Diabetes Self-Management Blog

Often, when I don’t really know what to blog about, I default to an entry about blood glucose. Why? Well, I’m Type 1, on insulin therapy, and using an insulin pump, so no matter what else I have going on that I need to pay attention to for my diabetes self-management, blood glucose is it. It always comes back to blood glucose.

There’s no lack of stories I can find in my daily endeavors at better blood glucose control, and so this week I thought I’d write about an attempt to be my own continuous glucose monitor.

But more about that in a moment.

Having just come off of a three-part series on my new — or rather my replacement — insulin pump, I realized that the past two weeks of my life with diabetes has been quite uneventful. I’m not complaining, but I write this blog about my experiences of living with Type 1 diabetes. I don’t often write about what’s going on in the diabetes community. But, sometimes, for inspiration, I’ll surf the Internet for other diabetes news. This week I found other diabetes news that piqued my interest, and while I don’t want to write much more about the following two stories, I nonetheless want to help continue the discussion. And so I’ll put these stories out there for you.

The first is a letter to the editor by the parents of Steven Krueger. Please click on that link, because to try to provide a synopsis here would result in my going way over my word count. I want to write so much more about this, but honestly I don’t know where to start. I think, “This kind of thing shouldn’t happen.” I think, “Given that we hundreds and hundreds of thousands of insulin pumpers are wearing something mechanical and computerized on our persons, that this is bound to happen to someone at some time somewhere.” And I self-protectively think, “The odds are slim it would happen to me.” I then think, “This story scares the hell out of me.” And I keep on thinking. About this. Every day since I came across it last Saturday.

The second is a story that I got in my RSS feed from Six Until Me — one of the best almost-daily blogs about living with diabetes. It’s an entry that Kerri Morrone Sparling, the author of the blog, discovered through TuDiabetes (another great blog). And I wonder, if I was treated this way if I took my pump to the pool, how I’d react. Would I capitulate? Would I raise a fuss? I don’t know.

Now, back to the mundane:

A few days ago I checked my blood glucose at work, around 10 in the morning. It was a slow day, and when I checked, the reading was 89 mg/dl. A knee-jerk reaction when my numbers are only double digits is to correct with some fast-acting carbohydrates, because I assume that when the reading is under 100 mg/dl more than two hours after having last eaten something, my blood-glucose is on its way down, not up.

This time, however, I thought I’d experiment. So I got some fast-acting carb drink at the ready, and rather than drink it, I decided to wait it out this time to see what would happen. I checked my blood glucose every five minutes. For about fifteen minutes the numbers remained in the 80s. And then at the 20-minute mark it dropped to 75. I checked on another blood glucose monitor and its reading corroborated that I was in the 70s. OK. Fine. I still felt good. Would I level off and begin to move back up?

Five minutes or so later, or roughly 30 minutes after I would have initially carbed up upon seeing a blood glucose reading in the 80s, I began to feel it. The low. The feeling that I always find difficult to describe but that seems to begin with a wooze-out in my legs, then a laziness that creeps into my arms, and a lightness that’s at once pleasant and unpleasant. (Part of me thinks that an entire book-sized stream-of-consciousness of living through a low is in order from someone. Electric Kool-Aid Insulin Test, maybe?)

To combat the low, I sipped on some juice and realized that, yep, I don’t level off and go back up; I continue to head down. So the lesson I took from this little blood glucose observation is that I’ll continue to treat my readings in the 70s and 80s as I have been: immediately.

Sure, I could do some tweaking to my insulin-to-carbohydrate ratio on my insulin pump, as well as tweak the basal rates that my insulin pump delivers per hour. Yet the system I’ve grown accustomed to works, for me, and it’s rather unobtrusive. So, my little non-CGM self-continuous glucose monitor experiment helped me gather more data about my self-management. Experimenting like this is not a bad thing.

Oh, and one more thing: My wife knew I was doing this. She was in touch with me via instant message and aware that I was checking my blood glucose and had juice at the ready. Were something to have happened, if I’d have become unresponsive, she would have called my phone and then probably called my colleagues. Nothing like that was going to happen, but just in case the remotest of possibilities produced such a reaction, we would have had it covered. I didn’t experiment alone.

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Comments
  1. I hit a 43 this morning. Had to go back and re-read a couple compositions; somehow they had improved significantly after some juice-chugging. Funny how that works.

    Posted by Aaron |
  2. I’m recently diagnosed type 2, and still getting a handle on getting my sugar down, while keeping it from bottoming out. A very weird situation indeed. 2 months ago, my fasting was 297 and A1C was 12. So it had been up for a while. Now my fasting is below 100, and pretty good when I eat.

    But sometimes it just bottoms out. One day I woke up from a nap and felt so bad I checked and it was 48! Now I can tell when it gets close to 70 because I get that weird “all tight” feeling but also get the shakes.. when the shakes get really bad..it’s below 70. Like at the grocery store today when it bottomed out for no reason, and there I was chugging a soda to hopefully get it back up.

    HOPEFULLY this levels out at some point. I feel like a newborn…..having to be “fed” every 3 hours….

    what a drag….boring…not yet…lol

    Posted by Lorian Rivers |
  3. I can relate to the TuDiabetes posting only because I work in the legal field (no pump yet). The most insane lawsuits are filed by Homeowners’ Associations. One of the commentors on the site was right - the associations can make wild accusations and it’s unfortunately up to the accused to put out the money and legwork to defend the insanity. That’s our legal system at work - when little “Napoleons” are allowed to run their little worlds and everyone in them.

    Posted by E |
  4. Eric-
    Be thankful you can identify the signs of lows approaching the “critical mark” and that that the feelings you describe are occuring while you are still conscious.
    After 45 years I no longer get any hint whatsoever that collapse is eminent.
    One time I had been speaking with someone who has known me for over forty years on a subject I don’t recall and detected no sign of slurred speach, sweating, wobbly legs, erratic dialogue, etc. all just before getting a glucometer reading of 33.
    Still was able to take the steps necessary to preclude a total meltdown but this was frightening to be sure and it’s not the lowest reading I’ve recorded(That would be a 26) without any indication that trouble was approaching. My friend who was present during the episode said she detected NO SIGN WHATSOEVER and she knows what to look for from our early days as compatriots.
    I’ve strongly considered getting a D4D Hypoglycemic Awareness Companion Dog and have been authorized for acceptance into their program but have had to put it off while tending to some other pressing issues not centered on little ol’ me.
    It’s one of the drawbacks that comes with having survived through the “dark ages” of insulin dependent diabetes when pork or beef based insulin was all you had available there were no glucometers, “dip-stick” urine testing which was always ten hours behind on control notification, and not always having disposable needles readily available.
    Somehow I thought the “pay-off” from having persevered through all that was somehow going to be better than development of a severe case of hypoglycemic unawareness!
    J.D.Taylor

    Posted by James D.Taylor |
  5. Dear Eric;
    Diabetes maybe boring but it’s more important to have accurate information in your blogs than the outright disinformation you will find in the ADA’s serial Diabetes Forecast.
    Harry……….

    Posted by Harry......................... |
  6. Eric-
    As a type 1 diabetic on the medtronic insulin pump, that sorry literally scares the living daylights out of me.
    I’m on my third replacement pump now, the first two malfunctioned in safe mode however.

    I loved your description of the low, that lightheaded-ness that is both pleasant and scary at the same time.

    That experiment was dangerous however…. if you’re dipping that low that quickly, you DO need to change your morning basal rate, even if it’s just by a smidgen.
    -Susie.

    Posted by Susie |

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