Midnight and Lows

I wrote about this hypo experience before I got my CGM (Continuous Glucose Monitor) and so these days crashing blood sugars are not coming at me like oncoming trains and I am able to get off the tracks in time.

A few nights ago, I experienced the feeling of watching a "train wreck" coming towards me and not being able to avoid it. The problem, I think, the fact that I had too many options available to me in trying to prevent my imminent hypo that I didn't know which one was best to choose.

Normally, when I check my blood glucose level two hours after my dinner and they are above my post-meal target, I know that some more insulin is required. On this occasion it was 3 hours after dinner and I was even more sure that I needed more insulin. See the 11.5 mmol (207 mg/dl)

HOWEVER! Approximately 60 minutes after I had given myself more insulin, the big red dot and the sharp dip in my mysugr app told me that my diabetes was not playing by the rules!  My blood sugar level had dropped sharply to  6.1 mmol (110 mg/dl). An otherwise respectable BG number but at this moment in time, especially with the remainder of my insulin dose to activate, I knew I was in trouble and that a hypo was coming for me.

I was already tucked up in bed with my teeth brushed. So, I reduced my background insulin by 50% for an hour and a half to counter the over correction of insulin. (Note to self; that wasn't the right choice - always go for the fastest acting glucose available).

At 12:13am, perspiration steamed off me. Thankfully, I had the wherewithal to check my blood sugars again revealing a 3.1 mmol (56 mg/dl). I took 3 dextrose tabs and lay back waiting for them to kick in. But, the heat coming off my body made me grab 2 more a couple of seconds later.

I tried to lay there waiting again but I became more agitated at having to wait.... and wait, and wait, for the heat and sweat and "jitters" to subside. The seconds felt like hours!

I decided to wait the 15 minutes out downstairs and suck on some boiled sweets to, maybe, trick my brain into thinking I was shoveling glucose into me hand over fist and avoid over-treating the hypo. I pulled out the laptop and tried to document this hypo ;-) Another effort to avoid over-treating-keep my hands busy.

12:37am, 5.8mmols (104mg/dl), still feeling shaky and mildly damp but can safely go back to sleep. After brushing teeth.... again.

And yes, I had the over-correction high blood sugar reading the next morning. Sometimes, you just can't win. But you try, and try to learn:-)

Happy New Year from Gráinne

I made it through another year with diabetes!!!

May the food be worthy of the bolus,

the alcohol worthy of the hangover,

may that one day not effect my HbA1c level too much and,

may we all be back on top of our diabetes in the new year :-s

Grainne.
See you in 2016.

I have nothing to fear but fear itself

Image from http://james-the-nose.deviantart.com/art/
A-deer-in-the-headlights-122552318

I attended a diabetes meeting once where one of the other attendees said they wanted to see photos of all the horrible things that can happen to a person with diabetes if they don't take care of themselves. That this would motivate this person into doing more to take care of their diabetes. I understood this person's point of view, they were much older than me and may have seen the "dangers" of diabetes as being more imminent than I did.

For me though "the fear tactic" doesn't work. I've heard all the horror stories. I've heard all of the threats in relation to what I should and what I should not be doing to take care of my type 1 diabetes. And I have been paralysed into doing nothing by them.

I think it's a well known piece of advice that fear is not a good motivator to get somebody to do something. Do you like it when someone threatens you? Even if it's for your own good? Does it make you want do what they say?

For me, it, absolutely, does NOT! But you might ask me what does get me moving and doing? My answer is "Information and inspiration" ;-D

I don't test my blood glucose more because someone told me I should. I do it because it was explained to me why I should consider it and how to use the additional information (EDUCATION, can't. say. it. enough.). And I could see almost straight away how this improved my management of my type 1 diabetes.

I do remember, all those years ago, when I was told that I had to eat a strict "diabetic" diet and I absolutely HAD to take my insulin at exactly the same time every single day. If I didn't I would end up with all sorts of ugly diabetes complications.

But guess what? Some people do all the right things and still get complications. And some people don't take care of themselves and don't get any complications.

Those were the days when we had very little in the way of diabetes research or education to revert to. But by God we had fear! And it got me nowhere!!

What did motivated me to do all the things that I do to take care of my diabetes? Education, education, education and some more education. Can't say it enough times!!! And of course, a good support network:-)

DKA Kills and the Type 1 Diabetes Awareness Project

We don't know how many children or adults die in Ireland because of undiagnosed Type 1 Diabetes but we can be sure that it does happen here, just like it happens all over the world. 

As the news is travelling through the diabetes community of yet another life cut short, I'm awakened, with a jolt, as to why the Type 1 Diabetes Awareness initiative from Diabetes Ireland is so important... And needs to happen soon!

Diabetes Ireland are planning on launching this Type 1 Diabetes Awareness project early in the new year. 

Image graciously stolen from Diabetes Mine

Up to 23 Irish children are diagnosed each month with Type 1 diabetes. The majority of these present to their GP feeling generally unwell but 1 in 8 will not be correctly diagnosed at that time. 

This delay in diagnosis usually means repeated visits to the GP and can result in diabetes ketoacidosis (DKA) which is potentially fatal.

The aim of this project is to encourage GPs to consider Type 1 diabetes first, as a potential diagnosis when a child presents feeling generally unwell and secondly to raise awareness among the general population of Type 1 diabetes signs and symptoms (The 4T's; Toilet, Thirsty, Tired & Thinner).

However, Diabetes Ireland still need to find one quarter of the funding for this project. They are determined to commit to the February 2016 launch date but if they don't find the rest of the money they will have to amend the initiative, which would make it less effective.

Does anyone have a wealthy relative??? 

Image from http://res.public
domainfiles.com/pdf_view/
52/13526046019596.png

Maybe if we start sharing this with our friends and talking about it, the people who hold the purse strings will take notice that this is important to us?

Just in case you're wondering; what is DKA?

" Diabetic ketoacidosis is a life-threatening problem that affects people with diabetes. It occurs when the body cannot use sugar (glucose) as a fuel source because there is no insulin or not enough insulin. Fat is used for fuel instead.

When fat breaks down, waste products called ketones build up in the body." Find out more here. 

I'm back on CGM (Continous Glucose Monitoring) Yayyy!

Back in June, I did a trial with a CGM (Continuous Glucose Monitor) and I wrote a little about my experience here. Wearing the CGM was so valuable that I was very much determined to get it permanently.

I'm thrilled to say that happened on the 25th November. So I've been using it for two weeks. I had a little hiccup with my pump, which decided to die on the 30th, which made me appreciate the CGM more as it's so helpful the not only know what my blood sugars are but also know where they are going. It was such a relief to see that down arrow.

This time around I feel like I know what I'm doing this time around with this new gadget. The workshop I attended in July presented by author of "Think like a Pancreas", Gary Scheiner entitled "Making Sense of the CGM Data" also helped.

The technology was so new to me in June that I was preoccupied by "how does this thing work?". I was only just getting a handle on having all that extra information by the end of the two weeks. I had been able to upload the information to the software programme and identify trends where I could make some adjustments in my insulin regimen.

But then the trial ended and it was like being blind again.

The major benefit of having a CGM is having this;

This is the graph from my CGM data.

 as opposed to this;

and knowing what to do with all those extra data points.

After two weeks, I have been able to prevent a number of lows by my CGM alerting me to the fact that my BG was 4.4mmol/L and dropping. And I've been able to reduce the impact of how high my blood sugar climbs. It's my hope that this will increase how much time I spend within my target blood sugar range of 4 mmol/L to 10 mmol.L (72 mg/dL to 180 mg/dL) overall.

People who have lived with type 1 diabetes since before the 1970's often talk about how access to blood glucose monitors changed diabetes management in a revolutionary way.

I think that the CGM is a game changer for my generation of type 1 diabetes.

Insulin Pump Wizardry

I have been using an insulin pump for just over 5 years and I'm still finding new benefits in pump therapy. I should explain that I know I am very much a slooooowwww adapter of all things new - I go at my own pace.

Earlier this year, I started using the EzCarb and the EzBG features on my pump a bit more. Previously, I really only used them for correction insulin doses. I use an Animas Vibe pump and I'm told that on the Medtronic pump this feature is called the Wizard.

Since I've started using this feature I have noticed a reduction in the number of hypos that I have been having.

Before, I had a tendency not to factor in my Insulin on board, I didn't really have a way to calculate it. Insulin on board is the term used to describe how much insulin is left working in your body from the last bolus and how active it is.

Also, I would only factor in a correction amount of insulin if I was over 10 mmols/L (180 mg/dL).

I have to say that since using these features I feel like I have reduced the number of hypos that I have. However, I have nothing to back up my theory, it's just a hunch! But it feels nice.

I also like it because it separates out my insulin dose so that I know how much of my insulin is related to the carbohydrate, how much is a blood glucose correction and how much I have to reduce for my Insulin on Board.

Here's to continually making improvements and to tiny triumphs!

Disclaimer: I have not been paid by anybody in relation to this post.