“Why does your mother come to the classroom every day?” Six-and-a-half-year-old Noor’s classmate asked her since her mother Simran Oberoi used to visit her in school every day.

“I have Type 1 diabetes and because the school has just started (post pandemic), for some time she will have to monitor my blood sugar levels so that it’s not high or low,” Noor replies with a slight smile on her face.

Simran Oberoi felt elated when she later heard her daughter explain her condition with utmost clarity and maturity. It was a big win for her, both as her mother and primary diabetes caregiver.

“I have never hidden her condition (Type 1 diabetes) which is a part of our lives now and will always remain,” explains the Bangalore-based 44-yr-old HR consultant. She feels it is also important for people around her to know about her daughter’s autoimmune condition if she ever needs help.

My 3.5 yr old baby getting diagnosed with Type 1 diabetes

Noor was diagnosed with Type 1 diabetes when she was three-and-a-half years old in November 2020.

Oberoi had taken Noor to the doctor after she noticed that her usually energetic daughter was showing sudden signs of lethargy and fatigue. She also started having breathing difficulty.

“Initially, we were scared whether she had got Covid as it was during the pandemic. She was not only urinating quite frequently but was even bedwetting which was totally unlike her,” recalls Oberoi.

After a detailed examination at the hospital, she was diagnosed with life-threatening diabetic ketoacidosis in blood and had to be admitted to the pediatric ICU for a week.  Diabetic ketoacidosis indicates the build-up of high levels of blood sugars in the bloodstream, which causes the blood to become dangerously acidic and could even lead to coma.

Learning about type 1 diabetes

Initially, it hit Oberoi hard, as a promoter of healthy baking, Oberoi was a stickler for healthy diet and even used to bake cakes using healthy ingredients and also never allowed ultra processed food in their household.

“The intention was to ensure a healthy diet for my family. It took me some time to process that she had been diagnosed with Type 1 diabetes,” she adds.

She also adds that she did not know anything about managing type 1 diabetes and decided to understand this condition and its dynamics so that she could ensure the best care for her daughter at home.

Schooling with type 1 diabetes

As a first-time diabetes caregiver managing Type 1 diabetes, Oberoi’s biggest challenge was to help Noor to adapt to a normal school life. Oberoi met her Montessori school principal and sought permission to work for the first few hours every day from the school reception. She would then visit Noor in her classroom at 10 am, to review her sugar levels and then wait for a few hours to pick her up at 12 pm.

To make the transition smooth for all, she also spoke to the teachers, staff and also printed and shared handouts about Type 1 diabetes with the staff and children and made a separate diabetes bag for her classroom.

“If the blood sugar level is anything below 70 milligrams per deciliter (mg/dL) then the thumb rule is to give 15gms of fast acting sugar which could be in the form of juice, sugar or glucose powder from the diabetes bag”, she says.

When you test the blood glucose again after 15 minutes it should rise but if it doesn’t then she is given the same thing again. For a small child even 5 to 8 gms of sugar is also enough to make blood glucose rise. “I have learnt only by trial and error and by speaking with other parents who encounter the same situation,” says Oberoi.

Oberoi goes to school which is at a walkable distance four times a day now. First, at 8 am to drop Noor and then at 11.15 or 11:30am is the second trip to school for the first dose of basal insulin. Basal insulin is a slow-acting insulin which regulates glucose levels between meals. For the second dose she is again at school at 12:45pm because that’s when Noor has her lunch and is given bolus insulin which is a rapid acting insulin. The fourth trip is to pick her up from school at 2:45pm.

From syringes to insulin pen and CGM patches

Noor needs four insulin shots a day but sometimes she needs five to six shots when she has had some extra carbs or her sugar is high due to reasons like growth spurts (hormonal changes).

Oberoi switched to insulin pen from syringe considering the pen hurts less. Oberoi then applies coconut oil on the injection spot (thigh, arm, or buttocks) to avoid scar tissue formation. Oberoi also started using Continuous Glucose monitoring (CGM) patches to monitor Noor’s blood glucose levels. However, since Noor is too young to carry a mobile phone, Oberoi has to go to her school and scan the CGM reading using her phone.

“My next step once she is older with the school’s permission is to give her a phone with an  active data connection. So that I can remotely monitor the sugar readings from our home,” Oberoi says.

She also adds that  her almost 11-year-old son Arjan and her domestic help—all of them can read the CGM and keep her updated about the numbers. 

Food habits for managing Type 1 diabetes

Though Type 1 diabetes is all about insulin management, those affected with it should also keep a watch on their diet so that they don’t consume too many calories as their insulin shot dosage also depends on the ingested calories.

Noor usually has a fiber rich parantha in the morning and sometimes zero refined flour bread which isn’t more than a slice.

Oberoi lets her have some diabetes friendly fruits in the morning which is safer than her having the fruits during the snack break in the school.

Oberoi has started giving her breakfast at  around 6:30 am and then her insulin shot which peaks (i.e lowers the blood sugar with maximum strength) in about one and a half hours around 8 am when she is dropped to school and Oberoi is around her.

“It should not peak and result in sugar drop after she goes to school and is in the middle of the class or playing and running around,” explains Oberoi.

Making the best of the situation

 Once she understood Noor’s condition better, Oberoi started sharing social media posts about her journey with Noor.

“I have had parents of kids with Type 1 diabetes reaching out and I am glad that we could speak and share these things with each other,” she says.

Does she worry about Noor being treated differently by those who know about her condition? “Yes, but the pros outweigh the cons,” says Oberoi.

She says that every new person who gets to know about her condition can either exclude or become a support system for her in any form. “We are lucky that we have found the latter kind of people,” she says before signing off.

Takeaways

• Simran Oberoi, mother of six-and-a-half-year-old Noor who was diagnosed with Type 1 diabetes, talks about the journey of managing her daughter’s sugar levels with insulin.
• Type 1 management requires her being cautious with food and constantly keeping an eye on the sugar levels.
• She talks about how she has created awareness around her daughter’s condition by explaining it well to her and people around her.