Living With Diabetes

Saw my MD sleep doctor yesterday. Was almost at the end of my rope, tired, which they could all see. That was good.

I asked for pain pills and we compromised with a 24-hour anti-inflammatory which seems to help already. Felt better going to bed, and feel better today.

Also got a narcolepsy drug also labeled for OSA (obstructive sleep apnea), for the sleepiness, but so far, I think it just makes me want to toss my cookies more. I think that is a symthom of not enough sleep too.

They also sent me home with an oxymeter. So here I am, sleeping with a CPAP, an insulin pump, and the oxymeter. I got completely woud up in the mess and had to take about 5 minutes to get unwrapped around 1:30. Husband was dumb enough to ask if I slept okay. NO, I DIDN'T! But I think they got good data, as I woke when I often do.

I've been going through a weird cycle -- hopefully we can get this fixed. I get progressively more tired, more strung out, then finally get to a point that I sleep the sleep of the dead -- often as much as 10 hours (machine showed this to the doctor). I predict that really good sleep is going to hit in the next couple of days. Or at least I hope.

I also wake up a lot during these cycles. Last two nights were around 4 times. I usually only have to get up once -- but do have a bit of trouble falling asleep, especially when bond in medical cords

FYI: being tired seems to increase my insulin resistance slightly. I'm consistently running 10-20 points higher both yesterday and today, and have the temporary basal on.

Posted by at 11:58 AM | Permalink

Husband and I were both very ill at the same time with something that caused vomiting and diarrah. We've never been sick at the same time before and it didn't go well. Usually there is someone in the house available to go get whatever we're out of that the other person craves. Not this time.

We're both feeling better now, and have restocked on "sick" food.

Weight loss is going super, and I'm using less insulin than I ever have, finally. I met with my CDE about it on Wednesday, and got some good ideas on how to proceed. We've agreed to meet monthly. I've gone from 100-120 units a day to 50-60 units a day, total. AND I have much better control.

I've lost somewhere around 15 pounds, I think, since I don't know my max -- the scale was broke when I started and I thought I weighed twenty pounds less.

Sleep isn't going well at all, but being sick didn't help that. I'm seeing the sleep medical doctor on Thursday. I've come to the conclusion that I probably need to take some light pain pill -- but heavier than OTC a few hours before bedtime and that would solve most of it.

Also getting rid of the gastric reflux coughing too, but I think some of that will come with more weight loss.

The other really good thing is that I've been able to work out in the morning at least 6 days out of 7 -- and still get the workout down in the afternoon.

Posted by at 11:30 AM | Permalink

Yahoo! News - Arkansas Governor Trims 100 Pounds

Interesting story ...

Posted by at 10:06 AM | Permalink | Comments (1)

AVENTIS > Aventis Receives FDA Approval of its Rapid-Acting Insulin Analogue Apidra®

Not sure what this means for us as diabetics or pumpers, but it is intended for pump use, and it is a 15 minute meal insulin. However, I haven't been able to find any thing else on the profile. I figure the more tools we have -- especially since I'm allergic to humalog, the better.

And of course, the online pharmacy doesn't have it listed yet.

Apidra has been studied in clinical trials in adult patients with type 1 and type 2 diabetes. It is designed to be injected within 15 minutes before a meal or immediately after a meal (within 20 minutes after starting a meal). It is intended to be given by subcutaneous injection, or by continuous subcutaneous pump infusion.

Posted by at 4:58 AM | Permalink

I'm very proud of myself, because my pump tweaks are working well. HOWEVER, I'm calling Monday and asking for a new pump because last night the occulsion alarm went off again and this time I slept for 3 hours.

The good news, is that my blood sugar was 117 when I woke up.

Posted by at 8:22 AM | Permalink

iShape and the personal gym in the house is working out extremely well. iShape gives me a means of tracking and the support I was missing from the gym that closed.

Having the gym at home cuts down on the excuses, especially morning ones, and I've been able to do most of my working out in the morning since I got the new CPAP mask and got the insulin adjusted correctly. Both are contributed to the lack of morning grogginess.

I am guessing I've lost at least 15 pounds, but since I don't really know what my highest weight is, that is only a guess.

The good news is insulin usage. Last night, I cut my midnight to 4:00 am basal to 0.95, from 1.0, cut my 4:00 am to 8:00 am basal to 1.10 from 1.30 and my 8:00 am on basal to 1.05 from 1.10. I'm not sure how that all refects in total basal yet, or in total insulin usage, but most days I'm in the 60-65 units a day range right now. And that's with good control. I occasionally still have a bad day, but since it takes almost a week to recover from a bad day, I think I'll be avoiding them more and more.

I see my CDE on Wednesday to work on planning for more weight loss.

Posted by at 6:49 AM | Permalink

This article requires registration. And the article was sponsored by Slim Fast. But interesting, non the less.

Weight Management and Type 2 Diabetes Mellitus

Weight loss is an important but difficult therapeutic objective for people with type 2 diabetes. The best dietary weight-loss strategy has not been defined, and all such strategies are compromised by the body's potent methods of maintaining energy homeostasis and defeating weight loss. The ADA currently recommends a reduced-fat diet as part of a structured program of lifestyle change for weight loss. Daily use of meal replacements can be an effective strategy for some people but must be continued long term if weight loss is to be maintained. Currently available weight-loss medications have modest efficacy but also must be continued long term if weight loss is to be maintained. More effective weight-loss medications will probably become available in the future as the biochemistry of energy balance becomes better understood and new pharmacologic tools are developed. Gastric bypass surgery is currently the most effective long-term weight-loss strategy, but this approach has not been compared with medical therapies for patients with type 2 diabetes and should be reserved for those with type 2 diabetes and BMI > 35 kg/m2.

Posted by at 6:36 AM | Permalink

I went around the corner to a day spa -- I've been there only once before -- and had a stress release massage. I think that helped, as last night was the best night I've had AND the husband wasn't at home -- that always bothers me.

Did wake up at 2:00, but I've been worried about blood sugar. Glad I did as the massage did elevate my blood sugar. At least I assume that's what did it.

I also think the adjustment I made on the basal was on the money since I'm at 106 now.

I'm also still able to get up in the morning work out -- though tomorrow will probably be difficult. Tonight's my dog agility night and between the physical activity and the stressful drive home -- it's a good hour in bad traffic -- I usually have trouble shutting down.

Posted by at 5:09 AM | Permalink

BBC NEWS | Health | Sticking plaster to aid diabetics

Interesting. Of course, it takes forever for these things to reach the patient.
Sticking plaster to aid diabetics

Posted by at 4:50 AM | Permalink

Even a commenter has complained on my blog about the Animas pump noise. I'm calling them today, because I slept through their siren for almost 2 hours.

WEIRD!

I have never thought my pump was very loud, and have always thought the complainers were nuts.

Posted by at 6:44 AM | Permalink

I talked with my CDE -- who I will see on Tuesday, and I want us to make a comprehensive plan for me to use in reducing insulin while I continue to lose weight. Yeah, I'm being a optimist. I am believing that nothing weird is going to happen to throw me off.

Oh, and I still haven't heard from the sleep doctor ... snarl.

We're going to reduce the night time basal first, since I don't know if I will wake up if I am low. Actually the 4:00 am basal. We're reduced it by .10 units.

If I can keep mornings stable, but still hit lows in the afternoon, I'm going to go from 5 grams of carb per unit to 6 grams, since I really like the afternoon's without carb freeze.

And I'm doing my part on the sleep -- I'm heading over to a day spa and having a stress massage.

Posted by at 5:55 AM | Permalink

Well, the first question -- yes, it was the siren, and yes, I had to take the batteries out to fix it, is yes -- that's the way the pump is designed.

The second question left the customer service rep with his mouth open, no one had ever complained that the siren was TOO quiet. We decided we'd wait until I slept through another siren before dealing with it.

Also -- I had to turn the pump down by 10% this morning. I was at 96 at 8:30, down to 93 at 9:00 so cranked it down and stayed stable all morning.

I haven't changed my lunch basal setting yet. I want to make sure there is a problem before I do, but am watching close. Abbott/Therasense/Medisense will love me because I am going through so many test strips.

I might want the CGMS now. I can get one for three days, but need to find out hw often. I would rather use it when I need it.

Posted by at 1:32 AM | Permalink

First, I'll apologize with boring everyone with the sleep reports, but here, I can pull them and get them just about whereever I am at. Could even download them to the Palm. Yes, I'm geeky. But what else would you expect.

The iShape thing is really working out well. It's nice to get up in the morning and know what I need to do to work out. It's nice to let someone else make all the decisions. I get up, check iShape, delete their meals, put Diet Gourmet in, and then sort of plan snacks so I keep as close to 600 calorie deficiet as I can.

Yes, I'm losing weight. Yes, people are even noticing. One of the counselors said something about it today. Clothing is fitting well. However, I'm not noticing it on the agility field yet, BUT Excellent is a long way to run. I'm going back to the beginning with a different venue on Sunday and it will be interesting to see how that goes.

Oh, and I'm also seeing a decrease in the amount of insulin I need. I actually ended up eating 4 lifesavers at school WITHOUT insulin, as I could feel I was headed for low. I had a piece of chocolate WITHOUT insulin on the way out the door to get a manicure, because my blood sugar was in the 90s. (I actually eat some sugar if I see the blood sugar in that range before I get in the car). I even ate a low-carb sandwiche with two pieces of bread WITHOUT insulin, and right now, my blood sugar is 133!

I'm going to have to keep a close watch on the blood sugar for the next few days, and may touch base with the CDE.

Posted by at 9:51 AM | Permalink

It is 9:35 and I am STILL groggy. I had a heck of a time driving in, and I am STILL cranking.

Right now, I am playing with the idea of planning on taking tomorrow off and catching up. It certainly didn't happen last weekend, and I know it won't happen next weekend.

And nobody is real happy with me cranky!

Posted by at 9:36 AM | Permalink

A Chance to Cut is a Chance to Cure

Very good article on the cons of bariatric surgery.

Posted by at 9:20 AM | Permalink

Nateglinide Reduces Both Post-and Interprandial Glucose Levels

I think we'll be seeing more of these kinds of studies.

Posted by at 7:10 AM | Permalink

Ketoacidosis Episodes Higher For Insulin Pump Users Over Glargine/Lispro or Aspart

Posted by at 7:08 AM | Permalink

Took an Ambien last night and went to bed before 9:30. Did not wake up all night at least, but now I am SO groggy.

Having trouble waking up. Which is why I hate the stuff so.

Posted by at 5:27 AM | Permalink

It is 12:35 and I am STILL tired. I have been groggy and have felt off for most of the day.

Posted by at 1:34 AM | Permalink

Fought sleeping all day -- as a result ate more than I planned to. Common sympthom for me when overly tired.

Had trouble going to sleep, but not due to mask fit. Was able to stay in bed until 5:00 am but woke at 4:15 and could not go back to sleep. I think I woke at least one other time, maybe two. but was able to go back to sleep.

This is NO fun.

Posted by at 5:10 AM | Permalink

As Obesity Surgeries Soar, So Do Safety, Cost Concerns (washingtonpost.com)

I do have a friend who is recovering from surgery and I saw her yesterday. She is looking good, is definately losing weight. She was complaining of low energy level though.

Posted by at 6:42 AM | Permalink

Sleeping was better. Getting to sleep still took a long time, but at least the mask stayed on and was comfortable. I woke up a lot, but forced myself to stay in bed. Woke up around 4:00 am as usual but stayed in bed and let the alarm clock wake me at 5:00.

Definately feel better this morning than yesterday.

Posted by at 5:46 AM | Permalink

This is primary for me and the sleep doctor, I'm having trouble sleeping, and this is the best place to write things down and keep them.

Last night was rough.

First, I couldn't sleep, the mask kept leaking and when it did, it made a popping sound. That went on until around midnight.

At around 1:30, my pump sounded an occulision alarm, which meant I had to wake up and prime it before it would shut up.

Then I woke around 2:00 am not sure why but was able to go asleep with difficulty. Woke again in the 3:00 am time frame and again couldn't sleep. And then again at 4:15. Again, had trouble going back to sleep.

Part of the problem at 4:15 was that I just didn't want to be in bed and in the mask any more, though I did keep it on. My face was a bit greasy and it was sliding around.

Am guessing, but did end up eating some crackers around 9:00 -- I was at a big calorie defiect and wanted to get in at least another 200 calories.
I had let the evening get away from me. One of my goals is to not go into starvation mode. I've done that before when losing weight, and it makes the whole process harder.

I was able to wake up with no problem at 5:00 and am downstairs doing iShape schedule strength exercises.

Posted by at 5:30 AM | Permalink

Came home, took a long nap -- almost 3 hours, and had absolutely no mask or other issues.

Weird. Though woke up because I felt I needed to get out of bed now.

Oh, and had eaten lunch about an hour before taking the nap -- a 700 calorie lunch, vs. the 200 calorie snack last night.

Posted by at 3:37 AM | Permalink

If you get diagnosed with diabetes -- see an endo, even if you have to travel a few hours to get one.

I just got home from seeing mine, I met him and his staff 4 weeks ago. They are super and have made all the difference in the world.

I will have to admit the new CPAP mask is helping too, BUT my blood sugar is best it's been since I've been diagnosed and I feel SO much better.

Food is easier to control because I am not having sugar cravings, one of the biggest side effects I have from high blood sugar.

And did I say I FEEL better?

Or and I've lost 9 pounds even though I'm using almost 10 more units of insulin a day.

Posted by at 12:47 PM | Permalink

Well, for some reason, they couldn't download my CPAP machine.

However, I've lost 9 pounds since I saw her last which made her happy. She could see I felt better which also made her happy.

I'm having a weird problem with the mask. If it is in the right place, it makes me gag, if it is about 1/4" inch, I'm fine, but she's worried it will leak. Weird.

We did have a conversation about how I felt last time. She did acknowledge that she knew I was upset.

I am still having problems falling asleep and acknowledged that Thursday was my problem, but the rest of the week is still an issue. Also complained about waking at 4:00 - 5:00 am -- I want to wake at 5:00, but not at 4:00. In fact, I've gotten up a few times when I've woke up at 4:30, since it wasn't worth trying to go back to sleep.

We agreed I'd call in two weeks and we'd see if I had improved.

The endo appointments have been going better.

Posted by at 7:43 AM | Permalink

MSNBC - Eyeball jewelry a new Dutch fashion trend

Eyeball jewelry a new Dutch fashion trend

Posted by at 10:45 AM | Permalink

I think you have to register (but it's free, and I don't think you have to be a doctor, but not sure) anyway, I quote the part that worries me.

Reclassifying Insulins

Insulins have hitherto been distinguished as clear (short-acting) and cloudy (long-acting). However the introduction of glargine, which is a clear long-acting insulin, has prompted the need for reclassification. In view of the increasing emphasis on intensive insulin therapy using basal-bolus regimens, a new, simple, pragmatic classification is suggested in which insulins are categorised according to the timing and purpose of administration: basal (maintenance), bolus (meal) and biphasic (mixed).

I'm a member of the internet insulin pump users list, and periodically we get an email from a member who has been given the wrong insulin by a pharmacist -- they always catch it because the insulin is cloudy instead of clear.

Clearly, pharmacists are human and make mistakes. I always double check my boxes when they come in.

HOWEVER, how are we going to catch this mistake? Hopefully they won't make the mistake -- BUT THEY DO!

Shouldn't this insulin be cloudy? Or another color? Someway the poor unsuspecting diabetic has to make sure someone isn't accidently given him the wrong meds?

Posted by at 6:12 AM | Permalink

Abbot Labs has acquired Therasense (makers of the Flash meter).

According to the press release, they are combining the two test units -- Therasense and Medisense.

They have made a lot of changes to the website too.

Posted by at 11:08 AM | Permalink

Postprandial Insulin Lispro May Impair Long-Term Glycemic Control

Insulin Lispro is Humalog -- it peaks at about 1 1/2 - 2 hours.

This is a discussion that comes up quite a bit on the insulin pumpers list. I've actually played with this -- and haven't seen any real change.

I would like to see what the time differences really are -- since I'm a teacher, I tend to eat fast, unfortunately.

Posted by at 8:01 AM | Permalink

I'm actually managing to wake up and exercise before the day starts more often than not lately.

Couldn't wake up last Thursday or Friday morning, early enough to get my "assigned" exercise done (I'm doing the iShape thing)., but did the majority of the week.

And this week is going okay, so far. Of course we're talking Sat, Sun, Mon and Tuesday only....

Posted by at 7:00 AM | Permalink

Yep -- this is why I saw a cardiologist this year and plan to visit one yearly now.

Why I keep up with the diabetes so hard.

I saw some patients like this when I did the pet therapy thing -- neither of the current dogs are pet therapy candidates -- but it is cheaper and easier to prevent, then to deal with the consequences.

code blog: tales of a nurse: There are fates worse than death

Posted by at 6:58 AM | Permalink

I was awaken by our police department at 4:30 am -- I usually call them our Finest, but friends call them the Gestapo, and this morning was why -- they had someone pulled over, probably for a minor traffic violation.

They are pretty good about making people pull over to the FRONT of the house, where it doesn't bother us, but for some dumb reason, they stopped on the street that runs along side. A dangerous spot, besides being under my bedroom window.

And for some weird reason, I keep waking up around that time frame anyway ... but was hoping ...

I've been nausiated every since, and have almost thrown up several times. Those of you who are diabetics realize that being on insulin and tossing your cookies don't mix, as you are never quite sure how many carbs remained in the stomach.

Plus the building is TOO hot, so between all that, I keep either falling asleep or running to the restroom.

ARGH! I wish I knew why I get this problem with nausa.

Posted by at 12:19 PM | Permalink

Tigers' Johnson, a diabetic, pumped up to pitch today's opener

Posted by at 9:50 AM | Permalink

Times Record News: Local News

These kiddos are in Wichita Falls, Texas

Posted by at 9:47 AM | Permalink

See Expert Patients

Several of the doctor medlogs have blogged on this issue.

I consider myself an "expert patient" and I agree that it's a misleading term, as it implies to me, that it might be derogatory.

There are two types of diabetic patients (and I am not referring to Type 1 or Type 2). They either fall under the expert patient category taking an active roll in their care. If you pump, you almost always have to be an expert patient.

The other type eat when and what their doctors tell them to. Can you imagine living a life where you eat at, say 8:00 am, 10:00 am, 12:00 pm, 2:00 pm, 4:00 pm, 6:00 pm and 8:00 pm, and they eat a precise amount of servings of carbs, protein and fat.

I actually know of a pumper that lives that way. My mother told me about her. Apparently years ago, her pump was programmed by her doctor and she has lived that way ever since.

I suppose that might work for someone who has been diabetic all of their life, but it certainly doesn't and wouldn't work for me! It really puts a crimp in your style if you want to socialize -- which is when my mother found out about this.

I really advocate being on top and in control whenever you have a chronic illness. That CPAP go around is a prime example though, of what happens when the patient is ready to be an expert and the doctors aren't

And of course to be effective as an expert patient, you have to research it all. Not just the advances, but the costs and the implications.

FYI: One of the good things about buying the pump last year, is that it, along with my husband's medical bills, managed to reduce our income tax overage from $1500 to $750, and eliminated the possiblilty of a fine for the IRS for underpaying.

Posted by at 2:43 AM | Permalink

MSNBC - Gastric bypass riskier than many patients know

Many of the reasons I'm not ready to go there.

Posted by at 9:04 AM | Permalink

Yep, I'm still doing iShape, and since the new CPAP equipment have been able to get up and work out in the morning.

The neat thing -- is that I got an email this morning, extending my iShape membership for 8 more weeks for $15.00

It really helps, having some guidance.

Posted by at 11:59 AM | Permalink

MSNBC - Medical school starts obesity course

Good idea.

Posted by at 10:17 AM | Permalink

This is pretty sad, actually.

Yahoo! News - 'Wristwatch' Monitors May Miss Low Blood Sugar

Posted by at 8:18 AM | Permalink

But I am still wondering if we should up my basal at lunch time instead....

We moved my insulin to carb ratio at lunch from 1:8 to 1:5. TODAY, it worked. Though I was still sleepy but that might be more due to the heat in the building. I'm on the second floor with 30 computers, and usually that many students, so this time of year it's hot.

But after lunch has always been my toughest time. My blood sugar is typically very high after low, but then goes low right before dinner. It's even more pronounced when I work out after school.

Posted by at 2:48 AM | Permalink