BGLs

Thursday Night, Diabetes Style

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When I last visited my diabetes educator in February, I brought my meter along in order to show her my numbers. I was stepping outside of my comfort zone. I was essentially exposing myself, and all of my highs and my lows. I wouldn’t be able to choose what I would share with her. I wouldn’t be able to summarise. It was a big step for me, but one that I felt ready to do.

Unfortunately, the focus seemed to be more on what I hadn’t done – logging my insulin doses into the meter. I apologised, and promised that I would send through two weeks worth of meter reports before my pump day, so that she would be able to work out insulin ratios and settings.

It was a simple task, yet one that has been weighing heavily on my mind for weeks.

Every time I have attempted to make a start, something gets in the way. In March, I got sick and was rage bolussing stubborn highs like crazy. A week later, Easter rolled around and I was eating more than I should have. I took some holidays, and the numbers didn’t reflect my regular routine. But most of the time, I’ve just been telling myself that the numbers aren’t perfect enough to send through.

I can probably guess what a healthcare professional might think. Lazy, slack, non-compliant (insert your favourite word here). But when diabetes already takes up so much of my time and energy, a simple task like stopping to log my insulin doses is a big deal. It’s hard to carry the same meter around with me, rather than rely on the others that are stashed in convenient places. It’s hard to stop and punch in the insulin dose, when all I really want to do is sit down and eat.

But I knew that I was going to honour my promise. I knew that I wasn’t going to lie.

Come Thursday night, I generated 14 days worth of Insulinx meter data on my computer and printed it out. I took a seat at my desk for what would be somewhat of a long night.

I went backwards, day by day, reflecting on the past two weeks of my diabetes life. Recalling exactly where I was, and what I was doing on that particular day. Thinking about what I’d had for dinner that night. Remembering the circumstances surrounding that stupid low, that stubborn high, or that victorious overnight result. It took me a few hours. It was a little confronting, staring at those numbers on paper and being reminded of where I had gone wrong.

I attached a note to my meter reports, apologising to my diabetes educator for not directly logging the insulin doses into the meter. I explained that I had thoroughly gone through my last two weeks, and provided what I believe to be a very comprehensive overview. I wrote notes about my typical day. A work day, where I was on my feet, moving around and lifting things. Night times, where I was often chasing post bedtime highs from things like Pasta, Fat and Protein foods. Insulin to carb ratios, correction ratios and Lantus doses.

I carefully folded my paperwork, placed it into an envelope and stuck an express stamp onto it.

As I placed my letter into the Post Box on Friday afternoon, that big weight that had been sitting on my shoulders for weeks was finally gone.

Glucose Monitoring Doesn’t Tire Me. Diabetes Does.

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I rely heavily on glucose monitoring in order to manage my diabetes. I check before, and two hours after every meal. I check before I go to bed, during the night and when I wake up in the morning. If there are times when my blood sugar is irregular, I find myself testing every hour. I have spoken out frequently about glucose monitoring, and how strongly I feel about it.

I was very keen to take part in the yourSAY (Self Management and You) research a few months ago, looking into the attitudes towards glucose monitoring in Australia. I was very much looking forward to reading the results that were released last week by Diabetes Australia, Abbott and JDRF Australia.

YourSAY Glucose Monitoring Survey_INFOGRAPHIC

Monitoring my blood sugar has become second nature to me. I can’t say that I’ve ever lacked the motivation to test. I hardly even think about it anymore. Glucose monitoring is not something that I see as a choice. It’s a way of life.

In that regard, I was surprised at how many people reported that they became “tired” of glucose monitoring. I think I’m more “tired” of diabetes itself. Diabetes is to blame for the lows that force me to stop what I’m doing. The stubborn highs that just won’t go down. The nights where my sleep is interrupted by blood sugar swings. The food that I feel guilty for eating. My glucose meter is only the messenger, telling me what’s going on. My meter gives me a sense of control over the unpredictability of diabetes, and I wouldn’t want to live without it. (Unless diabetes is cured, of course. Then I would love to live without it…)

While my attitude remains unchanged, glucose monitoring is without a doubt inconvenient. When I’m sitting at my desk at home with my meter within arms reach? Easy. When I’m going out for a few hours, and forced to carry that crap around with me? Not so much. I’ll often leave my stuff at home and fly blind for a few hours just for the sake of convenience. I would love to see an affordable, minimalistic device that offered greater convenience while travelling.

I was also interested to read that type 1s checked their glucose on an average of 6 times each day. Yet our National Diabetes Services Scheme only subsidises 5 test strips per day. 2 in 3 people do not always check their glucose as recommended by their GP. The survey itself highlighted a number of benefits of glucose monitoring in managing diabetes: adjusting insulin, managing illness, avoiding hypos or hypers, and peace of mind. Yet I was once made to feel guilty for purchasing too many test strips. Surely, removing these limits would be the first logical step towards encouraging glucose monitoring?

Finally, I was disappointed that these findings did not outline or commit to any solutions to lessen the “burden” of glucose monitoring. I can only hope that this research will trigger conversations and change in the not too distant future, for the sake of the people who took the time to contribute their valuable and personal insights.

You can read the full results of the yourSAY survey here, and the media release here.

Diabetes Game Plan: 2016 Edition

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New year, new me.

Kidding! Don’t even get me started on those Facebook statuses…

Ever since I’ve had diabetes, my New Year’s resolution has obviously centred around (wait for it) diabetes. Eat well, get my blood sugar levels down, maintain a good hba1c result without too many hypos and exercise. Scrap that last one, who the hell am I kidding here!

If I’m being honest here, I feel that for the better part of the last five years, my diabetes management has sort of stayed the same. I’ve chalked up good hba1c results, but they’re extremely difficult to sustain inbetween endo visits. Making a dedicated effort that delivers those sustained results is also hard, especially when there are a million other things going on in life.

But I want to do better than okay with my diabetes. I’ve already been at it for five, going on six years. That fraction of my life with diabetes is slowly, but surely growing. I want to look after myself. I want to minimise my risk of future complications. I want to remain hypo aware. I want to remain independent, and in control of my diabetes. I want to live a long, and healthy life.

So instead of that overall improvement this year, I’m going to strive for stable overnight glucose levels.

Night times over the past few months have never been such hard work. I can’t remember the last night where I didn’t have to wake up at 1am, test and give a correction shot. My last full night’s sleep seems like a lifetime ago. And mornings where I have woken up in range without minimal effort overnight have been rare occurrences.

I also know that it’s been a long time since I’ve had a full, uninterrupted night’s sleep. It’s been a long time since I’ve woken up feeling refreshed. It’s been a long time since I’ve woken up feeling pleased with my morning number, and have that sentiment echo positively throughout my day.

So, perhaps this is an argument in favour of switching to the pump. However, until that decision is made next month, I still need to manage with Multiple Daily Injections.

So, in 2016, I’m making a resolution to focus on the back end of the day. Say, from 4pm to 10pm – the 6 hour window before I go to sleep for the night. In these 6 hours, I will focus on doing as much as I can to not spoil my overnight glucose levels. Staying away from high fat foods. Satisfying my desire to graze on junk food with something healthy. Being patient when testing and correcting after dinner.

I know that I can do this.

I hope that I will eventually return to a point where I have some confidence that my overnight glucose levels will remain stable.

I hope that I will be able to return to a point of getting a full, uninterrupted night’s sleep more often.

I hope that if I can get those overnight levels within range, I will have one third of a stellar a1c result up my sleeve and a lot more enthusiasm in my mornings.

May The Force of Low Blood Sugars Be With You

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Because I was on holidays, because the fridge was empty and because I’d been wanting one for several weeks, I had a Subway footlong Italian BMT sub for lunch last Wednesday. I dialled up 18 units of insulin, and I was rather pleased with the way the results were tracking in the hours that followed. I was 14.1 at 2.18pm, 8.7 at 3.09pm, 5.7 at 4.04pm and 7.6 at 5.15pm.

At the time of that last test result, I was getting ready to go and see Star Wars. Still feeling full from that Subway, I figured that I would skip dinner (sorry, Mum!). I gave my Lantus dose an hour and a half earlier than normal, and headed out the door. I parked the car at 5.59pm, and a quick test showed I was 5.1. I knew straight away that I was on a downward trend. Definitely a combination of overlapping Lantus doses and skipping dinner that night. Which I should have anticipated, given this just happened a few weeks ago.

We walked in, bought our tickets, and went to sit down in the theatre. I knew that I was hypo, and that I would need some sugar to last me through the movie. For a lack of personal space in the theatre (brother on my left, stranger on the right), I decided to go and test outside. I leaned over to my brother and asked him for my ticket.

A quick test outside the theatre confirmed that I was a borderline hypo 4.0. I headed over to the candy bar, where thankfully, the line was empty.

“Do you have any juice in the fridge?” I asked the attendant, squinting at the drinks fridge behind the counter. I returned to the theatre with a very overpriced bottle of orange juice, noting the 34g of carbs on the label.

I sat back in my seat, reluctant for a few moments to open that bottle of juice in front of the two people I was with who I hadn’t brought anything for. I decided I could excuse myself later, and skulled two thirds of the bottle.

Thankfully the guy on my right had moved down 2 seats, giving me some personal space to test again 15 minutes later. By this point, it was dark. I was relying on the bright scenes on screen in order to see what I was doing. My meter backlight told me I was 2.9, and I quickly skulled the rest of my juice.

Another 15 minutes later I was 7.4, and at last I could finally focus on the movie.

While the force of low blood sugar levels were with me that night, I was pretty proud of how I handled the situation. One year ago, I would have sat that hypo out in the theatre until I truly felt those low symptoms coming on. 

Today, I have the confidence to attend to a hypo in public right away.

My Festive Season In 7 Adjectives

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I don’t particularly believe in “rules” or “secret plans” when it comes to diabetes and the festive season. I don’t “prepare” my diabetes management for big events. For me it’s simply about good food, lots of insulin and regular blood glucose testing. After all, it’s only a few days of the year, and I feel better that I’m not missing out on anything because of diabetes. Well, except for the finger pricks, insulin injections and the part where I have to think about those things…

In 7 adjectives, my festive season looked something like this.

No Breakfast. I have breakfast almost every day, and yet I don’t remember having it once inbetween Christmas and New Year. I was eating way too much at lunch and dinner (and desert afterwards, of course!), that I simply wasn’t hungry when morning came around. Correction: breakfast consisted of iced coffee, biscuits, and even leftover desert on one or two occasions.

Lazy. According to the Health App on my iPhone (which isn’t accurate because I don’t always have my phone in my pocket), my average daily step count over the 4 day Christmas long weekend was 1,290 steps. On a normal working day, I would average between 15,000 to 20,000 steps. Lazy.

Night Owl. I can’t remember a single night during the break where I didn’t go to bed after midnight, and wake up after 9am. Which is a stark contrast to my very regimented 10pm bedtime and 5.50am morning alarm (thanks, work!).

Single Digits. According to my meter, my average blood glucose level over the 108 finger pricks in the past fortnight is 9.7. Single digits during Christmas – I’ll take that as a win!

Non-Existent Hypos. I can’t be bothered scrolling through my meter for concrete evidence, but hypos were almost non-existent during the break. This was, of course, because my blood sugar levels were running higher than normal thanks to festive activity! Correction: there was one nasty night of hypos at the movies, story coming soon.

More Insulin. That’s a given, considering what I’ve just described. I’m also a firm believer in upping my Lantus dose when I’m eating more than normal. My Lantus dose hovered between 14-18 units during the break. When I’m active and eating well, it normally sits at around 11 units. Considering I’ve had to use more than 20 units during previous festive seasons, I’ll take this as another win!

Food. And lots of it. From Christmas Day, New Years Day, and various family gatherings. There was prawn skewers, stuffed chicken thighs wrapped in prosciutto, cannelloni, mediterranean baked snapper, pasta bake, roasted veggies, cannoli, biscotti, cheesecake, trifle, panettone, glazed pudding and Baileys Irish Cream. And chocolate. Lots and lots of chocolate.

There was also time spent at the beach, trips to the shops, walks with our adopted dog who was staying with us, a night at the movies and multiple episodes of Downton Abbey and Mr Bean.

 

In a nutshell, it was a break.

I hope you had a great festive season.