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Diabetes Life Hacks: #Dblog Week, Day 5 May 16, 2014

Posted by laosita in diabetes.
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Dblog Prompt: Share the (non-medical) tips and tricks that help you in the day-to-day management of diabetes. Tell us everything from clothing modifications, serving size/carb counting tricks to the tried and true Dexcom-in-a-glass trick or the “secret” to turning on a Medtronic pump’s backlight when not on the home-screen (scroll to the bottom of this post). Please remember to give non-medical advice only!

My current favorite diabetes life hack pertains to a beeping, high alarming CGM. Recently, I’d been over treating highs because I would dose correctly yet my DexCom continued to beep or go straight up arrow or double straight up arrows. This scenario leaves me more irate than what is rational, leading to the overtreatment of highs just because my calculated treatment was not working fast enough. So, I move Dex to a separate room with a closed door where it stays by itself for an hour to two (enough time for my insulin dose to do its thing). If possible, I go for a short walk or do some stretching to try and calm down. After the hour or two I go get Dex and reassess the blood sugar situation.

A few considerations if you give this a try:

  • Put your CGM in a logical place; i.e., don’t lose it. That undoes the whole not frustrated thing.
  • Not a good hack for down arrows or low alarms. In fact, don’t do this.
  • Don’t abandon your CGM for too long. Leaving an unresponsive high unattended isn’t super.
  • I’m not a doctor. Use your CGM as directed by your doctor.

When the Star Player Goes Down December 17, 2013

Posted by laosita in diabetes.
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I didn’t expect the appointment to go well. I recently switched back to multiple daily injections (MDI), and struggled to maintain a solid focus on waiting to eat, carb counting and over treating. I expected about a week of mountain-range style numbers while I adjusted my insulin dosages as compared the pump.

But not two months of drastic up and down numbers. Two months (for me) is more than an adjustment period – that’s frustration, emotion, lack of caring, lack of effort, lack of interest and not enough time to ‘fix’ it all before my next endo appointment.

I knew how to fix what was wrong. I just wasn’t doing it. I knew I would walk into this appointment feeling somewhat guilty, unprepared and defeated. I expected to leave slightly motivated, but not necessarily encouraged for the long haul.

But my endo team cared. Nobody was disappointed in me. Nobody was mad at me. Nobody made me feel guilty or like I had failed. Nobody insinuated that I was dumb or incapable.

My endo team cared. My nurse cared that I was am struggling, and provided a few simple things to work on. My endo was worried about my too-close-for-comfort-night-lows that some people don’t wake up from, or wake up from in the ER. He wasn’t worried about my highs. Other people don’t worry about these things because I don’t often share. But at the endo’s, that is his sole focus – to help me keep me safe and healthy.

I left feeling cared about. I could handle the few things my team suggested. I wasn’t overwhelmed with my failures or the solutions. My endo team IS a team. A team where I am the star player. A team where if the star player is hurt, the team rallies. A team that pushes you to be better, catches you if you fall and helps you back on your feet.

That’s a team I want. And it’s a team I need to remember that I AM on.

Banana Bread: The Five-Hour Breakfast May 28, 2013

Posted by laosita in diabetes.
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Oh Bananas. Yellow bananas, green bananas, brown bananas. Not until I had Dex did I realize the trouble you cause. The only safe time to eat you is during a down trending low. Double up arrows be damned, I could not give up the banana bread at my office café. Some mornings I NEED that banana bread. So, as any real-life diabetic might do (a good diabetic would give up the banana bread…that’s why ‘good’ diabetic is a horrible word choice), I took notes in hopes of finding an equation that leaves me eating banana bread with minimal spiking. The following course of events is the best banana-bread success I’ve had yet.

7 am: blood glucose (bg) 141 flat arrow trend, +200% basal rate set for 3 ½ hours

Banana Bread from the work cafe. aka, Trouble.

7:40 am: 4 unit SWAG bolus
8:15 am: bg 95, flat arrow
8:22 am: First banana-bread bite
8:25 am: First quarter of the slice, gone
8:30 am: 2.5 unit SWAG bolus
8:37 am: bg 80 flat arrow, another delicious banana-bread bite.
8:44 am: Sad moment – banana bread finished
9 am: 98, diagonal up arrow
9:06 am: bg 111 diagonal up arrow, 2 unit SWAG bolus
9:18 am bg: 145, one straight up arrow, multiple cuss words
9:44 am: bg 234 (via meter), 2 unit SWAG bolus
10:10 am: bg 195, flat arrow, sigh of relief
10:21 am: bg 173 diagonal arrow down. Could this be success?
11:15 am: bg 99, flat arrow
11:59 am: bg 49, diagonal arrow down. Whoops.

The equation (well steps – I got as far as making variables and then gave up):
1. Increase basal rate 2 ½ hours before eating said banana bread.
2. Prebolus 40 minutes before eating said banana bread.
3. Over the next 1 ½ hours, give 6.5 units. (What the hell is in this bread??)
4. Figure out what went wrong and fix it next time.

I think I’m going to need to space out the actual eating of the banana bread. That should allow the prebolus to be a bit more active, which should decrease the upward trend, which should result in smaller SWAG boluses later, which should eliminate the midday low. Unless it’s Wednesday. Or cloudy. Or windy. That’ll throw off the whole process for sure.

(To those of you with working pancreases – sometimes we’ll figure out the perfect solution to a meal, activity, whatever. Then some tiny unrelated thing will change and the perfect solution is perfect no more.)

I’d Prefer a Post-it Note March 24, 2013

Posted by laosita in diabetes.

My internal organs sent a message the other night, I’m pretty sure. It’s not that my numbers were outrageous. It’s not that I didn’t try to cover my carbs. It’s not that I was eating a brand new food. But it was a combination of all those preceded by a week of long days, short nights and goofy food combos.

I wasn’t feeling super to begin with, but proceeded to have some (ie, almost all) of my favorite trail mix with dried cranberries, nuts, chocolate chips, butterscotch chips. I know this particular mix takes a couple hours to kick in. That was going to be all, but I got sucked into the Costa Rica vs. United States World Cup qualifier game.

Costa Rica and I go back, plus game-night weather made for an interesting game. So I grabbed some sweet potato chips, an Easy Street beer, an increased basal rate with a bolus and settled in. Dex and I were taking a break (more on that later), so I wasn’t entirely sure which way my numbers were trending, but I tested and treated throughout the game. That trail mix is high-cal, so I rode my roller bike for the last half of the game (not entirely logical, but stick with me). Which, as expected, made me drop, so I fiddled with basals again.

To recap – it is way past my bedtime, I added trail mix, beer and sweet potato chips to an already not great feeling stomach, had changed basal rates twice, with a few boluses scattered throughout all that.

I went to bed at 11 pm, blood glucose, oddly enough, at 104. By 12:30 I was nauseous and 424. A 300 point rise in an hour and a half. Uhh….not good.

Sweet potato chips taste like plain corn tortilla chips on the way back up. By 1:30 am the point was made and I curled up, cold, in fetal position with a cat on my head (as cats do). Three and a half hours later, I woke up at 142.

Thanks for the uh-hey-you’re-diabetic-don’t-be-dumb-just-be-careful reminder. A post-it note would have been preferred.