drink your gatorade.

Last Saturday, July 17th, was C’s one year anniversary with type 1 diabetes. Not actually true since we saw very strong symptoms over a week before his diagnosis, but it marked one full year of knowing what we were dealing with.
A local group, Diabetes Outdoors, was having their annual beach day the same day. It sounded like a perfect way to celebrate how far we’d come in that year. And it was. Lots of fun, perfect weather, perfect water and lots of kids and some adults living with diabetes.
However, C refused to let me put sunblock on him. Since he’s never gotten a sunburn before, I didn’t really think much of it. I was more concerned with trying to remember to test him and carb him. After seven hours in the sun, even he with the perfect olive non-burning skin, had a horrible sunburn. The next morning he felt sick. I assumed it was from the sun. He had a low fever and couldn’t finish the raspberries he bolused for for his breakfast. Had to take glucose tabs to cover the rest. For the next few hours he layed on the couch feeling nauseaus and not doing much. I kept testing his blood sugar and it was between 60 & 90 most of the morning. It was a little nerve wracking trying to keep it higher since he didn’t want juice or anything else in his stomach. He had juice once & vomitted shortly after. I fed him 2 Smarties at a time for a few hours. What’s that a carb every 10 minutes or so?
It was a few hours when it hit me that even though he was low, maybe I should test for ketones. Pulled out the meter and guess what… 1.8
HO.LEE.SHIT. I hadn’t even suspected this issue earlier. He hadn’t regular-sick in the entire year before this. I’d never dealt with sick AND diabetes together. I called and left a message for his doctor at home letting her know he was vomitting and had large ketones. What should I do?? We’ve dealt with ketones before. We normally give about one unit of insulin and a ton of water. BUT, I certainly didn’t want to give insulin if his blood sugar was only 80 and he couldn’t drink water and keep it down.
After an hour of not hearing back from her, I gave 0.50 units of insulin. Blood sugar was just above 80 and I kept feeding him the Smarties.
I also pulled books out and started trying to read what I should do. Unfortunately people tell you to call your doctor. Hmmm. I also read that ketones over 1.0 for over 3 hours can lead to serious DKA. I tested again and got him down to 1.3. Blood sugar was 122 and I gave one unit of insulin. Decided I’d test like crazy and get our asses to the ER as soon as it started dropping too low.
A bit later, I gave him another juice box. He told me he’d drink it in the bathroom by the toilet. Twenty minutes later, he still hadn’t had any of it. I retested his ketones and it was 2.1. Found out that 15 minutes earlier he suspended his pump after hearing me say that we needed his blood sugar to come up. I freaked. Poor kid, I scared the crap out of him yelling about how he’s never ever allowed to touch that pump without checking with me all while running around the house grabbing my purse, the meters, whatever we’d need. Grabbed him and ran to the car headed for the emergency room. As I said before, we’ve dealt with ketones. We’ve cut them off before they could get any headway. I’ve never seen a 2 on the ketone meter. At this point, did I think I had a huge chance of losing my son? Yes. The only other time in my life I was that scared was the morning of his diagnosis thinking he was going to die in the waiting room.
We got to the ER, let them know why we were there and he was in a bed in under 2 minutes. The Dr. came in and after talking about everything his thought was this. C became dehydrated yesterday at the beach. From there, the ketones started and even though I was giving insulin, it wasn’t going to help without the fluids in his body. They put him on an IV with just saline and pushed some anti-nausea meds through it. That was it. He was fixed. We were home four hours later. He felt great, woke up with in-range numbers and life went on just like normal.
Here’s the part that’s stupid. I always have given gatorade as his extra carbs when he’s active. Last month at the pool, he couldn’t be bothered by drinking 1/2 a bottle at a time. He refused, so I just gave him 2 glucose tabs. Easy breezy. Since then, it’s just seemed easier to slip him a couple when I think he needs it. It doesn’t disrupt his playing and he doesn’t complain. However, now I see exactly why gatorade is so much better than just plain sugar. If we’d used it, we probably wouldn’t have ended up in the hospital.
Lesson learned.