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Good afternoon everyone! My wife and I have recently been thrust (totally against our wills) into the world of Type 1 management. It has been a major lifestyle change. We were preparing for my new job/relocation and were about 2 weeks from the big day when we took her to the doctor. Here's a bit of the story.

We have a 20 month old daughter. In April, she caught a cold. Then she didn't get better. She had the wettest diapers we had ever seen. Some nights, we would change her 3 or 4 times. We thought we had bought some very poorly made diapers and vowed never to buy that brand again.

One day, she was having a good day, so we changed her diaper and took her to the zoo. When we got back to the car she had soaked through her diaper, her clothes, and the stroller in less than 4 hours.

She was fiercely thirsty. She would suck down an 8 ounce sippy cup full of milk/juice and barely even breathe. Then she would throw up. Then she would scream for more. We started limiting her to two ounces an hour.

As the days passed, she became more inconsolable. She wanted to be held all the time, yet would be fidgety, irritable and uncooperative.

She lost 3 or 4 pounds, which was a big deal because she only weighed something like 24 pounds to start with.

Finally, my wife said it was time to go to the doctor, this just wasn't right. The doctor did a simple fingerstick blood test with the same kind of monitor a diabetic would use at home. I said "Whatever." I was in full-on denial at that point that diabetes could possibly be the problem. I was a bit incredulous that the doctor would even suggest it. The result was 334. I said "Well, that's not right." The nurse got a different brand monitor and did it again, 324. Uh... Alrighty then... She was in moderate ketoacidosis.

We spent 3 days in the hospital where she got insulin and fluids, and we got to learn a lot, really fast. We cried, we hugged her, and we loved her. We're still learning.

She has turned back into her normal, bubbly, adorable self. It's a lot of work, but we do what we have to do.

Since our move, we have found a pediatrician that's comfortable taking care of diabetic kids for the normal kid stuff, and we have a pediatric endocrinologist who can speak in plain-people language. Our diabetic educator is the absolute best.

Because I have a clinical pharmacy background with a solid understanding of basic nutrition, the dieticians weren't so helpful. I was hoping they would be able to tell me how to look at a plate of food and correctly estimate the carb count. Silly me. They wanted to explain the difference between carb, protein, and fat. And stop there. The diabetic exchange lists based on 15g carb counts weren't so helpful, either, because her sliding scale is based on 35g carbs, and she never eats that much, anyway.

She's still in her honeymoon phase, and producing just enough of her own insulin to really mess with us. As a toddler, I'm sure that's all part of her master plan to take over the world.

Her current regimen goes something like this:
1 unit of Lantus in the morning.
1/2 unit of Novolog for every 100mg/dl over 200. We change this to every 150mg/dl over 200 at dinner/bedtime.
1 unit of Novolog for every 35 grams of carb she eats. Of course, there is just no way she'll eat that much unless it's straight candy. Hooray for 1/2 unit syringe markings!
We test her at mealtimes and snacktimes. If bedtime is significantly later than dinner (more than 2 hours) we'll test then. And we wake her up at 1am to test her and give her a protein snack. So around 6-8 times daily. Our primary management problem is preventing lows.
Our goal is an A1C that's 7-8 and BG 100-200. We aren't shooting for tighter control than that because of the danger of hypoglycemic consequences to her developing nervous system.

Sometimes people ask us if it's hard to poke her fingers for the blood tests or if it's hard to give her injections. Yes, it's hard. She doesn't like it. She doesn't fight us, though. And it's a lot harder to watch our child deteriorate into a life-threatening case of ketoacidosis or worse.

Research I'm truly hoping for: a self-running glucometer (perhaps the glucowatch) that speaks with an intelligent insulin pump making essentially an external pancreas. I think we'll see this happen before we see a cure.

Anyway - I just thought I'd share our experience. I realize that type 1 and type 2 don't have a lot of crossover concepts, but our goals are the same - to live happy, healthy, productive lives.

Thanks!
Randy
And oh yeah - the Pink Panther book rocks!
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