Tough Day with Diabetes

While most days are business as usual with Type 1 diabetes, occasionally something flies in from the back of the room to knock you off balance. Today, Braeden's pump failed, probably. This is the fourth or fifth pump that has likely failed. It always starts with a high blood sugar reading. His normal range is 125 +/- 20 mg/dL. His breakfast check yielded 348.

When the body has consumed all of its insulin, the cells do not have a way to extract the sugar from the blood stream and convert it to energy. So, the blood sugar concentration increases unchecked. At this point, the affected person is feeling very poor and lethargic. Not because the blood sugar is high, but because the cells are starving. The cells still need energy, so they start to tap stored reserves of fat and protein. The chemical process that ensues creates byproducts including ketones. (Anyone out there ever try the Atkins diet?) Ketones are poison to the body and are measured on a funny scale: NONE, TRACE, SMALL, MODERATE, LARGE, EXTRA LARGE. At breakfast, Braeden's ketones were already LARGE.

This scenario happens from time to time even when the pump is operating well. But, it is a lot harder to fix with a broken pump! So, here is a snapshot of Braeden's blood sugar throughout the day. The red lines mark the upper and lower limits of his target range.


We turned the pump off and started using a combination of NovoLog and Lantus injections by syringe at 5:00 PM. A new pump should arrive via overnight mail sometime tomorow. But the damage is done. Braeden suffered through the swings all day, had LARGE ketones twice, and now has stayed low for several hours despite taking in lots of carbohydrates. Like they say, insulin therapy is not a cure, and this illustrates why.