Caleb is my second of three children. He was diagnosed with type 1 diabetes at the age of three in January 2007. He has used the OmniPod Insulin Management System since April 2007 and the DexCom Continuos Glucose Monitor since September 2009.
Well, not alone. He will be traveling to Italy with a group of scholars for an educational tour and leadership summit in Milan. By alone, I mean: without me.
We have a few months to prepare. I plan to simulate the experience at home as best I can. This will include Italian cuisine, varying levels of exertion, and the most challenging aspect: independent overnight care. This is the only area where Caleb is usually not involved. I prefer he sleep and let me do the number crunching.
Since Caleb was diagnosed with type 1 diabetes, I’ve been committed to not letting diabetes drive decisions about what he does. Having an older son has helped. We let Colin travel to Prague last year with his school jazz band. So when Caleb showed an overflowing enthusiasm about applying for a scholarship for a Global Summit to Europe, I knew I could not discourage it.
The fact that Caleb himself was not letting the thought of managing his diabetes alone in another county deter him is a significant progression in his self confidence.
So here we are. On Friday he received the news that he was awarded the scholarship. After initial shock, I’m in planning mode and am asking you for advice and suggestions.
We traveled as a family to Italy last summer. Blood sugars worked out pretty well as far as vacations go. Lots of increased basals overnight and extended bolus’ to deal with pastas, pizzas and gelatos. Temp basals to deal with daytime activity of walking seven miles a day in August heat resulted in no traumatic events. So I have an idea of what to do. Caleb does as well, but I was the one making the lion’s share of those decisions, so he needs to hone these skills.
The biggest issue is that Caleb just does not wake up at night. I hear Dexcom’s urgent low alert from his phone on the other side of the house and it wakes me up. It’s next to his head and he doesn’t stir. Given the complexity of activity and food, I think it will be necessary for Caleb to check at some point each night. But he has to wake up.
Here are some of my current considerations:
- I’d like to try a split basal regimen – half long acting insulin, half pump basal insulin. The reasoning behind this is I found that the margin of error was more forgiving when Caleb was on injection therapy. The longer action of NPH he was using seemed to soak things up like a sponge, whereas all fast acting requires a more laser precise dosing amount. This, however, was 10 years ago, when he was 4 and newly diagnosed.
- For months, I’ve been trying to figure out if we can get a #DIYPS project going . Caleb is an OmniPod user, and we have no current access to a compatible pump for this project. I’ve gone through the websites and forums, and am simply having trouble figuring this all out. However, given the reality of this now, I’m going to give it another go. I am welcoming of any help, aka: handholding, anyone is willing to offer. This seems like the ideal scenario for Caleb, and a commercial option won’t be available in time for his trip.
- I will definitely make sure he has international cell service and am interested to know if anyone has experience with “following” Dexcom internationally.
- New Dexcom inserter?! I’ve been watching for this – I thought it might be available by now. This will make one thing easier. Anyone with any info?
- I am always open to new fast acting carb ideas, particularly those that can travel in the heat.
Thank you for any input, suggestions, shared experiences and ideas!
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