the miracle of 20 minutes – change is GOOD

When my Obi-wan was younger, he would go low within 15-20 minutes of giving insulin if he did not eat WITH insulin.  In the beginning, “They” said to wait at least 10-15 minutes after insulin dose.  This made sense to me because my younger brother grew up with NPH and R, where you waited 30 minutes to eat…

We tried 15 mins before eating, he went low, we tried 10 mins before eating, he went low… too often, within 20 mins of insulin, he went low — lows that were unexpected since he JUST ATE, right…!?  Sign language conversation with 3 y/o Obi-wan:

“momma, me need milk”

“really… you ate”

“NO!  Milk Milk!”

Obi-Wan as SuperNova-logger

Obi-Wan as SuperNova-logger

A miracle in and of itself, little Obi-wan feeling and reporting lows since day-ONE. He used sign language, “Milk Momma, Milk” , then he started verbalizing his lows, “I need MILK”, which transitioned by the time he was 4 y/o, “I AM LOW!” Still, from across a noisy room, he signs, “me low!”  … and I believe feeling low must be primal, so signing “me low” makes all that much more sense…

— proud —

I digress…

So, we have been reluctant (and quite nervous) to wait even 3 minutes to eat after giving insulin.

…heres how we got to our Miracle…

We have been struggling with how to manage monster BG spike after breakfast.  We tried a sensible solution, increase bolus… yet, monster BG would plummet 2 hours later (40s and 50s)…  We tried a basal increase 2 hours prior to breakfast, so at 5-6AM, new basal setting is doubled for that one hour, intended to impact the 7:30 AM breakfast that we expected to SPIKE at 8:15/30-ish – it helped a lot, but still, preprandial BG 90, 100, 120 – whatever happy monster number you like – became evil monster number 300-350 in an hour!

Ok, so why are we testing ONE hour after eating…?

P.E.

sports are tricky, including pump placement!

sports are tricky, including pump placement!

We always test before PE since he can start PE at 180 and drop to 60 in 30 mins (labile little monster)… that’s another story, we have to TREAT 180 if he goes to PE!  yep, glucose tablets and crackers and he still finishes PE near 100! — cra-zi-ness —

Things change… and this year of 3rd grade, PE is just after drop off:

7:30 BG 115, eat with insulin,

8:30, Pre-PE BG check 350… what!?!?  Is the site working? is the insulin bad?  …after months of trying to figure this out and not even considering to “wait before eating,” because well, we already know what happens when we do that… why would THAT change…?

…of course it changes…

we are — and diabetes is — a complex dynamic system of chaos.

For whatever reason, this complex dynamic system of chaos has shown us that 20 mins is our miracle number (for now).

…he no longer goes low 20 mins after insulin dosing and we now wait 20 minutes after insulin dose before eating breakfast.  He has yet to have another 300-350 pre-PE BG number (for now).

Our Miracle of 20 minutes — Change is GOOD — surely it will happen again.


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