Monday, August 17, 2015

I Have Diabetes and I Can Eat a Donut

Over the years, many people have said things to me like, "Oh- you have diabetes?  So you can't have sugar, right?"

Or they'll walk into a party with some delicious looking dessert but then look at me and say, "Oh sorry, I know you can't eat this because of your DIABEETUS."  Out of frustration, I've occasionally answered their statement by saying, "Well, if I really wanted to, I could eat that plus a whole bag of sugar.  I'd just need to take more insulin to cover it."  But of course, I wouldn't eat an entire bag of sugar.

But a donut?  Yes.  I can and I sometimes will eat a donut.  But if we're being honest, no one really should eat them. Not someone like me who's a Type 1.  And not a Type 2.  And not even a non-diabetic person! So I generally stay away from them, only eating them on a rare but delicious morning.  But it's not my Type 1 that stops me from eating sugar.  It's my overall desire for good health.
Proceed With Caution- EVERYBODY!

But I confess. Today I indulged.  I ate a donut. And of course it wasn't a  healthy choice.  But, oh my gee, was it delicious!

I took my typical morning shot of insulin- although not a donut dose- thinking I could get away with it by running an extra couple miles during my morning run.

Sometimes that works for me.  I notice that when I do a more intense aerobic exercise, even if it only lasts about 20 minutes, it often drops my blood sugar more than walking for an hour does.  I think of it like my blood is moving that insulin into my body that much faster. Like I said, sometimes that works. (And I'd rather err on the side of not quite enough insulin prior to a workout, than too much. That's not advice, that's just how I like do it.) 

It didn't work for me today though.  After a 20 minute run, followed by a 1 hour and 15 minute walk, my blood sugar was still higher than I wanted it to be.

Thanks to my Dexcom, I could see what was happening~My blood sugar was stuck around 180 for nearly 2 hours while I was running and then walking my dogs, and it never really dropped.  So, I felt comfortable taking another small dose of insulin to knock it down another 90 points or so.  For a while, it was looking good...


 Then quickly, it started looking like it was going to go a little too low.
If all I knew was that my blood sugar was 88, and I didn't have the Dexcom to tell me it was falling fast by that straight arrow down, I might not have corrected until I was feeling a low blood sugar a little while later.

But thanks to my Dexcom, I ate handful of grapes...
The Grapes of the Donut's Wrath
and soon, I had an arrow that wasn't going up or down, but straight across.  Just how I like it.
Blood Sugar Recovery Post Donut
So yes, I have Type 1 Diabetes. And also yes, I CAN eat a donut.




Friday, August 14, 2015

Squeak.

A couple of weeks ago, when one of my friends read on my blog that I was using the Aviva Plus Accu-Chek glucometer, she passed along her test strips she no longer needed since she had switched to a different meter. Lucky me!

On top of that, I just recieved my first 3 month supply of the test strips from my on-line pharmacy.  The day they arrived, I put them in my cabinet where I had the other boxes of test strips. I felt like I had hit the jack pot with all these boxes.

And it was a beautiful, beautiful thing.  Maybe the kind of beauty that only another diabetic can understand.  But beautiful, no less.  So I couldn't resist posting the picture below on a Dexcom group I belong to on Facebook. 

My jackpot of Accu-Chek Aviva Plus Test Strips
I wasn't bragging, or trying to make anyone jealous.  I was just happy.  But after I read some of the comments people left on that posted photo, I felt sort of guilty for my own good fortune. 

Although I think everyone that saw it did understand my excitement, I was made very aware that not everyone is so lucky.  (For the record, I'm not usually this lucky either- in the world of diabetic supplies.) I got lots of "Jealous! :)" comments.  And several "Wow"s.  One women said, "So so so jealous! We don't even get enough to make it through the month with our 4 yr old! Your stash is beautiful". 

Insurance companies can be rough.  Sometimes, they pretend to know more than we do about how many times a day we need to check our blood sugar to maintain tight control over our disease.  And now with the Dexcom, some insurance companies seem to think calibrating it 2 times a day is all the test strips they need to provide us with. 

They're totally wrong.

They should be encouraging us to check more, not less! Down the road, it will save everybody money. But it's a world of short-term thinking, unfortunately.

For now, my insurance is covering the amount of test strips my doctor and I asked them to... And I am so grateful.  And I do not take it for granted.  I know not everyone is so lucky.  And I also know I might not be this lucky next time we go through another round of insurance policy changes.

But we need to keep sharing this information with each other, and with anyone who will listen, and even with those who won't. The squeaky wheel gets the grease!  So keep on squeaking.  Squeak to your doctor! Squeak to your insurance company! Squeak on forum groups!  And keep squeaking until we all get the things we need to take care of our health.

Thursday, August 6, 2015

Trying Out a Few Diabetes Cookbooks- Stay Tuned!

When I was very first diagnosed with Type 1 diabetes, a few well intentioned people gave me cookbooks written specifically for diabetics.  I tried using them, but I didn't like any of them.  The recipes were not tasty, and most of them called for artificial sweeteners. 

Whenever I'm cooking dinner, I attempt to add up the various ingredient's carb counts, but I tend to ignore everything but the very obvious carbs- sugars and starches.  I don't bother to factor in how many carbs are in veggies and other fibrous foods like beans- because usually, it's not that many.  But little by little, it can add up and make a difference on my blood sugar for sure.

So, I decided to check out a couple of current diabetic cookbooks from my local library- hopefully better than those I tried 20 years ago! Since I'm checking them out from the library, if I don't like them, I've lost nothing.  If I do like them, it can only help me in my quest for tighter control.  Besides the fact that the give the carb count with each recipe, they also are most likely low carb meals. Win/Win.

Here are the 2 diabetic cook books I have checked out and get to keep for the next 3 weeks.

I really haven't even looked at them at this point- So I'm not yet recommending either one, yet.  But I'll look thru them, and try some things, and let you know what I think!  If you have any great cookbooks you like to use, please leave them in the comment section below so others can take a look! Thank you- :)

Tuesday, August 4, 2015

Diabetes America- My Follow Up Appointment

Well, there's not a whole lot to report regarding my follow up appointment with my new endocrinologist at Diabetes America.

But that's not necessarily a bad thing.

Those small adjustments I made since my last appointment, which I wrote about in my previous post, have started making small positive shifts in my blood sugar control.

While the diabetic educator was looking over my Dexcom graph, she was commenting on how good everything looked.  "But look at all those highs and lows!" I said.  She told me that my highs aren't really that high (around 200) and they don't stay there long.  And the lows, thanks to the Dexcom, aren't all that low either. She said there's not that much to tighten up regarding my overall blood sugar control.  But still, I would like to see a larger percentage of my day spent in my ideal blood sugar range, and I really want my A1C to get back down to the very low 6% range. And by low, I mean 6.0%. I know it can be done.

The only suggestion my doctor made for me is to lower my Lantus by one more unit, so that I'm taking 10 units before bedtime.  This, he thinks, will help my problem of the falling blood sugars during sleep.  And I concur!  I had already lowered it by a unit the last week. Now, upon his suggestion, I'll go ahead and lower it one more.

Initially, when I first made my appointment with a new doctor at Diabetes America, I was hoping to be put on one of the drugs that makes you pee out excess sugar when your blood sugar gets high. It sounded at first like such an easy and logical "fix".  But to be honest, I haven't researched it at all, and I know that all drugs have side effects.  So if I can avoid new drugs, I realize, that is best.

I told the doctor I want my next A1C  (which which will be done in 2 months) to be 6%, or very close.  He told me not to obsess about the number.  I think his exact words were, "Don't be ruled by the number." 

And I said, "Oh really?!"
He said he'd much rather me have a steady 6.5%, than a roller coaster of highs and lows of 6%. I get what he's saying, but I think I can have both- An A1C of 6%, without a lot of erratic highs and lows.  So I probably will continue to be ruled by the number.  Isn't that kind of what the game of T1 Diabetes is all about?!

Like I said, not a whole lot to report.  But little by little, I'm making strides in the right direction.

Monday, August 3, 2015

Small Changes To Tighten My Blood Sugar Control

This week I go back to my new endocrinologist for a follow up appointment.  It's only been 3 weeks since my initial appointment at Diabetes America.  When I went last time, the doctor suggested I do the following:
1. Use the Aviva Expert meter- which means I really count my carbs (as opposed to my "eye ball" method I have discussed in previous posts), because I have to enter that info into the meter for it to spit out it's recommended insulin dosage to cover my meal.  I thought at first it seemed a little silly.  I'm able to figure out the math in my head, since my ratio is 1 unit of insulin for every 20 grams of carbs I take in. As it turns out, the meter is really helpful when making a correction a couple of hours after taking insulin if my blood sugars are still running a little (or a lot) high. The meter knows how much insulin is still "on board" and can calculate a good dosage for me to get my blood sugar in my target range safely.
2. Switch to the NovoPen Echo- so I can give my shots in 1/2 unit increments.

Type 1 diabetes is very much a self managed condition when you get down to it.  I have- and will- absolutely try implementing whatever my doctor suggests, but I thought of a few other things to implement to further tighten my control:
1. Reducing carbs.  I don't eat a ton of carbs anyway, but I know the less I can eat, the better.  So little by little, I keep peeling away at how much I feel like I must have.  I think having to document all that I consume really motivates me to reduce my consumption!
2. I'm taking my Lantus (long acting/non-peaking insulin) in the morning now instead of at night.  I was having so many lows during the night.  I learned at the Type One Nation weekend that although Lantus lasts for 24 hours, it tapers off and you get a slightly larger percentage of it during the first 12 hours.  This change has helped my lows somewhat during the early morning hours.  Sometimes I don't even have to eat a snack before bedtime! And honestly, sometimes that makes me sad.  Ha!
3. I've been (usually) taking my insulin a good 30 minutes before eating my meal. Sometimes even more if my blood sugar is high.

Over the last few weeks, since making these changes, I've noticed only a subtle change in my blood sugars- I'd say reducing carbs is the most impactful thing I know to do right now.  I wish I didn't love them so much and could just give them up completely.  Sometimes my stomach just feels like it needs a little bread, or a cracker... And then what about fruit? How can I give that up?  Do I have to?  Would I want to? My head and my heart and my stomach are all telling me "No!  Please, no!"  And I'm listening... at least for now.

My biggest challenge currently seems to be my night time blood sugars.  Unless I go to bed with them a little high (150-180), I still often wake up by 3am with my Dexcom beeping at me because my bs is below 60.  I am sick of 3am snacks!!!  It's funny, when I first switched my Lantas shot from 10pm to 10 am, I thought I had solved the problem.  But after about a week, I went right back to the early morning blood sugar dips. I think it might be slightly less of a dip, but it's still problematic.

My appointment is tomorrow, so I'm excited to see what's next!