Category Archives: Diabetes
Always working on it.
Woke up every half hour or so from 3:30 AM until the alarm went off at 6:00 AM this morning.
I am THAT excited about my endocrinologist appointment today. I will receive a number, an A1C reading. This time around, I am going into this appointment without any supporting documentation as to why it may be lower or higher than last time around.
While mostly sticking to the lower carbohydrate end of the spectrum and while workouts started again a few weeks ago after a nagging bout with patellar tendonitis, the meter has barely been used since the last appointment in September. It is test strip hoarding at its best, as orders keep getting placed with the mail order pharmacy even without much actual testing being done.
I cannot explain it. I used to be strict about checking blood glucose every morning, and after at least one meal per day. Did I get used to not testing when the supply of test strips was small in between insurance cards last summer? Have I burnt out on it? Does the fact I have yet to disclose at work play a role?
So even if the A1C is lower than last time (and oh, how I hope it is), there is still work to do.
Soon, I head overseas for a long-deserved week away. A regular pattern of checking blood glucose must happen before then, as the travel and walking and delicious European carbs will take a toll on the numbers. Without constant watch, there could easily be some nasty swings in blood sugar.
Of course, there is always work to do with diabetes…
Friday night high.
Nov 2
Friday night, and I am drinking glass of water after glass of water to quench a dry mouth.
All because of the 230 mg/dl staring back at me after a dinner of chicken, vegetables, and a smaller side of pasta.
I have not slowed down like I said I would, though the new thyroid replacement dose seems to be working. I ended up worrying more about the things I cannot control (work stuff), I ended up procrastinating more about the things under my control (finding a place to live in the city where I work), and I ended up taking on a new side project (studying for the GRE).
And, I thought I could go back to being mostly pescetarian, as I did briefly in my late teens. In fact, I thought I would be writing about my experience exploring lower carb vegetarian options, not writing about a blood glucose reading that really bites.
Clearly, I need to listen to the self who wrote that post six weeks ago. Slow down and stop complicating my life by worrying and procrastinating. It does not necessarily have to mean giving up on grad school or on trying to eliminate most meat and poultry. It does mean ignoring the things I cannot control and taking action on the things I can control. (But if I can rock the GRE and start developing a lower carb vegetarian recipe stack, all the better for doing the things I aspire towards.)
Because without slowing down, there is more opportunity for a Friday night high, which really crimps my style.
Diabetes Art Day: Connections.
Sep 24
Inspired by this weekend’s activities in Des Moines where several members of the DOC gathered for TCOYD…and just hanging out.
(Please see more 2012 submissions at the Diabetes Art Day website.)
You might not get the job…
This post is my August entry in the DSMA Blog Carnival. If you’d like to participate too, you can get all of the information at http://diabetessocmed.com/2012/august-dsma-blog-carnival-2/.
Your pancreas is in a job interview and totally bombed the question about its role in type 2 diabetes. It wants to take the blame for something that has roots of unknown origins.
Let’s face it – everyone associates diabetes with the pancreas or blood glucose levels. In type 2 diabetes, that is not where the disease process begins. It starts with insulin resistance, which means the pancreas is indeed producing enough insulin. However, the body cannot use it effectively to move glucose out of the bloodstream and into various cells for fuel. How insulin resistance develops is unknown – some would say lifestyle and/or genetics, but it might even be an autoimmune reaction.
Over time, the pancreas MAY begin to slow down insulin production. Come on, it is hard work producing higher and higher amounts of insulin to compensate for that insulin resistance. No wonder that some people with type 2 diabetes must supplement with or even depend on insulin.
So while you still can, pancreas, why don’t you play up what still works? You’re still producing digestive enzymes, that other function of the pancreas that is often overshadowed. You do what you can when it comes to producing insulin, and you want to work well with the body’s cells as a team player, but the glucose receptors just won’t cooperate.
It’s okay, you’re still a valued and important organ to me. (Unlike that friend of yours, the thyroid, who is totally lazy and incompetent.)
Takeaway and Giveaway.
Let me start this off by saying that I am not a pushover. I am not easily influenced by free stuff – if I do not like it, I will say so. Just because Roche paid for travel, food, and lodging for the recent summit does not mean they have bought me or my opinion.
That being said, my OneTouch Ultra2 has seen better days at the ripe old age of five years old. And while I have tried a few times in the past year, I cannot seem to qualify for one of the free meters from LifeScan due to having type 2 diabetes and “only” being on metformin.
I was thrilled to receive an Accu-Chek Nano with ten free test strips, if nothing else, to have a backup meter should the Ultra2 fail on me. It turns out the new health insurance covers the test strips at the same tier as OneTouch, which would be important for that backup meter.
The huge advantage of the Nano is that I am able to set an after-meal reminder for testing if I choose to do so following a pre-meal test, something important for a scatterbrain like me. Knowing when the meter is ready to accept blood on the test strip is also a positive for someone as impatient as me…
The meter averages of the OneTouch Ultra2 remain my favorite feature of that meter and why I will wear it out, especially since I cannot use the other tool given away by Roche – the Glooko.
The Glooko electronic logbook requires both an Accu-Chek meter (Aviva, Aviva Nano, Compact Plus, Nano) and an iPhone (4S, 4, 3GS) or iPod touch (3rd/4th generation). I will pick one random commenter on this post later this week (other than summit attendees), who does have these items available to them to work the system.
EDIT: To clarify, I am only giving away the Glooko at this time, saving the Nano as a backup.
Operation Carb Control.
No pasta, no pizza, no chocolate. And for goodness sake, no diet soda.
Last month’s A1C Now showed a 5.6%. Ever since then I feel like I have been riding a glucoaster of epic proportions. It all came to a head on Tuesday morning while participating in the Roche summit.
I found the darn flaky buttery croissant at breakfast too good to pass up, even though potatoes were already on the plate with not nearly enough protein accompanying the meal, not like the morning before. About an hour later, I found myself inching towards 200 mg/dl and racing to the bathroom every twenty minutes. There is nothing you can do in the middle of a meeting when your type 2 diabetes care regimen is metformin and exercise…except drink tons of water and wait it out.
Then, of course, the bottom dropped out and dealt with a blood glucose level inching towards 70 mg/dl, where a healthy snack bar full of balanced proteins and carbohydrates came in handy.
The thing is, that in spite of regular exercise, I knew I had been riding the glucoaster over and over and over again the weeks leading up to the meeting. Too much pasta, too much pizza, too much chocolate – and too much diet soda fueling the carb cravings.
And with today’s A1C Now reading showing a 6.0%, I know it is time to stop doing what I have been doing. While that 6.0% is far from alarming, it is an indicator for me that something is not right and I need to get back to what works to even out blood sugar.
Operation Carb Control begins today with those four simple rules in the four weeks leading up to a full blood draw in advance of my next endocrinologist appointment. (Oh yeah, I can totally do this.)
Roche Redux, Part 2.
Last Sunday, I traveled to Indianapolis for the fourth annual Roche Social Media Summit. Those invited represented a cross-section of the diabetes online community – adults with type 1 diabetes or type 2 diabetes, parents of children with type 1 diabetes, and even a trained health care professional now creating mobile health solutions. Roche covered all travel, food, and lodging expenses, as well as provided a couple of giveaways that I will touch upon in the next few days.
I may or may not have explained in the past that I once worked at a medical device manufacturer. In that other life, a whole decade ago, I provided administrative support for sales training as well as customer education. (Customers in this case included surgeons, nurses, and techs who would use the surgical equipment the company manufactured and sold.)
While I participated in a mandatory manufacturing tour as part of orientation, I ended up going on several more accompanying salespeople in their initial training as well as with those individuals who had been invited for a key customer meeting. (Customers in this case were the individuals’ hospitals or surgical centers, and representatives included nurses and purchasing managers.)
When you have seen one medical device manufacturing tour, you have seen them all. Not to discount the experience at all because my first time through allowed me to understand the complex processes that go into making a medical device. Even the design of the manufacturing plant is a complex process. However, I had “been there done that” multiple times in advance of the Roche tour and was kind of bored. (Just being brutally honest here.)
That being said, the highlight of the tour was actually the reaction from all of those who had not been through such a experience. How they now understood that incredibly complex processes were involved in creating a test strip, receiving more insight into the cost as well as the manufacturer’s attempts at making accuracy a priority.
I think that is something that all patients with diabetes should be aware of – how their test strips (and insulin pumps and CGMs) come to be. Not everyone can do a live manufacturing tour, of course, but a video tour…hmm?
Roche Redux, Part 1.
Last Sunday, I traveled to Indianapolis for the fourth annual Roche Social Media Summit. Those invited represented a cross-section of the diabetes online community – adults with type 1 diabetes or type 2 diabetes, parents of children with type 1 diabetes, and even a trained health care professional now creating mobile health solutions. Roche covered all travel, food, and lodging expenses, as well as provided a couple of giveaways that I will touch upon in the next few days.
As I mentioned earlier this summer, it took me by surprise to be invited again. Let’s face it, just about everything in my little world has changed since I last attended in Orlando two years ago. Yet for some reason, the powers that be at Roche felt this was a voice to be heard again. (As much as I talked during the sessions, then and now!)
The way I see it, the business part of the summit allows two things to happen. The patient voice is heard by upper management on concerns about safety, accuracy, and cost of the products the company develops. In turn, the medical device manufacturer is able to explain their side of the story through presentations on research & development as well as a manufacturing plant tour.
What happens as an informal “side effect” is some of the diabetes online community being able to hang out for a couple of days and get to know each other in person, beyond diabetes. It allowed me to reconnect with those I already met, it allowed me to meet some for the first time, and also introduced those whose stories I had not yet read.
I left this year’s Social Media Summit knowing that while my name and blog focus has changed, the passion to support and to empower others is still valued within this amazing diabetes online community.
Here I go again: Roche Social Media Summit.
Old faces and new faces will be representing the diabetes online community at the Roche’s Fourth Annual Social Media Summit beginning Sunday in Indianapolis.
To ensure the conversations do not turn repetitive, there is always fresh blood (no lancet humor intended). About third of this year’s invitations went to first time attendees. While people with type 1 diabetes are overwhelmingly represented, there are strong groups of people with type 2 diabetes as well as parents of type 1 children.
This summit allows diabetes advocates to come together with industry and with each other to talk about what matters to the greater online and offline community. It has allowed for brainstorming, leading to both formal programs partnered with Roche as well as smaller scale projects.
There are so few spots for an event like this, and so many great minds in the diabetes online community. Please believe this smaller group of attendees do what we can to ensure that little ideas we see around the community grab a big voice.
(p.s. Yes, I am attending this all-expense-paid trip to Indianapolis. Well, at least if I can get past security without a valid photo ID bearing my maiden name.)
(p.s.s.If you tweet on Twitter, please follow #dsummit12.)
Side effects.
The things we do, the things we endure, to manage blood glucose levels as people with diabetes…
For those with type 1 diabetes and insulin-dependent type 2 diabetes, there is always the possibility of too much or too little insulin, either of which becomes an emergency.
For those with type 2 diabetes treated by oral medications, many such meds come with gastrointestinal upset side effects. And often, the evil carbohydrates that are supposed to be limited are the only comfort for such upset, which seems entirely counter-productive. Not an emergency, but enough of a problem that it can impact daily life activities. Sometimes a temporary hassle, sometimes troublesome enough to switch to a different solution.
Due to a switch in insurance and some mix-ups in my endocrinologist’s office, I ended up going without metformin at the full prescribed dosage for a couple months as I stretched out what medication I did have.
This weekend, after a few weeks of weight gain and erratic blood glucose levels, I finally returned to the prescribed course of metformin. Complete with nausea, which I can only hope will subside after a few days. In the meantime, graham crackers and applesauce are my friends.
At least the weight will drop off quickly…right?
