I have been Type 1 for 43 years with no complications since I've kept my HbA1c < 7.5%. My target was higher than usual since I used to have a vulnerability to unexpected hypos, but that has been totally eliminated now (in the last year) since I have been accurate carb counting following DAPNE guidelines using basal/bolus regime. My last HbA1c was my best ever at 6.3%. So I know exactly what carbs I'm eating, also know the Insulin-Carb ratio (Humalog units per 10g of carbs), and adjust my Humalog based on the Ratio from the previous and average of previous 3 days achieved BG compared to my target of 5.5 after 4 hours, prior to next meal. This works really well and but I realise you can do similar things using a smartphone app.
I record everything (insulin dose, carbs, achieved BG before each meal etc) on a daily basis in a detailed spreadsheet which updates trend graphs and provides excellent visibility of how well I'm doing within my target levels. I of course always use an electronic meter, which in my extensive experience is easily the quickest and most accurate (displays exact BG numbers, always repeatable within a small margin of 10% and which Excel understands and uses to calculate projected insulin dose needed for next carbs)! Not way should a Type 1 be using the visual strips .. what is that all about!
Anyway, in answer to "dawn28378's" original question ..
My 5yr old has only been diagnosed T1 for three months and I wondered if someone could clear something up for me. One DSN has told me to check his blood sugars two hours after his pre meal insulin and one has told me to check it two hours after he has actually finished eating. What do you usually do?
You haven't stated what Insulin regime Toby is on, so much of what i say later on may not yet apply if not on a basal/bolus regime. The recommendation from many people that I have seen, is that the time should be from .."When you start eating i.e. the start of the meal" e.g. "2 hours (after 1st bite) seems to be the industry norm - when to test after meals" is one I've just found, and this assumes that the quick acting insulin has been taken just before the meal.
Nearly all the diabetes web sites just say "2 hours after the meal", rather than saying at the start or the finish. If the meal is eaten quickly, as most Americans do, then it hardly makes much difference, but with a young child like yours I can imagine meals can take longer. Personally I always test after 4 hours, just before the next meal, since that tells me exactly how effective my insulin/carb value actually was. I will sometimes test after 2 hrs, after the start of the meal, just to check particular food types which are new to me. The key point is to always do it based on the same (start or finish time) and repeat for at least 3 days to get a consistent picture since often the same carbs/dose can vary day-to-day due to varying absorption rates and other factors.
Anyway, your son is probably not yet on a basal/bolus since it is not always considered suitable for young children, but at some stage in the future he will be migrated to that. So here a few links that you might find useful to increase your knowledge (for diabetes management, knowledge is indeed power!)....
Books you should consider purchasing:-
Carbs & Cals: A Visual Guide to Carbohydrate & Calorie Counting for People with Diabetes (Chris Cheyette)
Buy this excellently illustrated book that provides clear pictures, portion sizes & weights plus carbohydrate values of nearly every food you might need.
http://www.amazon.co.uk/gp/product/0956 ... 01_s00_i01
Type 1 Diabetes in Children, Adolescents and Young Adults (Ragnar Hanas)
A comprehensive book with great detail in all aspects of managing diabetes with emphasis on children. This is easily the best book I have ever read about managing Type 1 diabetes, so if you only buy one book …. this is the one.
http://www.amazon.co.uk/Type-1-Diabetes ... gnar+Hanas
Documents available on the internet:-
An introduction to carbohydrate counting and insulin dose adjustment
https://shop.diabetes.org.uk/store/lite ... -book.aspx
An excellent introductory document from Diabetes UK that covers all aspects of diabetes, and the method of carb counting, insulin adjustment and insulin-carb ratios is covered in Chapter 2 (Carbohydrates) and Chapter 3 (Insulin). Even if you are not doing carb counting, you should definitely read this!
Basal Testing … how to check your Lantus or Levemir dose is correct
In the absence of food, exercise and mealtime/bolus insulin, basal insulin should hold the blood sugar steady. Any significant rise or fall in blood sugar during a fasting basal test probably means that the basal rates need to be adjusted - even if the blood sugar winds up near normal by the end of the test. This is how to check it ….
http://www.diabetes-support.org.uk/info/?page_id=120
Children with Diabetes in the UK (online support group)
http://www.childrenwithdiabetesuk.org/
Last point: someone earlier mentioned about being wary of some of the advice given on this site, and I would strongly agree with that, so I tend to find this diabetes support better from that point of view. It is supported by the main charity Diabetes UK ... have a looksee...
http://www.diabetessupport.co.uk/
Hope you find this useful, but ALWAYS CHECK with your DSN before making any changes, just to be sure.
Best of luck to Toby ..
JontyW