Strategies for Reducing Highs & Lows
Staying In Target... Together.
There are so many things that impact your child’s blood glucose reading at any given moment in time. Effective glycemic management (that is, reducing highs and lows, and maximizing the time your child spends in the target blood glucose range) requires attention to these factors… it requires work. But the good news is, the more time and effort we put in at the front end, making proactive changes in how you or your child manage his diabetes, then the less effort we need to put in on the tail end, reacting to blood sugar extremes and the associated symptoms.
Highs and lows, it’s how life goes, when little moments shine.
Hold them close, they should never be sold - they only get better with time.
– Highs and Lows, Mindy Smith
Articles on Blood Glucose + How to Manage It
This section on Managing Blood Glucose presents a wide range of both proactive and reactive approaches to managing blood sugar, for those on injections as well as for those on an insulin pump. We take a close look at the how and why: to check blood glucose (using meters, CGM & Flash); to balance the all the factors that affect BG; to deal with both high and low BG, and to adjust insulin doses with any insulin type and program. Click on one of the titles below to read that article.
Articles are categorized in terms of Readiness Levels:
Type 1 Diabetes:
What (and Why) Is Type 1 Diabetes?
Learning the New Language of Diabetes
Insulin:
Insulin Program Options: NPH vs MDI vs Pump
Preparing Insulin for Injection
High and Low Blood Sugar:
Factors that Affect Blood Glucose
Checking Blood Glucose & Ketones
Correcting High Blood Glucose: Correction Factors, Sliding Scales and ISF
Adjusting Insulin Doses (N/NPH):
N/NPH How Insulin Action Affects BG
Adjusting Insulin Doses,
Multiple Daily Injections (MDI):
Highs and Lows:
Why is BG So High? (or so Low?)
What is a Post-Meal Spike? How Do I Find Them?
Tame Post-meal Spikes: 14 Strategies Using Food, Exercise & Insulin
Continuous Glucose Monitoring:
Pros and Cons: Is CGM Right for Your Family?
What is Flash Glucose Monitoring
CGM vs. Flash (Libre): Which is Better?
Side-by-Side Comparison of Sensor-Based Glucose Monitoring Systems (CGM & Flash): Which System is Best?
Review of Libre2 (Pros & Cons of Flash)
Dental Health:
Adjusting Insulin Doses,
(using N/NPH):
NPH Assess & Adjust Insulin-to-Carb Ratios
NPH Assess & Adjust Correction Insulin
Adjusting Insulin Doses,
Multiple Daily Injections (MDI):
MDI Assess & Adjust Basal Insulin Doses
MDI Assess & Adjust Insulin-to-Carb Ratios
MDI Assess & Adjust Correction Insulin
Adjusting Insulin Doses,
Insulin Pump:
PUMP How Insulin Action Affects BG
Beginning articles act as an introduction to the basics of managing type 1 diabetes, written for families with a child who has been recently diagnosed (within the last 6 months or so), and for those who feel there may be gaps in what they remember from the early days. Beginning content represents the basic building blocks for what follows in Intermediate and Advanced levels.
Intermediate articles add another layer of information, expanding upon basic skills. They are designed for families who experienced a type 1 diabetes diagnosis several months (or years) ago, have the Beginning concepts mastered, and who are feeling that they want to do more than just “get by”. Intermediate topics will provide you with the skills to better manage blood glucose.
Advanced articles are designed for those type A’s in the crowd (you know who you are!) who feel that, after all the regular information out there, there must still be more to learn. You can live well with the diabetes dragon without exploring these Advanced topics, but if you are in the pursuit of excellence, and want to further refine and tweak things, the topics in this level are for you.
Another song that reminds me of managing blood sugar…
“I’ll be out here on the sea, just my confidence and me.
And I’ll be awful sometimes, weakened to my knees.
But I’ll learn to get by... on the little victories.”
– Little Victories by Matt Nathanson
I sincerely hope the information on these pages brings you little victories, which, in turn, lets you focus less on the dragon, more on life!
Other Resources for Managing Blood Glucose
These are a few of the resources that have been valuable to our family in our quest to have our son spend as much time as possible in-range. We hope this information helps you on your family’s journey!
The information below contains external links. Clicking on those links will take you to a different website outside of WaltzingTheDragon.ca. Waltzing the Dragon is not responsible for the accuracy of the information contained on those websites.
Education and Information
Alberta Children’s Hospital Diabetes Clinic website
What: The ACH Diabetes Clinic promotes healthy lifestyles for children and adolescents with diabetes through state-of-the-art clinical management, family focused education and psychosocial support. Their website is a resource for families living with childhood diabetes, allowing current patients to download the forms for your child’s clinic visit, read about research projects at the University of Calgary (including participant eligibility), and link to the Transitioning Youth with Diabetes program. All web visitors can read and download informational handouts on a variety of diabetes topics, including: adjusting insulin, managing diabetes when a child is sick, traveling with diabetes, preventing DKA in a child using an insulin pump… and many more.
Who: anyone with diabetes (especially those who use insulin) may benefit from the online information, though the resource is focused on children/teens/families
Where: Calgary, Alberta (Canada); their online resource is available anywhere
What: The Endocrinology & Diabetes Unit at BC Children’s is a diagnostic, treatment and education centre for children and families affected with diabetes and other endocrine conditions. Their excellent online resource is available to anyone, and includes detailed information and practice exercises in an self-learning program (a series of modules which take you through the principles and process of Insulin Dose Adjustment).
Who: anyone with diabetes (especially those who use insulin) may benefit from the online information, though the resource is focused on children/teens/families.
Where: Vancouver, British Columbia (Canada); their online resource is available anywhere
What: Via video and the web, Welcome to Type 1 promotes a proactive outlook and provides the important information needed by those newly diagnosed with type 1 diabetes.
Who: those newly diagnosed with type 1 diabetes
Where: online
Consultation
(founded by Gary Scheiner, MS, CDE, author of Think Like a Pancreas, and T1D)
What: Integrated Diabetes Services provides individualized diabetes education and management services, with specialties in technology (insulin pumps and CGM), and managing diabetes within exercise/athletic activities.
Who: for anyone living with diabetes
Where: any location, via video chat (physically located in Pennsylvania, USA)
RN, MSW, CDE – Diabetes Nurse Educator, Family Therapist, and T1D for 50+ years
What: Joe provides individualized guidance on the physical and/or psychosocial aspects of T1D. He specializes in assessing how familydynamics affect the management of diabetes and in designing interventions that result in more effective coping and optimal glycemiccontrol.
Who: for anyone living with diabetes
Where: any location, via video chat
Looking for Individualized Help on Your Dragon-Taming Journey?
Joe Solowiejczyk, RN, MSW is a world-renowned Diabetes Nurse Educator and Family Therapist who has lived with type 1 diabetes for more than 50 years. As a result, he is able to translate his personal experiences into unique and creative patient care programs and services. He specializes in assessing how family dynamics affect the management of diabetes, and in designing interventions that result in more effective coping and optimal glycemic control.
If your family could benefit from a session with him (from any location, via Skype), please contact Joe at [email protected].
Joe is also the author of A Type 1 Diabetes Guide to the Universe, a book that integrates the psychological and emotional aspects of dealing with diabetes into the core of its approach, to provide information that will help you and your family.
Note: You may want to check with your private health insurance provider to see if you may be covered for this service. If you live in Alberta, note that Joe is registered as a nurse in your province, and depending on your plan, sessions may be covered under professional services as chronic disease management education and training, or as family therapy. Additionally, if your family has a personal spending / taxable wellness account, you may be able to claim these services under caregiver support services, or training / tutoring, or even under stress management programs. For more information, contact your private health insurance company.