From FatCatAnna

I went away for the weekend to visit some friends - the main reason for this trip was to go to the Renaissance Fair in Sterling, NY.  Road trips tend to throw my diabetes off abit, but since re-educating myself with how insulin works, and counting carbs properly, my carb filled w/e was actually quite successful (and I ate alot - including the Ninja burgers - on a low-carb bun mind you).  I'm still on a pump vacation, and with the few BG (blood glucose) tests (10 over a 72 hour period - usually it's alot more) I did when I had some time to do it,  I seem to be getting the hang of it with MDI (multiple doseage injections) - just like I was with the insulin pump. 



Below are replies to my Facebook profile page statement I made earlier today below for you to read.  I felt it worth reposting here on Diabetes1.org - to show the different opinions of diabetics who take control of their diabetes with either the pump or MDI. For those of you who aren't hooked up to me there and to respect the folks who are discussing, I have just used their initials for now. 

FCA (me) wrote on her profile page - Woke up to #bgnow 5.2 - pretty good - considering all the high carb foods I ate on the w/e - mananged to maintain pretty good blood sugars the whole w/e on MDI - pretty impressed I can do as well with D management on needles as I did on insulin pump :)

DJD - See ... I keep telling people they won't die without the pump. You're proof of the pudding - so to speak.

HS - Wonderful B/S ...DJD , yes, but she is more dedicated than most diabetics. Pumping for 7 years now and I still don't have quite the control she has.  I still awaken with 6's or 7's in the morning. The ODD morning will be 4's or 5's. If I went back to multi-dose daily... my BS would skyrocket!!! I believe that most diabetics are more like me.

DJD - Hi HS... with an A1C of 4.7-5.1 myself, I can tell you Anna's not alone in her success. I have other pumpless friends who do it as well or better than I - consistently, without passing out.

Your blood sugar doesn't have to skyrocket.  The amount of time I spend testing and taking small shots is miniscule and well worth the what - 15-20 total minutes per day spent on the effort. There are plenty of tricks of the trade that are not taught which can be employed to accomplish the task.

The point - those who can't afford or don't want pumps shouldn't be made to think the ONLY way to accomplish good blood sugar is to spend an inordinate amount of money and/or be connected to a tool. They shouldn't be told they are going to die without it. Not everyone has to have horrible experiences and can learn techniques and info that may prevent any further horrible experiences.

Which is what Anna did. She learned more. She tried different insulin. And now Anna's proven her point and I'm sure sooner or later she'll go back to the pump. But she too can now teach people techniques that do work. She doesn't have to say "when I was on MDI I had horrible control" and leave it at that. She's seen the other side - the success.

People do not have to fear multiple shots and glucose testing (one without the other does not work). MDI just doesn't have to be a bad experience the way some people portray it. If a person doesn't want to do it, well then I/we can't help. But if someone wants to put forth 15-20 minutes of effort a day, there are much less expensive ways to control blood sugar than a $5-6k pump.

Some of the other reason I'm not interested in a pump - anything attached to me, scar tissue potential (I don't have any now), relying on one type of insulin, pump failures, progressive insulin resistance the longer the tubing/pod is attached.

Thanks for listening to my explanation.

JD - Anna and others are to be commended. I love my pump. I have been pumping since January 2001. I am doing much better now that I am off Apidra and back to Humalog.

DJD - When you tried Apidra did you adjust your basal and bolus rates - for the increased speed? I use both Apidra and Humalog. Apidra is at least 15 minutes faster (peak) and finishes about 30 minutes quicker than Humalog.

I don't know if you're in the US or Canada but in the US Humalog is usually cheaper both $ per bottle and copay wise. So you're probably saving $ anyway.

FAT - DJD - JD lives in NY (I probably waved at his house yesterday as we scooted back to Canada).

Well, I have to still say - that even before the pump I still had good success on the MDI routine - I had to plead with my endo to go onto the pump - and in the end - went ahead without his approval (needed his signature). When it came time for me to plunk the cold hard $$$'s down - and my A1C went from regular 7% to 5.7% - and that's with next to no hypos like I had with MDI - then he signed - otherwise my insurance company wouldn't pay the 80%.

That said and done - for me - both pump / MDI work - and to me - being a "lifer" - I'm lucky in that aspect. I personally find MDI no more work then the pump - but I have to admit - the convenience of the pump is in the basal side of things - e.g. sleeping in which I rarely do. With MDI, you have to be abit more clockwork with the basal insulin (back to Lantus now - Levemir reaction was getting annoying). Now, I have experimented with not taking my Lantus/Levimir at the "correct" times - and so far - touch wood - no ill effects. Again, this works for me, and like HS says, maybe I'm more regimented (darn - should have been in the military ).

I'll be going back to the pump in a few weeks - for holiday time on the sailboat - but am not 100% about that even as I type this out - since this past w/e of unusual life style proved that even with all the junk food I ate (and it was good - salt potatoes smothered in butter - never had that before) - and lots of other high carbs - didn't effect my blood sugars with taking the correct amount of insulin - but of course - I'm sure I gained some weight :)

From FatCatAnna

Well, since starting Ginger Viera's 15 week weight loss challenge I've been having a few issues with trying to complete my 30 minute exercise every day due to low blood sugars in the morning.  I've managed to get in abit of exercise by parking the car further away from the store front (I've always done that - now I go ... further).  Last night I managed to get my hubby to go for almost an hours walk along the river, we haven't done that in years! Only thing I forgot to bring was my Dex4 since my blood sugar went down.

Also, I'm just trying to rethink how each little thing I do, can help burn off some of the foods I'm eating.  I'm using small hand weights every day (3 lbs) - nothing like Ginger does, but I'm pretty happy with the progress of building up muscles in my arms and upper back.  I need these muscles more then ever now for the bigger jib sheet I have to work with on our 30' sailboat  (I was cursing / grunting like a sailor on the w/e even with the 2 speed winches we have as we were tacking alot for practise).

Today, I decided to step on the old scale.  I've never been a big lover of doing this, as I often find my bubble gets burst.  I go more by how my clothing fits me, and how I feel.  I'm now at 150 lbs / 68 kg and I'm really amazed at this.  I've not weighted this low for a long time.  I've been fighting not to go over 160 since I'm not a tall girl (my endo said recently that I'm 5' 3 1/2" / 1.61 m - my GP said last year I'm 5' 4 1/2" / 1.64 - go figure that one out).  I know, it's only an inch / 2.54 cm - but it makes a big difference to me!

 
And since I won't have Internet useage on the weekend to write - as I'm heading off to the floating cottage - here's a little picture for all you Dad's out there - Happy Father's Day.  Don't do what the Fat Cat does below - and guzzle too much beer (it's got alot of carbs in it - belch).

From FatCatAnna

To carb or not to carb – that is the question:

Whether 'tis nobler in the mind to suffer

The ups and downs of blood sugar fortune

Or to take arms against a sea of cheese sauce on broccoli ...

I feel like I’m in London at the Globe Theatre getting ready to watch Hamlet holding a high carb banana in one hand and a cheese curd in the other.  What fate befalls us as we contemplate their destinies!

When I was younger, my Mum followed the Canadian Diabetes Association way of eating (aka American Diabetes Association).   It was what all diabetics followed, and as a child, full of energy I had no problems with the diet which was maybe higher in carbs then what the CDA recommends today.  This is all my Mum had to follow on, since young children with diabetes were a very small percentage of diagnosed diabetics (less then 1%).  She was VERY strict with measuring out my food, no seconds, even if I was hungry, you ate what you had on your plate.  Going to friends house was my way of escaping her careful food planning.  It seemed that my friends had food like there was no tomorrow, but then, none of them had diabetes.  Even worse, going to a birthday party was something that my Mum had I think a hard time dealing with, as there was really no control with what I ate again.  So, birthday parties, sleepovers, didn’t happen too often.  I keep on wondering, if I had been a Mum with a diabetic child like myself, if I would have been the same way, maybe not so much now, but still I can understand her worry. 

When I left home at 19, it was hard to not break the “training” my Mum had taught me, with measuring out food since the age of 7.  Though as most of us know, with time, we eyeball what we are eating, but still, we always are calculating in the back of our minds.  Take for instance the spaghetti (tossed with tomato pesto sauce) that I just had for lunch.  It’s about ¾’s of a cup, so I’m “guesstimating” about 30 grams of carbs.  My blood sugar (BG) at the time was 4.9 mmol/l or 88 mg/dl – so I took a few units of fast acting insulin and hopefully I’ll stay within range.  That’s one thing I miss with my pump holiday – the combo bolus – where you can spread out the insulin coverage.  I’ll probably be checking my BG’s in about 2 hours and a correction may have to be made.  I am a human dart board for the pen needle these days, but it’s okay, 32 gauge needle, way better then needles of the “Stone Age” when I first got diagnosed.

 So, as you can tell, I love to eat carbs with a limit (though sometimes I go hog wild and don’t feel bad about it as it’s only once in awhile)!  I try not to go over 30 grams of carbs per meal if I can help it.  I do tend to eat smaller portions then what my friends would eat.  I find that this way of eating, to me is subconsciously done (calculate, calculate), is how I have kept my diabetes in control of 43 years.  I’m not sure if a really low crab (LOL on Kerri Morrone Sparling blog post today)  diet would work for me since I do cook a few vegan meals, and of course, beans are high in carbs, so those meals generally are >30 grams or more. 

Off to test my BG's - as I have a feeling the insulin is doing it's job a wee bit too well for what I just ate!  The Roller Coaster Ride of Diabetes - Whoo! Whoo!

From FatCatAnna

Last week I went to visit my Mum and Dad in Ottawa.  It's only a 2 hour drive, I'm used to longer drives by myself, but this was going to be my first time ever driving, alone, without Salvador Dali aka my Animas 2020 being plugged into me.

Of course, being stressed out about this, my blood sugars (BG's) didn't start off that great in the morning.  Because I was afraid of giving too much insulin by MDI (multiple doseage injecting) I probably gave less then I should have, but I did not want to experience having a hypo on the road.   It almost felt like I was learning how to drive again, with the way I was feeling when I left.

I arrived at my parents home, and of course, they are all set to eat (my Mum eats by the clock - if she was a diabetic - she would be very well controlled).  My first thing I wanted to do, test my BG.  Of course, it was high and here was my Dad wanting to know if I wanted a pizza (yikes - high in carbs) or a tuna fish sandwich.  Like all we PWD's do, calculations are going off in my head as to how many carbs are in this, how much extra insulin to give for the correction.  At this point in time, I was wishing I had Salvador Dali with me - I was REALLY missing him big time.  Meanwhile, everything my parents are serving up screams carbs glorious carbs, e.g. did I want a V8 juice, apricots, biscuits.  I know they mean well, but it's too many carbs for me to handle when I'm high like I am and personally even if my BG's were alright, I just can't stuff that much into me.

The jist of my story is, that, yes, I do miss Salvador.  I find when it comes to controlling my BG's that I have better control with him.  Having to pull out the pen needle, find some flesh to inject, is abit annoying at times. With Salvador, he looks like a fancy cell phone / camera (I've had people comment about him looking like one).  No one really questions what I'm doing (is she texting to her lover boy?).  Bing, bang, boom, it's all over and done with.  With MDI, it's put on a new pen needle (31 gauge, 8mm length - sweet - no pain), and you know the rest if you've injected as long as I have over the years.

What I find funny now, is that before going on the pump, I never thought about what I was doing, but 3 years ago, before I started on the pump, I was often just guessing in the dark as to how much insulin to give to cover foods/correction.  I'm sometimes amazed that I had the A1C's back then that I did (I tended to be in the lower 7% range).

Week 2 is almost over - still have 3 vials of Lantus to "play with" - before I head off to give Levemir a go (am really anxious to try that out - heard so many good things about using that insulin compared to Lantus).  My BG's this week incase you are wondering - are not bad - considering I'm still playing around with my basal injections with Lantus and I'm averaging 6 mmol/l (108 mg/dl).

From WestIslandDiabetesAssociation

The Canadian Diabetes Association guidelines suggests a blood glucose of 10.0 mmol/L (180 mg/dl) or less 2 hours after a meal (this target should be 8.0 mmol/L or less if you are not reaching your A1C target of 7.0 or less). Reaching this target after breakfast may be difficult because often this meal contains food with a high glycemic index. Examples of high glycemic index foods are: white bread, white bagel, Cheerios, Corn Flakes, Rice Krispies. Alternative low glycemic index choices would be 100% stone ground whole wheat bread, heavy mixed grain bread, pumpernickel, All BranTM, Bran Buds with PsylliumTM and Oat BranTM. More information about glycemic index and reference charts are found at http://www.carbs-information.com/glycemic-index.htm.

It is important to make sure that your breakfast is balanced and contains some protein and (good) fat to help slow down the absorption of the carbs and provide proper nutrition. Some suggestions are low fat yogurt, peanut butter, almonds, egg and cheese. For more information consult your dietitian.

Some authorities are suggesting to bolus about 20-25 minutes before eating breakfast as this would give the rapid acting insulin some time to start acting as blood glucose rises from these easily digested carbs.