diabetic question and stuff

[peaceful nurse]

Ok so Here is my current dilemma... My little type 1 can take up to half an hour to eat.. if she sits down in time ( its preschool and that hardly ever happens) do I stop here when the scheduled time is over? they are given 20 minutes for snack and her meals are timed 2.5 hours apart however it is more like two since they don't sit down on time and she take a long time... do you tell her she has so many minutes left and then she is through. It is just so complicated.

[AdobeRN]

I have 2 with the Dexcom device - I do not monitor them via my phone and I would refuse to use my own device to monitor. Parents will call me and tell me to check on them if they are getting a low reading - doesn't happen often; most of the time the kids are aware and are in my office already checking themselves. I really don't rely to much on them - if the Dexcom alarms we always check BG on the glucometer and go by the glucometer reading.

[NurseBeans, BSN, MSN, RN]

Ugh, the dexcom...my clever little T1D figured out how to manipulate his to show low numbers, then he would get out of class as much as he felt like and come hang out with me. Of course I caught on to him and I don't even look at the darn thing anymore.

It also alarms constantly when he is high, so he would come in still high from breakfast and would get sent right to me because the teacher would hear it and they don't want to even ask what's wrong, just go to the nurse.

His mom also told me I am not "allowed" to track him on my phone, as if I want to know his trends on the weekends and at night.

[peaceful nurse, RN]

That was my thought..I don't want to know what my diabetic is when I don't have to. I have a strict policy work stays at work. I like the idea that mom calls when she is low...Is there a way to look on the computer? Thanks you all for the help.

[GmaPearl BSN RN]

I think there is an app for that! One of my cohorts has multiple T1Ds in her elementary school and tracks several CGMs but needs a different device for each CGM… Crazy making. My T1D has a CGM and pump. As he has gotten older the health room visits are less. His mom will call or text me if she notices a major high or low on her phone and often kiddo has already responded and is in the health room making appropriate adjustments.

[peaceful nurse, RN]

Thank you so much for all your advice. this is sure is making me feel much better.

[peaceful nurse, RN]

I am sorry for all the questions but things are bugging me and I can't get it... this is my first T1D and for the most part I have worked in the hospital with T2D. Where novolog /insulin is given prior to eating like within minutes of the meal coming because it is fast acting. so when do most T1D check count the carbs and dose the insulin? I was told to do it after and I think that is part of the reason we struggle so much ... everything I read is before but then Her carb count changes sometimes she eats everything, sometimes she has seconds, and somedays it's not much. Counting before for everything would be pointless. so after seems better but it peaks wrong I think. I am just venting and confused. thanks

[MrNurse(x2), ADN]

My T1D on an OmniPod pump doses before. I always make her go over her snack/ lunch and make sure she is going to eat everything. She is horrible about coming to me when she is low and when she gets treats in class. She was 290's this AM, ate her snack and dropped to 36 2 hours later, told me "I felt low", she just doesn't get it. Mom is very laid back about it; I think that is why she is that way. Drives me nuts.

[AdobeRN]

I had one student when she was in Kinder where I administered insulin after she ate - mom packed a lunch for her, she stopped by my office on the way to lunch, I looked in her bag to see what she was eating and did BG. After her lunch was over she brought her lunch bag to me, she was instructed to not throw anything away - I looked at what she ate and dosed insulin from that. She was a picky eater and not always consistent in eating everything - some days only a few bites others the entire lunch. This worked well for us.

[grammy1]

Unless our student is a PRE-K or Kdg, our pediatric endos don't usually let them administer after eating, always before. Luckily at the jr high level, it's not usually much of a problem. I only had one T1D the year I did elementary and she was Pre-K. I can imagine it would be difficult with some of the littles.