Oh well. Over on the Diabetes Support Forum there’s been a wonderful community experiment where loads of folks are all eating spaghetti bolognaise of various sorts, and then tracking blood glucose levels through the evening, so see how people have reacted, managed, and what’s been noticed.

We missed this on the night it was done (two days ago) because we were all just shattered: and pasta in this house means we are up in the night testing, to see the insulin through its full effect and keep E safe.

So last night we all actually crave spag bol, and off we go. Yum. E bolused 12g ‘up front’ (eg all at once) for the actual sauce, and then spread the rest of the carb out through a ‘dual wave’ (dripping it in over x period of time, to try to ‘catch’ the slow-digesting pasta carbohydrate). The dual wave was 30/70 over 5 hours, (30% of the overall pasta up front, with 70% of it spread out over the next 5 hours).

All fine. Except we don’t test as he goes along. Again, we’re all so tired! Four hours later (11.15pm) we test, and he’s 3.6 (mildly hypo) — and sound asleep. Damn!

He manages to have some juice, under great protest, and we are forced to turn the dual wave OFF, to keep him from going lower and lower with the rest of it. We will check him at 1am.

We sit in his room. How the heck did THAT happen? This dual wave normally works.

OH and I hit the same thought without even saying it. E, says OH, did you do exercise today? Poor child has to rise up through his sleep again. Yes, he says, basketball. I’m sorry, I forgot to tell you.

That’s okay, we say. Did you put on a temp basal? (lowering the insulin temporarily to account for exercise)

No, I forgot that too. Sorry.

No worries, we say.

This child/young man rarely forgets anything to do with his diabetes. It really is okay. But this one thing also explains the TWO hypos he had in the afternoon (remember the afternoon problem from the last post? We couldn’t figure out why he’d had two, both at different times than the day before) AND the fact that the dual wave was too much insulin for him…

Damn! We have already come to the conclusion that exercise means he needs to be on a temp basal (lowererd insulin) all night. If we know about it, that is!

At 1am, he’s 6.9mmols. And by morning, he’s of course up to 11mmol. Which is too high. Which is the pasta going in late without enough insulin.

We couldn’t have taken the chance and given him more insulin, do you see? Not in the middle of the night, with unpredictable exercise still in play and an unknown amount of carb from the pasta yet to go in… He might go mega low.

Everything is thought through. But just because you think it through doesn’t mean it works.