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.

Needless Excuses for my A1c

I was suppose to go see my endocrinologist a couple of months ago.  No fault of my doctor, but the place he used to practice shut down.  With no notice!  Diabetes America, no more!

Because there was some lapse in time between Diabetes America unexpectedly closing down and Dr. Mora opening up in a new spot, I haven’t been in to get my A1c checked since December.

I figured it would be pretty good because I have a Dexcom, so I have that information available.  But the last month has been pretty challenging because we were out of town during the entire month of June. We were eating out more than usual, and at places that I didn’t know how long the wait time was, so my insulin doses were often “off”, and my blood sugars suffered because of it.  I saw way more spikes than I like to, or than I normally do.

As I drove to my appointment yesterday, I said a little prayer hoping that this new place Dr. Mora is practicing out of will have the “finger stick method” rather than the from the “vein method” for my lab work. It’s ridiculous that I’m so squeamish with veins, but I am.  I could never be an intravenous drug user- I would never be tempted to shoot drugs up for sure! So, that’s a bonus.  Anyway… Praise Hallelujah!!!  It was just a finger prick.

But even more Praise Hallelujah than that- My A1c came back lower than ever.  5.5%. So even though the last month has been a challenge, I worked hard enough that it didn’t screw things up.

I hadn’t checked the Dexcom Clarity app lately, but I did check after I got my lab results back from my doctor yesterday.  Although Clarity no longer gives a predicted A1c, it does tell your blood sugar average over a 90 day period (which is essentially what the A1c result refers to), and mine was 115.  According to the chart below, my A1c should be 5.4% based on that… That’s pretty close! And I’m very happy.  And proud!  My OCD behaviors are paying off.

As I drove to my appointment, besides saying my prayers about the blood draw via finger prick, I also mulled over my excuses I would give to Dr. Mora in case my A1C was higher than it had been at my last appointment. It’s funny that I feel I owe him excuses.  As if I’m being graded and my lab tests are something I either did or didn’t study for. As if it’s him I’m trying to impress. But I think it’s a common patient behavior. I know I’m not alone in this.

I’m not quite sure if the last month’s blood sugar average has more impact than the previous two months on the A1C, so I was a bit worried.  I was going to tell my doctor, “Traveling gave me an added challenge.” Paired up with, “Also, I’m a woman of a certain age, and I’m sort of going through “puberty” and it’s messing with my blood sugars.”  I will always have an excuse, because life always throws us little challenges, and sometimes big challenges.  But, we keep plugging away, and we keep trying our best.  And sometimes, you end up rewarded for all that trying. And this time, I was definitely rewarded!

And that’s the greatest motivation for me to keep trying my best. Not for my doctor.  But for me.

Yay, ME!

UGH. Fake Comments

I sort of feel like Trump in saying this, but it seems worth saying.

This is my first WordPress blog.  And it may be my last, and come to and end before I felt ready to end it.  I get SO MANY fake comments.  From people in the middle of the night.  It’s probably not the middle of the night where they are- But they’re writing in a different language, or in broken weird English, OR leaving super lame comments about my “amazing content”.  Ugh.  My email inbox gets filled up with all these stupid comments.

No idea what to do about this and how to make it stop.  But it’s so frustrating and it makes me avoid this blog.  So for now… I am.  🙁

Blame the fake commenters.  Which I’m sure will comment on this post… about the amazing content.

T1 Diabetes Looks Like Me.

Type 1 Nation Dallas 2017

This weekend, I got to attend the Type 1 Nation Summit in Dallas, hosted by JDRF.  My friend Tanya Conovoloff, works for JDRF and does a great job each year organizing this event. There are so many type 1s (kids, and grown ups) all in one place! And although because of that, we have a lot in common, this “disease” is different for everyone.  That’s what is always very apparent to me anytime we come together and share our stories.  And it’s why this blog is called MY T1 Diabetes. I can only write about my experience with Type 1. And I’m sure My T1 Diabetes looks different than yours.

One of the presenters Sunday, who I really liked hearing from, spoke of his experience managing his diabetes while running marathons and competing in triathlons.  He’s worked  hard to figure out what works best for him in controlling his blood sugars when it comes to things like the stress and excitement of race day, dehydration, swimming vs. running, etc.  Just like I’ve worked really hard to figure out what’s best for me when I work out.  But there is no special formula that works for everyone.  If there was, this thing called Type 1 Diabetes would be an easy cake walk, right? (And yes, pun intended.  And also yes, we CAN eat cake!)

Even when you figure out what “works best” for you, it can vary greatly from day to day.  So it’s a constant challenge.  But challenges are not always bad things.  And they do make us stronger.

My friend Willie took hundreds of photos for this event.  I asked him to send me the one I remembered him taking of me.  He actually sent a few more.  Here’s the one I had in mind… I’m standing beside a sign that says, “T1D Looks Like Me.”

Type 1 looks like Me.

This other picture, as you can probably tell is not posed- it’s so genuine.  I love this picture because it shows how happy (and lucky) I am to not only get to go to a great local event like this one, but to have people I know and love that also attend. This is the moment I walked through the door and got to see Willie, as his camera was pointed right on me!

Ok, so THAT’s a happy face!

I got to spend pretty much the entire day with another T1 friend, Roberta.  We sat through a few different presentations together which was great, but we mainly laughed a lot throughout the day about all sorts of stupid little things, which was most excellent.

So yep, going to Type 1 events for information is great, but knowing you’ve got friends there… the best!

As a P.S., I’m ending my post with yet another photo.  This is a little girl I saw soon after I walked in. I noticed she was wearing a Dexcom CGM.  So here’s another picture of what two Type 1 looks like.  Not too bad, huh?

Type 1 looks like US!

Come To the TypeOneNation Summit April 23rd!

This event! If you live anywhere near the D/FW area, you really should come check this out.

JDRF
Greater Dallas and Greater Fort Worth Chapters invite you to TypeOneNation Summit

Sunday, April 23
10:30 am – 5:00 pm
The Marriott Quorum
14901 Dallas Pkwy, Dallas, TX 75254

This event filled day of education, connection and inspiration is for anyone impacted by type 1 diabetes (T1D), including adults, parents, family members, friends, teens and children.

Expert speakers will present on T1D topics including nutrition, exercise, emotional aspects, technology and advanced care.

Industry partners will share the latest in support and technology.

Children and Teens will have a separate track to meet others their age with T1D.

Please join us by registering at http://NorthTXTypeOneNation.eventbrite.com

 

My great friend, Tanya, is the organizer and she always lines up incredible speakers.  I’ve had T1 well over 20 years, but I learn new things each year I attend this. PLUS, I get to be around so many other T1s, and as you know, they’re the sweetest people around!

So do yourself a big favor, and treat yourself!!- learn some things and make a new friend or two at this great event.  And I will see you there!

 

 

The Complications of Type 1 Diabetes

The other day, on another blog I write called Resparkable Vintage, I posted about my contribution for the upcoming JDRF Dream Gala Auction.  That website is really all about my repurposed vintage handmade designs, but in that particular post, since I mentioned the JDRF Gala, as well as the fact that I’m a Type 1, I gave a brief explanation about Type 1, thinking probably most of the readers over there don’t know much, if anything, about it.

Mainly, I just said Type 1 is an auto immune disease, and that our bodies don’tt produce insulin on their own, so therefore we have to inject synthetic insulin multiple times on a daily basis to survive.  I also mentioned that it’s a complicated disease.

And it is.  It’s hard to explain to someone what all of that means- Because what does insulin do exactly?  And that thing I mentioned about having to take synthetic insulin- how do you know how much to take? And when to take it? And what happens if you take the wrong amount?

Because, as anyone who lives with it knows, there’s no obvious or predictable formula for getting dosing amounts correct.  And the way a low blood sugar or a high blood sugar makes one feels varies from person to person, and from day to day.

Here’s a small, seemingly unimportant example of what it’s like to have Type 1 that I experienced today. I can never be spontanious about eating something.  If I’m at an event, as I was earlier today, and they happen to be serving lunch, I can’t just pop food into my mouth on a whim.  If I had wanted to eat at this luncheon, I would have needed to know what exactly I would be eating, at least 30 minutes before eating it, so that I could take what I hope is the right amount of insulin to cover it.  But since I didn’t know in advance, and they put a plate in front of me, I just said, “Oh no thanks, I already ate a late brunch.” It was a lie.  And truth be told, I was getting a little hungry.  But if I don’t take my insulin pretty well in advance of eating, my blood sugar will soar, and I will be on the diabetes roller coaster of high to low blood sugar for a good part of my day.  And it will likely make me feel like crap.

So, I keep it simple.  I say, “No thanks” to unplanned food.  I eat my same (some would say boring) lunch most days because it’s just easier.

I also happen to be a picky eater by nature, so most people who know me (including my husband) just sort of roll their eyes at me, assuming it’s all about my pickiness when I say no to food.  But I don’t even know which came first, my extreme pickiness, or just keeping my diet simple to avoid… well, COMPLICATIONS.

I don’t bother to explain these things.  It’s easier just to tell a little white lie.  “No thanks, my stomach’s a little upset.”  Or, like today, “No thanks.  I ate a late breakfast and didn’t realize there would be food here!”

Type 1.  It’s complicated.

One Touch Veria Meter

Every year or so, I have to switch my glucometer due to what my insurance will cover.  It’s not a huge deal, because meters are just meters- as long as they’re accurate.  I don’t care about the bells and whistles of meters that do special things with data anymore, because, well… I just don’t.  I have my Dexcom, and I feel like the bulk of important information comes from that anyway.  These days, my meter is just what I use to calibrate the Dexcom.  And as long as it’s calibrated, I trust the Dexcom’s numbers just as much or more than a glucometer.

My insurance company now only covers One Touch meters. So, it was time to move on again. My endo had two to chose from: the Verio and one other (I don’t recall the name) that looked a little flimsy, so I went with the Verio. I liked the sleek look of it.

One Touch Verio Glucometer

Instead of batteries, it has a charger.  Initially, I liked this idea.  But I just noticed last night that the charge only holds for 1-2 weeks.  So when I go on a trip that’s anything over a week, I have to remember to take yet another charging cord.  Ugh. So honestly, I think batteries are my preference.  They last for months, and double A batteries are cheap! Oh well.  Not a big deal.

Like pretty much all the meters I’ve tried in the past few years, the Verio is quick and simple.  Just a teeny bit of blood on the teeny strip, and 5 seconds later, you know what your blood sugar is.

I’m currently paying out of pocket until I meet my deductable, so this first 3 months supply of test strips cost me around $560 at my online pharmacy.  Just out of curiosity, my husband checked Amazon Prime’s pricing on the strips and they were actually CHEAPER on Amazon.  But we weren’t sure how regulated they were (when’s they’re expiration? why do the boxes look diffrent?) if I bought them through Amazon and the price difference wasn’t hugely significant. Before I order my next batch of strips, I might look into this a little more.  I guess I shouldn’t just assume that buying from my online pharmacy  (when it’s out of pocket and not a drug that needs a prescription) is always the best, most affordable option. I wonder how much the strips would be if I ordered them from Canada?