BGLs

Pressing a Button

Leave a Comment

“Go on. Take it!” One of my work Mums urged me at a plate of sweets she had brought in.

“Crank it up, Frankie,” my other mate added.

I definitely knew I was going to dive in and have something. But I was hesitating for a moment, while deliberating over a carb count and giving myself time for the insulin bolus to kick in.

Don’t get me wrong, my decisions around my food are my own. Sure, my work mates see me pull out my pump from time to time. They see me scan my FreeStyle Libre frequently while I’m wearing it. They see me drink coffee, eat sweets, laugh and do all the other “normal” things.

But I don’t think they actually appreciate just how complex these seemingly simple actions are.

Like making sure that bolus is delivered prior to eating. Making sure that I think carefully about the carb count I’m estimating. That I give enough insulin not to send me high after eating, but not too much that it will send me plummeting within an hour. Factoring in physical activity, and not being too reactive with insulin corrections.

As we were resting later, I pulled out my pump once again.

“You check it all the time?” She asked me.

For both of our benefit, I gave her a much, much simpler response.

“Yes. Whenever I eat, I pull this out and press the button to get my insulin” I replied.

“It’s better than injections?”

“It’s so much easier than before. If I want to eat, I can just press the button. If my blood sugar is high, I can just press the button, instead of having to stop and give an injection.”

I wish managing diabetes was as easy as pressing a button. But it’s nice to dream.

FreeStyle Libre Cheat Sheet

2 Comments

When I first began using the FreeStyle Libre back in May, it was a big change from finger sticks. The continuous nature of the data was strange and at times overwhelming. The device felt like a life saver at times, and extremely frustrating at others. By the time each sensor I used reached the end of its life, I felt well and truly ready for a break. Finger sticks were often a refreshing reprieve from the pesky trend arrows, vibrations and temptation to scan so frequently using my Libre.

It’s fair to say that the Libre has been an adjustment for me. Despite my obvious enthusiasm for the product, it’s something that I’ve slowly eased into using. I’m currently onto my third sensor that I have purchased since trialling the system in May. With time, I am starting to feel more comfortable using it and understanding how it works for me and my diabetes.


For instance, I definitely find that the Libre pronounces movements in my glucose levels after eating. After some experimenting, I’ve concluded that the Libre typically clocks in 2-3mmol higher than my meter 1-2 hours after a meal. It does eventually catch back up again by the time my mealtime insulin has worn off. It’s not a big deal, I just need to remind myself not to panic if I see a reading of 10 after a perfectly carb counted and pre bolused meal.


A change in environment can also cause the Libre results to momentarily jump. For example, getting up off the couch or stepping outside can produce a completely different result within moments of the last one. The jump is only momentary, and within a minute or so it’s usually back to where it was before. Showers tend to produce the wildest changes, so I tend to wait at least five minutes for the results to be reliable once again.

The trend arrows are the biggest advantage in being able to catch oncoming hypos with the Libre. This is a lifesaver at work when I’m physically active and more prone to going low. Looking at the trend arrow on a reading of 6 will tell me whether my levels are 6mmol and steady, or 6mmol and dropping rapidly. With a meter, this really was my best guess.

The biggest hurdle I have had to overcome is not to be too reactive to results after eating. Understanding how the Libre works on me has definitely improved my experience with it, and I feel far more comfortable using it today. When my sensor died last week, I decided to go straight into another for the first time since I started using it.

At the moment, I feel more comfortable with the added level of convenience and insight into glucose levels. I’m fortunate that I am in a position to be able to purchase the sensors.


Will I continue to use it? Time will tell…

A Basket Case?

5 Comments

I’m sitting here, typing this, with a blood sugar level of 18.8. My FreeStyle Libre graph for the past 8 hours looks absolutely dreadful. I had to override the maximum insulin delivery limits on my pump so that I could give higher insulin boluses, and run higher basal rates to bring my blood sugar levels down.

I feel like crap. I feel ridden with guilt. I feel sick and tired of all the discipline that diabetes involves. I feel like I really don’t give a shit about diabetes today.

Rewind back to yesterday morning, when I woke up to a 9.1. Nothing too terrible, but far enough out of range to make my breakfast bolus less sensitive. Which, despite an added bolus for 10 grams worth of insulin with breakfast, still led to a reading of 15.0 afterwards. Which led to an I-don’t-give-a-shit slice of black forrest cake with lunch. Which led to an I-couldn’t-give-a-flying-f*** about being diligent attitude for the remainder of the day.

Diabetes demands so much discipline. Checking my blood sugar. Counting my carbs. Weighing my portions. Delivering my insulin. Pre bolusing that insulin 30 minutes prior for a optimal post-prandial result. Setting the alarm to check my blood sugar at 2am to ensure that I won’t wake up high the next morning. Foregoing so much temptation, for the sake of better blood sugar levels.

Diabetes already demands so much of me, and yet it never seems to be enough. It never seems to be enough, and that’s where the cracks begin to show. 

Yesterday afternoon, I was curled up in front of the couch with a coffee and an almost-finished (not by me) packet of melting moments biscuits. I had eaten one, and was sitting there staring at the last one in the packet for what must have been 10 or 15 minutes. Should I eat it? Or I should put the packet away?

I eventually ate the second one, and of course watched my blood sugar rise in the aftermath. As I gave corrections that couldn’t quite catch up to my rising blood sugar, I began to murmur to myself “you’ve got problem, mate.” “You need help.”

The funny thing being that if I didn’t have diabetes, this would hardly have been a problem. I would have eaten the second biscuit and enjoyed the hell out of it, instead of feeling guilty. I might have bragged to the next person I saw about eating those two whole biscuits, instead of feeling ashamed. I might have complained about feeling ready for bed after satisfying my stomach, instead of cursing my rising blood sugar levels.

If I didn’t have diabetes, this would hardly have been a problem.

If I didn’t have diabetes, I wouldn’t be talking to myself like I were a basket case because I ate two damn biscuits.

Hungover From a Day of Rollercoaster BGLs

2 Comments

I feel well and truly hungover after a day of dealing with rollercoaster blood sugar levels.

It started with the slice of thick cut raisin toast I had for breakfast. Probably not the most sensible choice of breakfast, but I felt like it. My blood sugar was a lovely 6.8. I’ve been working diligently at producing straight lines overnight and into the morning, and I felt ready for a challenge. So I pre bolused my insulin, drank my coffee, dressed, prepared my toast and ate it.

My FreeStyle Libre showed a perfect 6.9 and steady when I arrived at work, and I was able to put my fears of the toast spiking me to the back of my mind as I started work.

About an hour later I checked again, only to find a 13.1 and an upward trend arrow on my Libre. Nowhere near the 20s territory that raisin toast could potentially send my blood sugars, but still a surprise considering the increased intensity of my physical activity at work yesterday morning. I’ve been producing some spectacularly stable lines through the mornings, so seeing that 13 was rather irritating.

I watched that 13 slowly go down to 12.2 and then settle at 11.0. I should have just left it. I still had close to 2 units of active insulin on board. I was working intensely and I knew the insulin would be extremely sensitive. But the frustration of that 11 got the better of me, and I gave a correction bolus of half a unit, as suggested by my pump.

No more than ten minutes later, before the insulin bolus would have even had time to kick in, my levels were already showing signs of descending. I felt so frustrated. I knew that I should have just left all and good.

As I watched the downward trend arrows on my Libre, I decided to have my morning tea of coffee and a small banana. As I watched my levels enter hypo territory, I added another 15 skittles into the mix and went back out to work.

I refused to check my levels for another hour to avoid any more impulsive actions, until I saw that I had rebounded to 13.3 with an upward trend arrow. I had very little insulin left on board from breakfast, so I entered my reading into my pump and gave half of the suggested correction dose.

I thought I had been extremely cautious, yet within half an hour I was plummeting once again. Not wanting to over-treat this one, I cautiously ate 12 skittles. I ended up needing another 8. My levels bounced back into range, before eventually falling back to hypo territory again by lunchtime.

I felt doubly exhausted from a morning of intense work, combined with rollercoaster glucose levels. By this point it was lunchtime, and all I really craved was sugar. A jam donut and a chunky Kit Kat joined my toasted sandwich for lunch. It was a crazy, crazy ridiculous carb count, but I knew that I would be able to get away with not spiking too high while I was working.

If I had just accepted that raisin toast will naturally send me higher than oats, I might not have had the rollercoaster day that I’ve just had.

Although surprisingly, my glucose levels didn’t go any higher than 14.3mmol all day. Silver linings, right?


Navigating Diabetes Through a High Carb Breakfast

3 Comments

I have always found diabetes extra challenging to manage around big meals. I’m the kind of person who likes to try a bit of everything at a party. I try not to let diabetes get in the way of enjoying myself on special occasions like birthdays or Christmases, because they only come around once a year. Often the consequence of this has been high blood sugar levels that are tricky to bring down in the hours that follow.

One of the biggest advantages of having an insulin pump is the extra flexibility that it gives me to work around high blood sugar levels. With tricks like temporary basal insulin rates, the pump has definitely saved me hours of frustration in trying to bring my blood sugar levels down in the aftermath.

Yesterday my pump got it’s first taste of a high carb meal, as I took the wheels out for a spin over breakfast. I had been craving pancakes all week, so my order was going to be a no brainer.

image

In anticipation of the extra carb load, I set a temporary basal rate of +100% to ensure that my mealtime insulin did its job effectively. I did this before I left home, so that the basal rate would kick in by the time I sat down to breakfast.

The cafe looked pretty busy, and I wondered how long I would be waiting for my pancakes. I guessed that I would probably need insulin to cover somewhere in the vicinity of 60-80g of carbohydrates, but I didn’t know for sure how big the serving would be. I decided to play it safe, and pre bolused half my insulin when I placed my order, and the other half when my meal arrived.

When I left the cafe, my blood sugar was 13 mmol. When I checked again at home half an hour later, I was 13 mmol once again. I noticed my blood sugar begin to creep up again at around the 3 hour mark, as I would expect for a higher loaded meal. I entered my blood sugar reading into the pump, overrode the insulin on board subtraction, and gave a correction dose. I kept the temp basal running, anticipating that I would need it to cover the delayed fat/protein spikes.

By around 2pm, my blood sugar was almost back in range at 8.3.

The majority of my numbers throughout the morning were around the 12-13 mmol mark, save for one brief peak at 15.7 mmol. To put that into perspective, a loaded meal like that has the potential to send me well above 20 mmol. 

Safe to say I was pretty damn pleased with my handy work.

Take that, food police.