Young people with type 1 diabetes, like other people with diabetes, want to lead a normal life without making diabetes their top priority. Their philosophy is, “I’ll do what it takes to keep from going too low and embarrassing myself in front of my friends, but I don’t want to be too ‘nerdy’ about it.”
If you are a teen, having low blood glucose at a time of pressure or stress is a real possibility. You may want to get up for a play performance, focus during a crucial test, laugh and go crazy at the mall with your friends, do homework with your study buddy until midnight or play soccer or basketball after school. But you don’t want to have a low blood glucose level.
Of course, you don’t want a high one, either-especially one so high that you feel bad and can’t do your best or have fun.
How Much Is Enough?
So how you can do just enough diabetes management to get you through your day without having to devote too much time or attention to it? Let’s get specific.
Review your situation and determine from past experience when you’re most likely to go high or low.
For example, if you are prone to going low while roller-blading, be sure to test your blood glucose just before leaving home to go skating.
If you’re blood glucose is 70 mg/dl or less, treat as usual for hypoglycemia. For levels 50 or below, eat 20 grams of quick-acting carbohydrate and recheck in 15 minutes; for levels 51 to 70, eat 15 grams of quick-acting carbs and recheck in 15 minutes. If you are still 70 or below at the 15-minute recheck, eat the same amount of carbohydrate again and recheck in 15 minutes. Delay exercise until blood glucose levels are stable, then follow this plan:
- If you’re above 70 mg/dl but below 120 mg/dl, one option is to drink 8 ounces of fruit juice and eat an energy bar on the way to your friend’s house.
- If you’re below 180 (but over 120), you may only need to eat the energy bar.
- If you’re below 250 (but over 180), you may choose to eat nothing eat and drink nothing, knowing your blood glucose will drop as you exercise.
- If you’re above 250, you may calculate how much fast-acting insulin you would need to take for this blood glucose level before a meal.
When you encounter a problem with your blood-glucose management, the basic problem-solving skills you learned from your diabetes care team (doctor, diabetes educators, nurse, dietitian) will come in handy.
You can practice these skills with your parents and close friends. Joining a diabetes support group is another way to get comfortable with the daily decisions your diabetes self-care requires.
|Just Enough Management, Plenty of Fun