From FatCatAnna

Well, I’m now into Week 2 of pull the plug on my pump and taking break.  Again, to those of you who think I may be bashing pumping – I AM NOT – far from it!!!  I’m just taking a break, trying to see if I can have as good control over my diabetes / blood sugars (BG) as I do with Salvador Dali (my Animas 2020 pump).  I have a friend who has been diabetic for 50 years since the age of 25 and he doesn't use a pump, and has an A1C of 5.1% - and next to no complications due to long term diabetes.  If he can do it, hopefully I and others who don't have the luxury of owning a pump can do the same thing!  Anyway, I will go back to pumping eventually, heck I paid $7K for the pump, might as well use it!  I’m not that crazy and looking a gift horse in the mouth.

One thing I’ve noticed is I found that being on the pump has made me so much more aware of how to use my insulin properly then when I was MDI (multiple dosage injections) for the previous 40 years.  Before pumping, I guess I just lucked in on doing the “right thing” and managed to maintain an A1C in the 7% range, but I have a feeling that was due to having low blood sugars (hypos) plus I wasn’t testing my BG’s (blood sugars) as frequently as I do now.  So, insulin pumping has made me a better  diabetic I feel.  I’m currently using Lantus / NovoRapid and I’m going to try out Levemir when I run out of Lantus pen cartridges.  

I know eventually I'll go back to the pump, maybe it'll be in a few more weeks, few months, not sure, but for now I’m actually finding the regime of Lantus (slow insulin – aka basal in the pump) twice a day - and the NovoRapid (rapid insulin – aka bolus / BG correction in the pump) no different then when I was using the pump.  I just have to pull out the pen needle, change the needle (I tend to use the needle twice - I know - bad - but I have a high pain threshold I guess).  Because this is still new to me, I'm finding it abit of a longer process, but I'll be back in the swing of things soon.

One thing I do find I’m perhaps performing more BG (blood glucose) testing then before. Remember, I’m slightly OCD as my endo called me (read previous blog here).  Heck, diabetes is something we live with 24/7 and you can’t shake this monkey off your back as a Type 1 diabetic.  It’s with you for life, so if you can keep things at an even keel then hopefully less complications in the future will befall us.  

Off to test my BG!

From FatCatAnna

I don't watch daytime TV that often as I'm a working stiff, but yesterday I recorded the Oprah show - which was all about diabetes.  I had read during the week from other PWD bloggers that they were abit disgruntled that probably the show would dwell on Type 2 diabetes.  That doesn't bother me, as I still clump all the different versions of diabetes as being one, we all are having to deal with living with diabetes whether it be with just pills/diet/exercise/insulin.  Below is a comment that I posted at one of the many diabetic forums I belong to which I find seemed to be highly critical of how Oprah / Dr. Oz brought it to the public viewers ...

I found it pretty good.  You have to remember, it's aimed at the average viewer, who may not have much knowledge of diabetes, and what they have is usually based on incorrect info (e.g. you get it if you're fat, yadda, yadda, yadda). Because of it only being an hour show (with LOTS of ads - not used to day time telly) - they could only really cover the basics, but I personally felt the info put forth was well done.  I think it helped my husband understand about what sugar in our systems does to us with the video that Dr. Oz showed on how the food breaks down in our bodies. Seeing how the "shards of glass" aka "sugar" go thru' our blood vessels if it's not been converted correctly due to our pancreas not squelching out the juice made me cringe (I will never look a broken glass in the same way again).  It didn't help that I was sitting down nibbiling on cookies and an espresso (with sugar) for my evening snack.  Yes, I had taken insulin to cover the carbs aka sugar - so hopefully less "shards of glass" will enter into my blood stream, but still I felt abit uneasy.

What got me crying, and I'm started to well up here as I type thinking about it, was Laureen, a 44 year old Type 1 diabetic who agreed to be on the show (bless her heart) telling us what bad management of diabetes can do to you (and she is a nurse).  It was when Dr. Oz started to remove the bandages from her legs that I really started to sob uncontrollably, and I'm not one to cry that often (I think diabetes makes some of us tough to emotions).  Besides that ordeal, she is also on kidney dialysis, which is something that all diabetics hope to never have to face.   It was so hard to watch, and of course, because of of a PWD friend of mine, Lois, having her leg amputated a few days ago due to mismangement of her diabetes (and she admits she f##ed up), it hit me hard.

So, yes, some of you Type 1's maybe disappointed that not more info was done on " our " type of diabetes, but as we've always known, we are a small majority. In the 60's/70's when I was diagnosed Type 1 was only about 1% of the diabetic population - now it's 10% - crikey.

--------------------------------------

Just a footnote - the video link above of Laureen may not be for the faint of heart.  I know I found it very difficult to watch as Dr. Oz removed her bandages ... BUT ... it might  jolt you into realising how serious diabetes is and how if left uncontrolled can lead to life threatening conclusions.  

From FatCatAnna

Well, I don't really have to be told this - though I sometimes wonder about my earlier years of not really caring - and just living for the moment.  In a nutshell the article points out that with Type 1 diabetics, " very intense glucose therapy reduces the risk of complications."   Diabetics that test their blood sugar levels 5 or 6 times per day are less likely to experience vision loss, kidney failure, heart disease, or to need an amputation when compared with those who check their glucose levels once or twice per day.  I know for myself, I average about 8 times a day - and there are others who test even more then that (if they can afford the test strips that is).

So far the only problems I have had associated with my diabetes has been trigger finger many years ago, frozen shoulder, and diabetic mastopathy (wierd noncancerous growths in the breast). My eyesight is checked twice a year - as well as following up with an endo twice a year along with other specialists that take care of my aging body. 

It's strange though that in this article it states that frequent blood sugar testing is fairly new - but I've been doing this type of blood testings for at least 10 years - and to me - it's not new - just having the use of a blood meter rather then having to test urine is still relatively new to an old timer like myself .

To read more of the article - which is very informative and has some other good links to help you in your goal for attaining good health with you diabetes go to :

http://www.cnn.com/2009/HEALTH/07/27/diabetes.better.control/

From dorisjdickson

I just finished reading an article in Diabetes Health written by, like myself, a 32-year insulin dependent diabetic veteran, Riva Greenberg.  The article is entitled “Mind-Shifting: A Valuable Tool to Control Diabetes.” 

Ms. Greenberg attended a a "Coping with Diabetes" workshop given by diabetes psychologist Dr. Bill Polonsky.  Apparently, Ms. Greenberg and most of the 100 people attending the workshop were under the impression that diabetes is the leading cause of a variety of diaseases including eye, kidney and heart disease.  Dr. Polonsky (a non-diabetic) explained that this is false.  Further, he continued, that “poorly controlled diabetes” is the leading cause of these diseases.

My initial instincts caused me to think “derr.”  Then I remembered how much of the last three years I’ve spent trying to explain exactly the same thing to other diabetics.  I can never figure out whether I’m more frustrated with the diabetics who believe that the inate consequence of being diabetic is major and often life threatening complications or with the physicians, researchers, studies, etc. who lead them to believe this.

For years I read (frequently in Diabetes Forecast) that diabetics had 20% shorter life spans.  During that time I figure that meant I’d have good quality of life until age 60 or 65.  Perhaps that was true minus rapid acting insulin, frequent glucose testing and yo-yo blood sugar.  However, we now have rapid acting insulin, self-management and do not have to live with daily yo-yo blood sugar.  Those tools, combined with learning from physicians such Dr. Richard Bernstein, means we no longer are restricted to such thinking. 

The 20% figure does not go through my mind regularly anymore.   Glucose testing, normalized targets and appropriate corrections can and do prevail in my mind now.   They can and do prevail in a successful, positive attitude.  They can and do prevail as I set my daily, weekly and monthly diabetes-related goals.  I know what’s possible.  I have seen it, read about it and live it. 

I do not take the somewhat laxadasicle attitude that Ms. Greenberg does, however.  I do not believe that a blood sugar of 265 is “just a number.”  In my mind, a 265 is a cause for immediate action and later, analysis.

A blood sugar of 265 is more than 3x normal.  It means I am spilling sugar into my urine.  It is a point that is going to cause possible damage to my body and I do not like leaving my body in that state any longer than necessary. 

I also know that as icky as the 265 is making me feel, the swing back down to 85 is not going to feel so good either.  In my case, a 265 means I am not eating carbs until I return to normal.  (I have a rule – no carbs >110.)  It also means I can’t necessarily count on my 70/75 point response to one unit of Humalog or Apidra, since a blood sugar greater thabn 170 tends to cause some insulin resistance. 

So, I enact my previously defined project plan of taking the mathematically correct 2 ½ units of rapid acting insulin.  That should get me a blood sugar of 90 in about 2 hours.  I might also do two things:  1) Inject the 2 ½ units in a little bit in two different spots on my arm.  Less volume means speeds.  I do not inject in muscle, however.  2) Add an extra ½ unit for good measure.  Again, sometimes a 265 is going to cause a bit of insulin resistance and I want down NOW.

The next part of my plan involves patience.  Minimally, I test my blood sugar at 60 minutes and 120 minutes.  Often, I test at 90 minutes, since at that point I’m almost at peak of either Apidra or Humalog.  If my blood sugar has not dropped a proportionate amount (relative to injection amount, starting blood sugar and previously noted dcrops in blood sugar based on similar circumstances), I am likely to take another correection and continue testing. 

I will have already attempted to assess the cause of the blood sugar – food (rapid or late digestion), dawn phenomenon, hormones, adrenalin release, etc.  Normally, in my case, it is not a miscalculation relative to food.  It is something more difficult to second guess. 

I am known for requesting the next tool to not be a new and better CMGS or pump but for a “liverometer” since it is my biggest nemesis.  I would also like an insulin sensitization-ometer.  I want to know the following information:  when is my liver going to release glucose, when will it bother to stop, is my insulin sensitivity level being affected and by how much. 

One final tool would be very helpful – digestion-ometer.  It is impossible to properly inject insulin or set a combo-bolus on an insulin pump without knowing at what rate food is planning to digest.  Digestion rates vary by person, activity level, time of day, type of food etc.  I use my log and experience to “guess” what my body might do but it is impossible to properly predict all the time.  Weighing food certainly helps but it is not an infallible resource either.  Even eating the same food, in the same quantity, at the same time, at the same blood sugar starting point doesn’t always work.  So … scientists, please make me a digestion-ometer!

So, though it is vital for patients to understand that complications are not inevitable and that the mere act of being diagnosed with diabetes does not put you in complication territory, I do not believe a number “is just a number.”  I believe in responding to and learning from blood sugar numbers and the circumstances surrounding them (thus my log books). 

Though I do not believe any one high is life threatening, I do believe that the percentage of time we spend out of target each day does lead to long-term consequences, whether they are defined as complications or not.  Therefore, I will never feel comfortable just shrugging my shoulders at a blood sugar of 265.  I will not have an anxiety attack about one number but I will not shrug either.

Doris J. Dickson

From Pastprovider