Diabetes Education: Sick Day

  
    Last week Boaz's sugar was all over the place.  He was having at least one low a day, which is very unusual for him, and no matter what we did, we just couldn't seem to manage it.  I took him to the doctor this week because he was throwing up at nighttime and we had ruled out every possibility as to why.  Much to my surprise, he was diagnosed with strep! He had no other symptoms that I could see.  He was wheezing, so we had to give him a breathing treatment every four hours for two days and nights (ok, so we didn't wake up to give him his 1am treatment. Whoops!).  He is on antibiotics now and getting better, but of course now Emory and I are sick!

     Anyways, sick days for diabetics are quite complicated.  We are supposed to check his ketones every diaper, and its seems that we are checking his sugar a hundred times a day!  Also, if he throws up or has large ketones we could very possibly spend a while in the hospital while Boaz is hooked up to fluids and monitored closely to make sure his sugar doesn't drop.  As I mentioned before, his sugar is all over the place.  He will be below 100 before a meal and so I will wait to give him his insulin (which, has often been a good choice, because it has kept him in range).  Yet, other times, his sugar is high, but, we are hanging in there, closely monitoring his sugar and washing lots of hands!

Diabetes Education: Ketones

This is how I understand ketones. Your body uses glucose and turns it in to energy. In order to do this, your body needs insulin. When Boaz's sugars run high we need to check his urine for ketones because the meter is telling us that his body does not have enough insulin. When your body can't turn the glucose into energy it turns to fat in your body. The by-product of that process is ketones. They get into your urine and can be very dangerous if left untreated. When ketones are present you must 'flush' them out. You do this by drinking lots of water, and usually some insulin. Ketones are measured by a scale of negative to large. With large ketones you may very possibly end up in the hospital so they can give you an IV to flush them out. Boaz has only had large ketones once, thankfully. With lots of cucumber-lemon water we were able to flush them out quickly.

Diabetes Education: Isulin

Boaz takes two different types of insulin each day: long-acting insulin and rapid acting insulin. Long-acting insulin, such as Lantus (there are others but this is what Boaz takes) is given once a day and keeps his blood sugar steady all day. Some people take it at nighttime and others in the morning. Boaz takes it in the morning so that it will not cause his sugar to drop in the middle of the night. Typically Lantus does not peak and it lasts 24 hours. Lantus only provides a base for rapid- acting insulin, so he must also take rapid-acting insulin every day, before each meal. Usually, Humalog peaks after about 1 hour and lasts 2-3 hours.