I'm writing a book that includes a child with diabetes. I would really appreciate any help I could get to better understand diabetes and maybe have some questions answered

Hello,

This forum was recommended to me as a good source of information on diabetes.

I’m writing a book that includes a four-year-old boy with diabetes. Most of the story that will include this child will be a survival situation where a family will be traveling on foot and camping in the woods over a period of 1-3 weeks. I would really appreciate any answers I could get to the following questions:

  • What physical items would the family need to keep on hand?

  • What treatments would be required and how often?

  • I understand diet control is very important. What specifically is important such as carb counting/sugar intake? Also, what kind of foods would be important to eat or avoid?

  • What are common symptoms? How might this survival situation affect those?

  • What would be a good example of a high pressure emergency situation? What might cause this? What would need to be done to remedy it?

  • In what ways would this child be limited in this experience such as physical endurance?

Note: I know I can get answers to some of these questions by googling and I am also doing that. I just wanted some first hand accounts if possible.

Thanks for the help!

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Welcome to the forum, @Skipper_of_Stones!

  • physical items:
    @walkingthedragon88 had a travel thread recently – this might save you some time as I think a lot of what you need in in this thread: Travel!

  • treatment
    If the child is camping for a long time, he may be on Multiple Daily INjections (MDI) rather than pumps, so he would have to take 1 basal shot or two per day, plus one per meal, plus some more shots whenever he/she is high. If the child is quite young, his/her Bg will vary like crazy and require a lot of treatment. How old is the child?

  • they can eat what they want, but anything with carbohydrates will require insulin – they will need to “count” their carbs and dose for them with insulin injections.

  • common symptoms of lows and highs: How do Hypoglycemia and Hyperglycemia FEEL?. @Kalean, who is posting in this thread, is 12 years old.

  • high-pressure situation: something creating a deep low with no sugar/carbs at hand, since it would lead to unconsciousness in a couple of hours, and death in 3-4.

  • limitation: none, really, except for insulin and sugar available – but physical exertions are MUCH harder to deal with for diabetics because they need to know exactly how their body reacts in order to anticipate Blood Glucose reaction. We could write thousands of pages about that.

You may want to give a few more details about the kid and the situation – we could be more helpful.

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Hi Skipper, welcome here!

That book sounds interesting.

A few things I can think of for survival. What we do everyday is not the same as a survival situation. Our day-to-day existence has luxuries like insulin pumps, and CGM, and BG meters.

But the only things that are absolutely 100% necessary for any diabetic to survive - insulin, a way of delivering it, and food.

So if you had insulin and a syringe or an insulin pen for delivery, and access to food, you could live. I have previously had to re-use syringes. That is not ideal, but it can be done.

Since you are talking about a survival situation:
For food, if you did not have sugars or quick acting carbs, you’d have to be very careful with how much insulin you took. You can bring down a high BG with insulin, but bringing up a low BG with only a squirrel you killed or a fish you caught would be tough, and take a long time!

In a survival situation, I don’t think you would be too terribly concerned with counting carbs. Carbs/food and insulin, you just balance them. In a survival situation, I don’t think you would avoid any food. Anything that you can eat, you eat. I wouldn’t be fussy in that situation. You just take the right amount of insulin for it. In general, you don’t need much insulin for protein, but you need more for carbs. So if you catch a fish, you don’t take as much. If you find a bush with berries, you’d need a bit more insulin.

You could use certain wild berries for carbs. That would be very helpful. For diabetics having access to carbs is very helpful for bringing up your BG. If it was me, anytime I found berries, I would pick the bush clean and stash or carry whatever I could.

High BG makes you thirsty and weak. Low BG makes you very weak, and you can’t really walk much because that would make your BG even lower. We have a thread on symptoms!

So it depends on what you are looking for. Because pumps require a few extra components like batteries and infusion devices, in a survival situation your best bet would be a vial of insulin and syringes, or an insulin pen. But a vial holds more than an insulin pen.

In an emergency, you can reuse syringes over and over!

Running out of insulin would be the crucial thing. Once your insulin is done, you don’t have much longer. A few days to a week or so. Not very long.

Anyway, hope this is some of what you are looking for, but we can give you as much info as you’d like. Ask away!

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Thank you for the answers, Michel.

The child is a four-year-old boy. Actually he’ll turn five in the few weeks that the story takes place.
Apart from being a survival situation in the woods, a major hurdle will be that the boy’s uncle will be his primary caretaker during this time. His uncle will have limited knowledge of what is required to aid his nephew as he has only seen the child’s mother take care of him up until now. He will be grabbing any info, such as booklets, he can find from their house before they leave in order to learn as much as he can.

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Eric,
Thank you so much for the info. Those are some really helpful points and I’ll be sure to ask more questions as they come.

@Skipper_of_Stones, I just started a thread that may be of help to you: Diabetes camping supplies?

Many of the questions you have would be very appropriate as a single thread: I think each will generate a lot of discussion. So, one suggestion would that, after this first thread, you go one question per thread at a time, so as to be able to get some deep and dedicated answers.

At age 4 or 5, the kid will be able to do a lot of things on his own. He may be able to inject himself if he is really precocious – or he may do it for the first time that trip (wouldn’t be stupid). In general, he will more or less know what needs to happen to him at all times – but his judgment may not always be good.

On the other hand, the uncle will be very sketchy, and will miss a lot of that knowledge. The boy will know more. It may be an idea for you to take some notes about your own understanding of things right now, and use yourself as a model for the uncle as you start learning about how to deal with D? D is a hard and complicated disease, and knowledge comes slowly. Essentially, you need to learn to think as if you were a pancreas (that’s the title for a great book about D btw, you want want to buy it).

Possibly the boy would know some things that the uncle wouldn’t believe, and the uncle would go against what the boy says because it would sound wrong.

Thanks for the help, Michel. I’ll keep an eye on your camping thread.

Depends on how the son is treated. If he’s on MDI (Multiple Daily Injections), he’d need syringes + insulin to combat highs and snacks, food, juice to combat lows. In any case, you’ll also need a GM (Glucose Monitor) so that you can check his sugars regularly. This would include the meter, test strips, alcohol wipes, cotton balls. You’ll idealy want a way to keep the insulin cool, but in an emergency case, folks here have tested insulin in extreme conditions and have found that it will stay in high temps over prolonged times, as well as being able to be frozen and maintaining ability to treat blood glucose levels. Also, very important would be a “glucogon shot”. This is an emergency shot administered in the event the childs sugars drop so low that he goes unconscious and is unresponsive. It’s an immediate shot of sugar directly into the bloodstream that will bring his sugars back up.

IF on an insulin pump and CGM (Continuous Glucose Monitor), you’d need pump parts and accessories, adhesive, etc., and the same with the CGM. Also any electronic needs batteries, or a way to charge the devices.

The treatments are carbs to treat lows (and to maintain proper metabolism) and insulin to avoid high BG’s. So any carbs that are eaten would need the insulin to cover them. MDI’s mean more manual shots each day (one per meal and any “correction” bolus that may be required, and pumps would be able to administer insulin but you’d need to program them. Diabetes isn’t too terribly hard to treat…but getting the RIGHT amounts of insulin at the RIGHT times is the hard part, and what takes most people the most time to figure out. There are long, medium and short acting insulins…and they each have their purposes. If they’re required, you’ll need to use these as often as necessitated by the insulin regimen.

The only important thing to a diabetic is that the insulin matches the carbs eaten. It’s really that simple. Anyone can eat anything at any time…although some foods are avoided because they tend to wreak havoc on the body, but that’s not to say they can’t eat them. They just have to learn how and when to administer insulin to avoid the havoc. But there’s nothing “off limits”. They don’t require any special “diet” although some people go no, or low carbs because it’s easier to treat.

I just asked this question in another thread and it may be a good read. My question was “How do Hypoglycemia and Hyperglycemia FEEL??” What are the outward manifestations of having a high, or a low, BG. In this thread, many T1’s and T2’s offer their own personal symptoms.

How do Hypoglycemia and Hyperglycemia FEEL?

Since the boy has already been diagnosed, he’d “hopefully” not have the initial symptoms of diabetes (such as being very thirsty, going #1 a lot, etc.,) With proper insulin management, those initial diagnosis symptoms wouldn’t exist any longer.

As far as survival, as @Michel’s son, @Kaelan found out last week…sun burn can cause very high BG levels. So lots of sun tan lotion and staying covered as much as possible will cut down on the high spikes. Avoid being injured or getting the child sick because diabetics tend to have a rough time when they’re sick (they require twice or more insulin as when they’re not sick.) Stay hydrated…this is important for anyone, but especially for diabetics. Also, hiking a lot may result in lows so always keep snacks, Glucose tabs, etc., to keep from getting Hypoglycemia.

Running out of insulin is definitely bad news (this will cause the BG levels to skyrocket and not come down which may result in DKA (Diabetic ketoacidosis). Remedy: Don’t run out of insulin. Also going low for too long a prolonged time is bad news (possible coma / death). Remedy: Check and treat frequently.

Welcome to FUDiabetes…A site dedicated to UNLIMITED people with Diabetes. The only limitations are those that each person may impose on themselves. With proper management, a diabetic can do anything that anyone else can do.

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I love to read this :slight_smile:

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@ClaudnDaye

Thank you for the answers. Very helpful.

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It occurs to me that they may run out of testing strips while camping. Or the testing strips may be dumped into the water and spoiled (they don’t deal with water well). in that case, the kid would have to really feel his own BG (blood glucose) to be able to know if he needs glucose or insulin. Feeling a low is not hard, unless it comes at night (if you don’t wake up you die, which happens all the time – very common cause of death). Feeling a high, as you can read in the hypo/hyper thread, is harder. Some, like @Eric, can do it reliably, while others can’t.

@Skipper_of_Stones, where are you located? It may be helpful for you to actually see a diabetes routine.

This may be a HUGE obstacle UNLESS the uncle really wants to learn and be prepared to check and treat frequently. It’s VERY tough for anyone not directly responsible for a child to really understand the ramifications of the lack of proper care for a toddler. As a real life father of a 3 year old T1 diabetic toddler (just passed his 1 year anniversary), I wouldn’t trust anyone with my son’s care. But if it’s an emergency and any ALREADY INFORMED person just isn’t available…grab that literature (Make sure “Think like a Pancreas” is one of those books that are in the house, that are grabbed), and be prepared to buckle in for the roller coaster ride…

Since you’ve indicated this is a survival situation, I don’t think the A1C is of concern…the important thing that you may be writing that the uncle is interested in, is just being able to keep his nephew alive…if this is the case, it will not be as tough. But trying to care for a toddler with a T1 is a two part job…you want a good A1C. The A1C percentage is based on how much glucose is attached to each hemoglobin ( the protein in red blood cells that carries oxygen.) The less glucose that’s attached , the lower the A1C. The lower the A1C, the better LONG TERM health of the person. The higher the A1C, the more chances of risk of medical issues in the future including blindness, amputations, organ failures, etc., So, the first part of caring for a toddler LONG TERM is controlling the A1C…Having bettween 6 and 7% is a good goal. But the second part is avoid LOWS…especially in toddlers, low BG’s directly impact brain development and can result in cognitive and other issues as the child grows.

So the hard part with long term management is having a good A1C while having as FEW low BG’s as possible.

But given this is an emergency situation, the uncle would be OK JUST making sure the child eats when he should eat, and that the child gets enough insulin that he doesn’t ride for too high, for too long (which results in DKA).

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@Michel

I’m in the midwest. I have come across a few videos on youtube showing some routines.

We’re talking about a 4 year old though. I know Tia’s son apparently feels his lows and knows how to communicate them, but Liam still doesn’t, and he’s 3. So knowing assumes the child knows how to do this and knows how to communicate it effectively. If you write into the story that the child knows, then you’re good to go. Refer to the link I posted on how you feel with lows/highs if you’ll be writing that in.

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We are in SE WI, not very far from Madison or Milwaukee. @Millz is in IL, not too far from Chicago.

Definitely have the 5-gallon bags and smaller zip-lock bags for the insulin supplies that may be damaged/ruined with water. Water-proofing supplies will help.

[quote="ClaudnDaye, post:14, topic:1225, full:true"]

We’re talking about a 4 year old though. I know Tia’s son apparently feels his lows and knows how to communicate them, but Liam still doesn’t, and he’s 3. So knowing assumes the child knows how to do this and knows how to communicate it effectively. If you write into the story that the child knows, then you’re good to go. Refer to the link I posted on how you feel with lows/highs if you’ll be writing that in.
[/quote]

Yeah… This particular character (the 4/5 year old) isn’t a great communicator. He doesn’t talk much.

Aside: when traveling to Costa Rica about 9 yrs ago, I ran out of strips (after my lowest low of 37 mg/dl occurred). I was young (and stupid) and brave!? I went four days without testing, blousing insulin, hiking, doing all the things. I came home at 179 mg/dl and no emergencies. Not medical advice :joy::sunglasses:

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@Skipper_of_Stones
Have you read Gary Paulsen’s novel, “Hatchet”? It’s a story of a 13 year old boy who gets stuck in the woods and has to learn how to survive. It doesn’t have anything diabetes related in it, but it’s a great story.

@Eric

I have. It’s a good one.