Author: Frank

All About That Basal, ‘Bout That Basal

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I remember those inflatable beach balls that I used to get as a kid. The kind that often came in showbags. Inflatable hammers, mascots, and giant fingers for that matter, too.

They were so much fun. I would muck around, and have such a good time with them for a while.

Then they would begin to deflate. They would get these tiny little punctures that you can’t see, and the air began to escape them. Even though I tried to blow them up again, playing with them just didn’t compare to an unpunctured one. No sooner than I had patched up one of those holes, I would discover another. And another.

At the moment, I feel like one of those inflatable beach balls. I feel like I’m trying to patch up these little flaws in my basal rates, and try to stop my blood sugar levels from spiralling out of control.

Since starting out on an insulin pump, I can quite honestly say that my basal requirements in the early hours before waking have been subject to the most fluctuation. I can recall having to make subtle changes every month, or every second month at the very least. It’s been a steady upward trend, which I usually pick up from my FreeStyle Libre, or when my levels stop responding to corrections during the night.

After steady upward adjustments in recent months, I’ve now found myself waking to a few lows in the early hours. Looking over my Diasend history, the downward trend seems to start out at the 4am mark, so I’ve made some subtle changes again.

I am still struggling to grasp the fact that a basal rate that once held me steady through the night, no longer does. One theory that has been hanging over my head in recent days, is the early morning light coming in through my window. Over the past few months, the earlier morning light could have enhanced my dawn phenomenon before waking. But with the mornings now getting darker, could my insulin needs be heading on a downward trend? Time will tell…

I’ve also noticed changes in my morning basal requirements after I wake up. I usually run a higher basal rate for the first 2-3 hours to combat dawn phenomenon, and I’ve had to jack this rate up by 0.1 units per hour. While the new rate gives me much better coverage, this basal rate still needs some more perfecting. Basal testing, particularly morning basal testing, is hard work. There are days where I deviate from my routine, days where my levels might not be ideal for a basal test, days where I can’t handle more failure, and simply days where no coffee is too hard.

Unlike my last problem, I feel like this one has been triggered by a shift in routine. Which brings me to another theory. I think basal rates are a little bit like a cog in a wheel. When you change something here, it might provoke subtle changes somewhere else in the wheel. I don’t know…I’m just thinking aloud here.

My biggest gripe about diabetes is that it is always changing.

But I truly believe that a well tuned basal, and bolus regimen, is the key to success with an insulin pump.

March on…

Insomnia, of the Diabetes Kind

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I stir in my sleep. Not like stirring on a fresh morning, after a relaxing night’s sleep. But rather stirring, as a result of nocturnal discomfort.

I open my eyes and squint at the bright red display of the clock radio sitting beside my bed, which reads 2.12am.

I feel hot. I’m not sweating. I simply feel hot. Mostly in my face. You could feel it in my face, for sure.

My mouth feels like the Sahara desert. It’s dry. And salty. It’s nauseating. I so badly want a drink of water, but can’t be bothered getting up and out of my bed.

I desperately need to go to the bathroom, but at the same time don’t want to budge from my bed. Discomfort wins out. I drag myself out from my bed, and into the hallway.

I stumble through the dark, not wanting to switch on any lights. I don’t want my eyes to adjust to the light, otherwise I’ll never get back to sleep. I don’t want my blood sugar levels to get any whiff of light either, and begin triggering dawn phenomenon before morning has even arrived.

I emerge from the bathroom. I grab a glass from the kitchen cupboard, and a bottle of water from the fridge. I pour the cold water into my glass, and slowly begin to relive my mouth of it’s revolt. I could easily go for another. But common sense wins out here, knowing that I have no inclination to budge from my bed for another bathroom break until morning.

I slip back into bed. I toss and turn, My eyes are closed, but my mind has zero inclination of nodding off. I suddenly have the urge to rip the light green blanket from my bed, despite feeling cold when I tucked in several hours ago. I want to turn the fan on, but I know I’ll probably be shivering by the time I wake up. My pillow feels more like a heat pack than a pillow. I flip it over, hoping that the cooler side of it will help me ease into a sleep once again.

It’s nearing 3am, and I can’t believe that I’ve been awake for a whole hour.

Do I get up and watch some early morning television in the sitting room adjacent to mine? Do I switch on my bedside lamp, and grab a really boring book? Do I stay here in the dark, continuing this pathetic attempt at sleep for a while longer? Or is it time to begin counting sheep?

This, is what hyperglycemia feels like.

Restaurant food does it to me nearly every time.

My Own Worst Critic

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Throughout my childhood, my parents constantly told me that I shouldn’t compare myself to others. Unless I had done poorly on my Year 12 English exam, in which case it was perfectly okay for them to ask me what scores the other guys in my class had obtained…

It’s easier said than done, right?

When it comes to diabetes, I am my own worst critic.

It’s so easy to feel guilty when I wake up to a number that’s out of range.

It’s so easy to place blame for a hypo that was caused by a lapse of better judgement.

It’s so easy to feel anxious about my future during times when my diabetes management might not be so smooth sailing.

Connecting with, and meeting other people with diabetes has been nothing short of amazing. Everyone has their own, unique story to tell. Everyone is passionate about their story, and the way that they manage their diabetes. I drank in the knowledge. I felt inspired, motivated, and dare I even say passionate about diabetes. I no longer felt so isolated, or so alone when it came to living with diabetes.

However after immersing myself in this world for a while, there also comes a point where I might begin comparing myself to other people.

Why aren’t I going for a run every morning?

Why am I not able to wear a CGM without letting it overwhelm me?

Why aren’t I eating clean?

Why don’t I have that hba1c?

Why isn’t my graph as flat as that one?

Why don’t I practice mindfulness?

Why am I not bursting with energy when I woke up this morning?

As amazing as this world is, there also comes a point where I have to put all of these perspectives into a box and focus solely on my own. 

I am not that person who goes running every morning. I am not that person who is reading my latest blood sugar levels from an array of devices. I am not that person who is eating clean, super mindful and bursting with energy either.

I’m no Matt or Joe or Anna or Angela.

I’m just Frank.

And that’s all that really matters.

Conversation Starter

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How much do one of those cost? a colleague asked me in the middle of a delicious ham and cheese sandwich last week.

She was referring, of course, to the medic alert bracelet that was wrapped around my wrist.

It was a good question. A good question, indeed.

My parents had ordered my bracelet for me back when I was diagnosed six years ago. Since then, I’ve only ever coughed up the annual membership fee of 20ish dollars, and watched the accompanying catalogues gather dust on my desk (with the best of intentions, of course).

Last year, I finally replaced the annoying expanda-band with the standard curb chain. But how much an actual emblem costs, I couldn’t tell you exactly. Maybe 70-ish dollars?

I’ve been wearing my bracelet diligenly since I last wrote about it in January. It’s still annoying. It still feels suffocating. I’d still rather not wear it. It’s still the first thing that I want to rip off my wrist, the minute I walk in the door of the house.

Yet I’ve still been diligently making a habit of putting it on when I leave the house each day, particularly if I’m going to be on my own. I don’t stash it in the drawer with my keys, wallet and watch at the end of the day, where I’ll likely forget about it. I leave it in plain sight atop my chest of drawers, so that it’s the first thing I see when I go to grab my valuables.

You can put whatever you like on your emblem, I explained. 

If I go to hospital, they’ll see that I have type 1 diabetes and am dependent on insulin. It’s just a great thing that communicates with paramedics or doctors if I’m on my own and can’t speak for myself.

It could save my life.

My trusty bracelet had not only proven to be a good conversation starter that day, but had also reaffirmed to me why I wear it, each and every day.

In and Around the DOC of Late IV

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Hello Tuesday! I’m fresh out of a relaxing 3 day weekend, complete with lovely grey skies and a nice cool change over Perth this week. Today I thought I’d share a few of the tidbits that have caught my attention in the DOC of late. BYO coffee…

I was so excited when I someone mentioned a Sophie Sweet spelled with all the ‘e’s. She’s only my favourite diabetes Instagrammer out there. She posts all these pictures of her latest Libre graph and what she’s about to eat. She shares the highs and the lows, and the snaps are so damn relatable. I just love her attitude, and she almost makes diabetes look fun.

View this post on Instagram

first sweet pancake, last good blood sugar 🥞😈

A post shared by soph 🙋🏼 (@whatthebetes) on

I’ve just finished reading the book Think Like a Pancreas by Gary Scheiner, and I can’t recommend it enough. It’s a book for anyone with diabetes who uses insulin. It starts with the very basics of diabetes and insulin, then goes into fine tuning basal and bolus insulin doses and adapting it into your life. I wish I had this book handy a year ago when I started out on insulin pump therapy and had to work out my basal rates and all. I’m already finding myself re-visiting sections of it for reference. It’s like having my diabetes educator’s advice handy at home for easy reference. I’ll definitely elaborate more on the book soon. I’m more of a paperback kind of guy, but you can also buy it through Amazon and start reading it on your mobile device today.

Bec made it to Rotto! The CEO of the Telethon Type 1 Diabetes Family Centre swam a length of 19.7km in the Rottnest Swim last month to prove to the kids that type 1 is a life without limits. I was fascinated reading through her blog, Swimsulin, where she talks about the challenges of fuelling her body and maintaining stable blood sugar levels during the race. She’s inching closer to her goal of raising $10,000 for the Family Centre, and it’s not too late support her cause.

Another plug for T1 Talk if you haven’t read it already. Myself and Bec of Sweet and Sour Diabetes wanted to start a bit of a dialogue that explored some of the similarities and differences of being diagnosed with type 1 at a similar age. Our first T1 Talk tackled some of the initial challenges we faced adjusting to life with type 1. Part 1 is here and Part 2 is here, and we plan on continuing this dialogue in the months to come.

I’m a big fan of Diabetes Daily, and in particular reading Ginger Viera’s practical advice on how she manages her type 1 through pregnancy. 

The pressure of managing a child with type 1 diabetes, who’s existence relies on your ability to care for him. This post from The Diabetic Journal is everything.

A person’s absence is the first thing that’s noticed when I arrive at a family function, or on a Monday morning at work. Everyone just has to know what’s wrong. Why do we have to explain ourselves all the time? Is this really the best way to support a person who has lost, is hurting or unwell?  Why can’t we just say are you okay? or I’m here for you. This piece over at Beyond Type 1 really nails it.

Need a good TV show to watch? Broadchurch season 3 has just started. It’s one of those season long mysteries with a tonne of suspects, leaving you unable to figure out whodunnit. It’s on Friday nights on the ABC.

I receive my fair share of messages about doctors who can cure diabetes, requests to share infographics, search engine marketers telling me what I should be doing to increase my site traffic, and sometimes just thanking me for the really “helpful” website. So, you can understand why Church goods really took me by surprise last week!

Last but not least – don’t forget the OzDOC chat at 8.30pm AEST tonight. Follow @OzDiabetesOC and the #OzDOC hashtag on Twitter to join in.