Difficult to control blood sugar. Is it just my kid?

[Jacob'sDad]

This is my first post. Hello everyone.
My son Jacob has been type 1 for 2 yrs. He'll be 7 yrs old next month.
Controlling his blood sugar has been tough since day one. Here's the problem:
First some background info:
1 unit of insulin (humalog) will lower his blood around 180 points (without any food).
15 grams of carbohydrate will raise his blood sugar up to 200 points (without any insulin).
He gets about 1 unit of humalog for 12 grams of carbs.
He gets 12 units of Levamir for his basal in two doses. 6 units in the morning and 6 at night.

Sorry about all the info but it is needed to show the problem.
So here's the problem:
The slightest error will either send him very low or very high. 1/2 unit too much will drop him 80 extra points. If I'm trying to get him to 120 that puts him at 40!
1/2 unit too little and he's 100 points too high.
On top of that, it it difficult to match it up so that the food he eats hits him the same time as the insulin.
For example: The other day he had Taco Bell. I'm pretty sure we had the carb count pretty close. I gave him insulin AFTER he ate. 1 1/2 hours later he was 40. I gave him a juice. 1 hour later he was 360. I gave him 1 unit for the high, figuring that the insulin hit him way before the food and then when the food hit he went high and now I had to cover for the juice. 1 1/2 hours later he was 430! 1 1/2 more units for the high and then he was in normal range 2 hours later.

Folks, this is a pretty typical day for Jacob. I'm quite good at math and pride myself on my ability to recognize patterns, but I'm quite confused. My wife has far more trouble with it than I do. She relies on me to make the best guesses on dosages.

Jacob will be starting on a pump in two weeks. We should be excited, but I'm worried that many of his problems will continue. They want us to gather useful information so they have good info to set up his pump settings. We don't have good info. For a couple of days we were supposed to give Jacob zero carbs for breakfast to check two things: 1) If he was high at breafast, how much did his correction dose drop him? 2) If he was good at breakfast did he stay good until lunch?
We gave him eggs and he shot up 200 points! This was AFTER we just increased his basal from 7 units per day to 12 units per day over the course of about 1 month. 7 units worked for a long time and then, suddenly, wasn't even close to being enough.

Sorry for the long post but I needed to vent and see if anyone else deals with stuff like this.

Thanks for reading!

[Mama2H]

Welcome! Unfortunatly, from what I have learned, this is just what Type 1 diabetes does :( My daughter has never truly been stable and the moment I think I have things perfect she goes too high or too low. We have also learned some foods need more/less insulin than others no matter when she eats them. I think this is why T1 in our kids is so hard, there really is no stable :(

[wilf]

Hi and welcome!

Your son may just be coming out of his "honeymoon" period, with the result that he suddenly needs considerably more insulin. Or it could be something else happening.

The fast food blow out is typical for many kids when they have fast food. We have to give our daughter insulin for the carbs, and then as much again for the fat in the food (which breaks down more slowly and gives the prolonged high you saw). Repeated trial and error is the only way to establish what works for your child, and you will find that it varies from one fast food place to another. We try to steer clear of them as much as possible.

Overall, the issues you're struggling with are common to many on here. The big problem in the case you cited was timing, and I have wrestled with that problem on many occasions. Feels sweet when you get it just right, but a real bummer when you don't.

Hope this helps.

[kel4han]

Hi Jacobs Dad, Lately we have been doing just what you describe. For us, Maddison's (7) sensitivity is 100 at night, and 300 during the day:eek: so I totally understand the 1/2 units. Maddison eats alot of cheese because she isn't a big meat eater, and *only* sometimes does that cheese mess with us hours later. So, how the heck do you know if it will or wont? I haven't figured that one out yet. Do you ever give a "sprinkle" trying to inject just 1/4 unit? We used to have to do this before our pump. It worked pretty well, didn't cause lows, but also kept us from being to crazy high. Sounds like you are well informed, and very diligent. Perhaps a pump will be the answer. :)

[Jacob'sDad]

Thanks for the responses!

I know the best thing to do and I kind of feel guilty for not doing it.
We need a two or three week meal plan for Jacob (and the rest of us too) that would repeat.
Ultimately it doesn't matter how many carbs or fat are in a meal (except as a starting point). What matters it what effect that meal has on Jacob's blood sugar. Next time he has the same meal it will probably have a similar affect. If we kept records of all those meals (and I mean EXACTLY what they were), and the effect it had on his BS, we would know for next time.
The problem is he is constantly eating different things. We don't really plan our meals so there is too much to keep track of. WE often can't nail the carb count exactly either.

I often think he would do far better on a low carb diet, but the diabetes dieticians don't recommend it. They say he needs the carbs (I'm not quite convinced of that) and that he needs to eat regular foods so he feels like a regular kid. But there is no doubt his numbers are better the less carbs he eats.

[Kaylee's Mommy]

HI and welcome to the board.. I think going on the pump will definitely be a good thing for your son!! My daughter, Kaylee, is 4.5 years old, has been type 1 for almost 2 years. We went on the pump on july 10,2006.. it was the BEST decision we ever made for her. We use to have to wait until she was in the 400s to give a correction because she was so insulin sensitive. her correction factor is still above 200. Each kid is different.. each reacts to insulin and carbs differently.. you could do the same thing every day for a week and no two days would be a like. The taco dinner you discribed, the only thing I could think of is that the fat in the meal slowed down the absorbtion, so like you said, the insulin hit him before the food did.. with the pump you will be able to give very tiny amounts of insulin over a certain period of time to help with that spike. What pump are you going to be using? We use a square wave a lot, it gives a burst of insulin up front, and then some thought a certain time period (you set the time in 30min. incriments each time) and then drops off at the end. We love to use this bolus.. it helps us with pizza, icecream, chinese food..anything that is high in fat and may delay the absorbtion..

glad you found the board, but very sorry you had to come here.. stick around.. we're all nice:)

[Jacob'sDad]

Kaylee's Mommy.
Wow, it's starting to sound like Jacob is pretty normal for his age and size.

Jacob will be getting the Animas 2020. Most of the pumper kids in this area are on the Medtronic pump. I had to be a rebel. They sure push the Medtronic pump in this area. They encourage the constant glucose monitor too, but I'm waiting for the technology to improve a bit on that.

[cgates]

Welcome! Sorry about Jacob's numbers being so erratic. My daughter
Stevie has a similar problem and she is on the pump. We keep records
of everything she eats, but do not plan the meals. Generally, we let her
eat whatever she wants, within reason (healthy foods if possible).

We have found that high fat foods, such as Taco Bell, will make her BG
go high and the insulin will not be as effective until far into the insulin
curve. I would just recommend that you keep as good of records as
possible without compromising being human. Don't let the Diabetes
control your family; you control the Diabetes. Easier said than done,
of course!

I'm glad you are posting here. And I'm glad that you are taking a pro-
active roll in Jacob's care. Please keep us informed on his progress.
--Charles

[Kaylee's Mommy]

Kaylee's Mommy.
Wow, it's starting to sound like Jacob is pretty normal for his age and size.

Jacob will be getting the Animas 2020. Most of the pumper kids in this area are on the Medtronic pump. I had to be a rebel. They sure push the Medtronic pump in this area. They encourage the constant glucose monitor too, but I'm waiting for the technology to improve a bit on that.


I think MM gets pushed because they are so large.. they have reps everywhere.. I know people on the animas and are very happy with it.. if your son is still honeymooning the tiny basals and boluses will come in handy:)

Kaylee just started the CGMS yesterday.. so far its been a wealth of information, and its only been a little over 24hours:)

It does sound like he's 'normal' and the stuff that you are experiencing is just stuff everyone goes through.. its a total guessing game.. somedays there is no rhyme or reason..

[kel4han]

I agree, if a carb was a carb, and we ate all packaged, labeled food our lives wouldn't be this crazy dealing with "D" When I look over our logs it clearly shows that when we guess carb counts we are very out of range, usually low to very low, which is why it takes me so long to make an adjustment, I always have an explanation...trampoline, ate dinner out, guessed the carb count, fat content messed with us again, emotions, Karate night, tired, runny nose, swimming. EEEK.

[Heather(CA)]

Hi welcome to the forums...When I was reading your post, I had a different take on what happened at Taco Bell. I could be wrong, but these were my thoughts. I'm thinking that the carbs were judged too high, that's why he went low. Then because he was soo low, he had a rebound. The fact that he was 430 after a correction, makes me think even more that it was a rebound. 1 1/2 units of correction is conservative, (which is a good thing) it gave the body a chance to take back the glucose and come back down. YDMV, but Seth loves Taco Bell, when we eat there his sugar is fine later, tha'ts just him though, yur child may be different and I could be totally off base...What do you think about what I'm saying??

Do you have the food in the fastlane book? If not I can give you the info to get one. Do you remember what your son ate and how many carbs oyu thought it was??? I could check it out for you if you like:D

Also, do you use 1 unit per 12 grams all day? You might find different ratios are needed because of activity...I hope this helps

[lynn]

Jacob's dad: The thing I would like to add to what everyone else has said is that you are worried about not being able to provide good information for pump start. I would argue that the information you have is good information. It isn't easy to understand maybe, but it is your son's info. so it is good. The doctor needs to work with the real-life numbers.
I've been tempted to try a low carb diet on my son too, but then I read up on it a bit. Little kids need the carbs for proper brain development. I can't sacrifice that for prettier numbers.
I hope the pump makes life easier for you. I bet you'll love it.
Lynn

[twodoor2]

It sounds like he's so insulin senstive that he needs to be on the pump, or he needs diluted insulin. Our daughter is very insulin sensitive as well, so our doctor is having us go on the pump immediately. I think once you start the pump, you can give insulin in such tiny doses, that it will make your life, and your son's, a lot more managable. Good luck!!

[Mama Belle]

It sounds like a pump would be great for your son! I am glad he is starting one soon!

My thoughts about the taco bell fiasco are centered on fat content. A high fat meal usually means low first then high later. A pump would really help this, since you can do a combo bolus with high fat meals.

Don't worry too much about not having the "important" information for pump start. Explain what happened and give them the info you have. Most initital pump setting as just that ... initial. You will be changing things like crazy the first week or two on the pump. It will work itself out and you will eventually get there. Fear not!

[momofsingingdiabetic]

I've been tempted to try a low carb diet on my son too, but then I read up on it a bit. Little kids need the carbs for proper brain development.

I agree with Lynn here... and she got to it before I did. That's one thing that Danielle's endo and dietitian stressed that she needed the carbs for proper brain development. Even as adults, the brain needs carbs each day to function.

I also agree with Heather. My first though was the high after such a low was a rebound high. And they are even harder to understand than a regular high.

Do you download any of his numbers to a computer to be able to compare. I know it's hard, but you probably do need to try to write down what he's eating and when..how much insulin, etc. to see if you can find any patterns. There are some foods Danielle has given up on her own just because they are very hard on her sugar, even with a combo bolus.

[Abby-Dabby-Doo]

This is my first post. Hello everyone.
My son Jacob has been type 1 for 2 yrs. He'll be 7 yrs old next month.
1 unit of insulin (humalog) will lower his blood around 180 points (without any food).
The slightest error will either send him very low or very high. 1/2 unit too little and he's 100 points too high.
Jacob will be starting on a pump in two weeks.
For a couple of days we were supposed to give Jacob zero carbs for breakfast to check two things: 1) If he was high at breakfast, how much did his correction dose drop him? 2) If he was good at breakfast did he stay good until lunch?
We gave him eggs and he shot up 200 points!
Sorry for the long post but I needed to vent and see if anyone else deals with stuff like this.



No two diabetics are the same but I wanted to let you know that Abby is also 7 years old, and 1 unit of insulin will also drop my daughters blood sugar by 180.

The slightest errors your talking about will improve by going with the pump. The pump can measure those small doses of insulin that we can't on a syringe. .1, .2, .3, .4 and so forth.

When your talking about giving him an egg for breakfast and he shot up 200 points, I'm sure it wasn't the egg. When your body gets up and gets going in the morning (often before your awake) your blood sugar rises. My daughter needs the most amount of insulin out of the entire day before her eyes are even open (5am) and it continues until about 8am. Every person is different, but I don't find that too surprising.

Never apologize, we all get that this disease can be wacky, and no question is ever dumb or silly.

I think your going to love his pump, no matter which one you pick. Essentially a pump is a pump, and it just doses more accurate.

Your going to be able to dose the insulin more efficiently on the pump for certain meals. Higher fat meals affect your blood sugar later and dosing for that on a syringe is a lot harder. One of two things happened at Taco Bell, his blood sugar went too low for his bodies liking and his liver spilled out some sugar sending his blood sugar soaring or it was a high fat meal that he ate affecting him later. We can't really tell without knowing times and what he ate.

I really think your heading in the right direction with the pump. Like all things that are new, it's going to take some work and trial and error before you start perfecting it. Be prepared for some high fives and some frustration, but it will all be worth it in the end.

Welcome to the forum! Your going to find a wealth of information here, and very caring people.
My two cents also be to invest in a Salter Scale
http://forums.childrenwithdiabetes.com/showthread.php?t=8399

[hughsfan30]

Hi Jacob's dad...I too have a Jacob ;) Since his dx he has been pretty much all over the place, however his endo has him on a meal plan..very old school if you ask me. In fact we are switching endos soon.
What you are describing is normal, as one of the gals said, sounds like he is coming out of the honeymoon phase. Just keep close contact with the endo and make sure Jacob keeps you posted on how he feels, we found that helped us alot.
Your doing great, we are all here for you!
((hugs))

[hold48398]

Kaylee's Mommy.
Wow, it's starting to sound like Jacob is pretty normal for his age and size.

Jacob will be getting the Animas 2020. Most of the pumper kids in this area are on the Medtronic pump. I had to be a rebel. They sure push the Medtronic pump in this area. They encourage the constant glucose monitor too, but I'm waiting for the technology to improve a bit on that.

Hi there,
I just wanted to say welcome. Mia has been pumping with Animas for 1 1/2 years. We are loving it!! Also, we just upgraded to the new 2020, and it is SWEEEEET. You and Jacob are going to love it!!:)

[twodoor2]

When your talking about giving him an egg for breakfast and he shot up 200 points, I'm sure it wasn't the egg. When your body gets up and gets going in the morning (often before your awake) your blood sugar rises. My daughter needs the most amount of insulin out of the entire day before her eyes are even open (5am) and it continues until about 8am. Every person is different, but I don't find that too surprising.

My two cents also be to invest in a Salter Scale
http://forums.childrenwithdiabetes.com/showthread.php?t=8399

My daughter's carb ratio is the lowest during the day 1:30. Her lunch time and dinner time carb ratio are 1:45 and 1:50 respectively. Therefore she needs more insulin to cover breakfast, but she spikes like crazy after breakfast. She wakes up around 200, eats her 40 to 50 grams of carbs, and then she's in the 400's at 10:00. Then she drops back into the 100's or low 200's by lunch time. The spike is amazing. I'm just afraid to give her more insulin to cover the spike because she might go hypo at lunch time. She probably does need more insulin though. We found the spike is there whether she has low fat yogurt, or low fat milk with her breakfast, and she only drinks a half cup (4 oz). I'm afraid to give her more milk than that. Her patterns look as though they're sensitive to protein and fat. It's funny that you mention that the blood sugar rises during the morning, maybe that contributes to the spike as well?????

BTW, thanks for recommending the salter scale. I got the travel size one, and it fits so nicely on the countertop, and it's so convenient and out of the way. I also like the fact that it folds up and I can take it out with me. I love the database of foods!!

[zimbie45]

ok..

So here is my 2 cents.. One it seems like alot of chasing numbers.. OUCH for you and him . THat tought when that happens.. How much are you giving to correct a low? YDMV.. my daughter will be 7 in jan.. she has been diabetic since the age of 3.. AND i can tell you if she is low, and i give her 15 carbs for her low.. sh ewill go thru the roof.. 300-400 easy..We used tablets and usaually give 1-2 at a time.. 4-8 carbs,,. that works great. for us.. it help to avoid a hugh rebound, that looks like is happening.. SO the questions still would be what is causing sucha big diffrance.. I also questioned the I:c ratio.. Is it 12/1 all the time.. ? that could use some tweeking... Also what is your ISF? for charlize.. we are at a ISF of 125.. We have had to use befor 100 and upto 200, sometimes an average of 150.. Yes we do ahve to change that ofthen too sometimes.. Charlize BS reek havok on us when either she goes thru a growth spurt.. but what really does us in is illnesses.. we have to do a total revamp on everything during and after amn illness..simple or not.. I also have to agree with the others that a pump is a great route. I have the animas 1250 for charlize, and absolutly love them.. My only compaints on them they fixed with the 2020.. Usually with the pump you will set basals about 25% less than what they are getting now in levimer.. that is typical but YDMV.. they wil start with basic's then tweek over a period of time... STARTING pumping can be stressfull, frusterationg and overwhelming.. a lot like being diagnised all over again.BUT it gets much better with time.. and is VERY much well worth it.. IT sounds like you are doing a good job so far, younger kids flux so easy and so often its hard to keep up with them..

Good luck and hope this helps

[Jacob'sDad]

Thank you all for the suggestions and good advice!

I will try to respond to a few of the questions and points people have made.

A few of you questioned whether Jacob's carb to insulin ratio is the same all day. This is a great question because it brings up something I've wondered about: Does carb to insulin ratio really change throughout the day or are we really compensating for basal rate requirement and activity level by changing the carb to insulin ratio instead?

If that sounded confusing let me give an example:
Jacob gets 12:1 at breakfast and if he is not active he should be OK until lunch. If he is active he will require a snack between meals but no insulin for it. He gets the same 12:1 at lunch and dinner and again, depending on how active he is he may get a snack between meals (15g snack).
He does tend to go lower in the afternoon but I think that's from the inability to adjust his basal rate (which we will be able to do once he has a pump). Then again, sometimes he doesn't go lower in the afternoon because he tends to have fattier meals later in the day which require more insulin. I do round his dose down at lunch and dinner too.

There were a couple of responses suggesting a rebound high from Taco Bell.
I think that probably did happen but I don't think it neccesarily means I gave him too much insulin. He went low quite fast, suggesting tha the insulin I gave him hit him well before the food did. He then went up for three reasons: I gave him a juice, his food hit him, and he rebounded.

Zimbie 45 suggesting giving less than 15g for a low. I guess the reason I don't is because I am never sure if Jacob is at the bottom yet. Because he gets low so fast I'm never sure if he's in free fall, therefore I give a full juice and if it's too much, I will give insulin later. There have been several instances where one juice was not enough. If I had not givin a full juice at first who knows how low he would have gone.

One of the biggest problems controlling Jacob's BS is that he actually requires a fair amount of insulin for his food and because of that it's easy to miss by 1/2 to 1 unit in either direction and those errors have a huge impact on him.

Thanks again for all the responses. I wish I would have gotten on these forums sooner. There is an incredible (almost overwhelming) amount of info here and great people too!

[mollysmom]

Hi Jacob's Dad:)

We have almost always had different carb/insulin ratios for different times of day. Right now Molly gets 1:14 for breakfast, 1:25 for lunch, 1:20 for Dinner. These pretty much stay the same regardless of her day. She does get a cut in her basal rates from 10am to 3pm on school days. Also her correction factor is different for night and day. 1 unit brings her down about 200 points in the day and about 250 points at night.

I think a pump will be great for you guys. It's so much easier to make little adjustments here and there.

Take care,
Amber

[Abby-Dabby-Doo]

Yep, we also have different carb ratios for the day.
Break 1:10
Lunch 1:18
Snack 1:25 (in the afternoon when she's playing the hardest)
Supper 1:20
Before Bed 1:25

Notice how low the breakfast ratio is for those stubborn insulin resistant mornings.

[Heather(CA)]

Yep, Seth gets different insulin too, the most in the morning. Hedoesn't like to have a snack all the time so at lunch I give him a unit less than I normally would to compensate for a 15 gram snack. It's probably the exercise from recess that's giving you a hard time rather the basils. But, I could be wrong...YDMV:D

[wilf]

... A few of you questioned whether Jacob's carb to insulin ratio is the same all day. This is a great question because it brings up something I've wondered about: Does carb to insulin ratio really change throughout the day or are we really compensating for basal rate requirement and activity level by changing the carb to insulin ratio instead?


I love this question! I have often pondered this myself. My daughter carb/insulin ratio is lowest (ie. she needs the most insulin) in the morning (when she has almost no basal insulin working) and at supper (when there is also not much). On weekends when we give lunch-time injections, I have to watch it because she has a big slug of NPG peaking and her carb/insulin ratio is highest (ie. she hardly needs a bolus).

Maybe its a coincidence, but I rather doubt it. I think the timing and type of basal DOES affect that ratio. But I do think that other factors come into play as well. I think that there are other factors because for some reason DD's carb/insulin ratio is highest at bedtime (when she has almost no basal working).

[czardoust]

Welcome to CWD. Geeze, your child sounds like mine. ;) T1D is a roller coaster. Someone said something here a few days back that really helped me take a load off when I was feeling a little bent up.... "I am not a pancreas." No matter how hard we, as parents, try to regulate, control, take care of in a perfect way--our childs diabetes, we cant do it 100% because we are not a pancreas. Does your childs take Lantus at night or during the day? Well, for that matter, does he/she take lantus as a long acting insulin, or NPH? How about Novolog/Humalog? <~~ same thing, different brand names. I recently (winthin the past month) changed Kat over to Lantus in the morning instead of at night which is how she took it for three yrs. It has changed everything, made managing her BS's much easier during the day and now, no crashes in the middle of the night. Anyway, welcoem aboard, this is a great place to be for support and friends.

[badshoe]

I am with wilf that is an advanced question - my answere is: YDMV.

Why shouldn't the ratios change everything else does.....

[Jacob'sDad]

Does your childs take Lantus at night or during the day? Well, for that matter, does he/she take lantus as a long acting insulin, or NPH? How about Novolog/Humalog? <~~ same thing, different brand names. I recently (winthin the past month) changed Kat over to Lantus in the morning instead of at night which is how she took it for three yrs. It has changed everything, made managing her BS's much easier during the day and now, no crashes in the middle of the night.

WOW, Last night was the worst! I should start a new topic on what happened last night.

We already had Thanksgiving last Sunday so last night we ate at my Mom's
and had barbequed ribs and stuff. I was concerned that I might not have given Jacob enough insulin for all the food he ate.
Just as we were going to leave my Mom's, about two hours after he ate, Jacob said he felt low. He was 37! We gave him a juice and went home. When we got home (20 minutes later) I checked him and he was still low (62). I gave him another juice. It was time for his Levemere so I gave him his usual dose (6 units) and he went to bed. 45 minutes later he was 55! I gave him another juice. 30 minutes later he was 93. Checked again 1/2 hour later and still 93. I gave him ANOTHER JUICE! One hour later he was 101. 45 minutes after that he was 109. 45 minutes after that he was 100. He seemed to be stabalizing. 1 1/2 hours later he was 66. I gave him another juice. 1/2 hour later he was 70. I gave him another juice. 1/2 hour later I CHECKED MYSELF and was 95. I checked Jacob and he was 187. Three hours later he was 425.

I have no idea what to expect now. He got a lower carb breakfast, slighlty less than usual bolus, 1 unit for the high, and 1/2 unit less on his morning Levemere (Jacob gets Levemere twice a day for his basal).

I think somewhere in there I gave him yet another juice because I counted 7 juices overall.

I did not give him Humalog instead of Levemere. That is a certainty. Maybe I gave him 11 units instead of 6 but I don't think so. Even that wouldn't account for the amount of juice he needed.
I don't even think it could be that his pancreas started producing insulin again because even MY blood sugar would have gone up after 7 juices!

It was more like from 5 PM last night until 5 AM this morning his body stopped absorbing carbohydrates. We've never seen anything like it. Thank God we never slept through the alarm!

[Mom2Will]

Juice has never worked to bring up a low in my son, we always use skittles, trial and error. It was so frustrating for us to finally realize juice just didn't work, it should but sure doesn't for us. My suggestion is to use something other than juice to get that sugar up

[Jacob'sDad]

JUice consistantly raises Jacob's blood sugar about 200 points. Until last night that is.

[wilf]

Thank goodness you stayed on top of this and managed to avoid what could have been a very bad low. How many carbs in the juices, and what kind(s) of juices were they?

Is it possible that the Levemir injection went not into fatty tissue but instead into the underlying muscle? If it did, then it would have been working like a bolus insulin and could account for what happened..

[Jacob'sDad]

Thank goodness you stayed on top of this and managed to avoid what could have been a very bad low. How many carbs in the juices, and what kind(s) of juices were they?

Is it possible that the Levemir injection went not into fatty tissue but instead into the underlying muscle? If it did, then it would have been working like a bolus insulin and could account for what happened..

Juicy juice. 15g.

It is not likely that it went into the muscle. I gave it too him in the same general area of the butt as always.

THERE IS ONE FACTOR THAT WAS DIFFERENT!
I left a box of Equal packets out on the kitchen table. They've been in the cupboard for a long time because we never use them, but Jacob's brother tried them on his cereal yesterday. Jacob wanted to know what they were and if he could have some, but I told him it was probably a bad idea.

Last night when we got home, for some crazy reason Jacob just had to try the Equal. He ate FOUR PACKETS STRAIGHT. I wonder if this could possibly have affected his ability to absorb carbs until the Equal worked out of his system. The Equal is in the trash now.

[wilf]

Hmmm... What is Equal?

[Jacob'sDad]

Equal is Aspartame artificial sweetener.