Insulin Change Stress

Lily's insulin was recently changed to Fiasp. This is a more fast acting insulin that is given after she consumes carbs, instead of before. We see how many she eats and give her the amount of insulin required. It sounds like a way better solution than giving her insulin based on what we think she will consume. I, however, was not so excited about this change.

It had been almost five weeks of the same insulin, constantly changing her ratios and sliding scale to fit her needs with this insulin. Then, what felt like in the blink of an eye, another change, and a big one. A whole new insulin, which means a whole new routine. Everything has been moving so much on me lately, nothing seems to stay still long enough for me to fully adjust to it before it changes somehow. I feel like I can't get ahead..

I'll explain more of why I wasn't happy about this change, because I feel like some people can't understand why I would have wanted to stay with the insulin that sounds harder to manage. Having a toddler that is constantly going through different phases can make it hard to know how much she will eat on any given day. But this never stressed me out. If I gave her insulin for 35g of carbs and she only ended up eating 20g I knew ways of getting those 15g into her. Maybe we would share an extra special desert that night, maybe I would give her milk, or her favourite, goldfish. Getting sugars into her was never an issue for me.

The first reason I was skeptical about Fiasp was because I didn't like the idea of letting her levels rise while she was eating, and then dealing with them once higher. I liked knowing the insulin was working at the carbs while she was consuming them with the old insulin. There are no immediate consequences to Lily's levels going high and then coming down, but there are long term effects. I have read about issues that type 1 diabetics encounter later in life, and they weigh on me daily. I don't want her to have those issues later in life. She deserves the most amazing quality of life now, and for the rest of her life. I don't want to just focus on today. What we do today effects her tomorrow.

Another reason I was nervous about switching, and I know this one will sound silly to some, was because it was not immediately recommended to us. This insulin was the back-up insulin. I don't want the back-up plan, because why is it not good enough to be the first plan? Why aren't all young children on this at the start if it is easier to control? It makes me nervous that it isn't as good. Maybe it does affect them later in life and this is why they avoid giving it to people unless they cannot maintain healthy levels on the recommended insulin. I try to tell myself that this is just me being a 'crazy mom', but I can't help but feel like there is a reason behind this being the second option.

The last reason is because of how aggressive it is. It concerned me that it is so fast acting, and if this could cause issues with more lows happening, or if her levels dropping so quickly could effect her. I don't necessarily love the idea of giving her really aggressive medication 5-6 times a day. Unfortunately we have been experiencing more lows since the switch. We are now trying to discuss different foods to feed her to deal with these lows and which ratios need adjusting. More moving parts, great, just what I needed.

I decided that I would give this insulin a solid chance, against my better judgement. I am trusting the team at CHEO to do what is best for my daughter and I will have faith in knowing they would not do something that is not in her best interest. They are doing their part in this, so I will do my part. I will do what is needed to try to make it work. I will be doing some more research on meals that Lily would enjoy that have both quick and slow releasing sugars to try to maintain balanced levels throughout the day. We will adjust the ratios safely and slowly to find what works best for her. I feel like this is a full time job. Preparing meals that are balanced for what she needs, researching new and existing medicines, giving her the necessary injections, the list goes on and on. So cheers to never getting ahead on things, to constantly trying to keep up, doing our best to be the best for her.