"Pumping Insulin" - Basal Rate Testing

A week from today is my next endo appointment.  It will have been three months since I saw him last.  I never in a million years thought I'd say what I'm about to say now . . .  I can't wait to see what my A1C is.  Wow, imagine that!!  But yes, for once I'm (cautiously) optimistic that I will see a big improvement.



No matter how good (or not) my A1C results are,  reading "Pumping Insulin" has me raring to do some basal rate testing.  I think my basal rate are really good, but I also think they can be tweaked a bit  to really nail things down.  I often go pretty low throughout the morning.   And sometimes high before dinner.  A smidge less insulin here and a smidge more there could make things easier.



So last night, I used what I learned from Chapter 11, "Select and Test your Basal Rates", to run my first over-night basal test.  When testing daytime rates, you monitor your blood sugar every two hours.  During the over-night test, the book says you only need to test every four hours.  But because I'm crazy . . .  an over-achiever . . .  very interested to see exactly what is going on while I sleep, I decided to get up and check every two hours.  At bed-time I found myself higher than usual (153).  Since I wanted to run the test, I decided to leave it rather than bolus a correction.  At 1am, I had risen a bit more. At 3am, I was back down to where I had started.  At 5am I was down a bit more.  And at 7am, I ended my test with a 101.  Ah ha, if I had gone to bed at 100, I may well have ended my test down at 48.  Yup, a little tweaking may be needed.



I love knowing that the pump will allow me to make the slight changes I might need to keep things stable over-night.  It's empowering to know I can run these tests and really act on the results I get.  I plan to do another test Tuesday night, and bring both results in for discussion at next week's visit.  But for now, I just need another cup of coffee.

An inspirational story . . .

The other day, I received an interesting e-mail from Meyrick. He had come across my little blog, and he thought I might be interested in reading a post that his friend wrote about a duathlon they completed.

I've never considered myself much of an athlete, so I have the highest respect for those who work and train so hard and compete in events such as this. And I'm even more impressed by Meyrick's friend Harley. He's competed in several triathlons and in this duathlon he's posted about. But that's not the most impressive part. You see, Harley has been a Type 1 diabetic since the age of 16. And he's never let that stop him from competing. In fact, his day job? Director of physical education at West Point. Pretty cool!

Go on over and read all about his duathlon experience. I hope you enjoy it as much as I did. It's a great example of how, although we may have to plan a lot more than the "average" person, we don't have to let T1 keep us from reaching our goals!

My Sugar-Free Walk Socks

Over the past few of weeks, I've enjoyed reading a couple of posts on Six Until Me about people who've found innovative ways to do diabetes fundraising. And it got me thinking about "my" socks. My story isn't as inspiring as those featured on Kerri's blog, but I thought it would be fun to share it with you anyway.

As I've mentioned before, I knit. (Okay, I knit a lot.) And I might have a bit of yarn. Well okay, maybe I have around 98,000 yards (that's over 55 miles) of yarn. No, I'm not kidding. I have it all logged in an excel spreadsheet. (dork) With columns that add up the yards and also convert it to miles. (super dork) And that doesn't even count a few more skeins I picked up on vacation that still need to be logged in. (obsessed dork) But I digress.

Two years ago, Pea and I decided to participate in the ADA Walk-a-thon. One of the first things I did was to put up a post on my knitting blog. I was overwhelmed by the response. Knitters not only began donating immediately, but they also posted about it on their blogs - and soon donations were coming in from people I didn't even know. They also donated yarn and other knitting loot so I could raffle off prizes to people who donated. I had set my fundraising goal at an amount that I thought was unreachable - $500. In just a couple of weeks, we had passed that goal.

But wait, I haven't even gotten to the best part yet. One of my blog friends was just starting to design her own knitting patterns. And she decided to donate her first sock pattern to me. She named it Karen's Sugar-Free Walk Socks, and donated the entire proceeds from every pattern sold until the walk-a-thon to my walk. I proudly walked every step of the walk-a-thon in socks I had knit myself, from a pattern named for me! In the end, she sold 90 copies of the pattern, and donated $450 to my walk. That brought me well over the top of my new unreachable goal of $1,000.

Hang on, it still gets even better!! To this day, Chrissy continues to donate $2 to the ADA each time that pattern is sold. It's so amazing to me that someone would be so generous with their talent. I am extremely proud to be able to think of that pattern as "my pattern" - and I get such a thrill every time I come across a pair of "my socks" on a knitting blog. I truly hope the pattern continues to be a hit, until the day when a cure for all of us is found.

And yes, Pea and I are walking again this year, in October. I don't think I'll have a cool fundraising story to go with this walk . . . . but hey, you never know!

More ups and downs than a see-saw!!

Perhaps you remember a few weeks ago, I was bitching about discussing the fact that my blood sugars had been running really low. Well, diabetes can be like a see-saw. One minute you are down, and the next you are up.

That's right . . . I'm smack dab in a spurt of highs. Tell me if you do this when you are high:

#1: Play the blame game. "maybe I've been slacking off on my exercise" "I haven't been as careful with what I've been eating" "man, I'm really screwing up"

#2: Decide time will make it better. "well, it's almost that time of month - a few more days and things will settle down" "it's just stress - a few more days and things will settle down" "I know, I'll be diligent about exercise - a few more days . . . you can see where I'm going with this.

#3: Have an ah-ha moment. Yes, it's almost that time of month - but my BS isn't usually thrown so out of whack. Yes, I have been slacking on exercise and eating - but not enough to warrant so many highs. Stress - eeeehhh, I'm not really all that stressed. But, AH-HA, I recently opened a bottle of insulin that had come on vacation as a spare. Could the problem be that it didn't travel well? An hour ago, I threw it out, opened a fresh (and untraveled) bottle of insulin and changed my site.

I still think there are multiple factors at work here, but I'm hoping a better bottle of insulin will help get things moving in the right direction. I've had enough of the see-saw!

Second nature

I've been on my pump for almost four months now.  It took me years to come around to the idea of even trying the pump.  I was "happy" with MDIs, because I had been doing them for so long. They were what I knew, and what I was comfortable with.  But I wasn't happy with my control.  My A1C's hovered in the high 6's and low 7's.  I'd only achieved a 6.4 once, and it didn't last.

I began reading about pumping on diabetes blogs and talked to other pumpers on a knitting site that has a great forum section.  And I spotted a pump on one of the instructors at the ballroom studio where Pea and I take lessons.  I decided I could do it too.

It was scary.  My first insertion set changes were done with every instruction guide I had spread out in front of me.  And it took forever.

Today I did a set change.  The instructions now stay somewhere in my Diabetes Drawer.  And the whole process takes only a couple of minutes.  It's all second nature.  That great, right?  Right.

But for some reason, it's making me really sad.  Not sad that I'm on the pump - I couldn't be happier with it and it's the best decision I've ever made (diabetes-wise).  But a bit sad that another diabetes-related thing has become second nature.  Sad that there STILL is no cure.

New tips I've learned

As I mentioned in an earlier post, I picked up Pumping Insulin recently after reading in several places that it's a Must Read for any pumper. Being the OCD person I am, I decided to read every single page. I have to admit, the first few chapters seemed kind of dry and I was anxious to get into the chapters that cover pump operation. But even in those "dry chapters" I'm learning tips and info I didn't know. I plan to hope to share a few new discoveries with you each week.

So far I've learned this:

• Fast acting insulin is not as fast as I've been lead to believe. I'm now bolusing even earlier before eating, and as a result my 2 hours blood sugars have shown real improvement. (Almost always 140 or below).


• Using the bg reminder is great! When I went for my pump training, the CDE was quick to notice my OCD tenancies. She told me I wouldn't need to use the reminder, since she was sure I'd remember to test two hours after eating. Which is true. It's also true that the alarm bugs many (most?) people. However, after reading about it in the book, I turned my pump's Reminder Feature on for at try. And I love it!! While I CAN remember what time I ate and what time I need to test again, it's nice not to HAVE TO remember. When I'm distracted and busy (okay, reading blogs *ahem*), the little BEEP BOOP BEEP will tear me away from the computer for my next test. After all the keeping track I do both diabetes-wise and in general, it's nice to have something do the keeping track for me.

There is also great info on carb counting and the glycemic index. I've been carb counting for years and recently read a couple of books on GI eating though, so most of it was just a refresher for me.

I highly recommend adding this book to your library, and I know I'll turn to it in the years to come for reference. I'll try to keep you posted on the other useful info I find as I finish reading it.

How can you laugh when you know I'm down

Just like The Beatles song, "I'm down (I'm really down)".

Don't get me wrong . . . my mood is just fine. It's my blood sugars that are down. Really down. (Well, actually no . . . not really down . . . just kind of down.)


The weird thing is, things have been pretty level for the past few weeks. But now, suddenly, lots of lows. The details:

• 56 - before dinner yesterday. Ate 14g "fast acting carbs (yum)" , then bolused for and ate dinner.
• 51 - 2 hours after dinner. Ate another 14g of carbs, then had a big spoonful of frosting. Then, although I knew I was over-treating, I ate three cookies. Yup, it was one of those lows where I couldn't stop eating. I decided to bolus enough to almost cover the cookies, so I wouldn't spike too high.
• 139 - 1 hour later and before bed. Seemed good, but I set my alarm for 3am in case I was still spiking up.
• 2ish am - while half asleep, decided I was fine (didn't feel thirsty and didn't have to pee), so I shut off the alarm. Had I been fully awake, I would have tested anyway, regardless of how I felt.
• 58 - fasting sugar this morning (I was shocked that it was so low). My Bolus Wizard and I agreed that skipping the normal .7 unit bolus I take to cover my coffee would work just fine.
• 94 - Yes!!! In the good range before breakfast. Ate my usual 1/2 cup Fiber One and 1/2 banana and took .1 unit less than my usual bolus.
• 97 - 2 hours after breakfast. That's a bit low after only two hours, with insulin still on board. I had a snack and only bolused for half the carbs.
• 52 - before lunch. What the heck!!!! Good thing I didn't spend the morning cleaning the house like I had planned!!
• 143 - 2 hours after lunch. That's more on target for an after-meal reading.

Just another case of "don't know how, don't know why". Oh well, at least it seems to be Getting Better. "A little better all the time (It can't get no worse)" (Well, actually yes. . . it could . . . let's just hope it doesn't!!)

Meet my biggest supporter

One of the most important things I've learned over my years with diabetes is this:

It helps so much to have people in your life to pick you up and cheer you on when things get tough. Things will get tough. Not always, but sometimes. And that's when you really need people you can count on to keep you going.

Hands down, my biggest supporter is my husband - whom I call Sweetpea on my knitting blog . . . . and in Real Life . . . . and now here. I figured it was about time he was properly introduced, since I'm sure I'll be referring to him often.

I met my Sweetpea in 1999 (see #2 here if you want the details). We went on our first date on June 26, 1999, and six months later he took a job 3 hours away. I understood why he needed to go, but I was insistent that I would not, could not, do the long distance thing. Until the decision was made that he would be moving. Then I decided to give it a try.

We saw each other only on weekends for three long years. Then he moved back, and soon after we got engaged. We were married on June 26, 2004 - five years to the day of our first date.

Pea is the best thing in my life. He encourages me to no end. When the stress of my old job was becoming too much for my blood sugar to handle, he didn't hesitate to crunch numbers and put together budgets so we could get me out of there. And as I continue to try to figure out what I want to be "when I grow up", he is nothing but patient and supportive. He finds me "treats" when I'm too low. He encourages us both to eat a very healthy diet. He gently nudges me to test at the first sign of crankiness (and quite often, there is a low I didn't feel. Although, many times I'm just cranky by nature!) He would do anything he can to keep me healthy - and that really helps on those days where it just feels not worth the trouble.

He's pretty cute too!!!

Hey, what's that he's pouring into the glass? I think we need a closer look, no?

They look yummy, don't they?? What you see there are the Frozen Strawberry Daiquiris Pea whipped up the other night from our 375 Sensational Splenda Recipes cookbook. No sugar (besides what occurs in the unsweetened frozen strawberries), only 7 grams of carbs per serving, and so yummy that I no longer have to miss Strawberry Daiquiris! And what did Pea think about them?

Yup, he liked 'em just as much as I did!!!