Nudging Blood Sugars Along… Thanks to Dexcom

DEXCOM G5 xoxo

I love my Dexcom so much.  I mention it on this blog often. It allows me to nudge my blood sugars in the right direction whenever things get a little off track.

In the days prior to having a CGM, if I remembered, I would check my blood sugar with my glucometer about 2 hours after eating, as advised by my endocrinologist.  It gave me a little information, but not a lot.  I didn’t know if my blood sugar was still trending up, if it had stabilized, or if it was falling.

I rarely bothered with a correction dose if my blood sugar was a little high. Or even a lot high.  I’d just check it again before my next meal a few hours later and regroup at that point.  It was a lot of highs and lows…a rollercoaster that was not very fun!

These days, it’s a whole lot different and a whole lot better.  I’ve learned to use the Dexcom to a great advantage!

As an example…

Yesterday, I ate lunch around noon.  And oh, yes!  It was delicious.  I had a hamburger from this yummy local spot called Diggs.  They “dig” out part of the bun to allow space for the toppings of your choice.  I dig away even more to get rid of some of the unnecessary carbs. But I digress…

Before my hamburger, I pre-bolused my insulin, about 25-30 minutes before eating.  Then, about an hour after I ate, I noticed on my Dexcom, my blood sugar was steadily trending up.  I knew since I had a lot of protein, this upwards trend would most likely continue if I didn’t do something about it.  (I know protein does that to me, because I’ve noticed this based on lots of meals!)  But I also knew I still had short acting insulin working away, trying to battle things out.

I thought about taking a small amount of extra insulin.  But then I looked outside, noticed the rain had stopped, and looked over at my Ricky Ricardo.

Ricky says a walk is always a good idea!

We talked things over, and we decided we’d go on a brisk walk,  between raindrops, and then see what my blood sugar looked like.

It wasn’t long before my trend line changed it’s direction. And Ricky’s tongue was hanging out.  And the sky was starting to darken once again.  So it seemed the perfect time to head home.


I thought I had it made.  But before too long, that little trend line was heading up again…


But the good news was, the rain wasn’t heavy at all, and I had another friend that wanted her turn to walk with me!

“Take me! Take me!” said Lucy.

Lucy and I walked (fast!) for about 30 minutes.  I think that walk kept my blood sugar from rising higher, but it never really brought it down near 100 which is ideal for me.

Once I saw that my blood sugar was stuck around 135/140, (which isn’t bad but not as low as I’d like it once I’m sure all my fast insulin is out of my system), I took a very small correction dose and then things slid in the right direction.

Back in my happy range!

I know that walking helps the insulin I have taken really get going and do it’s job usually.  I was lucky, because I had a flexible schedule yesterday. I’d rather try a walk first, and then if necessary, take insulin if my blood sugar is still higher than my target range.  Of course, I can’t always do it this way, but it is ideal.

The rest of the day, things stayed steady.  I find that if I just nudge my blood sugars here and there, slightly up and slightly down, it’s so much easier than once I’m really chasing things down (in either direction). I owe it to Dexcom for giving me the ability to handle things this way.

And I thank my two best friends, for always being willing to take a walk with me!

The Cheerleaders: Lucy
and Ricky!

Insulin Mistakes Happen

Back when I was using Lantus for my long acting insulin, I bought a Timesulin cap to help me remember not only IF I had taken my insulin each evening, but WHEN I took it.  It was helpful to me, because prior to that handy Timesulin cap, I would occasionally go into a panic around bedtime trying to remember, “Did I take my insulin, or did I just think about taking my insulin.”  There was no great way of knowing the answer other than waiting until the next day to see if I had a big spike in my blood sugar.

Anyway, this simple little Timesulin cap solved that problem. You just cap it on your insulin and the digital timer starts so you know when you took your last dose. Easy.

Until I switched over to using Tresiba for my long acting insulin.  I definitely prefer the way Tresiba worIMG_0426ks for me(it lasts longer, and doesn’t seem to have a peak at all- it’s very steady and predictable). However, the Timesulin cap doesn’t fit on the top of the Tresiba pen.  But, the way I’ve  solved the problem has been to keep that old Lantus pen in the drawer, beside my Tresiba.  I no longer use the Lantus insulin, but I take the Timesulin cap off and put it back on as I take my daily Tresiba shot.  Great.  So far, so good.

Until last night.

I was tired and I was multi tasking (which never works for me, no matter how simple the multi tasks are!), and as soon as I gave myself a the my shot, I said out loud, “Oh shit!”

I had given myself my usual dosage of long acting insulin… but I used the old (very old) Lantus instead of my Tresiba.  It wasn’t dated as expired, but I had stopped using it about 5 months ago.  All that time, it had just sat in a drawer in my bathroom- unrefridgerated.  So was it still working?  Even a little? I’ve always been told unrefridgerated insulin lasts only a month or so.

There was no way to really know how well this insulin could actually do it’s job, but it seemed a little too iffy and dangerous to just pile on more long acting insulin by taking a second shot, with my Tresiba pen.  Like I had said out loud to myself, Oh Shit.

But that night, and the next morning, everything seemed pretty typical, and my blood sugars were staying in the range where I like to keep them.

But by about 4pm that day my blood sugars started climbing.  I hadn’t eaten anything that would explain this late afternoon spike, so it seemed that whatever long acting insulin had been working earlier in the day, was finally leaving the building.  And it was running out of there pretty quickly all of the sudden.

I went ahead and took my Tresiba, far earlier in the day than I usually take it- Or a day late, depending on which way you look at it.  I also had to take some short acting insulin to get my blood sugar down near 100 (finally…it took some time, multiple shots, and patience).

Now, I’ve taken the needle off of the Lantus.  Duh.  Why didn’t I do that the first time around so that a mistake like this couldn’t happen?IMG_0427

But that’s the great thing about mistakes.  You learn from them.  And if you’re lucky, you won’t make the same mistake twice.

Managing Type 1 Diabetes is a constant learning process… I make all sorts of mistakes.  But I don’t let them bum me out.  I just learn from them, and try to do all that I can to do better next time.



Tricks of the Trade With Type 1 Diabetes


This is the last day of Diabetes Blog Week, and today’s topic is “Tips and Tricks.”

Let’s round out the week by sharing our best diabetes tips and diabetes tricks. From how you organize supplies to how you manage gear on the go/vacation (beach, or skiing, or whatever). From how you keep track of prescription numbers to how you remember to get your orders refilled. How about any “unconventional” diabetes practices, or ways to make diabetes work for YOU (not necessarily how the doctors say to do it!). There’s always something we can learn from each other. (Remember though, please no medical advice or dangerous suggestions.)

I have 2 quick little tricks to share that work well for MY T1 DIABETES…

I used to take my “fast” acting insulin about 15 minutes or so before eating, as recommended by my endo.  It wasn’t until I got a Dexcom CGM that I became aware of how slow that fast acting insulin actually is… at least in my body, with my metabolism.  Some days, it’s a little faster, some days, a little slower- I’m sure, for a whole host of reasons.  I now typically take my insulin shot 30 to even 45 minutes before eating.  It depends on what I’m going to eat (how fast will it spike my bs), how active I’ve been, etc… But I use my CGM to see when that trend line starts to travel south- But I don’t let it get to the point of taking a dive, or reaching an uncomfortably low number.  This is NOT advice, but it’s just the way I do it, and for me, it serves me well.  It’s one of the things that’s helped me to bring my A1C from the mid 6’s to the mid 5’s, while staying in my target range 80-85% of the time.

There have been the occasional unintended lows from this method, for sure!  But it’s always treatable, not a big deal because I see it coming (thanks to the Dexcom!), and it always teaches me something. I’ve gotten more and more in tune with my body and the way it reacts to all the things that effect the timing of the rise and fall of my blood sugar.

My 2nd and final tip for today’s post is just to be as active as possible.  I’ve got a couple of high energy dogs that keep me active- I walk briskly with them about 2 to 2 ½ hours a day.

Lucy McGilicuddy
IMG_0079 2
Ricky Ricardo

I take Ricky and Lucy on separate walks, and they each get two walks a day.  It’s easier for me to handle them one at a time, it gives us a little one-on-one bonding time, and it ups my activity level times two.  SO, it’s a win-win. I use to run anywhere between 6 and 8 1/2 miles daily, now I walk it instead.  It takes a larger chunk of my day, but has the same over all (great) effect on my blood sugar.  I never have to take a day off, because it’s just brisk walking.  I’m never sore from it, or I feel like I need a recovery day. I’ve read, and believe based on my own experience, that those long daily walks keep me highly sensitive to insulin.  And the less insulin I need to take, the easier it goes for me.

Those are just a couple of simple little tricks I’ll share today- I can’t wait to visit other T1 blogs to see what others have to say on this topic!

One Simple Wish

Today’s topic for the “Diabetes Blog Week” is about healthcare.

Most people who live with a chronic illness end up with a lot of experience when it comes to dealing with healthcare. How would you improve or change your healthcare experience? What would you like to see happening during medical visits with your healthcare team? How about when dealing with your health insurance companies? What’s your Healthcare Wish List or Biggest Frustration? Today is the day to share it all!

I go to my endocrinologist every 3 or 4 months, but it sometimes seems like an unnecessary cost to go so often.  Now that I have a Dexcom CGM, I have a pretty good idea what my A1C is these days, even without the lab work at the doctor’s office.  That used to be my main motivator to go to my quarterly appointments.

Since Type 1 Diabetes is a self-managed condition, especially after having it for 20-something years, I’m not waiting for my doctor to tell me how to adjust things when my blood sugars start to get a little jacked up.  I trust myself to make adjustments in my management… because that’s really what Type 1 is all about– constant adjustments! So really, why am I still going to those endo appointments as often as I do?

I’m happy with my current endocrinologist and I especially like the diabetic educators he has staffed at his office.  The thing I used to dread the most about my appointments at my previous endo was getting my blood drawn for lab work.  Needles, combined with veins, is just something I’ve never gotten used to.  And saying it’s just “something I’ve never gotten used to” is actually a huge understatement.

This kid is handling it much better than I usually do…

I get pretty nauseated and there’s a big dramatic build up. Then, because I get so nervous, I tend to freak out the nurse that has the unlucky task of drawing my blood. It’s usually not pretty, or easy. But the great news is, at Diabetes America (where my current endocrinologist practices), they use a simple finger prick to give me A1C results.  It’s only once a year that they do a more thorough panel that requires the dreaded vein drain.  And that has been a dream come true for me!

Although I don’t dread the appointments nearly as much as I used to, they do consume at least half of the day, require me to “fast” for 4 hours (which depending on time of day, and my blood sugars, can be challenging), and they are costly! And they give me little to no new information. So again, why am I going to these appointments on a quarterly basis?

Maybe it’s because I want to be a “good” diabetic and follow the “rules”.  (A little lame, I know.) Maybe it’s because it keeps me motivated to have a “good” A1C that a health care professional is going to look at and hopefully praise me for. (A little shallow, I realize.)Maybe (and this reasoning actually seems to have some value), keeping regular appointments keeps me very accountable and makes me feel like I’m doing everything in my power to say on top of diabetes.  And that’s important to me! But maybe, “regular” appointments could just as well be every 6 months, rather than every 3 months.

So I guess I’m putting that idea on my wish list… The wish list I’m pretty sure is going to come true!









Language and Diabetes

Because I was out of town, and then in a training class the week I returned from vacation, I’m late to the game of  “Diabetes Blog Week”.  I didn’t realize it was going on until I visited a few blogs I follow just last night.

This is my first year to participate, because, well, it’s the first year I actually have a blog about diabetes!  I’m so excited to participate and write about the remaining topics of the week.

So, here we go!

Language and Diabetes. There is an old saying that states “Sticks and stones may break my bones, but words will never hurt me”. I’m willing to bet we’ve all disagreed with this at some point, and especially when it comes to diabetes. Many advocate for the importance of using non-stigmatizing, inclusive and non-judgmental language when speaking about or to people with diabetes. For some, they don’t care, others care passionately. Where do you stand when it comes to “person with diabetes” versus “diabetic”, or “checking” blood sugar versus “testing”, or any of the tons of other examples? Let’s explore the power of words, but please remember to keep things respectful.

There are very few words that offend me.  And personally, whether someone wants to refer to me as a “diabetic” or “a person with diabetes”- I totally don’t care.  I prefer the word NOT be pronounced like this though: “die-a-BEET-us”. But does it offend me?  Not at all.

The only “language” that sometimes frustrates me in my  world of diabetes, is that although Type 1 and Type 2 have so many major differences, they are both referred to as diabetes.  I feel a  little ridiculous clarifying and saying “I have TYPE 1 diabetes”, however the distinction  seems necessary.  I wish there were just two completely different words for the two conditions.  I don’t at all expect people to know all about my disease, but often times, they mistakenly think they know more than they do. I guess that’s  because Type 2 diabetes is so prevalent.  (about 95% of people with diabetes have Type 2)

Type 1 diabetes is an auto-immune disease.  I got it in my early 20s. I cannot reverse it, or make it go into “remission” by changing my diet and exercising more.  And actually, I do look like someone with diabetes.  Trust me.  And yes, I have to take shots (or be on a pump) because my body mistakenly attacked my cells that produce insulin.  If I want to live, I need insulin, and I need to take synthetic insulin since my body doesn’t make it’s own.  But no, I don’t think of Type 1 diabetes as “the bad kind”.

That’s it.  That’s my only beef with the language around diabetes.  I think, as a rule, each disease should get it’s own, distinct name.

Diet Coke is My B*tch

First- I would like to begin this post by saying:

I know Diet Coke is apparently a terrible thing.  I read the posts on Facebook about the dangers of Aspartame. But like a heroin junkie, I just can’t give it up.  I have  tried to quit.  Numerous times.  But little by little, it sneaks it’s way back into my life.  It starts with a, “Oh, I’ll just have it this once with popcorn,” when I’m at the movie theater.  The next thing you know, I’m indulging when I’m out eating pizza because it goes so good with pizza.  Then, I’m allowing it when I eat Mexican food too. And then, the next thing you know, I’m back on the sauce.  Daily.

While on vacation this past week, I had a lot of time to sit around and think. And I kept thinking about Diet Coke.  I kept thinking how it just doesn’t seem like something I should be putting into my body as regularly as I do. I eat a pretty healthy diet… but that damn Diet Coke. Not only does it contain unhealthy chemicals, but for some reason, for me at least, I crave it the most paired with unhealthy, salty foods. I’m sure Diet Coke my worst vice.

So, I decided I would cut down on my diet soft drink consumption, and possibly cut it out completely (we’ll see…), once I got back to real life.

Well, here I am.  First day back from vacation. Back to real life. And really… I’m cutting down.

But tonight— was Mexican food.  (…to celebrate our return from our vacation in Mexico, which didn’t have Tex-Mex, and tonight I was craving it!)  And as stated before, Diet Coke tastes so good with  (unhealthy, salty) Tex-Mex.  So how could I not treat myself completely?

When the waiter brought my Diet Coke out, it looked a little funny.  Very light in color and a few too many bubbles.  I know my Diet Coke.  Especially at Mariano’s, one of my favorite and most frequented Tex-Mex spots here in Dallas.  And this is not it’s normal look.  Or taste!  Something was off.

A little too light, a little too bubbly.

So I told the waiter it didn’t taste right, and he offered to bring me another from their other fountain machine. The second Diet Coke came out looking much the same.  And tasting just as weird.

Ok, so this IS the same photo. But the two Diet Cokes pretty much looked the same, and I forgot to photograph both of them. Both: a little too light, a little too bubbly.

I told our server I would just have ice water instead.  I then said to my husband, “Maybe this is the Universe’s way of telling me not to drink Diet Coke tonight.  I was planning on really cutting down on it anyway.”

So there you go.  I was drinking ice water, and I felt good about it. Thanks, Universe! 🙂

But then.

But then the manager showed up with a new, slightly darker and less bubbly, more normal looking Diet Coke.  She told me that earlier in the day, someone had accidentally combined the Coke and Diet Coke in the fountain machine, but then they cleared the line, and now, finally, it was back to normal.

Oh what?!  I’m a diabetic, so actually if that was a real Coke that’s really something I need to know.”

She assured me, “Oh no! No, no, no.  Much earlier in the day it had Coke in it.  But yours didn’t.  No worries.”

But I did have some worries…

Although I drank a little of that new Diet Coke, I didn’t drink all of it.  Or even that much of it.  I told Fermin that if my blood sugar spikes, the Diet Coke would be the culprit.

I know that when I eat Tex-Mex, I don’t get a quick rise in my blood sugar.  I usually get a rise about 3 to 4 hours later.  I think the fat and protein must jack things around.  But this is what my trend line looked like from that “meal”… I took my insulin at about 6:25pm at home, and got my Coke about 30 minutes later…


See how my blood sugar has an immediate blast off, with just a few sips of my drink?  I’m pretty sure the Universe was trying to tell me not to drink that “Diet” Coke after all.  Why didn’t I listen to the Universe and ignore the restaurant manager?

Diet Coke and the drinkers of all diet drinks are all too common.  Most servers don’t take it seriously that it really needs to be DIET for someone like me, that takes insulin based on how many carbohydrates I’m consuming.  They just think I’m some silly girl that eats fattening Mexican food, and likes to make herself feel better by ordering a Diet Coke.  It’s probably how people with Celiac disease have to contend with the importance of emphasizing that a dish be gluten free- as in absolutely none at all, even cross-contamination.  For people with Celiac, it’s not just a trendy thing to cut gluten out of their diet… They have to or they will really suffer.

Anyway, I’ve now injected more insulin.  The Dexcom graph is looking a little better.  But this really annoys me.  If that Diet Coke likely had sugar in it, or if there was even a chance, I’d prefer complete honesty so I can do what I need to do!

Maybe the bottom line is this:

It’s not so much that restaurant manager that led me wrong.  It was me!  I ignored my instinct to not drink that weird looking Diet Coke tonight.  My addiction won tonight.  But it was a good lesson for tomorrow…