29 May Learning from Our Mistakes
There’s no need to be perfect to inspire others. Let others get inspired by how you deal with imperfections. Success, especially when it comes to diabetes management, doesn’t come from perfection. It comes from putting forth a consistent effort and making adjustments as needed. You don’t have to have it all figured out. Give yourself room to be a beginner. Take as long as you need. Everyone who’s now managing diabetes well started as a beginner and made a beginner’s mistakes.
Want to know about our “uh-oh” moments? We have our share. Every T1D family does. Not checking to make sure Ellie received Diet Coke (not regular Coke) before she downed it during a movie, dosing too soon before a meal, failing to check for ketones when her BG was above 240, overcorrecting a high… Not only were these mistakes okay, they were necessary. They were important. Mistakes are how we learn.
Not only are mistakes okay, they are necessary. They are important. Mistakes are how we learn.
Taste Testing
Ellie can now discern the difference between a diet or regular soda, but we try a sip from a different straw if there is any question.
Dosing with the meal instead of bread or appetizers
We now typically wait until the food is plated or served before dosing. At a celebratory meal with a large party, we calculated carbs for the dinner Ellie ordered and dosed insulin when the bread arrived (well before the main course). This was prior to the pump when Ellie was still doing multiple daily injections. The meal was delayed, and Ellie—with insulin already on board—started to feel her blood glucose drop. Ellie was still treating her low as the entrée arrived.
Issuing a Correction Prematurely
Once, when Ellie’s BG hovered around 300, we issued a correction from the pump without first checking for ketones. The cannula was bent. When we did check for ketones after the correction, we were unsure how much insulin Ellie had actually received through the bent cannula. With active insulin on board (but, how much?), we were trying to figure out how to treat her moderate ketones. Would 10% of her total daily dose (TDD) of insulin via injection send her too low if the bent cannula still administered some insulin? We learned to always test for ketones any time Ellie’s BG is above 240. If her ketones are small or trace, we issue a correction from the pump and/or drink water. If her ketones are moderate, we give her 10% of her TDD of insulin via injection (not pump). We also change her infusion site. If her ketones are large, we give 20% of the TDD via injection and change the site.
Overcorrecting a High BG
Ellie’s pump (the Medtronic 670G) automatically calculates corrections when she is above range. Once, with Ellie’s BG running high, we tested for ketones, determined they were negative (see above), and then–instead of simply letting the pump calculate and issue the appropriate calculation—entered a few carbs (which Ellie would not consume). The pump calculated the correction and added more insulin for the carbs we entered. In this case, we should have had the patience to let the pump bring Ellie’s BG down with a combination of a correction and incremental dosing of insulin to help Ellie reach and stay in range (a feature of auto mode). Entering carbs she didn’t consume sent her low. The pump was already working to bring her back into range, and we learned to trust the process and protocols that would gradually lower her high BG.
We all have missteps, and it’s time to be more open about them, especially online where we’re constantly seeing, sharing, and even comparing highlights instead of “gag reels.” We all tell stories about ourselves, and our stories should include the hard times that shape us as much as the joyous moments that linger as favorite memories. The tests and trials are part of the triumph, and that applies exponentially to diabetes management.
For the highs and lows
And moments between,
Mountains and valleys,
And rivers and streams,
For where you are now
And where you will go,
For “I’ve always known”
And “I told you so,”
For “Nothing is happening,”
And “All has gone wrong,”
It is here in this journey
You will learn to be strong.
You will get where you’re going,
Landing where you belong.
—Morgan Harper Nichols