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[IPp] RE: something really sad happenned

When Sigrid's blood sugar is high, we give her more insulin.  We don't 
restrict her food intake.  Temporary high blood sugar may make her 
cranky (or thirsty) but it isn't dangerous.  High blood sugar is a 
symptom of insufficient insulin.   Also, it means  that the body isn't 
able to use the food it has already taken in.  So a person with high 
blood sugar could, quite legitimately, still be hungry.  It took us 
quite a while to get used to the idea that our daughter's blood sugar 
really had nothing to do with whether she needed food or not.

What about DKA, you might say?  High sugar is a symptom of DKA, but not 
the cause - DKA is caused by insufficient insulin.  Since the body 
isn't able to get energy through the usual insulin pathways, it uses 
backup systems which throw off ketones and acid.  The acid is a 
problem, and the backup processes aren't very good, so the body is 
starving (hence the weight loss in undiagnosed diabetics).   In the 
long run, it's true that high blood sugar itself is the cause of 
blindness, neuropathy, and other complications.  But these are the 
result of years of overhigh blood sugars - not of one birthday party.

When we've all been told all our lives that sugar is poison for 
diabetics, it's really hard to break out of that thinking.  But as far 
as I can tell, this was a shorthand way of explaining the situation in 
a time when diabetes management consisted of forcing your life to fit 
your fixed insulin dose.  Once you're fluent in pump use, you should 
reverse this pattern, and make insulin adjustments to fit your life.  
If your doctor and CDE aren't helping you to do this, try getting a 
better doctor/CDE.

mom to 22 m.o. Sigrid - dx'd @ 11 mos., pumping since 17 mos.
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