T1 Diabetes; Hyperglycemia vs. Hypoglycemia

So, we had thought that Type 1 Diabetes was basically the same thing as being hyperglycemic, meaning your blood sugar was too high.  This is what it seemed like with our son being first diagnosed.  The whole reason they had sent us to the hospital was because they had found something called "ketones" in his urine which meant there was an extremely high amount of sugar in his blood.  

When we were admitted to the hospital his level was only in the high 200's, which I later learned wasn't half as bad as some of these other kids who had been admitted with numbers in the high 600's.  

We learned that Type 1 Diabetes can show signs of hyperglycemia, when the blood sugar is too high, and signs of hypoglycemia, which is when blood sugar is too low.  

As it turns out, the whole reason they had tested our son for Ketones is because he had shown the signs of hyperglycemia.  Here is a chart below that explains some of the signs:

So, many of these symptoms had been going on for some time.  Our son was really thirsty all the time, but I thought that was good he was drinking more.  He did seem to be snacking an awful lot, but hey, he was a 12 year old boy.  I was hoping he was going to go through a growth spurt.  He was going to the bathroom an awful lot, but hey, he needed to if he was drinking so much.  He did complain of headaches a lot and feeling sick, but it wouldn't last too long, so I didn't get too concerned.  His hands had become EXTREMELY dry, but I thought his school health class had something to do with it putting some chemical on them.  He even complained that he couldn't see the screen at this concert we went to when I could see it just fine.  So, yeah, I suck as a mom.  Here he was with basically every symptom of hyperglycemia, and I didn't know it.  

They taught us that if blood sugar gets too high it can be very dangerous when ketones get in the blood.  This is very bad, and having high amounts of blood sugar can lead to all sorts of problems like nerve damage, kidney failure, and even blindness!  

Thank goodness they had caught it early!  

But now we had to learn about the other side of Diabetes--Hypoglycemia, when blood sugar gets too low.  Here is a chart of the signs of hypoglycemia;

Now, to my knowledge, I had never seen our son with low blood sugar, but then maybe I had and just hadn't realized the symptoms.  Headache can go either way and the fatique or impaired vision can go for both hyper or hypo, so how did I really know?  

And this is where I could mess up.  Yes, if we gave him too little insulin, then his blood sugar might be too high, but we could correct it with a correction dose at the next meal, but what did we do if it was too low?  And how would we know?  This would get into checking blood sugar more often or correcting not with insulin, but with a quick fast acting carb.  Of course the book at the hospital made me laugh, as it suggested giving "tablespoons of brown sugar".  Also, just to be clear, hypoglycemia (low blood sugar) is not just caused by giving too much insulin, but it can also be caused just by not eating enough or regularly, or by too much exercise without the carbs to balance it out.  

Missing the Signs and Symptoms of Juvenile Diabetes

I suppose there are many parents out there that may be aware of the signs of type 1 diabetes.  I'm sure there are many people who are familiar with diabetes by having some one in the family or a friend who has dealt with it.  I'm sure there are many out there who would recognize the symptoms right away and get their child checked out by a doctor.  Well, we weren't one of them.  We didn't have a clue.  

The signs and symptoms were all there if we had known any better.  They probably had been going on for several months!  Our son was 11 years old at the time.  He was a pretty healthy kid.  He had a little bit of asthma, but nothing major.  

At the beginning of his first year in Junior High School, he began not feeling well on and off.  He would come home from school not feeling well, but then he'd eat a snack and be fine a half hour later.  He would be fine and go to dance classes, but then complain that toward the end of class he felt a little sick.  We really didn't worry because the bouts of not feeling well were so short and sporadic.  It just seemed a little weird.  He was always fine in the end.  

Another month into the school year we started to notice that his hands were all of the sudden incredibly dry.  So dry in fact that we thought he had been chemically burned from some experiment in health class.  We tried all kinds of lotions and creams for months, but his hands continued to crack and bleed and look burned up to his wrists.  

It seemed as if he was awfully emotional lately.  He would get upset by the littlest of things or angry and frustrated so easily.  But then of course, he did have Asperger's Syndrome, a form of high functioning autism, so maybe it was part of that, or he was reaching puberty, so maybe it was just some extra hormones kicking in.  

At dance classes, we looked to see if he would be moving up to the next levels, and the comments came that he was just so thin.  Others around us all seemed to comment on how skinny he was.  We had realized his thinness, but just assumed he was going through a growth spurt.  We were always trying to get him to eat more to bulk him up a bit.  

So, all these little bits of signs were there, but he seemed like a regular happy kid to us.  

When he turned 12, we noticed that all of the sudden he was up going the bathroom an awful lot at night.  We would send him to bed at 9, but then he would be running up the stairs at 10, midnight, 1 am, 3 am.....it was insane!  At first I thought, "Good grief!  What is this boy drinking at night!?"  Then I thought maybe he had a bladder or urinary tract infection.  It was crazy.  I even googled his symptoms and nothing really came up except for overactive bladder or incontinence.  I was getting rather annoyed that the bathroom was becoming such a mess.  He had such urgency that he was rushing to get to the bathroom and was often missing the bowl.  I was cleaning the toilet and floor almost after every bathroom visit!  

This is when I thought something has got to be up.  It's got to be some sort of bladder infection.  He had an appointment with the doctor in the next week for a check up, and so I thought he hasn't complained about any pain so maybe we'll just get him started on some home remedies like cranberry juice or supplements.  

Then he got sick.  He had a fever and wasn't hungry.  His fever was really high---101.8 degrees.  We gave him some motrin and sent him to bed.  In the morning he was worse.  He complained his throat really hurt and we checked his temperature and it was 103.8!  That was enough for me to want to get him to the doctor right away.  But what we suspected was strep throat.  I made an appointment with his pediatrician and took him in.

The nurses and doctor ask you why you are there.  Our initial reason was the high fever and sore throat, but as long as we were there, I commented on the frequent urination and the redness and rash of his hands and wrists.  Might as well get everything taken care of all in one visit!  They did a strep test, examined his hands, and then had him leave a urine sample.  I figured they would come in to tell us he had strep, but that wasn't the case.  Or maybe he did have a urinary tract infection and that had caused the high fever.  I wasn't so worried about his hands.  I thought they might prescribe some prescription cream or something.  

Well, the doctor came back in and I knew something was up because he closed the door.  Pretty much they leave the doors open when we have been there, or maybe I hadn't paid attention, but it just seemed a little weird at the time.  

No, he didn't have strep (at least the initial test had come up negative), his hands were a problem of washing too much with antibacterial soap (which we would later learn it was more because he was going the bathroom so often he was washing his hands way too much), but then there was the problem of his urine sample.  This was it, I thought.  He's got a bladder infection.  But that is not what the doctor said.  

He began talking about something called Ketones and having sugar in the urine or something.  I'm still thinking he has a bad urinary tract infection, but the doctor is going on about things I'm not familiar with and really not making sense, but then he throws out the word "Diabetes".  I'm very confused at why he would be talking about this.  He says we need to take him up to the children's hospital emergency department right now and that if what he suspected were true, that they would admit our son and he would stay there for the next 3 days!?  What?  How?  I was bringing him in for strep throat.  What was going on?  Panicked as we were, but still confused, and a bit thinking the hospital might think differently, we headed on to the hospital with too much running through our heads.