What Did I Miss?

Today, we'll look back 2 years to a pool party for all girl scouts from our area.  As troop leader, I was there, in charge of feeding and keeping track of my group of fifth grade girls. 

This was our first pool visit of the season.  My daughter disconnected her pump and got in with her friends.  They then got out and opened a couple of bags of chips.  "Can I?"  "Just a few."  We'd delivered  a correction bolus for a 200-ish number on the way to the pool.  With the exercise, I figured a couple of chips couldn't be too bad.  Plus, to be honest, it seemed like such a 'normal kid' thing to sit on a circle on beach towels with your 11 year old friends, talking, braiding each other's hair, and muching on chips.

After another swim, the pizza arrived.  I did (to my credit) remind her to plug her pump back in and check.  230.  I juggled the meter-remote, paper plates for all the girls, opening the grapes and watermelon, pointing out the drink cooler and providing napkins.  I bolused for pizza and watermelon.  I might have added the bg.

She ate, unplugged, and headed for the water slide.  An hour later they came back for dessert.  A cupcake and 2 mini girl scout cookies.  She was already partway through the cupcake when I realized she hadn't checked again.  She was reading the box for the cookies (reclaiming a bit of good will).  "4 each, mom."  I had made the cupcakes, so had a number in my head for those.  Still juggling dessert requests and napkins, I bolused.   I glanced over.  She had no pump attached.  She plugged in and we bolused again.

Half an hour later, she found me talking with a mom on the other side of the pool.  A friend's sister's troop and given our troop mini fire cracker pops.  Could she eat hers (which she was holding, open, in her hand)?  From the cobwebs of my brain came the knowledge that these were 'only' 9 carbs.  I gave the o.k.  She was standing there with her friends, on the way to the shuffleboard court.  She bolused for it when she got back to the table.

Once we'd packed up and gotten in the car, her blood sugar was around the 250 mark.  She corrected and had some water when she got home.  An hour later, still 250.   Obviously, the whole evening was riddled with diabetes mis-steps.  Chips with no insulin (probably more than a few), not accounting for missed insulin in the pool, a dinner diet of pizza, chips, watermelon, cupcakes, cookies and popsicles. Everything was bolused for on the fly, often after the food was partially consumed.

Yet, you diabetes detectives out there, there's one more big reason that high number didn't come down. 

Anybody guess it?

I had bolused for dessert while the pump was detached.  Then again when it was.  The pump included all of that insulin in the insulin on board total.  So when we went to correct the 250 after the party, it gave very little, assuming a whole extra cupcake and 2 cookie's worth of insulin was still hanging around.

Any 'party by the pool' event is a challenge, diabetes-wise.  The level of difficulty rises exponentially if I'm in charge of more people than my own kid.  In the end, it was a fun evening and the 250 came down quickly once I'd realized the error of my ways.  But keeping track of diabetes at this kind of event is a full-time job.