Insulin

Same, Stupid Mistakes

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I wrote this last night, hence the timing may not make any sense if you’re reading this morning.

My blood sugar was a perfect 4.8 when I woke up this morning.

Yet right now, I can taste the sickly residue of skittles that are stuck on my tongue after all of the hypos I’ve treated today.

I wonder where I went wrong today. I wonder where I keep going wrong.

I’m exhausted, just writing this, but I need to get today off my chest.

It was one of the first real winter mornings of the year. I woke up after a comfortable 8 hours sleep. Feeling the early morning chill, I began to prepare one of my favourite winter morning breakfasts – a hot bowl of porridge with half a cup of milk. The sweet smell of Espresso was brewing in the kitchen, as per usual.

36 grams of carbs for my breakfast, a carb ratio of 1 unit for every 6, and I dialled up 6 units on my insulin pen. For a moment, I considered opting for 5 or 5.5 units instead, seeing as I was close to the hypo range. Add to that the fact I would be at work and on my feet shortly, meaning greater insulin sensitivity. I don’t know why I dismissed that thought, but I did. I dismissed it, and went with the full 6 units of insulin instead.

By the time 8.30am rolled around, my blood sugar was 3.9. Three point fucking nine. Fuck diabetes, I thought to myself. Fuck diabetes, I told myself as I reached for the canisters of skittles in my locker and started shoving them into my mouth.

It was the stupidest mistake. I’ve made so many stupid mistakes like these recently that it’s not funny. I should know better. I do know better. Yet I just don’t seem to be thinking clearly. I feel like shooting myself in the foot.

I was in awe of the DOC members yesterday who took part in sharing a #dayofdiabetes on Twitter. I’m in awe of expectant people like Kelley and Kerri who are so diligent with their diabetes. I’m so happy for them, but at the same time I feel like I’m failing. I feel like I can’t even give myself the diligence that I deserve.

It was one of those days where I just had the words fuck diabetes on repeat. I ripped open a bag of Malteasers (which I did share, FYI), because I really couldn’t give a fuck for today. But at the same time, I think to myself, how much longer can I afford to keep saying this?

One of the best things about today was reading this from Brianna.

And learning that she’d never heard of Malteasers. Malt coated chocolate balls, FYI.

DOC friends for the win.

Here’s hoping tomorrow’s a better day.

An Insulin Logging Adventure

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My meter is a pain in the ass at the moment. Every time I’ve gone to use it over the past couple of weeks, I’m reminded of a promise I’ve failed to keep. A promise to my diabetes educator that I would log my insulin doses into the meter. I flicked past Monday, February 29 in my diary, where I’d reminded myself of that very promise.

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I feel so guilty that I’m not using this new, smarter device to it’s full capability. I feel like I don’t deserve the luxury of having a shinier, fancier looking meter that goes with this decade. I feel like I don’t deserve the smaller test strips that use less of my blood and make less of a mess on my desk.

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I’m slack. I just haven’t been bothered to do such a menial task, when diabetes is already so consuming in itself. It’s a task that seems so worthless when there are so many more important things to do in the grand scheme of diabetes. I’ve also been a bit worried that the numbers won’t live up to Gwen’s expectations.

But I’ve made the decision to switch to an insulin pump. For lack of a better phrase, I’m going to have to own the consequence of that decision. Carb counting. Logging my insulin doses. Sending the meter reports to Gwen, so that we can fine tune things and prepare my insulin ratios for the pump. If I want to maximise the benefits of insulin pump therapy, then this is something I’m going to need to make a habit of. And I need to stop obsessing over the numbers not being “perfect.”

Today marks day 4 of my insulin logging adventure. I’m no longer relying on 3 different meters stashed in lockers, desk drawers and satchels. I’m carrying my Insulinx meter around with me everywhere, which gives me no excuse not to log an insulin dose when I forget! I’m also hoping to be able to send off some data to Gwen before Easter next week (eek!). 

Four days in, and I’m already seeing benefits. I’m thinking more carefully about what I’m bolussing for. When I go to test 2 hours after a meal, I’m reminded of how much insulin is still on board in my system. I can see on the screen how much more of a drop I can expect, which has stopped me from my bad habit of over-correcting and ending up hypo later on.

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Despite being sick, battling stubbornly high BGLs, and being hypo more than two times in one week, I am powering through all of this. When I looked at my lunchtime reading yesterday afternoon, I kind of felt like I was kicking diabetes’ ass!

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Selfish Perspectives

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I feel like I’ve been pretty selfish this week.

On Monday I shouted iced coffees for my team at work on a 42 degree day. I drove my air conditioned car to diabetes clinic, paid an overpriced fee to park undercover and complained about it. I made the decision to switch to an expensive insulin pump in May, even though I can do the same thing with injections. I whinged about an endo who wasn’t supportive enough, despite the fact that I had access to a diabetes specialist and paid absolutely nothing to see him.

On Tuesday I bought croissants to have for lunch the next day, even though I had bread in the cupboard at home. I bought my favourite coffee capsules that were on sale, despite the fact that I already had a stockpile in my locker and instant coffee in the kitchen that would do the same job in satisfying my caffeine fix. I also went out dinner with my family for Mum’s birthday, despite the fact that the cupboards and fridges at home are never empty.

On Wednesday I wanted to make a cake for my Mum’s actual birthday, despite the fact that we’d already celebrated with a fancy dinner. I drove my air conditioned car to the supermarket that is literally a stone’s throw from my house, despite the fact that I could have walked there. I bought cooking chocolate, almonds and whipping cream, even though I could have easily made a simpler cake with the ingredients on hand at home.

On Thursday I asked my team mates if they wanted to pitch in and play lotto for the $20 million this Saturday, even though I already have enough money to live comfortably. I walked over to the coffee shop at lunch time for an iced coffee, even though I had coffee capsules and instant coffee at work. I apologised for the gift card I gave to my Mum for her birthday because it wasn’t thoughtful enough, despite the fact that I’d spent a generous amount of money on it.

Which brings me to Friday. More than likely, I’m going to buy an overpriced coffee on the way to work this morning. I’ll be too lazy to make my lunch at home, and I’ll just buy junk food that I don’t really need to be eating. I’ll probably withdraw some money from the ATM on the way out for the weekend, even though I have bank cards in my wallet that do the same thing.

And you’re probably wondering what the point of this rambly post is, right?

I’ve been reflecting on all of this today, and it really got me to thinking about Spare a Rose and my own donation to Life For a Child a week ago. When I think of the disadvantaged children in other parts of the world who cannot afford insulin and diabetes supplies, my own complaints look really petty and selfish. Compared to all of the unnecessary money I’ve spent this week, my own donation to Life For a Child seems pretty poor.

So, today I’ve matched the donation I made to Life For a Child a week ago.

Without access to diabetes supplies, education and healthcare, people with diabetes will suffer. Without insulin, people with diabetes won’t survive. That’s a human being living with the same condition, just like you or I. Or a son. A daughter. A sister. A brother. A mother. A father. A friend. A family member. An aquaintance. Or even a stranger.

If you are reading this, you are touched by diabetes.

And nobody deserves to die because they have diabetes.

This weekend, consider telling your loved ones that you’ve given life to a child with diabetes rather than gifts.

Flowers die, but children shouldn’t.

Visit sparearose.org, and give life to a child with diabetes today.

Also be sure to check out the folks at t1interational, who advocate for people with diabetes in developing countries. I wrote about their Insulin 4 All campaign in November.

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I Know What My Supplies Mean to Me. #Insulin4All!

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If you’ve been reading this blog for a while now, you’ll know how strongly I feel about blood glucose monitoring and test strips. I could not possibly survive without my test strips. Sometimes I use as many as 10 a day. Test strips, among other diabetes supplies, help me to feel grounded and in control of my diabetes. I could not possibly live without them. So much so that I’ve been driven to write some pieces, both here and for Insulin Nation, advocating for greater access for people with diabetes in Australia.

So when Elizabeth Rowley from an organisation called T1International reached out to me about a campaign called #Insulin4All, it seemed like a natural cause for me to support.

It’s easy to take diabetes supplies for granted when I live in a country where I have always had excellent and affordable access. It’s easy to take my diabetes healthcare professionals for granted when they are so easily available, and at no cost to me under public healthcare. It’s easy to forget that these supplies, and professional support, are what keep me alive and healthy. Today, and each and every day for the rest of my life. And I couldn’t imagine my life without them.

When I think about disadvantaged people in other parts of the world who cannot access insulin, among other diabetes supplies, I really have nothing to be complaining about. There are people out there with type 1 diabetes who struggle to survive because they cannot access life saving insulin, blood glucose test strips and basic healthcare. Some take insulin without knowing if their blood sugar level is high or low. Some suffer diabetes complications, or die a premature death from a lack of supplies, education and healthcare. There are plenty of really touching stories on T1International’s blog.

I support #Insulin4All this November, because I know what my diabetes supplies mean to me!

I hope that you will join me, and have a bit of fun with it too.

So, you need your sign, with the words “we are the world in World Diabetes Day,” and the hashtag #Insulin4All. I felt like a kid again, with my ruler, lead pencil, eraser and textas, carefully outlining my letters and words on a straight line and then marking over them!

Then you need a photo, with yourself or a group holding the sign. Get creative. The best I could come up with was holding a handful of my Lantus pens. And, trying to find the best lit spot in the house free of noticeable junk in the photo!

Then, head on over to insulin4all.tumblr.com and upload your photo to the campaign wall.

And spread the word! #Insulin4All!

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Lantus Adjustment Struggles

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It was the night of Easter Monday four years ago. The very first Easter after my diagnosis. My chocolate haul was proudly spread across my desk, a remarkable feat considering how old I was getting. The fridge at home was full of leftover food and deserts from our family gatherings over the weekend. I’d been pigging out over the past few days and eating more than normal. We were getting new floor coverings in my bedroom tomorrow, and I was sleeping in the spare bed in our games room.

My blood sugar level was somewhere around the 14 or 15 mark before bed. I gave myself three units of correction, knowing that one unit of insulin would bring my BGLs down by 3mmol/L. I tossed and turned, and before I knew it another hour had passed. I tested again, and my BGL hadn’t budged below that 15 mark. I was frustrated, and made an impatience-driven decision to give another 3 units of insulin. I finally drifted off to sleep, and woke up again at around 2am. I tested again. My BGLs had barely budged, and I gave another 3 units of insulin. The same thing happened at 4am. And again at 7am.

I was so angry that my blood sugar levels had been that high for the whole night. I was so frustrated that despite my best efforts, I couldn’t get my blood sugar levels to budge.

Ever since that night, I’ve known that my Lantus dose needs to be adjusted to match the overall amount of food that I eat in a day. Lantus is my long acting, or basal insulin dose that I take once a day to keep my BGLs regulated. On days where I eat more than normal, I know that I need more Lantus in order to keep my BGLs stable through the night. If I’m eating out at a restaurant, pigging out on party food or going crazy at Christmas time, I generally dial up my Lantus dose.

Doctors and other people I talk to have struggled to understand this concept over the years. Most have tried to talk me into giving rapid acting correction and waiting the full four hours for my BGLs to drop. It doesn’t work. That Easter Monday night four years ago was evidence that it doesn’t work. And up until now, I’ve been lost for the words to explain this concept to them.

Multiple Daily Injections are hard. It takes so much fine tuning to get right. There are so many variables that change every day such as food intake and physical activity, which impact on my BGLs and insulin requirements. I was really pleased to hear that my #DOC friend Ally at Very Light No Sugar understood the Lantus adjustment struggle. She offered me a really good analogy to help explain this concept. Lantus, or long acting insulin is like a mitten. And we fine tune this mitten with rapid acting insulin to make it fit like a glove.

At the end of the day, I’m not telling you what to do. I’m just telling you what works for me. Because it’s not anyone else’s diabetes but mine. But I really could use some advice on dealing with Lantus dose adjustments if you’ve ever experienced anything similar. Just putting it out there.