I remember vividly the week when it all started, four years ago. Our 23-month-old son, Teddy, wanted to nurse again and again. He would wake up and grab his water bottle, carrying it around the house all day and drinking from it nonstop. Having had type 1 diabetes for seven years, I knew what the symptoms looked like and reluctantly pulled out my blood glucose meter. I just hated pricking his little finger. The test result read "HI," so we went straight to the emergency room. Teddy's blood glucose was 798. Our baby had diabetes.
For the first time, I was thankful for my own diagnosis. I had already learned so much about diabetes. But how would I manage it in a toddler? How do you give insulin to a child who may or may not finish his meals? And how in the world do you count the carbs in breast milk? We met with a pediatric endocrinologist and a diabetes educator, and they helped to answer these questions.
Over time, my husband and I learned how to recognize Teddy's signs that he was low. He'd fuss, sweat, or want to be held. When he started talking, it got easier. At first, he'd say that he was hungry or that he felt funny. Now that he's 6, he'll announce, "I'm low and I want candy!"
Teddy got an insulin pump within a month of diagnosis, which made the adjustment much easier. We haven't had to force him to finish his food, and he gets more choice in what he eats. He continued nursing after his diagnosis, and through trial and error we found that very small boluses were enough to cover breast milk. Teddy's continuous glucose monitor, which he got when he was 2, has also been invaluable. It helped us improve his control and made all our lives easier. Before the CGM, it was tough to sleep soundly. I would wake up in a panic: Was my son still alive? Thanks to the CGM, that anxiety has subsided.
We keep the device's receiver next to our bed while Teddy sleeps in another room. The alarms have roused us from deep sleep many times, alerting us to low blood sugars we would have missed. Like any mother, I sometimes sacrifice my own needs for those of my children, including my diabetes care. As Teddy's A1C goes down, mine inches up.
Fortunately, the seesaw doesn't work both ways. When I am doing a good job caring for my own diabetes, it only helps me be more vigilant with his. When I feel low, I've found myself checking Teddy first, sort of like the mom who tells her son to put on a sweater because she is cold. Diabetes does not control Teddy or us. It used to take two of us to hold Teddy still for infusion site changes, but now he cooperates. He tolerates finger pricks as routine. Our goals are for Teddy to lead as normal a life as possible, and for him to maintain excellent control of his blood glucose. Sometimes we compromise on one in favor of the other, but most of the time we can achieve both.
Sarah Howard lives with her husband, Tim, and their children in East Greenbush, N.Y. Her website is www.diabetesandenvironment.org.