This has been a crazy week. On December 10, 2008, we officially moved away from Alex’s pre-mix insulin to Lantus plus. Lantus is a basal insulin which she gets once a day, and which is intended to mimic the pancreas of a non-diabetic person which has a low level of insulin secreted all day long, thanks to the workings of the liver which pumps out low levels of glucose, day and night. I know, enough with the lesson – that was last post. Anyhoo, Lantus is injected once a day and that’s good, because Alex doesn’t exactly like it, as it stings going in since it’s more acidic than the other insulin.
With the Lantus, Alex also gets another 2 or 3 shots a day. “Ouch!” you say, and rightly so. But not for Alex. She really doesn’t mind, because it means that she can have her breakfast, lunch and dinner and all the snacks in between, whenever she wants. Just like a regular kid. Instead of me having to wake her up at 6:00 to have breakfast, as we had to before, she can sleep pretty much as late as she wants. Instead of ensuring that she eats lunch at 11:30, we can eat at 11:00 or hold off till 1:00. That’s pretty inconsequential for most people. I mean, who gives a crap what time you eat your lunch. But for a person with diabetes, it is a big deal. It means flexibility. It means freedom.
How it works is this: Alex eats her lunch, I estimate how many carbs she’s consumed and I give her an injection of soluble, fact acting insulin (Humulin R, in this case) to compensate for the elevated blood sugar that I know is going to come. In an ideal world, she’d get the shot before she eats, so that the blood sugar and the insulin meet at the same time. But this ain’t an ideal world. I never know how much Alex is going to eat. She is the original picky finicky kid. So, I’m a little bit slow on the uptake, because the sugar is already starting to rise, but I’ll snag it back down as soon as possible.
It’s a good insulin plan, but it isn’t an exact science. It’s still (and always will be) a lot of guess work, and a lot of checking her blood sugar to see where we are and how things are affecting her. The Lantus is not supposed to peak, but it does, but it happens to peak right around when she’s eating dinner so it often works to bring her blood sugar down without me giving her a separate shot for it. Sometimes. Her numbers are looking erratic with the change, but that's to be expected until we iron out the wrinkles.
Someone on the children’s forum board that I frequent coined an acronym that is absolutely perfect: YDMV: Your Diabetes May Vary. Everyone is different, and even a day that is the clone of a previous one won’t render cloned results. It’s weird. It’s like the Butterfly Effect as it applies to Diabetes.
This week, we also got Alex’s A1C report back. Without fanfare, it was a 7.4%. Now, granted, not as good as the 6.0% she had the last time, but it’s still a very good number for a child. Alex is definitely moving out of her honeymoon, and this number is evidence of that. But, I like this number. It’s doable. It’s livable. We’ll work to keep it here.
Alex and her brothers are now officially on school holiday, and will be home annoying us until January 8, 2009. Pray for us. Please.
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