# How We Treat Our 10-Year-Old's Type 1 Diabetes

According to JRDF, T1D diagnoses in 2020 included 1.4 million adults, 20 years and older, and 187,000 children younger than 20. This is up nearly 30% from 2017.

What really makes those numbers scary is that the medical community isn't sure why this is happening.

According to an article on WebMD, "What isn't clear is what specifically is driving this increase. Numerous theories abound, but none has yet been proven."

Another disturbing fact, this one from the JDRF: "The rate of T1D incidence among children under age 14 is estimated to increase by three percent annually worldwide."

## Diabetic Number Calculations Are Critical

So what exactly does it mean to have Type 1 diabetes? For parents of a small child, it can be easily misdiagnosed and lead to death. Some of the symptoms include:

• excessive thirst
• cranky moods
• frequent urinating

Of course, with a baby, this is hard to detect. We almost lost our 14-month-old, and it changed our lives. It's been nine years and we want to share what daily life is like.

The very first thing that comes after diagnosis is calculations. While still at the hospital, we were introduced to a couple of formulas that would become something that we have to do multiple times daily. Unless they find a cure, our son will do this every day of his life.

The first is a corrective formula. The endocrinologist determines a 'target' blood sugar number based on age and weight.

It goes like this: blood sugar-target number divided by corrective.

For our son at age 4, an example might be:

150/80: This means that we check his blood glucose (sugar) by poking his finger. Then we subtract 150 from that number. The product of that is divided by 80. For example, we check him and his number comes up 200.

200-150=50.

50/80=.625.

At age 10, his numbers are 120/70.

So, to correct his numbers, we round to the nearest half, which in this case would be .50. This is the number of units of insulin we would have to dose him with to get him closer to a healthy number.

But we aren't done yet. Each time he ingests carbohydrates, another formula is used. Again, this is based on age and weight factors; the endocrinologist determines an 'insulin sensitivity' number.

After each meal, the number of carbs is calculated and divided by this number. For our son, at age 4, he gets 1 unit of insulin for every 18 grams of carbs he ingests. At 10 years old, it's 1:12.

### What a Typical Lunch Looks Like

1 peanut butter and jelly sandwich with 4 ounces of milk= 51 grams. So we divide 51 by 18 and round to the nearest half.

51/18= 2.83, rounded is 3 units of insulin.

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However, at meals, we take the corrective dose (CD) and the food dose (FD) and add them together for a total dose (TD). So for this lunch example, he would actually get 4 units of insulin.

## T1D daily routine

From the time Gage wakes up, a critical life routine begins.

1. Poke finger and check blood sugar.
2. Inject daily long-acting insulin dose.
3. If sugar is high, calculate the corrective dose, eat breakfast, count carbs, and calculate food dose. Then inject with total dose.
4. If sugar is low, dose with 15 grams of fast-acting sugar, (we use strawberry syrup), and wait 15 minutes. Recheck. If still below 100, dose with another 15 grams and wait 15 minutes, if above 100, eat breakfast but don't calculate a corrective dose.
5. In 2 hours, recheck blood sugar. Insulin used for food dosing is a quick release and fades out in about 2 hours.
6. Repeat this process for each meal and any snack with carbs.
7. At bedtime, check blood sugar. If low, dose the same as the daytime process but set an alarm to recheck again around 1 or 2 am to make sure blood sugar doesn't go low again. If low, wake up long enough for a sugary dose of syrup and recheck every 15 minutes until above 150.
8. Wake up the next morning and start over.

Everywhere we go, we always keep Gage's glucose tester and insulin with us. Also, we carry an emergency pen that will hopefully save his life if he goes extremely low..

## Insulin Pen

The pen is the insulin delivery device we are currently using. This device offers the smallest needle available and is very discreet. The insulin is contained in a vial on the pen—only the needle tip is changed every time it's used.

The insulin vial in the pen is changed monthly. That's because Gage currently doesn't use very large doses yet. An adult may go through the vials more frequently. Regardless of how much insulin is left, the remaining insulin is thrown away because it's not as effective after 30 days.

To load the pen, a dial is turned to the amount needed for dosing. Then the pen is inserted into the skin, and the same dial is pressed to complete delivery.

## Insulin Pump

The pump creates a more hands-free approach to insulin dosing.

• The inset is attached to the body with a spring-loaded device that inserts a tiny catheter under the skin.
• A tubing line runs from the insulin pump to the site. Inside the pump is a vial of insulin.
• The blood glucose meter used to test is also used to enter the amount of insulin to be dosed.
• The inset site needs to be moved every few days to reduce the likelihood of infection in the inset site.

The pump is the closest thing that the industry has to an artificial insulin delivery system. The problem is that a small child doesn't respond well to the removal and installation of the inset site. The adhesive on the site catheter sticks very aggressively so that it won't fall off. Removal is like the stickiest band-aid ever being pulled off your skin.

Then the installation is a spring-loaded device with a needle that snaps the site into the skin, forcibly. For Gage, this became a little too traumatic. He would cry with the site removal, and cry even harder with the install. As parents, it broke our hearts. So we took him off of it.

Most adults find the pump the easiest way to go. It's discreet and easy. No needles and no vials. Also, paired with new continuous glucose monitoring systems, the device automatically responds to changing sugar levels detected in the skin. The drawback is that it's another device that has to be inserted into the skin and changed regularly.

## Insulin Syringe

The syringe is used in conjunction with a vial to provide insulin dosing. As mentioned earlier, a set of numbers is used to calculate the amount of insulin needed. Then the correct amount of insulin is drawn into the syringe, inserted into the skin, and injected.

This process has been around for the longest amount of time and is the delivery system one receives after being diagnosed. Gage started on this system originally and after our stint with the pump, we went back to it for a while before we went to the pen. It requires more steps and math and is a very visual process. It can cause a few funny looks at a restaurant as you insert the needle into a vial, tap the air bubbles out, and draw up a shot.

## Getting Carb Counts at Restaurants Can Be Difficult

Speaking of restaurants, getting accurate carb counts can be pretty challenging. Most have no clue how many carbs are in a dish. In light of this, we carry a dietary information book that has carb and calorie counts for most foods. We actually had a manager at a fast-food chain get nervous when we asked for nutritional information.

The manager stated that they had none printed and that they weren't legally obligated to. We stated that they could relax, we only asked because some do and it makes it easier than thumbing through our book.

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This content is accurate and true to the best of the author’s knowledge and does not substitute for diagnosis, prognosis, treatment, prescription, and/or dietary advice from a licensed health professional. Drugs, supplements, and natural remedies may have dangerous side effects. If pregnant or nursing, consult with a qualified provider on an individual basis. Seek immediate help if you are experiencing a medical emergency.