Ninety percent of the time, my high blood sugar has an identifiable reason, and there’s a cluster of common causes. Did I under-estimate the carbs in a snack and therefore under-bolus? Did I over-treat a low blood sugar? Did I eat without bolusing at all (it happens)? Is there a lot of stress floating around that I’m responding to?
Most of the time, those questions cover the why. Once in a while, my highs are for rogue reasons, like an air bubble in my pump tubing. Or when I eat something carb-heavy right after an insulin pump site change (it’s like that first bolus doesn’t “catch” somehow). Or I forgot to reconnect my pump. Or if the cat bites through my pump tubing.
But rarely, if ever, is one of my high blood sugars the result of bad insulin.
Except it totally happened last week, when two days of bullshit high numbers had me mitigating every possible variable … other than swapping out the insulin itself. (And clearly I’m stubborn and/or in denial about the quality of my insulin’s influence on my blood sugars?) I rage-bolused. I exercised. I low-carbed the eff out of an entire day. I did a site change at midnight to take a bite out of the highs. Nothing. The downward-sloping arrow on my Dexcom graph had gone on hiatus.
(Always a punched-in-the-gut feeling to see the word HIGH on a Dexcom graph, accompanied by an up arrow.)
But ditching the bottle of insulin entirely and swapping in a new Humalog vial? That did the trick in a big way. For once, it was the insulin. Next time, it will surely be the cat.
Is it a glitch? A misfiring Internet tube? A mistake that they haven’t realized yet and now I’m that jerk for pointing it out? WHEN DID THIS HAPPEN?!!
Dexcom data, now available for upload on Diasend. I don’t know when this changed (last time I looked was over 18 months ago), but it’s working now. Even here, deep in Rhode Island (can’t go too deep, actually, as it’s a very small state).
After digging through the box of diabetes-related cables that lives in my bathroom cupboard, I can easily upload my glucose meter (Verio Sync), insulin pump (Animas Ping – actually not the easiest upload because it requires dongle dexterity and I can barely say “dongle” without losing it, so being dextrous is extra difficult), and continuous glucose monitor (Dexcom G4). All my data garbage, dumped into one source.
It’s not streamlined, but it’s closer, and I’ll frigging take it.
(For a list of supported devices, check out this link. And if you knew Diasend worked with Dexcom for US accounts a long time ago, sorry for being late to the game. Also, why didn’t you tell me? I am now VERY EXCITED and the CAPS BUTTON is sort of STUCK.)
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.
Changing out an insulin pump infusion set is a methodical moment for me. I do things in the same order almost every time, with the same mildly frenetic mindset.
- Remove old set from my body so I can enjoy the “connected to nothing” feeling for as long as possible.
- Take out a new infusion set and new reservoir.
- Ferret out the open bottle of insulin from wherever I’ve stashed it last in the bathroom. (Usually it’s in the medicine cabinet, but during the hotter months of summer, I tend to keep it in our bedroom, where it’s cooler.)
- Line the insulin set, reservoir, and bottle up on the counter.
- Unscrew the reservoir cap and remove the old infusion set and reservoir from the pump. Throw the tangle of tubing into the garbage, making sure said tangle doesn’t dangle over the edge of the garbage can because otherwise Loopy and Siah will find it and drag it all over the house.
- Open the packaging for the reservoir and take out all the little parts (except that one frigging thing that I don’t know what it’s for and I usually throw it right into the garbage – see below):
- Rewind the pump.
- This is the point where I mentally set some kind of timer, challenging myself to race against the time it takes for the pump to rewind. While the pump is whirring, I rush to fill up the reservoir and connect it to the tubing. I do this every, single time. It’s as satisfyingly ritualistic as shaking the bottle of test strips before I check my blood sugar.
- Thread the tubing through the battery cap and connect the luer lock, then insert the cartridge into the pump.
- Load the new cartridge.
- Prime the cartridge, trying to stop the prime before more than a single drop of insulin escapes from the needle in the infusion set.
- Hold the tubing up to the light and inspect it for bubbles.
- After the pump is primed, again the mental timer is set. This time, the challenge is to unpeel the sticky backing from the infusion set and find a place on my body that’s suitable for insertion before the screen on my pump goes blank from inactivity.
- Insert the new infusion set, prime the cannula (sort of holding my breath while it primes because I’m never certain that the first introduction of insulin won’t burn under my skin).
- Tuck the tubing out of sight and clip the pump to my clothes.
- Fin. (As in “the end.” There’s no marine life actively involved in this process.)
This process takes less than two minutes to complete, but if it’s interrupted in any way, I’m thrown so far off course that it takes me five minutes to recover. The method of this madness is that it’s one, fluid mental movement and any upset to the process makes my brain disengage to seek the comfort of something shiny.
It’s an intricate process involving several steps, precision handling, and the safe housing a powerful drug. And if I have to change the battery at the same time …
So whoa! Much woe.