One of the most frustrating things about diabetes is that often times there are no answers. No explanations. No matter how hard you try to figure it out, examine it, investigate root causes, use your experience, knowledge, history, there just sometimes is no explanation.
Case in point. We have been having issues recently with what we think may be insulin effectivity. We use a pump. In theory, one of the benefits of pumping is, instead of multiple injections a day, you inject 1 inset every 3 days. You load up a reservoir with insulin, and change out the insulin and inset every 3 days. That assumes everything goes well.
What we think we have experienced the last couple of weeks, is the insulin getting warmed up and losing it’s effectiveness. Could be due to the heat and humidity we had this month. Could be due to my daughter sleeping on her pump at night. Could be due to a bad batch of insulin. There are multiple scenarios, and we can’t figure out exactly what is happening, and it could be a little of all of those things. This leads to more set changes more often, wasted insulin, and extra shots (or more frequent) for our daughter.
We had another slightly different but related issue yesterday. We noticed the overnight numbers creeping up on us (that is normally where we have been noticing the issue above) when we have to bolus at every check, and she STILL wakes up in the 200’s. So first thing in the morning (a typical site change day has us changing sites before dinner) we changed the site. This has rectified our problem the last couple of weeks, we had no reason to think this would be any different. She was still high through her horseback riding lesson. Normally she burns off BS while riding. But yesterday she stayed in the 200’s. Here is where diabetes really gets confusing. During a normal lesson, Stella burns off blood sugar. But yesterday she was riding a new horse. He was a little more advanced horse, so she was nervous. That will cause BS to rise. So, was the high BS due to a new horse, stress/anxiety/nervousness? Or was it an issue with insulin going bad? Or, since we just changed the site, was it due to a bent cannula/kinked hose? Are you confused yet? We bolused her again and waited. At lunch time she was still not coming down, so I left the pump alone as it had been refilled with insulin, new tube, new reservoir earlier that morning, and just inserted a new site in case the cannula (the tube inserted into the body) was bent. And we waited again.
While this was going on all morning (at this point it was now around 1:30 pm, and we started with the site change at 7am), the dogs were alerting. The highs tend to agitate the dogs more so than the lows, and they take longer to fix. So the dog is exposed to the scent for a long time. Raven alerted to a high initially at 2am. So they were pretty spent. After lunch, both dogs alerted. She was 318. That isn’t totally unheard of after lunch, and she had a lot of insulin on board. So we waited. 30 minutes later they alerted again. Stella was 350. At this point, we decided to pull the insulin out of her pump and replace it. I even threw out the old bottle and started fresh. To get things kick started, we decided to give her a shot instead of going back through the pump. It has been a long time since she had a shot, and she freaked out. Lots of crying, screaming, and anger. It was devastating. This disease is always horrible. Sometimes it is even worse.
Here is the good news. We fixed the problem. Here is the bad news. After all of that, we still really don’t know what the hell the problem was to begin with. It could have been any one of those things that we did, or it could have been several of them all together. Or it could have been a growth spurt or hormones kicking in, and nothing was going to fix it until that worked it’s way through and all we had to do was wait. Type 1’s and their families deal with these issues ALL THE TIME. It is always something. And just when you think you are in a groove, you got it all figured out, this disease throws you a curve. We are playing with lives, and quality of life here. Not shit you want to mess around with, and it causes tension and anxiety for everyone.
I hate this disease. We need a cure.