As acting pancreases, we do a lot more thinking than we give ourselves credit for. When it comes to diabetes we make thousands of decisions a day. Many of which come so naturally it’s hard to process the true amount of brain capacity it takes to keep the numbers in check. Summer tends to be my big wake up call. A shift in the boys’ insulin needs begins, and as such I need to make many more conscious diabetes decisions than normal. Situations arise, and for whatever reason the alarm bells start going off. “Meri! You need to think this one through! Variables! Think of all the variables!” Diabetes steps up the pace, and in turn, the cogs in my brain need to be dusted off. Below, please find a list of our family’s summertime alarm bells:
As summer vacation begins, activity becomes a factor right out of the gate. Sometimes my boys become totally sedentary playing video games, recovering from finals or the end of school-year frenzy. Other times, basketball camp starts right away and they are running themselves crazy from morning until night. Either way, change in activity changes their insulin needs. Patterns of high or low blood sugars inevitably emerge, and basal changes must be made.
Next comes the heat. Keeping insulin cool, keeping low blood sugars at bay after swimming, and remembering to actually take off the insulin pump BEFORE the boys jump into the water comes into play. Swimming brings so many variables, sometimes I feel like my brain is swimming in numbers. Should I pre-bolus for the missed basal while the boys swim? Will that missed basal be a plus since they are so active? How often should I have them break to test their blood sugar? Will they go low tonight because of all the activity today? Again, did they take off their insulin pumps before they jumped into the pool? (We had Medtronic send us two replacement pumps after two cannonball jumps into the pool during our Disney vacation one year. I still suffer from post-traumatic stress every time the boys jump in the water.)
3. Playdates and Sleepovers
And then there is the increase in play dates and sleepovers. Leaving my children in another adults care for more than a few hours takes forethought. Thankfully in this day and age we have cell phones and texting, but even then, who will count the dinner carbs for my youngest? How will that 2AM check happen? Is that necessary? How much information do I tell the host family to keep them informed, but yet not scare the pants off them? My solution usually comes in the form of a practical information sheet with bullet points and telephone numbers.
Also, our diet changes as summer starts. Sometimes we seem to subsist for days on only fruit. Other days we are going out to dinner to beat the heat and our diet is full of fat, hidden sugars and sneaky carbohydrates. We all know restaurants like to add sugar so their food tastes extra good. Giving a good scientific-wild-guess on carbs within a restaurant meal can be full of angst and regret, and require a ton more brain power than one would think. Case and point: Chinese food buffets. Square-wave boluses are a lifesaver. It helps us to research websites for nutritional information beforehand to get an idea of what we are in for as well.
Then there is the traveling. Planning plane trips, or car trips brings up issues we were impervious to months before. I always review the TSA guidelines before flying with diabetes. It helps to know our rights. They can be found here. At the airport, Medtronic says it is ok to go through the metal detector – but not the new full body scanners – with insulin pumps. I’ve learned it’s our right to refuse the scan and get the pat-down instead. Life-saving apple juice will be questioned and sometimes even require a long conversation with security. Being far away from home requires thinking ahead on supply needs. I like to bring twice the amount of supplies that I anticipate we will need. And when swimming is involved I like to bring enough for a set change every day…just in case. Also, if we are traveling out of the country, Medtronic can provide us with a loner pump as a backup, just to ease our minds. Better to be safe than sorry when traveling far from home. With long car rides, sometimes a temp basal is in order. I always have a long talk with our endocrinologist and CDE before we travel…they are a wealth of knowledge!
These alarms are the tip of the iceberg when it comes to summer, but our thought process will adapt, experience will be our teacher, and problem solving will prevail. We may have to make a lot of educated guesses, but we are capable…and the fact that we are putting in the work is half the battle anyway.
Happy summer, to you and yours!
IMPORTANT SAFETY INFORMATION
– Medtronic Diabetes insulin infusion pumps, continuous glucose monitoring systems and associated components are limited to sale by or on the order of a physician and should only be used under the direction of a healthcare professional familiar with the risks associated with the use of these systems.
– Successful operation of the insulin infusion pumps and/or continuous glucose monitoring systems requires adequate vision and hearing to recognize alerts and alarms.
Medtronic Diabetes Insulin Infusion Pumps
– Insulin pump therapy is not recommended for individuals who are unable or unwilling to perform a minimum of four blood glucose tests per day.
– Insulin pumps use rapid-acting insulin. If your insulin delivery is interrupted for any reason, you must be prepared to replace the missed insulin immediately.
Medtronic Diabetes Continuous Glucose Monitoring (CGM) Systems
– The information provided by CGM systems is intended to supplement, not replace, blood glucose information obtained using a home glucose meter. A confirmatory fingerstick is required prior to treatment.
– Insertion of a glucose sensor may cause bleeding or irritation at the insertion site. Consult a physician immediately if you experience significant pain or if you suspect that the site is infected.
For more information, please visit MedtronicDiabetes.com/isi.
, insulin pump
, square wave bolus
, temp basal
, temporary basal