We Failed as an Artificial Pancreas: The Anxiety of Being a T1D Parent

Sep 25

7 min read

An accidental double dose of long-acting insulin turned an ordinary evening into an all-night diabetes emergency—and reminded me just how much responsibility comes with being a pancreas parent.

There is something people don’t always understand about raising a child with Type 1 diabetes (T1D).

You don’t just become a parent.

You become the pancreas.

You calculate.

You count.

You monitor.

You remember.

You correct.

You anticipate.

And you try, every single day, to make thousands of decisions that a healthy pancreas normally makes automatically.

But there is one thing an artificial pancreas cannot do:

It cannot be human-proof.

One night, we learned that the hard way.

Life Before the Insulin Pump

Before Pablo started using an insulin pump, managing his Type 1 diabetes meant using two different types of insulin: long-acting insulin and rapid-acting insulin.

His long-acting insulin was insulin glargine, which he was taking as Lantus at the time. His evening dose was 11 units.

Long-acting insulin provides the background insulin the body needs throughout the day and night. Insulin glargine is designed to be absorbed gradually after injection, providing a relatively steady insulin effect over many hours.

Think of it as the body’s background insulin supply.

Then there was his rapid-acting insulin, insulin lispro.

That was the insulin we used around meals and for corrections when his blood glucose was higher than his target range. Rapid-acting insulin begins working much sooner than long-acting insulin and is used to help manage the rise in blood glucose associated with food and corrections.

So our lives involved a lot of math.

Carbohydrates.

Insulin-to-carb ratios.

Correction doses.

Blood glucose.

Activity.

Timing.

And, perhaps most importantly:

Keeping track of what had already been given.

We Tracked Everything

We were meticulous.

Maybe too meticulous.

The Dexcom app had an insulin-tracking feature where we could record the type and amount of insulin given. We logged doses because it gave us something incredibly important:

certainty.

Did we give the insulin?

How much?

What type?

When?

Why was his blood sugar changing?

What should we do next?

The log became part of our safety system.

It helped reassure us that we had already given a dose.

Until one evening, our safety system failed.

The Call That Made My Heart Stop

It was an ordinary evening.

I gave Pablo his usual 11 units of Lantus.

I logged it.

Done.

Check.

Then I decided to take the dog for a walk.

I wasn’t far into the walk when my husband called.

I could hear it in his voice.

Something was wrong.

He asked:

“Did you give Pablo his Lantus?”

“Yes,” I said.

Then came the sentence that made my stomach drop:

“I just gave it to him too.”

For a second, I think my brain stopped working.

Then the math became painfully clear.

Pablo had just received 22 units of long-acting insulin instead of his usual 11.

Twice his usual dose.

And unlike a meal bolus, we couldn’t simply wait a little while and watch it wear off.

Long-acting insulin is designed to work for many hours.

The insulin was already in his body.

There was no button to press.

No undo.

No way to take it back.

No pancreas waiting in the background to rescue us.

I took a deep breath.

I told my husband:

“I’ll be right there. We’re going to be okay.”

And I started walking home as fast as I could.

When You’re the Pancreas, Your Brain Never Stops

My body was walking.

My brain was running.

What do we do?

How low could he go?

How long would the extra insulin continue working?

Should we feed him?

How many carbohydrates?

Should we go to the emergency room?

What if he drops while we’re sleeping?

What if we miss it?

What if the Dexcom doesn’t alert us?

What if…

This is one of the hardest parts of being a T1D parent.

The responsibility doesn’t turn off.

Even when you’re terrified, you still have to make decisions.

There is a child standing in front of you who needs you to be calm.

So you become calm.

Or at least you try.

When I got home, my husband and Pablo were understandably freaking out.

I tried to calm them down.

Inside, I was scared too.

But I already had a plan.

When Your Child Has T1D, You Need a Plan

Pablo’s endocrinologist is affiliated with our children’s hospital, which meant we had access to an after-hours emergency service.

I called.

I explained exactly what had happened.

They listened and told me the endocrinologist on call would call us back.

Then we waited.

Those minutes felt like hours.

Finally, the phone rang.

It was Pablo’s endocrinologist.

And, of all nights, she was the one on call.

She already knew our family.

She knew how meticulous we were with Pablo’s diabetes care.

She knew we took his treatment seriously.

She was surprised this had happened—but she was prepared.

She asked me:

“Has Pablo already had dinner?”

“Yes.”

Her response?

“He’s going to have a second dinner.”

Pizza, Ice Cream and a Very Long Night

It was already around 8 p.m.

The goal was to keep Pablo’s blood glucose from dropping too low while the extra long-acting insulin was still active, following the specific instructions from his endocrinologist.

And her suggestion was very specific:

Pizza and ice cream.

My husband ran to the store.

Pizza?

Check.

Ice cream?

Of course.

And Pablo got to choose the flavor.

He went all out:

Birthday Cake.

And honestly, it turned into the perfect accidental diabetes movie night.

Pizza.

Ice cream.

Movies.

Dexcom alerts.

And two exhausted parents watching a glucose number on a screen.

The Night We Didn’t Sleep

Pablo went to bed.

My husband and I did not.

We watched his blood glucose.

Then we watched it again.

And again.

The Dexcom became the third person in the room.

After the meal, Pablo’s numbers stayed roughly between 180 and 200 mg/dL through the night.

We watched.

We waited.

We breathed.

And every time the number changed, our hearts changed with it.

This is the part of Type 1 diabetes that can be difficult for other people to understand.

Imagine being told that your child’s blood sugar cannot safely drop too low while they sleep.

Now imagine being told that you need to monitor it throughout the night.

Now imagine knowing that the reason you are in this situation is because you made a mistake.

Not because you didn’t care.

Not because you weren’t paying attention.

Not because you were careless.

Because you are human.

And humans make mistakes.

The Mental Load of Being a T1D Parent

The next morning, Pablo’s endocrinologist called to check on him.

She gave us instructions for the day, including reducing his rapid-acting insulin boluses by half. We followed her instructions and took it easy with activities.

We had survived.

But something stayed with me.

The physical emergency was over.

The emotional one wasn’t.

Because this is the part of T1D parenting that doesn’t always show up on a medical chart:

the mental load.

The constant responsibility.

The fear.

The second-guessing.

The calculations.

The alarms.

The overnight monitoring.

The feeling that one mistake could have consequences.

And the knowledge that you can do everything you possibly can, and blood glucose can still behave unpredictably.

We Failed as an Artificial Pancreas

People sometimes use the phrase “artificial pancreas” when talking about diabetes technology.

And I understand why.

Technology can do incredible things.

CGMs can continuously show glucose trends.

Insulin pumps can deliver insulin throughout the day.

Automated insulin delivery systems can use glucose information to adjust insulin delivery.

These technologies can take some of the burden off families.

But that night reminded us of something important:

There is still a human being at the center of the system.

And humans get tired.

Humans get distracted.

Humans can accidentally give the same injection twice.

Humans can forget.

Humans can panic.

Humans can make a mistake while trying their absolute hardest to keep their child safe.

That doesn’t make us bad parents.

It makes us parents.

The Invisible Weight of Being a Pancreas Parent

This is the part of T1D that I wish more people understood.

The hardest part isn’t always the injection.

It isn’t always counting carbohydrates.

It isn’t always changing a CGM sensor.

It isn’t always responding to an alarm.

Sometimes the hardest part is simply carrying the responsibility.

You become the:

Calculator
Carb counter
Medication tracker
Alarm responder
Nurse
Planner
Decision-maker
Overnight monitor
Emergency contact
And, sometimes, the pancreas

And you’re doing all of this for a child who simply wants to be a kid.

A child who wants pizza.

A child who wants ice cream.

A child who wants to play soccer.

A child who wants to sleep.

A child who doesn’t want his parents staring at a glucose graph all night.

And yet we do it.

Because we are their safety net.

We are the people who have to wake up.

We are the people who have to decide.

We are the people who have to keep going.

Sometimes…

we are the pancreas.

Even a Pancreas Parent Needs Help

That night taught me something I already knew but perhaps hadn’t fully accepted:

I cannot do this perfectly.

None of us can.

Type 1 diabetes management is too complicated, too relentless and too unpredictable to expect perfection from a human being.

What we can do is build systems.

We can log doses.

We can communicate with each other.

We can use technology.

We can have emergency plans.

We can know who to call.

We can listen to our medical team.

And we can give ourselves permission to be human.

We made a mistake.

We called for help.

We followed our endocrinologist’s instructions.

We monitored Pablo throughout the night.

And we got through it.

The next morning, Pablo was okay.

And so were we.

Barely.

But we were okay.

Sometimes Being the Pancreas Means Knowing When to Ask for Help

Living with Type 1 diabetes has taught me that being a good pancreas parent doesn’t mean never making mistakes.

It means knowing what to do when something goes wrong.

It means having a plan.

It means asking for help.

It means trusting your medical team.

It means using every tool available to you.

And sometimes it means sitting beside your child at 2 a.m., watching a number on a screen and hoping it stays exactly where it is.

That night, we didn’t need to be perfect.

We just needed to keep Pablo safe.

And we did.

Have You Ever Had a T1D “Oh No” Moment?

A forgotten dose?

A double dose?

A pump mistake?

A CGM failure?

A midnight emergency?

An all-night monitoring session?

If you’ve ever had one of those moments, you are not alone.

Share your story.

Because sometimes the stories we’re most embarrassed to tell are the stories another T1D parent desperately needs to hear.