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Trying Times

Jan Chait

March 27, 2007

Oh, what a week! My husband is in New Jersey visiting his brother. My little friend Ryan was here on three days. My teenage grandchildren insisted on “keeping me company” even though I wanted to be all by myself, alone. And I’m trying to cut back on the amount of Symlin (pramlintide) I take, a goal that was somewhat thwarted by continuous glucose monitor (CGM) glitches in the beginning.

To top off the week, I changed the basal profile on my insulin pump and messed up one of the times, which created its own problems.

Ryan is the son of my grandchildren’s former babysitter. He usually stays with his Aunt Judi, but when she is unavailable he comes to play with “Auntie Jan.” He’s been over off and on since not long after he was born last June, but never any more than once a week. There was one period when I didn’t see him for more than a month and, when he returned, he’d become very mobile. I thought I had child-proofed this room, but he quickly proved me wrong.

Babies and diabetes, I’m finding out, are an “interesting” combination. My blood glucose is dropping and I need to sit still a bit, but Ryan decides that’s the time to start pulling books off the shelves. I take my insulin and Symlin and start to take my first bite of lunch when he wakes up from his nap and wants to be cuddled. I prick my finger to check my blood glucose and he’s trying to climb up my leg with those little, razor-sharp fingernails.

Because Ryan’s mother has Type 1 diabetes, she tells me what she does in some circumstances, but that’s always after the fact. I think I need to check out Diabetic Mommy (www.diabeticmommy.com) so I can anticipate! Honestly, I don’t know how moms with diabetes do it on a daily basis, but I sure do have new respect for them.

Bottomless-pit, hormone-ridden teenagers are another matter, but my biggest problem with mine are that they tend to eat my stuff. For example, I went to the cupboard today to get something to treat a low and found an empty box.

I could probably have used one of them around yesterday, however, despite my wish to be alone. As I mentioned, I’m playing with my Symlin doses to see if I can take less. After mentioning last week that I read drug inserts, wouldn’t you know that I skimmed over a possibly important one on Symlin? It can cause tiredness, and I’ve been tired pretty much to the point of non-movement for ages now. I found that out when I was talking to a CDE who also takes Symlin and who described feeling exactly as I have been before she cut back on the amount of Symlin she takes.

Since I have a continuous glucose monitor, it’s possible for me to see a graph of where my blood glucose levels have been. Most of the time. Saturday, the day I began my Symlin experiment, was not a good CGM day. First of all, I got the sensor wet when I took a shower, which threw off the readings for about two hours. Then they didn’t come back quite right, so I restarted it. That was another two hours. I took some insulin and Symlin for a snack that night and, just as I picked it up to eat, my husband called. The snack went back into the freezer and I forgot about it. That night, as I was going to bed, my CGM was failing to show readings, so I felt for my sensor/transmitter. The sensor had come out. No overnight readings for me.

Sunday was going to be a different day. I woke up with an excellent blood glucose reading (84 mg/dl), a new sensor was in, and I limited myself to familiar foods so I could get a better handle on the Symlin thing.

I also decided that it would be a good day to program a new basal profile on my insulin pump. Well…Monday morning my blood glucose was at 57 mg/dl when I woke up. Then it went down into the 40s. Back to the 50s. Back down into the 40s. To make a long story short, my blood glucose just was not coming up.

Have you ever tried to troubleshoot when your brain isn’t working? It took me a while, but I finally figured out that when I changed my basal rates, I’d put in the correct time—but the wrong time of day. I run a higher basal rate overnight than I do during the day and had programmed in 7 PM for the lower rate to start rather than 7 AM. I was getting nearly twice as much insulin as I should have. I ate a peanut butter and jelly sandwich—without the benefit of either insulin or Symlin—sat down, fell asleep, and woke up at 120 mg/dl.

I’ll try again today. After all, when it comes to regulating blood glucose, that’s all it possibly can be: Trying.



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