Champagne Bubbles

I stirred in my sleep.

A glance at the alarm clock behind my bed indicated that it was almost 3am.

I stuck my arm out from under the covers, fumbling around on the bedside table for my Libre reader.

A quick scan of my arm registered 8.6.

I knew what was wrong.

I gave a generous correction of 2 units, but I knew it wasn’t enough. I contemplated a temp basal rate, but I knew that I would only be putting band aids on the real problem.

Besides, I knew that I wouldn’t be able to lie still while knowing what I needed to do.

I sprang out of bed, switched on the lights and reached for the box of t:slim cartridges from my wardrobe. I made a dash through the hall and the dining room, making a beeline for the bar fridge where cold insulin was sitting.

I had swapped out my insulin cartridge just after dinner several hours earlier. I knew I hadn’t chosen the best timing before bed, but at the same time I prefer to run my insulin down to the wire if I can.

I knew I had drawn a lot of those fizzy little champagne bubbles into my syringe as I was drawing the air out of my empty t:slim cartridge. Part of me suspected that I hadn’t successfully drawn all of the air out of my t:slim cartridge amid those champagne bubbles.

I’ve had my fair share of moments like these in the four months since I’ve been using the t:slim. As much as I love this pump, it’s beauty, it’s wearability and it’s positive impact on minimising my device fatigue, I absolutely hate that I can’t see what’s going on inside those insulin cartridges. Which means that I’ve had to learn to rely on intuition.

I’ve come to assume that when I haven’t properly drawn all of the air out of my cartridge prior to filling it with insulin (a.k.a. champagne bubbles), the delivery of insulin from the pump is compromised. My blood sugars feel sluggish and harder to manage, even if I can’t see any visible signs of air bubbles in my pump line.

I’m slowly but surely working on my technique. Making sure my insulin is as room temperature. Pushing insulin from my penfill cartridge into my syringe using a pencil, rather than pulling. Holding my cartridge upright. Being really gentle with my syringe when I’m drawing from it.

Who knew diabetes was such a fine art?

Turn of the Year

I snapped this photo as I was walking on the evening of New Year’s Day.

It was a quiet evening. The carpark a little further ahead at my local IGA was desolate. A cool and rather grey change had just swept through after a warm day.

It just summed up the general vibe of January perfectly.

After the craziness of December and the festive season, things have finally wound down. The world is back to normal once again, seemingly somewhat quieter. For me, this turn of the year seems to trigger a great deal of reflection on the year gone by, as well as ideas for the year ahead.

I’ve been mulling over the fact that I’ve been a part of the diabetes community for four years now. My life, my outlook on diabetes and my level of knowledge has changed for the better thanks to the sense of community I’ve found online since I began writing this blog.

I’ve been mulling over how much better I feel, physically, over the course of this past year. A combination of eating more substantially to meet my energy expenditure, and improving the quality of my sleep have left me feeling the best I have in a long time.

I’ve been mulling over how I need to shift gears and give more focus to my blood sugars this year. I feel that BG management has become a little too stagnant, and that I’m spending more time than I’d like coasting toward the upper end of my target range.

I’ve been mulling over how lightning fast some of the developments in diabetes technology are moving of late. I fully expect that we’ll see more exciting diabetes tech hit Aussie shores this year. More competition and more choice for people with diabetes is always a good thing, but at the same time I wonder how many will actually have access to these new tools.

I’ve been mulling over how relatively affordable insulin and other medications are here in Australia. No matter how much I whinge about missing out on government funding, or how many concerns circle my mind over money, it really pales in comparison to people in other parts of the world.

I’ve also been mulling over trying to focus more on the now. Not letting those little nagging doubts or what-ifs take over. Reminding myself that while self improvement is not necessarily a bad thing, I also need to acknowledge all of the little things I’m doing today and the achievements I already have behind me. (Thanks for this timely reminder, Rachel…)

So while I’m at it, Happy New Year.

I hope that 2019 is everything that you want it to be.

The Silly Season.

It’s nearly Christmas.

I guess everywhere I look at the moment, I feel like I’m seeing a lot of ‘rules’ that I need to be following as we head into the silly season. Undoubtedly followed by the barrage of New Year, New You stuff.

To be honest, I don’t really have much of a strategy heading into the next couple of days.

It’s Christmas, and to be honest, I want to celebrate Christmas like every other person around me. That will undoubtedly involve food that contains carbs, and drinks that contain alcohol. There will likely be chocolate. And shortbread. And bailey’s. And plenty of other good stuff.

As much as I would love for diabetes to shut up shop over Christmas and New Year, I will have to keep on keeping on. I will be monitoring my blood sugar with a little more ease thanks to the FreeStyle Libre sensor I’m wearing, and giving insulin doses my best guess with the help of my trusty insulin pump. I don’t expect it to turn out perfect, but then again diabetes never is.

The one thing that I will be avoiding when approaching the Christmas dinner table is the food coma that comes after it. Over the years I’ve learned that I don’t need to try everything from the smorgasbord, and would much rather just choose some of my favourites that I might not have so often. Waking up to high blood sugars, insulin resistance, extreme thirst and sweat in the middle of the night is definitely not pretty. This post sums up the experience quite nicely…

I guess one of the more challenging things at this time of the year is being asked questions around how I will manage my diabetes as I sit down to the Christmas dinner I’ve so been looking forward to. Super helpful, right? A few days ago, I was so happy to have a conversation with someone who wasn’t asking me if I had to be careful or if I had to check my blood sugar levels over dinner. Instead, I got to talk about my involvement in the diabetes community.

As I talked about some of the amazing things that have been happening around me this year, I couldn’t help but be reminded of just how much of a highlight continually connecting with people in the diabetes community really is.

To my diabetes family near and far, thanks for sticking around this year.

Merry Christmas, and a Happy New Year.

The Pizza Bolus.

This is what I woke up to at a little prior to 1am this morning.

It was the result of, you guessed it, pizza.

Pizza is one of those foods that I wouldn’t be able to bolus for if my life depended on it.

Despite trying to recall Gary Scheiner’s Think Like a Pancreas and Dr Kirstie Bell’s research findings prior to the meal, the pizza (and the company) was so good that once I had started it was hard to stop.

I started out at 15g per slice, which was the consensus among a table of type 1s. I think I should have gone for closer to 20g.

I didn’t use a dual wave or set a temporary basal rate.

I clearly didn’t get my insulin in quickly enough, and the insulin resistance had set in by bedtime.

I woke up to the graph above at 1am, sweating. I gave a full correction and set a temporary basal rate of 150%.

I ran to the kitchen, and skulled down two glasses of water to rid the salty aftertaste from my extremely dry mouth. Followed by a dash to the bathroom.

As I laid back down in bed and switched on my phone, I smiled as I saw notifications from some of the friends who I’d had dinner with.

We were all in it together.

I think that was the most well received 17.9 I’ve ever seen.