Dear Peanut Butter,
I have to say that both of my kids, The Superhero and The Princess, seem to enjoy your gooey goodness most days for lunch. I am sure it is the yummy peanut buttery taste you bring to their sandwiches each day.
After The Superhero was diagnosed with T1 Diabetes was the first time he had a taste of your deliciousness. We had heard what affect you can have on the blood sugar of a T1 Diabetic and were prepared for your fat causing spikiness. We started with a regular bolus for you. Not enough. Then we added some extra carbs to the total carb count for the PB&J that became a regular lunch time addition.Still not enough.
By the time we made you work successfully for our T1 Superhero, we were doubling the carbs for the entire sandwich. This made the carb count for a 1/2 sandwich 56 carbs and the whole sandwich 112 carbs. (based on the bread, peanut butter, and jelly we use)
We finally have you figured out. The Superhero has been eating your gooey goodness for lunch for over 2 years now and we have it down. When we switched insulin to Apidra, you threw us for a loop. You see, Apidra works differently than the Novalog we were used to. Apidra has no tail end and is OUT of the system for our Superhero within the first 3 hours. But you, my dear Peanut Butter, were still working overtime in The Superhero's body. To make you work for us again, we ended up having to combo you. It was the only way to keep you from crashing and spiking my Superhero in a matter of hours. We now double the carbs (112g total) AND combo you. And of course, it gets even more complicated.
The combo is not a simple 50/50 split. Not a 60/40 split. Not even a 70/30 split. No, that would all be too easy. We have to combo you based on the starting BG of The Superhero. That's right. Now this pseudo-pancreas has to decide the amount of insulin you need based on the starting BG.
If the Superhero starts out at a nice 140, I usually have to do the double carbs for the sandwich and then a combo of 65/35 for 4-5 hours. If he is low, I would do a 50/50 split for 4-5 hours. If he is high, usually a 75/25 for 3-4 hours. It just can't be easy. And this doesn't work every time either.
But, for the most part, we have you figured out. At least for LUNCH TIME.
On the RARE occasion The Superhero eats you in the morning (almost never) or at night for dinner (again, almost never), ALL.BETS.ARE.OFF.
You NEVER seem to be consistent at this time of day. You either leave him LOW or steady and then HIGH. This is exactly what happened last night. Our poor Superhero was running a good 176ish before bed. Then he went up to the 300's and stayed there for a while. And then, then it hit. He was HIGH on Dexcom. For HOURS.
If we didn't love you so much, Peanut Butter, we would HATE you for this. We will just learn from this and not let our sweet Superhero eat your deliciousness.
The Superhero's Mommy and pseudo-pancreas
*Disclaimer: I am a mom of a T1 Diabetic child. I am NOT a doctor. I just play one in real life. Please do not take anything in this post or any other post on this blog as medical advice. If you have questions or concerns of your own, please seek advice from your doctor.*