On Meter Accuracy and What to Do in the Meantime…

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While I do give my time and energy when it comes to petitioning for better meter accuracy, I also have adopted a few personal safeguards.  These safeguards are like self imposed regulations that I don’t know how to live without.  I used to live without them but there were a lot of close calls.  And sometimes I forego them and scary things happen.

Meters being a good bit off (up to 20% off is it?) is an important issue to tackle, indeed.  But since it’s the reality of our current situation, we might ask ourselves in case we haven’t already, “What can I do about it?”  I’ll share what I do in case in inspires anyone to answer this question for themselves:

It’s been my experience that the further away from 100 my blood sugar is, the less accurate my meter may be.  Well how about that?  My meter and I mutually agree as to what my “target” is.  Just kidding.  Sort of…

Since low blood sugar comes with clearer symptoms for me and is an immediate emergency situation, I don’t question my meter when it says I’m low.  Though, if I don’t feel low at all, I will try jump in jacks and if I have energy for those I will retest because something strange is going on.  Perhaps leftover fruit juice on my fingertips from the apple I had earlier.

When my blood sugar is within my target range I relax, cheer, do a dance, etc.  But I try to have faith in my meter and assume it’s right on.

When my blood sugar is over 250, I retest.  It hurts me to retest because strips are like gold but I do it because this could happen:

Years ago, I tested 350-something.  When my blood sugar is that high, it’s hard for me to bring down so I usually push it down with a larger than usual bit of insulin.  Well, I gave insulin and then stopped.  I thought about how I didn’t feel 350 high.  So I tested again and saw I was 260.  I tested yet again and was 249.  “OK” I thought, “Now I’ve got a heck of a lot of insulin coming my way”.  Sure enough in 40 minutes I was 98 and dropping fast and still had over an hour of active insulin coming.  Nowadays the times that has happened have been handled differently.  I start to eat after 15 minutes to deflect the steep drop.

But better yet, it really doesn’t happen too often because I test twice.  If the second test is really far off from the first, I test a third time and go with the majority rule.  I would never ever test, see a high number, give insulin, and go to sleep.  Our meters are not built to support that level of responsibility.  Not with our lives.  That is a shame, yes, but that’s where our brain comes in handy.  What can we do to help ourselves against this?

Something a lot of my friends do is to eat low or moderate carb.  They have many reasons for eating low or lowish carb but one of the reasons for many of them is that this way, there is usually not a lot of insulin circulating at any given time.  And the food they eat is going to minimize the likelihood for being high enough to see super large discrepancies in their test results.  This works well for me.  In particular, what works well for me is to be careful with processed food.  I find that avoiding it makes my blood sugars more stable and my life easier because I don’t have super high highs.  And then my meter isn’t as big an issue for me as it could be.

But they should totally work on meter accuracy.  Or at the very least give everyone more strip allowance.

Please.

My Reason

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I take care of myself for my husband and children.  For my parents, brothers, sisters, and friends.  For my extended family and friends composed of the DOC.  Last but not least I take care of myself for me.

Have a fabulous Friday everyone!

Remember, love and respect yourself and the rest will follow.

XOXO

Travelling with Diabetes…and other Health Issues

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I haven’t travelled by plane too much in my life.  I’ve been to visit relatives in Venezuela, gone to Aruba with my pump (would have loved the Omnipod for that trip), went to Mexico for business and my honeymoon, and just this past week, Kansas City for A1c Champions training.

For this trip, I was so nervous about forgetting my insulin that I instead forgot my anxiety and allergy medications.  So not only did I not have my anxiety relief, I endured awful withdrawal symptoms like nausea, extreme anxiety, sweating, insomnia, and dizziness.  And since I didn’t have allergy relief, I got a sinus headache, sore throat, and swollen limph nodes.  Thank goodness the training and the people there were all splendid because without all that going well I would have cried the entire time.

Thanks to that anxiety I was having, my adrenaline sent my blood sugars skyrocketing.  Oh and plane rides seem to make my blood pressure drop, too.  I was almost sure I was going to pass out a few times and since I had forgotten my medic alert bracelet (another genius move), I had to write type 1 diabetes on my wrist with a permanent marker.  Geez, diabetes, how I’d love to leave you at home.

I’m better now and very equipped with information on how to not forget things when I travel again next month (aka, make a travel check list!)  Fingers crossed for a better travel experience.

Any tips for dealing with low blood pressure and motion sickness on planes?  I’m going to be travelling more and could really use some advice on what helps.  Asking the stewardess for a vomit bag does not make the poor soul next to me feel very comfortable.

By the way, if you’re curious about the A1c Champions program, it’s AMAZING.  Seriously, AMAZING.  You can learn more here: A1cChampions.com

Low Blood Sugar Dreams

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I don’t know about you but when I have a low blood sugar at night, I end up having dreams I remember when I awake.  If my low comes on really slowly, and most of mine do, the threat isn’t as immediate and I sometimes find myself in a lucid dream while somehow acknowledging I’m low but refusing to stop the fun.

The other night I dreamt Kelly Kunik, a diabetes blogger, ran and won a marathon.  Last night I dreamt that I was suddenly Angelina Jolie’s secret agent, hired (hmm…I don’t remember getting paid) to hack into a computer (though hmmm she provided a password) and retrieve some secret information before Brad Pitt found it.  Where was Brad Pitt in my dream, you ask?  He was lurking in the shadows trying to get the info before I did!  He was not very skilled at trying to get to the computer because I wasn’t very good and I beat him to it (he was much like his dopey character in “Burn After Reading”).  Then I got the info, whatever it was, back to Angelina “Boss” Jolie and she thanked me with a silent nod (though I never got paid…) and then I ninja rolled on the carpet and leapt out of a window in my black secret agent suit, never to be seen again.

At that point I let myself wake up because my mission was over and my blood sugar was low.  So I muttered to my husband, who had been in my dream dancing at Angelina and Brad’s party, “Aleeeex…”  He jumped up in the most freaky alert way “Low?!”  I nodded.  He brought me juice.  Then I laughed because the last thing I remember from my dream is someone saying “Wow, your Alex can really dance!”  And from what I remember he was doing something undeniably goofy.

Wacky dreams happen to me when I have lows and I find it helps with the sting of resentment towards lows, that’s for sure :)

Does this ever happen to you?  Any crazy dreams you can tell us about that will make me not so embarrassed about what I just shared?

One For Every Year

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My most memorable thoughts about diabetes for each year with diabetes, starting with the first year as an 11 year old:

1994  “I can do this.  No, I won’t go to diabetes camp, I’m just like everyone else, I’ll go to regular camp.”  “Ok, regular camp was fun but I thought I was going to die”.

1995  “Alright, I don’t like this at all.  I’m not sure I can do this.”

1996  “I can’t do this!  But I don’t want anyone to know…”  “I just want to be normal”.

1997  “Recovering from a gum grafting surgery.  So this is what happens when I try to be normal.  Not fair.”

1998  “I wonder what boys think about my diabetes?”

1999  “I hate diabetes.”

2000  “Feeling out of control.  Help!”

2001  “The way things are going, I might as well give up.”

2002  “I can’t do college while panicking like this.  I can’t even pick up a pencil.”

2003  “Can I turn my life around?  Is it possible?  I can’t live like this anymore.”

2004  “Ooooh…alcohol…what a nice way to forget my problems!”

2005  “Alcohol is useless.  Trying to do better.  Trying to do better.  Trying to do better.”

2006  “Eat this not that.  Do this not that.  Change is hard.  Super hard.”

2007  “Wow, I’m doing better…Just keep going.”

2008  “A1c is down.  Weight is down.  I can run a 5k every day.  Getting married this year.  Happiness is totally up.  I can’t believe this is my life now.”

2009  “TWINS!  Must. Have. Sleep.”

2010 “We’re not poor, we’re just struggling. (Can I borrow a $5 for groceries?)”

2011 “Hello DOC!”

2012  “I can do this!  Wait a minute…I am doing this.”

Life ebbs and flows.  When you’re on the up, enjoy it and take steps to safeguard your future.  When you’re down, know that you will be back up again.  Just don’t give up hope.  Giving up hope prolongs the process between going from down to up and we don’t want that.  Don’t give up hope.

The Dangers of Some Diabetes Medications

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*This is a guest post from Barb Stephens from Drugwatch.com, a website which raises awareness to consumers about drug safety information.

There are more than 25 million Americans who have diabetes — that’s more than 8 percent of the population. You may be one of them. If you’re like the majority, you have type 2 diabetes, which means your body does not produce enough insulin or your cells do not use insulin efficiently.

Your doctor may prescribe one or more medications to help you control your diabetes. Make sure you are aware of the dangers of any drug you are given, as side effects for diabetes drugs can range in severity from minor pain to impaired vision to cancer and even death.

Drugs with Severe Side Effects

Thiazolidinediones are the most popular class of diabetes drugs. These medications work by increasing the sensitivity of cells to insulin. Unfortunately, the three drugs in this class have all had serious problems.

Rezulin was the first drug in this class, but it is no long available after being linked to liver failure.

Avandia (rosiglitazone) was the next hit in this class, but it too has been shown to cause severe side effects, including a higher risk of heart attack and liver failure.

Avandia is no longer available in U.S. pharmacies. A few patients still take it, but they have to go through a special program to have access.

Actos (pioglitazone), the world’s best-selling diabetes drug, has also been a huge disappointment.

Bladder cancer is one of the more dangerous side effects of Actos, and in some cases proves fatal.

One study showed that Actos (and Avandia) heighten risk for macular edema, which causes swelling in the eye. Another study showed that the same two drugs raise the risk of bone fractures in post-menopausal women.

Drugs with Less Severe Side Effects

There are other popular diabetes type 2 medications, which all come with common side effects (including low blood sugar). Most of these side effects are milder, like stomachaches, weight gain and gas. Many of these side effects will decrease as your body adjusts to the medication.

Biguanides work by preventing the liver from releasing a high amount of glucose.

Side effects may include nausea, metallic taste in mouth, vomiting, cramps, diarrhea, gas and loss of appetite.

Sulphonylureas work to decrease blood sugar by stimulating insulin release from the pancreas.

If you retain water, have congestive heart failure, or have cirrhosis of the liver, approach with caution.

Side effects may include upset stomach, skin rash or itching, weight gain, breathing difficulties, drowsiness, muscle cramps, seizures and swelling of the face.

Alpha-glucosidase inhibitors stop enzymes that help digest starches, which prevents blood sugar from spiking.

Side effects may include upset stomach, diarrhea and gas.

Meglitnides stimulate the pancreas to produce insulin.

Side effects may include upset stomach.

D-Phenylalanine Derivatives stimulates insulin production after a meal.

Side effects may include dizziness and weight gain.

Dipeptidyl peptidase IV (DPP-IV) inhibitors help insulin to work longer and prevent the liver from producing too much glucose.

Side effects include runny nose, sore throat and headaches.

While the FDA looks into the more serious side effects of these medications some patients have chosen to start filing cases against companies, an example being an Actos lawsuit after incidents of bladder cancer resulted when taking the medication for longer than a year.

You can take an active role in the health by alerting your doctor to any pre-existing conditions and any significant change in your health. You should also read all of the materials that come with your medication.

Author bio: Barb Stephens is a writer for Drugwatch.com. She uses her knowledge about medications to help raise awareness about drug safety and to educate consumers and patients.

My Biggest Worry about Pumps

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“Ketones” by Ana Morales

 

I’m all about people using pumps if they like them (or don’t like them but find they manage their diabetes well with them).  It’s a wonderful device and I’m happy technology like that exists for us.  I used a pump for 7 years, which is plenty of time to experience just what pumping is all about.

So I want to talk about something I noticed during my pumping years and after them.

It occurred to me recently that my numbers rarely go high enough to induce DKA.  I can count on one hand the occasions in the past 5 years where my blood sugar has gone over 350 and it hasn’t been over 400 in 6 years.  I’ve been off the pump for 6 years and find I can’t go back, yet.  One of the most dangerous things in my mind is DKA and very high blood sugars.  I experienced super high blood sugars enough as a teenager to know I never want to go through that again.

When I was on the pump, it was a regular monthly occurrence to have a 400+ blood sugar reading and it was almost always due to a pump or tubing or pump site malfunction.  I knew that my being human provided sufficient variability and error to my diabetes management and I began to seriously resent the pump for adding to that risk simply because I didn’t have the energy to keep up with it’s extra requirements.

What I mean is people who don’t endure these pump issues have very good discipline when it comes to changing their pump site and checking their tubing and changing the site when they suspect they need to.  However, I know that many of us don’t do this.  I completely understand why-it’s hard to keep up this kind of diligence, especially if it means inserting a painfully long needle more times than we’d like.

Those who use pumps should probably be in a very good place when it comes to their motivation to do all that is necessary to successfully use the pump.  I was not one of these people because I resented wearing the pump and as a result, kept my site in too long sometimes and suffered the consequences.  Of course, sometimes, we can do everything right and something wrong can still happen with the pump though the likelihood is very much decreased if we keep up the right routine.

I love using syringes because I get piece of mind each time I give insulin, knowing I don’t have extra variables to contend with (there are SO many as is).  And mostly because I never have a high blood sugar surprise that is a result of my not receiving any basal insulin for a mysterious amount of time.  The danger of very high blood sugar isn’t just that, it’s also the lows that can result from giving insulin over and over again in an effort to push that really high and resistant blood sugar down.

Obviously there is more involved in keeping blood sugars stable.

Reducing my carbs and using shots has made my blood sugars so much more stable, with little extra effort involved.  And to me that’s practically miraculous in terms of gains to my quality of life and health.  So while I don’t mean to say that people shouldn’t use a pump I just think we should each be honest with ourselves about how it works for us.  I realized I was no longer a good candidate and got off the pump and there is nothing wrong with that.  And there is a good possibility that one day I’ll get back on a pump.  They are making wonderful improvements to pumps each year and I’m becoming a more responsible and disciplined person each year.

Very well meaning people tell me all the time, “but don’t you miss being able to sleep in and eat when you want?”  News flash my friends, there are now long acting insulin such as Lantus which serve as a basal insulin.  The NPH and R insulin of the past are just that.

I guess what I’m saying is, are you having a lot of extremely high numbers due to pump issues? If so, work to reduce them with your healthcare team and if you know in your heart that you aren’t keeping up with site changes and all the pump requires, think about your options.  Whatever you do, do it in favor of your health.  Everything else will surely fall into place.

Reminder to Self

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From my head AND my feet.

I recently had a two week stint of…oh I don’t know, diabetes burnout or just feeling “blah” and unmotivated.  I didn’t exercise much for two weeks and I had some processed food and began to need about 25 units of my long acting basal insulin a day.  I’m back on my exercise routine and regular eating pattern and I just wanted to share that I’m down to 15 units of my long acting.  That’s a huge change isn’t it?

I don’t know which I love more: healthy food or exercise.  I feel like I can’t manage my diabetes unless I use the powers of both.

Sometimes I’m jealous of our ancestors.  Exercise was a built in way of life (no cars, no TV, no internet, no food unless you work for it).  Healthy eating was a lot easier (no processed or gmo foods, no two week old produce shipped from another continent.)  See?  They almost had it easier.

How can we make the most of what we have?  How do we exercise smart choices over temptation?

I don’t know about you but what helps me is to meditate and work on being aware of what I want for myself.  This keeps me focused (most of the time) on what needs to be done to get me where I want to go.

I’ll try to remind myself of all this next time I go into a “I don’t feel like it” phase.

29 Things to Be Happy About Today

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Today I turn 29 years old.  While I’m a little bummed that this marks the beginning of my last year as a twenty-something, I’m going to focus on happy thoughts instead.

1.  Despite my children calling me anything but “mama” (they can say “mama” they just don’t want to) at least they are healthy, kind, and have quite a sense of humor.  That’s all I ever want for them.

2.  My husband is out of state for work, which is hard on us, but at least he’s got work.  Others aren’t so fortunate.  (Alex come baaaaaaaaaaaaack!)

3.  I had a first call with my training coach for A1c Champions the other night and it was awesome.  I’m so excited.

4.  My mom watched the kids on that call from the other night.  I don’t know what I’d do without her.  Or my dad.  Every time I need uplifting, he knows just what to say.

5.  Today, if I have anything diabetes related I want to discuss, I have an entire community of people available who help each other out.  A few years ago I had no clue that existed.

6.  My little brother keeps wowing people with his guitar playing.  I won’t lie.  I’m excited at the prospect of having a famous family member one day!  When he was 3, I knew he was going to be something really special.  As usual, I was right.  Here he is from this past weekend.

7.  I have a husband who feels comfortable enough with me to tell me when I’m being an arrogant know-it-all.  I appreciate that level of honesty.

8.  My sister Ana, who has type 1, is about to start her senior year of college.  She is number 4 of us 5 kids and the first to finish college.  I’m so proud of her and am glad I can call her artwork my favorite (and I love that I don’t have to lie about that).

9.  I have two other siblings who I never mention on the blog but I should.  I have a brother named Alejandro who is a year younger than me.  I’m happy he’s fighting to make his life what he wants it to be.  Growing up with him helped me try harder at everything because he was always so smart and athletic and generally good at everything.  I hope he remembers his immense potential.  I have a younger sister named Sara who also should remember her potential.  I’m amazed at how she handles being a single mom to two young kids.  I have been doing it for a few weeks due to Alex being out of town and I’m just about ready to lose it.  And Sara always looks so cute.  I don’t know how she does it.  I’m happy that they are both close by.

10.  I’m grateful I have health insurance.  It’s a big deal and I wish this for everyone.

11.  My brother-in-law gave us his old TV a few days ago.  It’s huge and in our bedroom and I no longer have to watch movies on the computer screen, from the computer chair.  I feel positively spoiled!

12.  I love blogging.  I spent years aching to write and now I get to do it all the time!

13.  I’m happy it’s not Winter.  lol

14.  I love that last night my kids were mocking me.  They repeated what I said with their hands on their hips.  It was hysterical.

15.  I’m very thankful for Lantus.  I’m a fan of my insulin-aren’t you?!  hehe.

16.  I just discovered the show Frasier.  I was too young to get into it when it was on but now I’m watching it from the beginning and I have to say it’s my all time favorite show!  I totally relate to Frasier and wish I had a brother like Niles.  Is that weird?  Don’t answer that.

17.  Yay for TED Talks on Netflix!

18.  My birthday is on Fabulous Friday.  How nice.

19.  I’m attending the best nutrition school ever.  It’s compassion for people and respect for their differences is awesome.

20.  You really don’t want to read more than 20 right?

Thanks for all the birthday wishes, they made this warm and fuzzy post possible :)

Pin A Personality!

 

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I pinned Hope Warshaw, who is a member of Diabetes Advocates and author of multiple books for people with diabetes.

 

We need people to see the blue circle and immediately think, “DIABETES”.   The more united we are under one symbol, the better outcome we’ll have in our advocacy and awareness efforts.

The International Diabetes Federation is behind this mission and are encouraging us to “Pin a Personality”

Here are the instructions straight from the IDF:

“Take a picture of a personality with the blue circle pin.

How to choose a pinable personality?

Your personality can be anyone who you think would profile our blue circle to a wider audience or contributes to IDF’s mission to promote diabetes care, prevention and a cure worldwide.

Your personality could be a local celebrity, a politician, a teacher, a chef, a local councilor or your gym instructor.

Do you have anyone in mind or are you attending an event before November 14? Will you see anyone pinable? Let us know at wdd@idf.org and we will send you some blue circle pins.

Upload your photo to our World Diabetes Day Facebook page or on Twitter using #WDDPin by November 14. Don’t forget a short one liner explaining who your chosen personality is!

Let’s get the blue circle out there and recognized as the global symbol of diabetes!”

 

My blogger friend Stacey graciously pinned a few personalities because yours truly is a wee bit shy about these things…

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Dr. Nat Strand and Stacey with DiabetesSister’s Founder Brandy Barnes.

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