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Posts from the ‘Blood Sugars’ Category

CGM in the Cloud and All Over the Web.

diaTribe has posted a new column about CGM in the Cloud and the why (and why not) of clouding your Dexcom data, and thanks to a lot of input from people in the diabetes community, there are a dozen different perspectives.  Click over to diaTribe for a read.

And diaTribe isn’t the only site talking about CGM in the Cloud this week.

Why wait?  #WeAreNotWaiting.

Free Foods!

…  “You can have pickles?  Or gelatin?  Or cucumber slices!”

My mom tried to make these options sound appealing and delicious, but when I was a kid and my blood sugar was super high, pickles weren’t what I craved.  My body wanted to chug water and cheeseburgers simultaneously in efforts to cleanse the ketones and sate the high hunger.

“Can I have something else?”

“Not right now.  Those are the free foods you can have, until your blood sugar comes down.” she’d reply.

The phrase ‘free foods’ was a real one, twenty years ago in our household.”

more about free foods at Animas.

Diabetes Relics: Accu-Chek II.

Whose pockets were what size now?

[here's a link to a full size photo]

Scanned from the pages of the Fall 1986 issue of “Diabetes Forecast: The newsletter for people who live with diabetes,” this was my first glucose meter.

Next week marks 28 years with type 1 diabetes for me, and looking back at the technology I used upon diagnosis, I see how far things have come.  I wonder if I’ll look back, decades from now, and marvel at the cumbersome technology of 2014.

Maybe I’ll be all making my own insulin and tending to a big, fat glass of Reisling and not giving a shit because research will have finally caught up with hope.

Pre-Bolusing for Snacks.

“Do you pre-bolus for your meals?”

“I do.”  (I was happy to answer this question because I actually do pre-bolus.  Pre-bolusing is my A1C’s saving grace.)

“Okay, that’s great.”  She made a few notes in my chart.  “How about for snacks?  Do you pre-bolus for those?”

“I … um, nope.  I am horrible at pre-bolusing for snacks.”

Unfortunately, hat is completely and utterly true.

Meals are easier to pre-bolus for because there’s time involved in making them.  If I know I’m cooking chicken and green beans for dinner, I have 25 – 30 minutes to let that bolus sink in before the meal is even ready.  Going out to eat at restaurants is easy, too, because I usually have an idea of what I’d like to eat, so I’ll bolus for the meal once we are seated at the table.  (Pre-bolusing backfires at times, too, but as long as I’m not in the middle of the woods, I’ll take the risk.)  A meal feels like an event, and therefore easier to accommodate.

Snacks feel like an accident.  An unplanned moment.  I don’t take an apple out of the basket and bite into it in a premeditated fashion, but more like a fluid movement without any thought involved.  (A run-by fruiting by any other name …)  It’s not until I’m done with a snack – apple, yogurt, nuts, protein bar … cupcake? – that I realize I haven’t taken any insulin to cover the carbs.  My post-snackial blood sugars aren’t grateful for the misstep.

This would not be a big deal if I wasn’t such a grazer, but when 50% of my caloric intake throughout the day is on a whim, pre-bolusing for snacks matters.  My A1C is currently in my range (under 7%) but I know if I can remember even half the time to pre-bolus for snacks, I bet my standard deviation will tighten up and blah blah blah other numbers as well.

Little, conscious changes will hopefully become habit.

 

Not A Single Decent Number.

“Huh.  223 mg/dL.  Still.”

This was the mumbled mantra of our vacation to Maine.

Aside from the long drive to Bar Harbor (six hours, plus coffee stops and bathroom stops and “Hey, look at that lobster!” stops), the time we spend in Maine is usually very active.  As a family, we did the hike around Jordan Pond (about 3.5 miles), the hike up South Bubble Mountain (with a stop at Bubble Rock), and spent hours walking through downtown Bar Harbor.  The lure of blueberry ice cream was enticing, but I tried to avoid the sweets and instead downed buckets of iced coffee instead.

And yet my blood sugars were complete shit while we were traveling.

I wanted to blame my infusion set, but I changed it once while we were in Maine and my blood sugar numbers remained crap.  I wanted to blame the bottle of insulin but it was the same bottle that worked just fine at home (and it wasn’t like we microwaved it or let it bake in the car).  I wanted to blame my own actions but I was exercising, checking my blood sugar, pre-bolusing for meals, correcting highs, and sticking with reasonable carb intake.

So I blamed diabetes.

The graphs over the four days we were in Maine were gross.  When I wasn’t high (which was the majority of the time), I was erring on the side of high, teasing the edges of 160 and 180 mg/dL all day long.  Why?  No clue.  Hesitant to up my basal rate in the face of constant walking, I just watched the graph ride the mustard for a few days.  Not convenient, because blood sugars running higher means more water, more “Hey, it feels like someone put cement in my sneakers,” more teeth sweaters, more bathroom breaks.

“Mom, do you have to go potty?”

(Fun when the four year old is asking me, instead of the other way around.)

Sometimes the numbers don’t make sense, and this time, I choose to roll with it for a few days.  There are probably six dozen different things I “could have done” to take a bite out of the high blood sugar trend, but I didn’t want to the micromanagement of diabetes to eat up my brain on vacation.  Instead, I did what I was willing to do and thankfully, now that we’re back at home, my Dexcom graphed has settled back into a more forgiving pattern of Pac-Man dots.

I prefer mountains in the landscape, not in my Dexcom graph.

 

 

Whoa! Woe.

First this:

Then this:

So whoa!  Much woe.

BOLUS: Beware Of Loose, Unsupervised Snacks.

I graze.  I’m a grazer.  Visually speaking, my food choices are spread out over a gigantic field and I run through, grabbing bites here and there and never properly taking amounts or serving sizes into account.

“How many grapes did I just eat,” is a common, whispered question.  “Did I bolus for that protein bar?” is another one.  “Hey, I only had eggs and not toast – how many carbs did I bolus for, and what needs to be consumed now so I don’t hit the deck?”

I am good at going through the motions of diabetes management, but I have been slacking on minding the minutiae of late.  I don’t sit down to formal meals throughout the day (schedules are nonexistent at the moment), so keeping track of the food I’m eating has been a challenge.  Grazing makes for dodgy carb counting.

I need to mind my B.O.L.U.S:

Must Beware of Loose, Unsupervised Snacks!  When carbs are roaming around unsupervised and unbolused-for (terrible grammar, worse when spellcheck changes it to “unbloused-for”), blood sugars go high and stay there because I’m chasing my insulin-tail or I go low because I’m over-estimating.  Insulin is potent stuff, and SWAG’ing it makes for Ms and Ws on my Dexcom graph.  If I can just pay-the-fuck-attention to what I’m eating, I’ll have fewer frustrating results.  Right? RIGHT??

The more I mind what I’m eating, the more even my blood sugars will be.

Now let’s see how that theory shakes out, as I attempt it for the 10,000th time since diagnosis.

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