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April 2004

Sleep problem update

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.

Been an interesting week

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.

We have a new insulin

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.

Good day..

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.

Speaking of Weight Loss...

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.

Interesting article on weight loss and Type 2 Diabetes

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.


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.

Animas Pump noise

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.


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