. I guess I need to revisit that. Do you lower your child's basal for PE? By how much? How do I go about instructing the school nurse? Should I just cut back on how much she's bolused for snack?
Can you help out an embarrassed D-mama?