Caring for a Diabetic Toddler


 2016-07-12

Since Winnie’s body doesn’t produce insulin due to her type 1 (T1) diabetes, we are, in essence, her external pancreas. Every time she eats carbs, we need to give her insulin to “cover” them—that is technical doctor lingo right there.

Every morning now, Winnie gets one shot of a long-acting insulin called Levemir. This insulin is to help regulate her by “covering” the natural sugars in her body. Then, throughout the day we check Winnie’s blood sugar to see if she is too high or too low and give her a corrective dose every 3+ hours. Typically, we check her before meals and snacks. If Winnie’s blood sugar is too high (above 200) we have to give her extra insulin—called a corrective dose. If her blood sugar is too low (below 90) she gets to eat a few “free” carbs.

In addition to the corrective dose, Winnie gets diluted Humalog (10 percent insulin, 90 percent saline) to “cover” any carbs she eats. Currently, Winnie is getting 1 unit of insulin for every 3 carbs. Carbs vary based on the type of food, but to give you an idea of some common items in Winnie’s diet, one 8oz glass of Vitamin D milk has 12 carbs in it. For Winnie this is equal to 4 units of insulin. One half of a PBJ sandwich made with fiber-rich jelly is 25 carbs, which is (rounding here) 8 units of insulin.

We’ve found a really helpful phone app called “Lose it” for weight loss that has a nutrition tool to make calculating carbs very easy. We can even scan food barcodes with our phones and voila! there you have it, all of the carb information. This app also lets us type in any quantity (1 tablespoon, 1/4 cup, etc) and will give us the nutrition information for that specific amount. That’s really helpful when we are trying to decide how best to balance Winnie’s meals so that she doesn’t need a super-human dose of insulin.

Because Winnie’s diagnosis is still very new, we are having to also check her blood sugar two times in the middle of the night. We don’t need to give her insulin to “cover” carbs at these times since she isn’t eating, but if her blood sugar is too high she needs a corrective dose. On the chance that her blood sugar would be too low, she would need to eat a snack. However, that hasn’t happened yet. So far, she has either had high blood sugar or in her target range. We really like the target range because then Winnie can go right back to bed with no shot. When this happens I celebrate by making a little smiley face in her glucose chart. It’s a small thing, but it’s my little victory party.

Once Winnie is more regulated, and a bit older, the hope would be that we will only need to check her blood sugar in the middle of the night once per month. The daytime routine won’t change at all, but we will be able to get more uninterrupted sleep.

All of these things we do, all of this measuring and calculating and blood sugar checking and insulin-giving round-the-clock gets recorded in a little book. This reminds me of having a newborn baby, when you have to write down BMs and wet diapers and track how often they eat and for how long. Only, to tell you the truth, diabetes is a lot less work than a newborn. I think our main challenge right now is that people see diabetes as something scary and so, until today, we were having a really hard time finding someone to watch Winnie while we work. Although having a newborn was less work, it was less stressful, in my opinion, because it was more normal. Diabetes in toddlers is definitely not normal.

Day cares can’t legally turn us away for diabetes because T1D is considered a disability. But, the day cares we met with were skeptical, discouraging and not all of them could do basic math (not a good sign). I could legally fight for my kid, but I can’t say that I disagree that it would be difficult for a daycare with a 1-7 ratio of caregivers to kids—especially if they aren’t feeling up to the challenge. I want my kid to be wanted; I refuse to force her on someone just because we are legally entitled.

For awhile I was feeling completely helpless, then a doctor suggested reconsidering home day cares and I right away remembered this really cool mom from our church who has a few kids of her own and has occasionally taken on caring for one other child at a time. I contacted her and instantly felt encouraged. I will be providing food labeled with the carb calculations and I will be taking a lunch break to help with shots until we all feel comfortable. If this isn’t a God thing, I don’t know what is. I feel like this mom is the angel my mom’s friend Lin prayed for while we were in the hospital.

Since Winnie was diagnosed, I don’t think I’ve felt so encouraged by someone who isn’t David, my husband, or one of Winnie’s doctors. Diabetes is treatable, but you have to be willing to learn. I don’t want to jinx this, but man, we have a good feeling. Alrighty, I’ve digressed enough. I’m off to sleep for a couple of hours now before the next blood sugar check. Thanks for reading and following us on this journey.


Read more from Michelle LeGault: Insulin Pumps and Princesses and her blog.

WRITTEN BY Michelle LeGault, POSTED 07/12/16, UPDATED 09/29/22

Michelle LeGault is the mother of two beautiful children. She knew very little about type 1 diabetes before her 16-month-old (now 3 and thriving!) was diagnosed in the summer of 2014. Michelle and her husband now use their family blog to advocate and educate for type 1 diabetes awareness in addition to writing about their adventures and mis-adventures alike while living in Minneapolis, MN. Presently, their family is preparing to serve a two-year stint with an overseas missionary school in Prague.