When I got home from work, R had just gotten up from his nap and wanted his afternoon snack. Q had already had a snack but was still hungry. I washed and weighed a big bowl of strawberries for her. R wanted some Newman’s Own Organics Alphabet Cookies.*

He was naming the letters as he ate each cookie. When he said “B,” I replied “‘B’ is for ‘ball’” as I walked toward Q with the PDM to give her insulin for 9 grams of carbs.

She said, “And ‘B‘ is for ‘bolus‘ like you are about to give me.”

*Newman’s Own Organics cookies do not have HFCS.

The ABC’s of Diabetes

A is for “A1C,” or as I like to call it, “judgment day.”

B is for “butt,” or the site that does not work well for her OmniPod because she accidentally knocks it off every time we try to put it there.

C is for “cake,” or “Yes, she can have cake at this birthday party.”

D is for “diabetic,” I say own it.

E is for “everything but the kitchen sink,” in other words all the supplies that we carry with us everywhere we go.

F is for “fish crackers,” or something Q never wants to eat again but for some reason parents always send in for school snack in gigantic cartons. Me, I like to arrange with the teacher to bring in frozen yogurt tubes.

G is for “good number,” or as Q calls it “three numbers that start with a 1.” Though we all know we aren’t supposed to define blood sugars as good or bad, but let’s face it, any number that’s in range is good.

H for “huge ass bolus,” or HAB as I abbreviate it on Twitter.

I for “ice cream,” or “yes, she can have both cake and ice cream.” (See C above.)

J is for “juggle,” because I feel like I always have three balls in the air.

K is for “blood ketone test strips,” or as I like to call them “Ouch, there goes another buck.”

L is for “laughter,” because at the end of the day sometimes all you can do is sit back and laugh.

M is for “mother’s intuition,” something you should always trust.

N is for “no,” something we have to tell our diabetic children more times than we would like to.

O is for “overnight,” or the dreaded overnight basal testing.

P is for “protect,” I wish I could protect her, particularly from insensitive parents who bring gigantic cupcakes to school on their child’s birthday when they know snacks are supposed to be 10-15 grams of carbs because the school nurse is not there at snack time to give her a bolus. But that’s okay because it doesn’t affect them or their child.

Q is for “Super Q,” my favorite super hero.

R is for “rant,” something that I have to do once in a while just to stay sane.

S is for “Skittles” and “Smarties,” two items in our arsenal of quick acting glucose sources to bring her up quickly from a low.

T is for “time to make the donuts,” I mean, time to get up and check on her again and probably not fall back asleep until right before it’s time to get up in the morning. Thankfully this doesn’t happen every night.

U is for “Ugh,” what I exclaim when numbers are wonky for absolutely. no. reason.

V is for “valuable,” what I consider all of my friends I have met through blogging, Twitter, and Facebook. Thanks for being there at 2am!

W is for “water,” which has zero carbs don’t you know. But Q also likes drinking fruit pouches with only two carbs.

X is for “X-ray fish.” Huh? (Life isn’t all about diabetes.)

Y is for “yo-yo effect,” or what happens when you over treat a low, go too high, give a big bolus, and end up right back where you started.

Z is for “ZZZ,” something I don’t get enough of!

Visit D-Mom and D-Dad Connection

LOL: ABC’s of Diabetes is a post from: D-Mom Blog

The Face of Diabetes

I should say that this is a collaborative work between Q and I. She often gets out my MacBook and opens up Photo Booth taking a series of self-portraits, some goofy, some serious, some sweet like this.

This image is one she took of herself, the photo editing is mine.

Warhol would be proud.

See more Diabetes Art Day projects on The Butter Compartment.

Diabetes Art Day: The Face of Diabetes is a post from: D-Mom Blog

Here are the photos I took in August, documenting a year in a life with diabetes. This past month included a lot of photos as we got ready to head back to school, having a lemonade stand to raise money for our Step Out walk, and overly expensive organic eggs.

Click on an image to enlarge and then use the arrows to scroll.

View more of my images that are part of the Diabetes 365 Photo Project. You can see descriptions of each by viewing in Flickr.

Visit D-Mom and D-Dad Connection

Diabetes 365: August ‘10 is a post from: D-Mom Blog

I invite you to read about Renata, and then visit her blog The Diabetic Duo. Not only is she an expat living in New Zealand, but she has two teenagers with type 1 diabetes. You can also follow her on Twitter; she’s @DiabeticDuo.

I’d like to introduce you to Renata of The Diabetic Duo.

Tell me something about your children.

Both of my children are really funny. Very witty and make me laugh at times when it’s probably not appropriate to do so.

How old were your children when diagnosed?

Kelsey was four and Marty was nine.

How were your children diagnosed?

I was completely clueless with Kelsey. We were going through a big custody battle over her (I’m her stepmom) and all I knew was that she was sick and she looked worse and worse every time I went to pick her up. I won’t get into the details because it’s a pretty brutal story, but my husband had a voice mail on his office phone when he showed up to work one Monday morning. Let’s just say obtaining custody was pretty straight forward after that stunt. I do remember being an overwhelmed new mom of a child with a disease I knew nothing about. It brought Kelsey and I together pretty quickly; we all were learning to love and take care of each other. It was a lot to take in, but we rallied as we Porters tend to do.

Martin’s hit me just me like a ton of bricks. He was allergic to red dye for the first six years of his life then he moved into epilepsy. I had just pulled Marty out of the neurology department because I knew in my gut something wasn’t right. I never once felt it was epilepsy. We finally figured it was most likely sleep apnea and had surgery scheduled for his tonsils and adenoids to be removed. All the weight lifted, so I thought. We were sitting at the movie theater a couple of days later and Marty had finished his gigantic diet coke, gone to the bathroom and started drinking mine. I remember yelling at him to not be so greedy and him crying because he was thirsty. My heart just sank. All four of us left the theater, sat at a table and tested him with Kelsey’s meter. People swirling around us all happy with their cokes and popcorn and we just had the rug pulled out from under us again. And…that was that, we got up and went straight to the hospital.

How have your children’s life changed since diagnosis?

Kelsey’s been diabetic for 13 years, so I don’t know that she knows any different. To be honest, I don’t know how to answer this question. It just is. Their life, our life, just is. The kids do what they have to do because they love themselves and life. They complain but it doesn’t last long.

I guess one thing I could say is they are more organized than most kids their age and like all D-children have more responsibilities.

How has your family’s life changed since diagnosis?

I think we are a really close family. And I don’t know that diabetes is fully responsible for that, but I do know that it plays a part. I think Marty is still getting over my being a worry wort with him since he is basically a new diabetic. But he understands why I check in often and doesn’t resent it. As far as our overall life, I don’t know that we would be doing anything different. We don’t hold back from anything now because of diabetes, so I don’t imagine that we are missing anything.

How has connecting online helped you cope with diabetes? What online resources do you use?

The online community has been amazing for me. I read about 15-20 blogs a day. I use Twitter when I can, TuDiabetes and the new D-Mom and D-Dad Connection site. I have learned so much and there are so many people there to support me even in times when I feel I don’t need it. I wish New Zealand had a bigger online community because I know there are families that would benefit from it. Kelsey has started to read my blog consistently and now has made some quality D-Facebook friends. I am hoping she will get the bug and jump in. (I am trying not to push!)

How do you manage diabetes?

Both of my kids are on MDI. They love their freedom and are extremely active. They don’t want the hassle of unplugging and re-plugging in. They know they have the option to explore the pump, but for right now they have no interest. They both do a great job with counting carbs when there are labels and they are diligent, I am quite proud of that. It’s when there aren’t labels that I think we all kind of slip up from time to time.

They test often (4-5 times a day). Marty tests more than Kelsey but he has that type of personality and sometimes goes overboard. I am thinking about getting the funding for a CGM. Being able to strap that on once a month would do wonders for us since night time (like most families) are the most nerve wracking.

What would you tell parents of a newly diagnosed child?

Well telling them to not worry is useless isn’t it? I would say have faith.

Have faith that you and your family can manage diabetes. If it’s a family effort and everyone tries their best, that’s all you can ask. I would also tell them to have an open, honest and as much stressless relationship you can have with your D-kid. They pick up on the stress and you don’t want them to hide it if they ate a cupcake at school. You need to know everything that is going on so you make the right decisions. Blood sugars do what they want to do even when you manage the disease tightly. No sense in freaking out, just correct it. Bolus or pop some food into them and move on. The more even keel you are, the better they will be during the teen and grown up years.

Lastly, connect with the DOC. Read blogs and go through their blog rolls until you find ones that align themselves closely to your personality. There is someone out there for you to connect with. All you have to do is look.

What do you know now that you wish you had known at diagnosis?

We were told that Kelsey’s life was over. And I think we believed it for a few months. Thankfully we came to our senses early, but even now I think back at how stupid I was to believe it even for a minute.

I think the other thing I wish I had known early is that there is no one way to treat and manage diabetes. That it’s an ever changing disease and you need to expect the unexpected and it’s okay to follow your gut if you feel like you wish to adjust some things.

Are you involved with any outreach or support groups? Do you do any fundraising?

To be honest, as the years moved on I fell out of outreach in the US. Since moving to New Zealand, I have started again. I am on the Diabetes Youth Auckland committee and the Diabetes Youth New Zealand committee. I feel privileged to be a part of two big organizations and I am truly enjoying myself. It has also forced me to pull my kids into more events and learning activities. Now I wish I had done more in the US if only it were just for them.

An Expat in New Zealand

Were your children diagnosed before or after your move to New Zealand?

Before, we have only been in New Zealand a year.

Were you hesitant to move to another country so far away? Did their diabetes play any role in your decision to move?

Yes, we were hesitant. We found out that the kids would be covered under the medical system. However, I probably should have done more looking into it. Some things are covered and some aren’t. Not that it would have changed our minds, just so we would be financially prepared.

Were you able to find out about medical care before the move or did you go into it blindly?

We were able to call and ask about it before hand. However, I am nervous about what will happen to them if they have serious complications. If something happens before we get residency, we will have to go home. If it’s after residency, the burden of proof that medical treatment will further their life is on us.

How does the medical care compare between the US and NZ?

Our care is wonderful. There are some things that are behind the times but, it’s more from an administrative standpoint. However, there are people who live nowhere near the cities and don’t and aren’t able to receive quality care with regards to their diabetes. It’s a big issue here. But overall I am very pleased with the quality of care my kids are receiving.

How does the insurance differ? Is there private or nationwide insurance there?

You can purchase private insurance if you have no medical issues. The kids don’t qualify, which may or may not create big problems if they have complications when they are older. I would say the good thing about socialized medicine is that the kids don’t have to worry about getting that top notch job to be covered. But how much they will be covered is always going to be an unknown.

Anything else?

Laugh, Love, Listen and BELIEVE that it will be okay. Diabetes sucks, but it’s manageable. You can do it, your kid(s) can do it, your family can do it. Have faith.

Meet other D-Moms and D-Dads each Monday.

Visit D-Mom and D-Dad Connection

Meet a D-Mom: Renata of The Diabetic Duo is a post from: D-Mom Blog

The Christmas Gift

One weekend my mother, my daughter, and I headed to Chicago to spend the day. Her grandmother had wanted to buy her an American Girl doll for her Christmas present.

When Q came to the case of 20 or so Just Like Me dolls, she quickly picked out the one that she thought looked, well, just like her.

That night as she and the doll sat on the couch in their matching pajamas, ready for bed, Q said about her new doll she named Sophia:

She looks just like me.
She’s a super hero just like me.
She’s fast and strong just like me.
She has diabetes just like me.

Since then, Sophia, along with Rufus and her super hero bear, have been subjected to countless blood sugar checks, injections, and check ups at home.

The Doctor Visit

As we packed for our most recent trip to the endocrinologist (remember it’s 200 miles each way!), she said it was important for Sophia to come along. After all, she has diabetes and needs to see the doctor, too.

After the nurse took a big drop of blood for the A1c test and measured Q’s height and weight, she did the same for Sophia.

After the nurse took Q’s blood pressure and listened to her heartbeat, she did the same for Sophia.

When the doctor came in she asked if her doll was here for an appointment too. Q responded by saying that Sophia has diabetes this week. Sometimes she has diabetes, but sometimes she doesn’t.

After the doctor gave Q the once-over, Sophia got a once-over, too.

Role Play

I think it’s important for younger children to role play and have dolls or stuffed animals that have diabetes too. It’s true that children need someone to identify with since the majority of their friends do not have diabetes (thankfully).

When we upgrade meters, I give her the old one. I give her empty test strip vials and the old insulin pens. Her diabetes supply bag for her dolls includes logbooks. The animals get once overs with the real stethoscope that the nurses kindly gave her in the hospital at diagnosis.

She helps manage their diabetes.

If your newly diagnosed child has not received the Bag of Hope which includes Rufus, request one right away. You only have three months.

Sophia Goes to the Endocrinologist is a post from: D-Mom Blog

If you are new to D-Mom Blog or to our family’s particular story, I invite you to read my previously written posts, which you can do by visiting the Archives.

Join me each Wednesday as I highlight a post from the past.

Overheard: CGM Edition, originally posted August 26, 2009.

Q is always thinking of great inventions. She builds them from empty boxes and found items, but sometimes she asks her dad to bring her vision to fruition. Hear what she came up with this time.

From the Archives 08.25.10 is a post from: D-Mom Blog

We are counting the years (yes, years) until Q gets to go to diabetes summer camp. Our local camp starts at 8 and with a late summer birthday she probably won’t make the cutoff that summer.

Have you seen the D-Mom Blog list of diabetes camps? It’s quite extensive and even includes camps in Canada in addition to those in the states.

Here are a few blog posts about children with diabetes who experienced camp this summer:

Stacey of Stacey Simms Blog: D-Camp (Camp KUDOS)

Megann of My Life with Diabetes: Diabetes Camp 2010 (Humphreys Diabetes Center Sweet Kids Day Camp)

Valerie of vmjess: Camp

Colleen Strauch of My Sweet Life: Why should you care about diabetes camp? (Harrisburg Diabetic Youth Camp)

Penny of A Sweet Grace: Camp Pros (and oh yeah, cons too) and Diabetes Camp and Diabetes Camp SWAG and The Return of Grace and Interview with a D-Camper

htimm=) of A Work in Progress: Camp and Camp Photos (Gales Creek Camp)

Jennifer of Diabetes and Then Some: Diabetes Camp: In the Majority But Not

Melancholywings of T1D Jilly Bean: Yay for Camp Stealth!!

Julie of Pump Wear: The Camping Experience (Circle of Life Camp)

Grab the shiny button to tell your readers that your post has been featured right here on D-Mom Blog.

Type 1 Tuesday: D-Camp Edition is a post from: D-Mom Blog

I saw this press release a few months ago announcing Abbott’s new FreeStyle test strips which use a small sample and will work in all their meters without coding.

We use the OmniPod PDM and also a Freestyle Flash (which they just replaced with a FreeStyle Freedom when I called for one).

Word on the street (actually word in my driveway and then on Facebook) is that they are becoming available in the US and some people are automatically getting these as they refill prescriptions.

Have any of you received these new strips with ZipWik? Are they in fact working in meters that previously used the FreeStyle (not FreeStyle Lite) strips such as the Flash, Freedom, and OmniPod PDM? Does the meter automatically know that it doesn’t need to ask for the code?

We haven’t had many issues with FreeStyle Lite and FreeStyle test strips in two plus years. Abbott’s customer service has been great the couple of times I have called with a problem or question about the actual functioning of the test strips. Each time I called they diligently asked me for lot numbers, expiration dates, if we had high or low blood sugars as a result of test strip error, etc.

The only real issue I guess is that our six-year-old can’t easily get her blood onto the test strip by herself. But she can talk anyone through it. I hope that these new strips are easier for her to use.

I’m always looking for improvements in all the products we use for diabetes management and hope these are an advance.

Press Release:

Abbott Introduces New, Easier-to-Use and More Accurate Line of FreeStyle Test Strips in Europe

New FreeStyle® and FreeStyle Lite® Test Strips Offer a Better Testing Experience and Minimize Interference

• ±15 percent of the true glucose value for glucose values equal to or greater than 5,6 millimoles/liter (mmol/L); and,
• ±0,56 mmol/L of the true glucose value for glucose values less than 5,6 mmol/L.

May 14, 2010

Stuttgart, Germany — Abbott (NYSE: ABT) today announced European availability of its new generation of FreeStyle® and FreeStyle Lite® blood glucose test strips at the 45th Annual Meeting of the German Diabetes Society (DDG). The new FreeStyle line of test strips features a new, easier-to-use ZipWik* design tapered test strip that offers a better blood glucose testing experience. The new test strips are designed to ensure faster blood application, to reduce the number of error messages and wasted test strips, and to deliver a significantly improved level of accuracy.

“The new FreeStyle line of test strips represents Abbott’s latest success in delivering innovative products for people living with diabetes,” said Heather L. Mason, senior vice president, Abbott Diabetes Care. “By providing a better testing experience and achieving greater levels of accuracy, Abbott is delivering on what patients and health care professionals demand in diabetes care, especially for people who use insulin to manage their diabetes.”

The new FreeStyle line of test strips is compatible with all FreeStyle blood glucose monitoring systems,eliminating the need to switch meters. The new test strips also offer all the same benefits FreeStyle users have come to expect, specifically: no-coding required, the world’s smallest blood sample size and virtually pain-free testing.

New FreeStyle Line of Test Strips Achieves New Level of Accuracy

The new FreeStyle line of test strips is the most accurate ever produced by Abbott and capable of meeting a tighter accuracy standard than exists today.

The new test strips produce finger-stick blood glucose test results such that 95 percent of results fall within:

This improved level of accuracy provides added confidence for health care professionals and people with diabetes when managing diabetes and dosing insulin.

The new FreeStyle and FreeStyle Lite test strips do not use the GDH-PQQ enzyme, which can be affected by common non-glucose sugars. The new FreeStyle line of test strips uses the GDH-FAD enzyme, which is unaffected by common non-glucose sugars, such as maltose or galactose, and minimizes the potential for interference.

European CE Mark (Conformité Européenne) approval for the new FreeStyle and FreeStyle Liteblood glucose test strips was obtained in October 2009. The new test strips are now available to customers in Belgium, Denmark, Finland, France, Germany, Greece, Ireland, Italy, the Netherlands, Portugal, Spain, Sweden, Switzerland and the United Kingdom. Over the coming months, the new strips will be available to customers in Australia, Israel and Norway. Abbott submitted 510(k) applications to the FDA in August 2009 for the new FreeStyle and FreeStyle Lite test strips.

New Abbott FreeStyle Test Strips is a post from: D-Mom Blog

Diabetes Mine has a post about glucagon: Enject’s GlucaPen: Diabetes’ Answer to the EpiPen

We do have several glucagon kits. We keep one in her bag that we carry her supplies and OmniPod PDM around in. Another at home. And one at the school office (though there is no “nurse’s office”).

The issue I have is that when we try to train people, their eyes glaze over. It seems so complex. ESPECIALLY for young kids who only need HALF of the liquid.

Add that to the fact that we’ve never actually used it (knock on wood, I can’t believe I just typed those words, please diabetes gods don’t give us a crazy low) makes it difficult to explain.

I don’t know if in a stressful situation if I, an experienced D-Mom, could remember all the steps, let alone expect someone who is overseeing her at school and doesn’t do the day to day diabetes stuff to remember how to use it.

We NEED glucagon kits that have half the regular dosage for kids. Seriously pharma, I hope you are listening!

I think that for young kids who are in school, there should be glucagon kits (with saline instead of the actual glucagon perhaps) that allow people to learn how to use it properly. (I’ve heard that you can get such a kit from Lilly, though I haven’t tried. 1-800-545-5979)

I would LOVE a glucagon pen and I would LOVE there to be an option of getting it with the appropriate dose.

Here is a video from the dLife YouTube Channel showing how to use a glucagon kit. She seems so calm!

A couple of our glucagon kits just expired so I took one to school to demonstrate to the staff. To tell the truth, I was a little nervous to demonstrate since I haven’t actually done it before. I was surprised at how quickly the powder dissolved. I took a nectarine because we didn’t have any oranges at home. I laughed because I got glucagon all over the principal’s table.

As I explained the circumstances where she might need glucagon (severe low causing seizure or unconsciousness) I saw the momentary look of terror on their faces. I explained that we have not used it and hope not to. But it’s like an insurance policy, you have it on hand and you know how to use it just in case.

I also checked my own blood sugar to show them how it works. Every time I have done this I am surprised at how much the finger prick stings for several minutes. Q rarely complains. As I waited for the number to appear I joked that I hoped it wasn’t too high or too low. It was 110. Phew.

Glucagon is a post from: D-Mom Blog

At our last endocrinology visit I asked the doctor why we were having way high highs after swim. We were treating swim the same way we did dance and ice skating and the technique was obviously not working out.

She gave us some advice which really seemed to work.

I told her that soccer camp was coming up. Camp is one and a half hours each day for a week. I remarked that we probably needed a lot of snacks. She said that at soccer sometimes there is standing around listening to the coaches, especially at this age. She said what is most important is to have lots of water and Gatorade available.

(I know I usually write in a prose style, but I’m giving you a play-by-play here.)

My Footballer

Day 1:

Stopped at the gas station to purchase a sport bottle of Gatorade.

Helped her get all her gear on, slopped on sunscreen, gave her a snack. (Note to self: remember a hat and sunglasses for her tomorrow.)

Introduced Q to the two coaches and told them that she’s diabetic. Said if she told them she felt low or didn’t feel well to let her come to me. They seemed happy that I would actually stay there the entire time each day.

About 40 minutes in Q ran up to me and said she felt low. Yep, 74. Let her freely drink Gatorade and had one roll of Smarties (figured I could treat a high later if needed).

Rechecked BG 15 minutes later when the kids had a quick break and she was at 117. Let her drink more Gatorade. She had two handfuls of mini pretzels that another parent brought (she didn’t want the snack I brought because the snack another parent brings always tastes better).

At their break that they took under the pavilion she finished off the Gatorade (the entire bottle had 42 grams carbs) and had 10 more mini pretzel sticks.

While I was talking to another mom I had just met about “school of choice” in our town, a mom I know well came over and whispered that the other mom has diabetes…just in case I wanted to breech the subject.

Turns out the mom is a Type 1.5 diabetic. She was talking about pumps but not wanting to be connected all the time. I showed her Q’s PDM and told her about patch pumps.

At the end of the 1.5 hours she was 174, which is technically in range (her range is 100-200, but we correct at 150).

Showed the other mom Q’s pod.

Stopped at Subway on the way home to grab a sandwich.

Realized I lost her medical ID bracelet, which I took off of her when we got to soccer because I was afraid that it would fall off and get lost. Oh, the irony.*

Days 3 Thru 5:

The rest of the week I was a little more conservative, not wanting to chase lows all morning. I watered down the Gatorade so that she could drink it a little more freely and gave her two snacks. At lunch time she was a little high each of these subsequent days, but I thought that was better than her teetering on being low the entire time she was in the extreme heat exercising.

I think if soccer was a permanent thing, I would work really hard to figure out the balance between snacks and Gatorade and activity to try to keep her between 100 and 200 the entire time. Though she was a little higher than I would like at lunch, she quickly came back down with her bolus.

What’s your strategy for preventing lows while playing sports? Do you have different ways of handling different sports?

Having a snack with her brother in the shade of the umbrella.

*Still haven’t found the bracelet. You would think someone would have found it and returned it to us. It’s not like it doesn’t have three of our phone numbers engraved on it.

D-Sports: Soccer Camp is a post from: D-Mom Blog