Stupid Diabetes

So here is my day :

1:53 a.m. 220

5:10 a.m. 167

6:21 a.m. 141

6:54 a.m. 119

9:02 a.m. 150

9:50 a.m. 134

11:00 a.m. 80

4:19 p.m. 113

5:41 p.m. 109

6:25 p.m. 134

Dinner I take one unit to cover dinner of 50 carbs so I could trend up for my run.

6:50 o.m. 134

 

7:11 p.m. 168

On the way I down 30 carbs to keep pushing me up. 

7:35 p.m. 90

Two miles in I test since I took off my cgm. Down 60 carbs because I'm only half way done

7:45 p.m. 65

Run a mile more and see where I'm at. Start to walk. 

7:52 p.m. 79

Keep walking. 

7:56 p.m. 90

Coming up, I can run again. 

8:03 p.m 73

FML. On my way down again and call it quits. Walk out to car, sit I. Parking lot and start typing this up. 

8:17 p.m. 146

Seriously?!? 15 minutes and I'm here? I recall saying I would go high later in the night. Did a 5.7 bolus 1.7 correction with 4 extra because I'm heading that direction. 

3,6,12,24

Sometimes it amazes me how a 3 hour line can look so flat until you change it to the roller coaster 24 hour line....

The Dilemma.

Good evening. I tested my blood sugar around 3:00 pm and it was 147 so I did a small correction bolus. A few hours later when I had zero insulin on board I went ahead to test and I was 105, I'd say this is a win for the doctors and for the pump for knowing how to calculate my correction rate along with how to squeeze out .6 units if insulin to come out. Normally all this would be great except I don't understand basal rates and how they affect me yet. I'm looking to go on a seven mile run but obviously don't want to leave the house at 105, easily I would pass out. N

ow for "the dilemma" 

1) how long should I set a temp basal for?

2) should I eat anything and not temp basal?

3) if I eat, how long after until I leave?

4) how long do I wait on a temp basal to be not be impacted with my activity? 

5) how much in carbs do I need during?

6) how high will I spike my sugar after the run? 

Any advice or suggestions? 

Here is a photo of how it went....

Finished my run at 220 and had no carbs since and in 265. Temp basal was 3 hours at 50% and when I was 98 I ate 12 x 4 carbs for 48 total carbs. Left the house at 180 with double arrows up. About mile 4 the arrows stopped and blood sugar stabled out at 237 for the last 3 miles. Got home and tested and also did a bolus to correct and have been high the past two hours with another correction bolus before bed. Will see in the morning where I end up.

Sweet dreams. 

To temp or not to temp, basal

Left work at a reasonable time today and checked my blood sugar from the car, 115 so I set a temp basal for 60 minutes at 20% thinking a 3 mile run should mesh well with that. This was at 4:30 and when I was at home stretching I tested again. This next test I was 89 so I decided to turn off the temp basal, eat 40 carbs and see where my sugar was an hour later. I then saw my wife eating some skittles so u asked for a handful and ate those too. 

Cgm is reading 96 at 5:30 and now reads 119 with one up arrow. Going 3 miles ill probably burn about 100 off my current reading, off to my hair cut and test with meter after that. 

Here is the before shot: gross, way too long. 

Ok, haircut done and blood sugar now 234. Hair looks great again and off to the treadmill. 

Post run blood sugar is 175, it was 4 miles not 3....good thing I double checked while on the dread mill. 

Cgm graph

Run tonight

Went to the gym tonight for a few reasons, first it's HOT and I don't want to run outside. Second because I wanted a controlled environment with speed. So here's the run:

5:00 at 5mph to get started

1:00 at 6.8

1:00 at 5.0

Repeat x 7

5:00 at 5mph to end 

Total time was 34 minutes and total did stance was 3.2, just under 11:00 per mile. Best part if the run was no temp basal with a pre run sugar of 240, to end with a 133. 

I'm not sure what brought me to 240 pre work out but I could have done a bolus to correct it or get active and burn it off. If I was running after dinner I would have used less insulin to make me go high or burn during run. 

Have a great day. 

Why I test.

Today I was pulling out my meter and a woman at work asked "how many times a day do you test?" And I replied "8-10" her response was "oh wow". I then told her I also wear a continuous glucose monitor and that hives me a reading every five minutes. "Why do you test so much then" simply because technology fails and my cgm may have me at 140 and I'm really 190 and that's a chance for me to bolus and correct my number. 

I mostly wear a cgm so I can see the trend while running. Case in point was yesterday when 2 miles in my sugar went low but I didn't feel it, also to tell me when I'm going back up. I like a cgm reading if 150-250, never like double arrows down and rarely see double arrows up. If I tested 3-4 times a day I would run higher for 25% of my life instead of 5-10%, worth the finger prick to prevent a high or low. 

Test often, your meter is one if the best defense systems you have to prevent long term diabetes related problems. 

Coma or regular oversleep?

You ever have one of those days that you have a feeling something is going to happen and you set two alarms to be safe?  The oddest thing today, I looked over at my alarm to see how much time I had left to sleep and the clock read 6:58!!! Noooo good! Tested my blood sugar in the car and it was 67, reviewing my CGM it was in the 40's most the night. Did I go into a mini coma or just oversleep? I guess we will never know, I am alive and kickin' though. 

Hope the week improves off this Monday. 

Sunday long run

So it was a long weekend, I had to work on Saturday and I also got some things caught up from home on Sunday. I was going to skip my run all together today but I saw a post from another friend with diabetes and she had biked 20 something miles so I was inspired to get my run done. 

Starting my run I was an hour into a 50% basal and thought I was on track to have a good run. I tested prior to the run and was 148, the correction on that's would have been 2.25 and u had one unit on board so I figured I was high enough to get going. I had 6 bee stinger gu packs at 29 carbs each and I had 50g carbs sports drink powder called heed. 

Stretch and Stewart running, first mile is a crazy fast pace at sub 10:00 first mile, slowed it up mile two and had my first gel pack to see a "predicted low" at 2.5 miles so I had another gel pack and walked. Set my basal to 25% and started running again around 4 miles. Cgm read 66 but the double arrows down were gone and with the cgm bring 15-20 minutes behind I figured I would be ok to get moving again. 

Aside from the walking I had a pretty good pace, finished at 10 miles instead of 12 and check out the photo of my final readings. I was pretty satisfied , always am when I get done and see that! 

That's right! CGM says 94 and the meter says 88 #ftw right? Well it's about 90 minutes later and I tested and my sugar is 347?!?!? WHAT?! 

The diabetes life I guess. One day ill figure it out. 

Make it a great week folks!!

Up/down days - not blood sugar

Today started out pretty decent, I had a good nights sleep and woke up to go potty around 2:30 a.m. and thinking I must be high because I don't usually have to get up and use the bathroom in the middle of the night but my blood sugar was 91. A bit later at 4:20 my low alarm woke me up and i tested again and still was decent at 88. My overnight target is 100-120 and my daytime target is 80-100 so I'd say another win. I do have a bit of a dawn phenomenon so I tested again before breakfast at 7:30 and was up to 131. I wonder if this is because of the disconnection time of being in the shower or if it is a actual dawn phenomenon issue?

I'm a poor writer and don't really know when to start a new paragraph but that last one was looking long so I'm going to start a new one here. At 9:10 I did a post breakfast test and I was 79 and my pump told me I had a couple of active insulin on board so I did a 15% temp basal for 45 minutes and when I tested at 10:00 my blood sugar made its way up to 106. Onto the afternoon and lunch.....

Pre lunch blood sugar is 166, unsure exactly the amount of carbs I had but I do know it was a lot of pasta and a cookie, I did two separate boluses for these. I guessed on carbs for both the pasta and cookie and here are my next few #'s: 159 @ 2:20, 146 @3:45....The day started to get stressful and when I get stressed I eat, I don't eat carrots and strawberries like the rest of America, I eat candy or other food that is bad for you. I had a bag of skittles and some gummy sour worms, either one of those usually do the trick. I did a bolus for both but at different times and my 5:30 blood sugar was 198 and 193 at 6:30. I currently have no active insulin on board and am planning on a six mile run at 8:00 after Big Brother. I'm going to leave my temp basal alone, test before the run and make adjustments accordingly. I hope to eat one or two gel packs on my run, each one is 29 carbs.

I've often wondered the stand alone effect they have on my blood sugar so I'm considering a fasting test on Thursday or Sunday. The plan is to only eat the gel packs once every 45 minutes w/o a bolus and testing every 15 minutes so I can see how long it takes to raise my blood sugar. I know running and managing your levels it would be ideal to have glucose tablets or rapid acting materials but have you tried to eat 40 - 80 glucose tablets in a 2-5 hour period and you'll understand this test. Then another day I'm going to put myself on a 50% basal rate and do a 50% bolus to cover the gel packs to see how that impacts my numbers. Going to run the test in the same manner as the previous, I'll take the gel packs every 45 minutes and bolus as I take them but still test every 15 minutes. Length of either survey will only be 3 hours tops, that should build a long enough graph on the CGM to compare to actual results.

Have a great 4th of July, enjoy your Independence

Mobile post

I'm sitting at Noodles & Co waiting for them to bring my food out so I thought I would do a quick blog post through the mobile system. 

So I was thinking the other day that googles circle club or social networking In theory is a great idea. I would like to post some comments to just work friends and other things to my new found #doc

What I'm feeling

I was diagnosed with diabetes in 1999 and over the years my family and friends would say "Doug, how is your diabetes going?" and most of the time I would say "good" and not really elaborate on things. So now I'm going to go ahead and make up for the past 14 years........

There's this overwhelming stress of thinking life needs to be lived 100% spot on and you have to manage your blood sugar to be 90-110 to avoid any problems long term. I lived scared for so many years, I recall the first five years I was afraid to go to bed at night if my blood sugar was less than 200 because god forbid I go low in my sleep and die, I was doing my body no good by feeling this way.  During one of my appointments with my endo I brought up my concern of long term issues and how not managing your diabetes well can impact long term health implications. She took out a piece of paper and said "based on managing an A1c of X you're risk of complications are as big as this piece of paper, if you bring it down to Y your risk is cut in half as she tore the piece of paper in half, she then said if it is Z it is cut in half again, and if it is B your chance of long term problems is cut again in half.

Pretty clear here, you have to do your best to manage diabetes to maintain an average blood sugar and the closer to an A1c of 6.0 the better. When I was originally diagnosed I took two types of insulin and those were NPH and R. The program worked initially, I would take NPH at bedtime and in the morning I would mix my NPH and R depending on what I was thinking I would eat for lunch and what time I would be eating lunch.

Fortunately I worked at a place where my schedule was relatively flexible and I could eat lunch at the same time every day, the problem, I may not be hungry or want to eat the carbs discussed in that plan when the time came. Eventually we switched to Lantus and Humalog and I really enjoyed this combination. I could eat what I want, when I wanted or I could skip food all together. I can't recall if this is when I started gaining all the weight but either way I look at it I am glad I was able to do things this way. One problem is both insulin bottles looked the same and I am/was a bit of an OCD Freak and I would get scared wondering "Did I take Lantus when I was supposed to take Humalog or visa versa" Eventually I was on a pen for my Humalog and a vial for the Lantus so it was quite easy for me to distinguish between the two and not have a concern which I was taking.

I never was a fan of the idea of a insulin pump but as the years went on I decided it was something I wanted to try and I'm very happy I did! I've learned more in the last 16 months on the pump than I did the previous 12 years on insulin injections. Here are a couple words I had no idea existed "Bolus" and "basal" how did I make it to the doctor for 12 years and never get informed of these two things???!!!! I'm still trying to get a handle on how they play in together but I have a big understanding vs a year and a half ago.

A continuous glucose monitor is also a huge difference maker for someone with diabetes, even if not on a pump I would highly encourage talking to your doctor about getting on one. You really can see how your sugars are effected on a more immediate impact if you take a bolus injection just before you eat vs. 15-20 minutes before you eat, the long term effect on that bolus is pretty huge.

So to my family and friends that are wondering how I am doing with managing my diabetes I would like to give you an honest answer and say that I'm pleased with how I've been managing things the past 5-8 years and most happy with the past 1 to 2 years. I'm unsure what damage has been done based on how I treated things in the beginning but as my endo said the quicker you realize what you're doing and change the habits the longer normal life you'll have.

I'm most pleased with lowering my A1c from 8.6 to 7.0 in my last doctor visit. I look forward to getting it below 6.0, I'm even more excited about the #doc and all the support that is out there. I'm also excited to be the Chapter Chairperson for Insulindependence for the inaugural years of the Twin Cities Chapter.

Also for those that ask "how is your diabetes" be prepared for an answer. I once saw high level employee of the bank and asked "how's business?" and I got a 15 minute answer. Be prepared if you're going to ask me "how is your diabetes going?" to get an educated answer on how things are going and what the challenge of the day may or may not be!

Who ever actually read all of this you are a better person that me, I would have been bored at the second paragraph.

Don't forget to test!
Sincerely,
Salguodmai