Instruction Manual

In an attempt to fix a sticky drawer this morning, I removed it from my daughter's dresser and found a very detailed set of instructions.  I believe I wrote them up 8 years ago, and left them with my in-laws when my husband and I spent a night away at a friend's wedding.  It's a fascinating picture of caring for an almost 2 year old who's taking shots of NPH and Humalog for her diabetes.

Low Blood Sugar:  Usual symptoms of low blood sugar are repeating "cookie cookie, " clinginess, or laying down on the floor.  If blood sugar is below 85 between meals, give her 2 oz. juice and half a sugar free yogurt.  If it's before a meal, give juice but no yogurt.  If she won't take the juice, give one teaspoon of cake icing.

High Blood Sugar:  Unless she's sick or high for a couple of hours, we do not give extra insulin.  Encourage  extra fluids (water, crystal light, sugar-free jello), and a little exercise.  We find that tantrums can lead to high blood sugar.  These highs seem to self-correct after a couple of hours of calm.  The correction dosages are on the fridge with the other insulin information.

Refusing to Eat:  Missing up to 4 grams at most meals won't usually make a huge difference, so we don't usually quibble too much over the last bite or sip except at mid-morning snack and bedtime.  If she doesn't finish the mid-morning or bedtime snack, or if she won't eat at all, try these options:
  1. Distraction:  A new book or picture album or toy to look at while she eats
  2. Changing the scenery:  Snack on the sofa, kitchen, or outside
  3. Joining Her: Have someting to eat or drink too (maybe an alternate option that she'll want to try and think she's stealing from you)
  4. Offering an unusual alternative like cookies for morning snack or cereal for supper
  5. If desperate, give the equivalent carbs in juice, or if really desperate, frosting

Giving Insulin and Checking Blood Sugar:  We do all blood sugar checks and injections in our bedroom with the t.v. on tuned to Noggin.  She prefers to sit on a lap for these.  This also makes it easier to keep her still.

Thankfully, the instruction manual has gotten shorter as she's gotten older.  The flexibility of the pump and her ability to manage so many of the details by herself, even at the age of 9, make it much less complicated to leave her with a family member.  There also aren't as many tantrums, though I realize the teenage years are still ahead of us.

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