RAPID Acting Insulin

Last week, I went to my local JDRF office for our monthy DADA (Dallas-Area Diabetic Adults) meeting. A couple of reps from Omnipod spoke to us briefly about that particular pump and what’s on the horizon for new developments.  They spent a little time talking about how the hybrid closed loop system would work, but weren’t quite sure- or at least weren’t able to tell us- when it would be available.

I don’t use a pump.  I use an insulin pen to deliver my insulin throughout the day instead.  I tried a pump many years ago and it was just too cumbersome.  I know they’ve come a long way from that (especially Omnipod- and seriously, IF I were leaning towards a pump, I think that is the one I would be interested in), but at this point, I haven’t been motivated to make a change to the pump.  “If it ain’t broke, why fix it?”- Hey, I’m from Texas.  Those kind of annoying phrases are common around here. 😉

Since I’m not a pumper, I’m not anxiously awaiting the hybrid closed loop idea either.  It seems that I’m having to change up my insulin ratios every few months anyway (thanks, mid-life!), and I’m pretty good about figuring out those adjustments on my own.  Would the pump be better at this stuff than I am?  I don’t know… I kind of feel like an expert at this point.  I don’t feel like being on a pump, closed loop or otherwise, would make my control better.  And I honestly just don’t feel like having to learn something new when I’m happy with the way things are currently.

So although I’m content to stick with MDI (multiple daily injections) there IS something I’ve heard is on the horizon that cannot get here soon enough, in my opinion!

And that is a true-to-its name “RAPID ACTING INSULIN”.

BRING IT.

One thing that drives me crazy is how long it takes for my “rapid” acting insulin to effect a high blood sugar when I’m making a correction.  In my experience, the higher my blood sugar is, the longer it takes my insulin to make any kind of an impact on bringing it down.  I’m always very cautious and conservative when dosing for a high blood sugar post-meal.  I watch my Dexcom, and I check with my glucometer after about 25 minutes and usually at that point, it still hasn’t moved at all.  That is not rapid. I end up waiting- sometimes nearly an hour or more!- to see if, and how much, it’s going to drop. Then, after another hour or so, if it still hasn’t dropped much, I’ll take another small dose. All this takes far too long, and if you’re not super careful, it can cause the worst kind of roller coaster.

I want to be able to take insulin and see a drop in my blood sugar within 5 minutes. I want that insulin to peak in 20-30.  And I want it cleared out of my system within 2 hours.  THAT would be the perfect rapid acting insulin, in my opinion.  That would be something I’d get more excited about than a closed loop pump.  And I bet even pumpers would love a more rapid acting insulin for their pumps!

All I know for sure is that if and when such an insulin becomes available, I’ll be in a rapid hurry to jump the ship of Humalog.

Tips on Avoiding Blood Sugar Fluctuations at Night

There was a post the other day on a Facebook group I belong to that’s for type 1 diabetics. Someone had posed the question, “Do you try to get above a certain number before going to sleep to prevent lows in the middle of the night?”

There was a wide range of answers, but based on most of the people’s answers, this fear of blood sugars dropping off during sleep is a common one.  A lot of people feel comfortable and safe going to sleep with a blood sugar of 150, or even 200 to avoid the possibility of a dangerous low.

This USED to be the way I felt.  I used to have a ritual of eating a “just before bed” snack to get my blood sugar up to about 150 so that it wouldn’t crash during the night.  It often still went low anyway.  And I would wake up sweaty and confused, and have to find my way to some kind of carbohydrate in the kitchen.  And even if I didn’t go low during the night, I was definitely low most mornings when I first woke up.  And whether I was hungry or not, I had to eat something fast, as soon as I rolled out of bed.  And honestly, for me at least, that is NOT the fun or best way to start a day.

But gradually (very gradually!), since I started using a CGM (continuous glucose monitor) and am aware of my middle-of-the-night blood sugars, I’ve adjusted a couple of things and they’ve made all the difference in the world for keeping a stable blood sugar during the night. Now I’m very comfortable going to sleep with my blood sugar around 80-100mg/dL, because it stays pretty consistent during the 8 hours (give or take) of sleeping. And I’d much rather have 8 hours of my blood sugar around 100, than around 200!

TIP #1

First of all, I realized, I was taking far too much long acting insulin.  My blood sugars used to steadily fall throughout the night.  If you’re taking the correct amount of long acting insulin, that really should not be the case. A huge benefit to using a CGM (like Dexcom, for example) is being able to look at the trend line during the night. Your Dexcom (or whatever CGM you use) should have a fairly straight, horizontal line during the night, showing a steady blood sugar all night long. None of my endocrinologists ever told me this, but I learned this from reading Dr. Stephen Ponders book Sugar Surfing, which I highly recommend. I gradually cut back on my Tresiba until I started to see a consistent horizontal line during the hours I sleep.  If my trend line goes up, I’m not taking enough; if my trend line goes down, I’m taking too much.  The slightest adjustment can make a difference… Which is why I did it gradually.

TIP #2

I’ve found that the other big component to steady blood sugars during the night is to make sure I don’t have any short acting insulin on board when I go to bed.  Therefore, I eat my meals fairly early (at least 4 hours before bedtime), so that my fast insulin has time to do it’s job, and then clears out of my system.  I know for me, my short acting insulin seems to peak at about 1.5-2 hours after injection, and is pretty much done within 3-3.5 hours. This varies, but for me, I’ve tracked it for a long time, and I know how it generally works for me. (Notice, “for me” is in italics.  Your body is not my body, and things may be different for you.)

I think these consistent blood sugars during the night is a big reason why my A1C is where I want it to be.  There’s very little guess work during those 8 hours since I’m neither eating, taking insulin or working out, which are the 3 things that effect my blood sugars the most. And the less lows I’m having to treat, the less I have that whole “roller coaster” of highs and lows that nobody likes.

As I’ve mentioned a lot on this website, I’m certainly not a doctor or a nurse.  I only know what works for MYT1Diabetes.  And I’m just sharing that information.  Definitely discuss any changes you want to make with your team of health care providers.  🙂

 

The Joy of Pockets

This is my adorable niece, Abigail, who began pre-K just this past week.  Here she is, modeling her first school uniform- this little red dress:

As you can see from the photo, she was obviously  pretty stoked about the first day of school.  However, in this picture she is even MORE elated…

When her mom sent me the photos, I commented on that extreme happy face in the second picture.  And she told me, that huge smile came right after Abigail’s discovery that her dress wasn’t just cute, but also functional because it had pockets.

As a girl who loves dresses, I identified with this kind of joy over the pockets! I’m not sure why Abby cares, but I can tell you why I do.  I can put my Dexcom in that pocket and have it with me all day long without needing my purse, or worrying about misplacing it.  I can also use that pocket for a candy storage compartment. Oh yes, pockets, are a huge bonus for a girl like me.

Abby, fortunately, doesn’t have Type 1 diabetes.  But still, she knows the magic of dress pockets and seems just as overjoyed about them as I am.  It’s the little things in life sometimes.

My T1 Diabetes Blog. Reboot.

When I first began this blog about Type 1 Diabetes, although it had the same title, it was a Blogger blog.  I got a good amount of traffic in the beginning, and I felt like what I was writing was helping some people, and creating some great conversation among fellow Type 1 diabetics.  And that was my whole intention.

I thought switching to my own domain, and using the WordPress.org blog would give me better ownership of my content, and seem more legit.  But something got lost along the way during that transition.

boo hoo

I guess I just lost the momentum I had at the beginning. I started getting a lot of bogus comments from robots in the middle of the night. (Apparently, that’s a common problem for WordPress users) I got less feedback from real people than I did at my previous blog address.  I wasn’t sure how to promote my blog and get the readers that had found me the first time around to jump over to this new blog address with me.

I also started to feel like there were only so many posts I could write about insulin and glucometers and my beloved Dexcom. I felt like maybe I had said all I had to say on the topic of diabetes management.

I became frustrated and I decided this blog didn’t really matter to anyone anyway.

Actually, I’ve been re-thinking my pity party.

I’ve had diabetes for most of my adult life.  Something like 22 years.  And I think I have a pretty good handle on how to keep it under control, most of the time.  It’s a lot more complicated than just taking insulin and counting carbs to keep things in balance.  It’s recognizing patterns, it’s dealing with hormones, and emotions, and sleep, and workouts, and!, and!, and the list goes on. All of the things I do for my health- my physical, emotion, mental and even spiritual health- ALL OF IT, has at least some effect on my diabetes.

So I feel rejuvenated to begin again with this blog. I realize now that I can broaden the scope. I won’t just be writing about insulin and blood sugars.  I hope by posting regularly, I can find consistent readers who are also interested in choosing to live a happy and healthy lifestyle with an auto-immune disease like Type 1 Diabetes. Whether it’s in the comment section, or in sharing posts with friends, or in directly emailing me, I appreciate any and all conversation with you!

I’ll be posting on a regular weekly basis. Please subscribe so you won’t miss anything.  Thank you SO MUCH for visiting My Type 1 Diabetes Blog.