Diabetes Musings

Think Like a Pancreas. My first diabetes educator often reminded me of the job that I was ultimately trying to replicate.

It was also the title of a very useful book that she recommended to me, if I were ever able to get my hands on a copy of it.

I only wish it hadn’t taken me six years to finally shell out and order it from eBay.

For me, this book ultimately reflected much of what I had gone through in my journey with diabetes. From my diagnosis, to getting my head around diabetes, to getting a bit more active in my management with basal and bolus calculations, to finally learning to navigate my way through the daily diabetes challenges a little more smoothly.

Many of the little intricacies and quirky things I’ve learned about my diabetes over the past six years are covered in this book.

Several of the lightbulb moments I’ve had since I started pumping insulin last year can also be found in this book.

Answers to the many questions or musings I randomly have about my diabetes are also tucked away in these pages.

Ultimately, this book would have saved me so much time and frustration in the last year or so!

Think Like a Pancreas is a book for anyone with diabetes who uses insulin, whether on multiple daily injections or an insulin pump. Author Gary Scheiner is a longtime type 1, diagnosed back in 1985 at the age of 18. Gary starts his book with the very basics of what diabetes is, and talks us through many of the common insulins and insulin regimens. I felt that in this regard, the book would also be easy for a family member or loved one without diabetes to read.

Gary talks us through some of our common motivations for reading this book, and some of the advantages we can expect to see from seeking out better control. He also highlights some of the tools that we will need in order to succeed in our quest for better blood sugar levels – our healthcare professionals, our diabetes tools, glucose monitoring, record keeping, data analysis, and the right mindset, to name a few.

As we head into the meatier part of the book, Gary highlights the importance of setting a well tuned background rate of insulin. I know that a well tuned basal rate will keep my blood sugar levels steady while I’m fasting, and generally easier to manage the remainder of the time. A not-so-well tuned basal rate will leave me feeling like I’m walking through quicksand.

Gary gives practical, actionable tips for setting a background rate of insulin – a chapter I feel would be highly advantageous to a new insulin pumper trying to figure out basal rates. There’s a very useful table in this chapter where Gary gives suggestions for tweaking basal rates based on the current rate, and the magnitude of the rise or fall while fasting. For those on multiple daily injections, Gary sets out the conditions for conducting an overnight fasting basal test, and advises how to go about adjusting long acting insulin doses.

Gary then proceeds to talk about calculating bolus, or mealtime insulin to cover carbohydrates, and insulin to correct blood sugar levels. Ever correct a high blood sugar level during the night, only to wake up low soon after? One of my lightbulb moments in this chapter was the confirmation of greater insulin sensitivity that seems to occur in the wee hours. There are more useful tables in this chapter giving tips for bolus timing to minimise post meal spikes in blood sugar, and adjustments for post-meal exercise. 

Welcome to the real world. Gary proceeds to talk through the many other elements that tend to affect blood sugar levels. Caffeine, stress, illness, travel and pregnancy, to name a few – with tips for dealing with them. There are also tips for dealing with protein when consumed in the absence of carbohydrate. And have you ever gone out for dinner, only to find yourself correcting resilient blood sugar levels well into the night? One of the lightbulb moments for me in this section of the book, was Gary’s suggestion of using a temporary basal rate for several hours to combat the insulin resistance that typically follows a larger, restaurant, or higher fat meal.

This is the best book I’ve read about diabetes, ever.

I loved that it didn’t tell me that I was doing anything wrong, or that I needed to change something about myself. It simply helped me to better utilise my insulin regime, so that I would be able to get more out of it.

It went so much further than simply talking about diabetes. It gave me practical, actionable tips to better navigate my way through the daily diabetes challenges, helping me to ultimately see more in range blood sugar levels.

Today, Think Like a Pancreas sits within reach on my bookshelf, for easy reference. It’s kind of like having my diabetes educator’s advice handy when I can’t get to her. Whenever I sense that something’s a little bit off, I’ll pick it up and revisit the relevant sections of the book.

A must read.

P.S. I’m more of a hard-copy kind of guy, but if that sort of thing doesn’t bother you, you can grab a digital copy from Amazon and start reading on your iPad/tablet/device today. I swear I wasn’t paid to say any of this – it’s just a really good book! 

I stepped off the tram, and out into a blustery, wet Monday morning. I made my way down a deserted street. The left side was filled with tired looking town houses and units, most of which were hidden behind fences and overgrown trees. Behind the fences on the opposite side of the road, I could see stagnant wheels and rollercoaster rides of what would almost certainly be a deserted day at Luna Park.

I reached the end of this tiresome road. Across it I could see palm trees, which were bordering an observation deck that looked out onto a very grey and rough looking ocean. I crossed the road, and made my way towards what I could only assume was an entrance to St Kilda beach.

When I reached the deck, a very long stretch of boardwalk extended to both my left and my right. In front of me, I was greeted by one of the flattest, gravelliest and dullest looking beaches I had ever seen. It was a miserable day, or course. But any West Australian would still tell you that this was not really a beach.

At the instruction of my iPhone, I veered left in search of the Pier. My Lost Highway jacket was flapping in the gale. I stopped, and tucked the umbrella in my hand underneath my right arm. I felt around for my FreeStyle Libre, mobile hotspot and digital camera in the pockets of my jacket, before tightly zipping it up.

I made my way past deserted cafes, fish and chip shops and kiosks, which I could only assume would be packed on a sunny Sunday afternoon. The wind only seemed to pick up even more as I reached the Pier, by which point I attempted to tighten the strap on my satchel. After a failed attempt, I decided that securing it against me with my right arm would likely be the best option.

The icy cold wind was whipping against my face, and I could feel the spray of the sea as the rough waves made their way across the pathway of the Pier. I could hear the constant whirring of the wind, a wind that makes you hope all the loose items in your backyard are fastened tight before a storm. I began running at one point, to avoid getting a drenching from the waves. Well, I minimised the drenching, at least. 

This was the most miserable day one could ever imagine.

Yet it was oddly exhilarating, too. 

For the first time in a long time, I wasn’t stressing over work. I wasn’t thinking about all of the things that I need to do, but haven’t done yet. I wasn’t exhaling my exhaustion loudly, like I normally do. I wasn’t looking at my phone. I wasn’t thinking about my diabetes, either.

As I stood at the end of the Pier, drinking in the sights and trying to snap photos without letting my camera fly away, I didn’t have a worry in the world.

For the sake of disclosure, Medtronic Diabetes Australia flew me from Perth to Melbourne to attend Diabetes Advocates Day on Saturday. I decided to stay in Melbourne for a few additional days at my own expense. 

A.k.a. How to alleviate a tangled pump line.

https://www.instagram.com/p/BSQfVD4g6mH/?taken-by=franksita

Back when I was first diagnosed, blood glucose meters didn’t have all the bells and whistles they do today. 

I had to keep that dreaded paper logbook of blood sugar levels and insulin doses. It was an absolute pain to have to stop and write things down, on top of all of the other diabetes management tasks. I often found myself filling in weeks of missing data prior to clinic day, and even fudging some. When my diabetes educator pointed to a spot in the logbook and asked me “what happened here, Frank?” I was left scratching my head trying to remember. 

I love how far blood glucose meters have come since I was first diagnosed. Back then, blood glucose meters weren’t as flashy or stylish as they are today. They were boring. 

Today, meters have USB ports. I can simply plug my meter into the computer before an appointment, and upload the data from all of my devices to computer software such as Diasend. I don’t need to scratch my head every time I’m asked “what happened here,” because Diasend compiles data from my insulin pump, meters and Libre into one easy to read report. 

Today, meters have backlights for testing in the dark, colour screens, bolus calculators, alarms, smaller test strips, smaller samples of blood, stylish cases and cooler lancing devices. There are Mum and Dad businesses online selling stickers and accessories to brighten up our diabetes devices. 

Thanks to all of these features we have today, I have developed a newfound appreciation for good old fashioned finger sticks.

Diabetes can feel so monotonous at times, that these small features really do help pep me up in my daily management tasks.