July 8, 2011

How Would You React? - P3

(Continued from the last blog - P2) Then a few weeks ago now, they emailed me wanting to know why on a site they had found, the person was so upset about people asking about a number on the meter. It is this blog and I have tried to explain it. I told them that a lot of people don't like to talk about numbers and value their privacy more than talking about numbers, and in this case, it was plainly rude. That while one number does not mean much in and of itself to some people, others rely on this number at the point in time for information in that moment. Others look at the number for the direction their blood glucose may be trending.

While those of us with Type 2 diabetes are looking for trends in our numbers and use them for regulating our food intake, those with Type 1, seem mainly concerned that they have given themselves the correct amount of insulin for the food (carbs) eaten and whether they are going higher, or are on the way to a low. If wearing a continuous glucose monitor, the number is not so much the concern as the direction and speed at which numbers are changing and how much longer the insulin will last. It can be contextual in these circumstances, but for those of us with Type 2, it can indicate trends.

We look at the numbers as indicators of trends that we may need to adjust for in the long-term. This is very true for Type 2's on oral medications and those using exercise and diet to manage diabetes. Those of us Type 2's on insulin do a lot more carb counting and try to cover the carbs to be eaten like the Type 1's, but also are looking for trends and possible insulin resistance.

This of course raised the issue of why the concern. So I took time to explain the diabetes police and some of the other problems that would come her way when school started. I said that if she wanted, she should discuss this with other Type 1's. Fortunately, there were several Type1's available and we had a good meeting the following Saturday, a few laughs, and I think the family came away with a better understanding of the problems of being out in the public or even family gatherings.

The one point everyone raised was to take advantage of the summer and test often as the endo had asked her to do. This would help her confidence and she would recognize the symptoms of heading into a low and know what to do immediately. To watch out if she did not recognize the symptoms and talk to the endo immediately if this happened, to see if a continuous glucose monitor may be necessary. One of the group is that way and showed the family the instrument they were talking about. Then they discussed pumps and among the four there were three different brands.

The biggest thing the group of T1's emphasized was learning how to count carbs and determining the insulin dosage. We discussed many of the sites that would help calculate carbs and other nutrition information. We looked at several of the cookbooks the family had and she had one of the newer versions with the nutrition information with each recipe. The daughter had pulled up several of the sites and bookmarked them as we looked at the cookbooks. I could see the relief on her mother's face.

I know all of the group passed the family phone numbers and said if they had questions to ask. And the last item before we left was to give them advice on meeting with the school nurse and principal before school was to start. The 12-year old really won the hearts of everyone when she thanked each person for their time and input and willingness to be a resource for her to lean on.

As a person with Type 2, I had to admire these people for opening up together and coming to the support of this family. This is so different from what most of my Type 2 friends do. We acknowledge each other, but seldom talk about diabetes individually or when we are together as a group unless it is a support group meeting.

End of this series – there may be more later.

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