Hi,
@salty ,
@Kaylz and
@therower have made good points which are sometimes overlooked by newly dx'd and, dare I say it, by health care professionals too.
T1 is all about balancing blood sugar. Many think it's just about looking at the carbs in the meal, call it as X grams, then say my dsn says Y units of insulin will cover that. Those two components are important, but just looking at those two alone miss out the other big, important, one: exercise.
Insulin lowers bg by providing a pathway which lets glucose go into cells to be used as energy. Starts out by us eating carbs, gets broken down into glucose, goes into the bloodstream, gets distributed around the body into smaller capillaries and arterioles, seeps out from them into the interstitial fluid between cells, then insulin lets the cells suck it up to be burned as energy to keep them going.
But, and this is a big but, if you're exercising, that also provides a pathway to let cells to use glucose as energy. There's things called glut4 - glucose transporters 4 - in cells which get a lot more active when exercising. They invite glucose into cells because they know the cells just want more energy to deal with the exercise.
And that'll lead to bg dropping. If it happens when there's a lot of active insulin on board, it'll lead to a double-whammy of insulin and glut4 dropping levels hard.
That's why, when we're trying to balance things, we'll look at not only the carbs and insulin, but also exercise.
In practical terms, what it means is that when I'm going to be having a meal, I'll be thinking about not only the amount of carbs in it, but also what I'm planning on doing in the next 6 hours or so.
If I'm going to just be sitting in front of the telly, then it'll be X units, but if I'm going to be trampolining (something I've not done since me and my cousins were kids!), I'd be raking a few units off, because I know that the glut4 coming into play from the trampolining will knock it down anyway on its own and I don't want that doubling up with an insulin shot based on a telly viewing evening.
Takes a bit of time to learn this, and we never get this right all the time, but main point I'm trying to make is don't just look at an insulin injection as an isolated one-off thing like taking a pill: it operates over time, generally about 4 to 6 hours, and has a relationship to everything else, like exercise, which happens in that window.
It has a "shape", or "pattern", over time which is well worth learning if you want to let the wee one make the most of it.
Which I'm sure she'll do. This is a terrifying condition to start with, I'm not going to pretend it's going to be a walk in the park, but it's amazing how soon people figure out practical ways of dealing with it.
