Diaberic – DIABetic ERIC

My life so far as Type 1 Diabetic

Archive for the month “August, 2012”

Diabetes Advocacy

Definition of AdvocacyWhen I decided to start this blog, I thought about being an advocate for diabetes.  I thought I could do something good in support of a worthy cause.  ‘Cause I had diabetes 🙂  and I maybe wanted to share my 2 cents worth to someone trying learn for themselves or a loved one.  And again I needed to heal my own emotional self.  A great idea.  Now as I do research for what to write about here, I am presented with a dilemma.  What do I want to advocate?  Self care, research for a cure, advise for the wayward?

advocacy n.  The act of pleading or arguing in favor of something, such as a cause, idea, or policy; active support.

By definition, I want to plead in favor of a cause, and show active support. So what is my cause, what do I want to show active support for?  Well, I am looking out for number 1, ME, first.

I,  as well as all the people with Diabetes,  want a cure for diabetes.  I ran across an article, that has concluded Phase 1 testing of an old vaccine, with a new use.  BCG vaccine is used for tuberculosis, but has been found to reverse Type 1 diabetes, even in small doses, in humans.

Great news for all of us.  Then I made a mistake, I read the comments from others.  One person was saying there is too much money being made by all of the companies that make supplies for diabetic care.  Then another reply indicating insurance companies would be interested in a cure because of their costs.  The former seems supported on the the researching doctor’s lab page declaring the research is supported 100% by philanthropic individuals and foundations.

Upon reading this today, I decided to advocate first for a cure. Second to give whatever support I can give to others affected in any way by Diabetes.   I like to think there is not a conspiracy, world wide, in diabetic supply companies that would prevent a cure from be discovered and shared.  In my optimistic view, this  just can not be.  There are other ways to make money.

I guess before I was diagnosed, I was an “advocate” for cancer.  My real photo shows my hair rather long.  I just got it cut about 8 or 9 months ago.  For the last 7 years or so I have grown my hair to donate it to make wigs for children with cancer. I always said as long as it does not turn gray, I will continue to support this.  I point this out to show that it does not have to cost you anything to be an advocate.  This blog is free, to me, but you may see advertisements when you read these pages of wisdom.  I have even added this site to a couple of search engines for free.

Right now I cannot provide monetary support, but if you can, please do.   If you can’t, there are ways to support your personal cause.  Make others aware, support local events, teach something about Diabetes to someone, anyone interested.  If you have questions, ask.

If you have a question of me, I have an email me form that I will keep confidential, and try my best to find answers for you.  Even you just want to vent.

Star date:  2456170.420139

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Little Victories

The A1C GoalLittle victories.  A good step in the right direction.  Not a complete victory, but getting there.  A positive.

I got some test results back today,  but still not where I set my goal. But headed in the right direction.  My HBA1C or simply A1C  is 8.3.  My short term goal is in the 7’s, longer term to get down to 5’s.  Considering that my number was never below 10 for a long time, and that it is almost down 1 point in 3 months, it is a victory.

A1C represents a person’s estimated average blood glucose over the last 2 or 3 months.  What happens:  glucose reacts with hemoglobin (contains iron and carries oxygen in red blood cells) and is called glycated hemoglobin. The higher your glucose, the more of the glycated hemoglobin is found in the blood.  The average life span of red blood cells is 2 to 3 months, that is why it is explained as a 3 month average.  I also read that A1C is rated more heavily for the last 2-4 weeks.  Meaning, to me, there is a sliding scale for the final number.  How the lab can tell if a cell is an old cell or a new one, I haven’t a clue. This is a real simple explanation.  There is some more science to all of this, but if you are concerned with your A1C, I suppose it is enough to know keep you glucose low, and you can expect  to have a better (lower) A1C.

I have tried different ways to lower my A1C, and daily blood glucose; more insulin, less food, different meal times, different diets, different combinations of these things until I think I found a one that seems working for me now.  I try to eat 30-35 carbs per meal, at least one piece of fruit every day between lunch and supper, sometimes a treat for being good, chocolate covered peanuts, better known as M&M’s  (The peanuts are more of an excuse to eat chocolate, but it is usually the chocolate that I really want).  I eat pretty much the same things, the same ingredients for my meals, just prepared in different ways.  For example, whole wheat pasta, I make sometimes with tomato sauce, sometimes with just a bullion flavoring or like macaroni and cheese.  It all has about the same number of carbs, just tastes different.  It makes counting easier that way. Most everything else I eat can be worked out the same way.

At the beginning of this journey, I wanted to know what I really could and could not eat. I wanted as little change as possible.   I soon realized, reluctantly, if I wanted to be in control, I would need to change a lot. I make most of my meals now, fast foods and frozen tv diners are out.  I don’t eat very much meat, and now eat almost all plant proteins. That was more for high cholesterol, more than diabetes, but that change has helped with both.

Back to little victories now, I know I still have a little more to do, but I feel I am winning.  You can too 🙂

star date:  2456166.031250

Giving Up?- Never

We all have felt like giving up, just laying down, and letting what is going to happen, happen.  I spent most of my life without diabetes, and there were bad days, and there were times when I gave in and didn’t try quite as much as I should have.  With diabetes, I had a long period, when I didn’t want to think about it, didn’t want to take care of me as well as I should and didn’t really care about too much.  I still went to work, and did my job, but it was easier to call in sick during that time.

My 1st year after diagnosis, I went to see a couple of different doctors, for different things, one was checking me for cancer, found nothing there. The other was my primary care doctor, an internist.  I saw him 2 or 3 times the first year, got my IC ratio, my basil almost right, prescriptions fixed all up.  Found out it was cheaper to buy 3 month supply of insulin, than just a month at a time.  On the last appointment that year, my doctor gave me a prescription for my insulin and other supplies  to last for a year.  So I thought, I did not really need to go back until I needed more supplies.  I don’t remember the doctor giving me any other instructions otherwise.  In my life before I had little experience with doctors, never for illness, only injuries. You always get instructions, come back in a week to check.  I don’t remember hearing other instructions from the doctor, the other times that I saw him, he made a point to give a follow up appointment before I left. The last appoint before,  I brought up about getting a pump, he gave me his opinion (I was not in control, wait a little more), he put me on a sliding scale for insulin dosage, gave the prescriptions, and sent me away.  The last time I seen that doctor, was when I needed a new prescription, I was unpleasantly surprised. The nurse first scolded me for not being back sooner, and asked who was taking care of me.  She scoffed when I said me. Then the doctor came in, some more scolding.  Even more disheartening, he threatened not to write another prescription, just too much liability, for him (??).  I didn’t say anything, but thought it is my life you are threatening. I really had to get control to not walk out, I didn’t have enough insulin to last more than a week or so, I had to take it.  I was happy when I left with a prescription, for another year’s worth of insulin. Needless to say, my test results were terrible, 11.5 A1C, high cholesterol,  I should have found another doctor, but didn’t, opting for new insurance, when I could change in about 8 months.  I did however, use the internet and social sites, JDRF and ADA sites to get help.

During that last year, I was depressed, and not sure how I was going to deal with everything.  Fortunately, I made it thru the year, got the new insurance, and a new doctor, who in turn referred me to an endo, who in turn started me going the right way with diabetes. It has only been 8 months, at the time of this writing, since the changes, but it is sooo much better now.

If I would have just given up, gave in, I would probably be in pretty bad shape now or worse.  By not giving up, I know I have a brighter future and a good confidence that I can make lemon aide, complete with a sugar substitute :D, from the lemons I have been given. I am happy to report in January my A1C was 10.0 and in Mar was down to 9.2. Still bad, but progress.

I just noticed, the bad part is much longer than the good part of this post. I am not going to change it.  Instead, I will say, the bad is much more work, than the good.  If you are “lazy” like me, and want to work smarter than harder.  Do stuff the good way, much less work.

Star date:  2456161.465278

Daily Coping

Daily coping when your body doesn’t make it’s own insulin is a combination of food, testing, delivery and  testing again and trying to understand what is happening on the inside.  I also try to be aware of how I am feeling,  like if my blood sugar is low or high. I am lucky in a way,  I can “feel” both, sometimes I can’t distinguish if the sugar is low or high, I just know something is wrong.  Thus the need for testing and test again.

Daily when I wake up I test my blood, the involves a finger stick, a drop of blood applied to a test strip, a meter reading.  This is when I decide what to eat for breakfast. I have wake up patterns, but depending on something unseen, a normal reading will last a couple of days or weeks, then low readings for a while, then high readings for a while.  I don’t really decide what to eat, but rather how much.  I like when the test shows low,because I am usually hungry, I can eat a little more.  I don’t like highs in the morning, I eat less, and feel hungry most of the morning.  A couple of hours after breakfast, I test again.  If the sugar is low or normal, and I still feel hungry, I will eat some nuts or a granola bar.  If really low, I have an excuse for M&M with peanuts :D.

During the work week, I usually have something that I made and froze just for the occasion.  Where I work they have a couple of microwaves in the break room, so heating up the food is not a problem.  I have tried several times to pick up some “fast foods” but they have never worked for me.  A test before and a couple of hours after eating is a must.  About a year ago I tried a hamburger and fries, and had high sugar levels for 2 days.

I live about 10 miles from work, so about an hour before I leave for work I test to make sure I can be safe driving.  I always have a banana or apple to eat for this part of my day.  Sometimes I need to use more insulin, sometimes not, but I always eat the snack.

Supper is almost almost always made for this occasion.  The only caveat here is I will usually make extra to freeze for lunch later on in the week.  Another finger stick and more insulin before eating is in order.

Before going to sleep, another finger stick, insulin (if needed) and depending on my “cycle” for morning sugars levels, I might eat a little bit to try not to go too low during sleep.  It is not fun to wake up at 2 am to take care of lows.

That takes care of just eating.  There is more.  I have an emergency bag that I take with me any time that I am going to be away from home for more than an hour. The emergency bag has an extra battery, a couple insulin reservoirs, a couple of infusion sets, the device to insert the infusion set for my pump.  I also have some alcohol prep pads, a couple of syringes, glucose tablets, a glucagon kit, extra test strips and  lancets.  Depending on when I last changed my reservoir, I may also carry around insulin too. Almost everything in there gets rotated too, and replenished as needed.

In my desk at work, I keep a battery for my pump, at least a dollar in change for the snack machine,  an old test strip container to keep used test strips and usually some glucose tablets.

In my car again I keep some change and glucose tablets.  I also have one of those portable coolers that plugs in to the lighter outlet and keep about 10 packets of sucralose.

After I was diagnosed I never had a real emergency, but I hope I am prepared for one.

I try not to miss work too often.  If I don’t feel well because of diabetes, I go to work, and try to deal with it as best I can while trying to do the normal work.  I let everyone know that I have diabetes, and feel like too many missed days give not only me, but everyone else with diabetes a bad reputation.  I don’t make a big deal of it either, however if someone asks, I try to give them an answer and give a positive impression.

I started this blog as a means for me to cope.  Many times it helps to get out there and just say something.  On my links page is another coping method. I visit some of the sites there daily just to see if there is something new and interesting.  It is also reassuring for me to know, that others have the same issues and questions and learned how to deal with it all.

I don’t have too many bad days anymore. And bad days are not as severe as they once were.  I think because of what has been become the above “routine” and with research and understanding about diabetes.

Star Date:  2456159.171182

Costs of Diabetes

I have been thinking about some of the costs for diabetes. In particular, testing supplies, namely blood glucose test strips.

Of all the supplies that I need those are by far the most expensive, and wasteful.  Without insurance test strips cost somewhere around $1 per strip.  I use at least 4 a day, but can use as many as 10 on bad days.  With my current insurance, it is about $.15 each.  Here is where the problem is:  each strip is one time use only.  I tried to put a used strip in the meter one time, and it complained, loudly.

Diabetics have been complaining for years about the costs of these tiny strips.  Manufacturers say  the chemicals and metals used, cause the cost to be so high.  These are the manufacturers that give away the meters that can only use their strips. While some other manufacturers that don’t give away meters, sell strips for about 60 – 70% less.

From the above 2 paragraphs I have 2 ideas to help lessen the burden on those of us, that know frequent testing is key to good control, and good control is key to living a long, healthy life.

The first idea, recycle old strips.  I understand that the strips use chemicals that may not be able to be recovered and reused, but the metal should be able to be recovered and reused. I have read the metal is gold.  I have also read in different places where used test strips are found all over the place, under couch cushions, bottom of purses.  One person found a trail of them on the way to the gym they used.  Lets start a recycle campaign for strips.  Keep your old strips in an old container they came in, turn them in when you need more, and get a discount on new strips.  That simplistic idea saves on 2 things, the gold recovery, and maybe reuse the container, may be cheaper to sterilize and refill than to make a new one every time.

The second idea, don’t give away free meters, make some of profit on those as well, not just a loss.  Manufacturers that don’t give away meters, are able to sell strips for less.

A recent article on test strip costs can be found here.

Star Date:  2456158.232293

What is Diabetes

The easiest way for me to explain Diabetes is to fist explain how a non-diabetic’s pancreas functions.  I have already said that I learned stuff that I think only doctors and such should know.

The pancreas is part of the digestive system in the body, it has a lot of functions, but here I am just explaining the part that has to do with diabetes.  There are 3 hormones that affect the blood glucose (sugar) levels.  They are glucogon, insulin and somatostatin, each are produced by alpha, beta and delta cells respectively.  If there is too much insulin, and not enough glucose in the blood, the pancreas sends out  alpha cells to make glucogon, which in turn tells the liver to release some stored glucose.   If there is too much glucose, and not enough insulin, the liver stops releasing glucose, and the pancreas starts releasing beta cells, to make more insulin.  If everything is balanced, the the pancreas releases delta cells, producing  somatostatin, which blocks both alpha and beta cells from being released.  I don’t know how the body knows this, that is a little too much for this post, and me too, after all, the important part is that it happens, and it works well for most people.

When you have Type 1 Diabetes, there is an anti-body that kills off the beta cells, and you can no longer produce insulin.  With no insulin, the cells don’t have energy, and starts using stored fat for energy.  Before insulin was discovered,  people would eventually starve to death, even if they were able to eat.  If your body uses fat for energy for too long, that causes other problems that I will talk about in a later post.  With Type 2 Diabetes, the pancreas still produces beta cells and insulin, but the  cells don’t use the insulin efficiently or does not make enough insulin.

If you have Type 1 Diabetes, (T1), then you need to get insulin from an external source.  Currently T1’s have 2 main methods of getting insulin. The first way is Multiple Daily Injections (MDI) of insulin, or the use of an Insulin Pump.   I have experienced both.  If you do the MDI method, you will usually have a rapid acting insulin and a long acting insulin.  The rapid acting is for use when you eat, the long acting is injected once or twice a day and provides the body with insulin when not eating.  The best place to inject is in the stomach, but you can use arms, legs or butt.  With an Insulin pump, you usually use just the rapid acting insulin. The pump injects small doses of insulin every hour to help regulate the glucose levels when not eating.  For every time you eat, you tell the pump how much (how many carbohydrates) you are going to eat, and the pump will inject a larger dose of insulin, to take care of the extra glucose that you will have.  For me, I believe that pump is better way to go.  I just think it mimics the pancreas and is a more natural way for glucose control.

I guess this will not be complete without adding some of the symptoms to look for.  Here goes. Probably the two most noticeable are extreme thirst, and frequent urination.  For me, the urination was the worst, the feeling to have to go would “sneak up” on me.  I would not feel the urge to go on second, then the next second, have the feeling like an urgent need to go, and it really was urgent.  Some others are hunger, fatigue, weight loss or sometimes a gain,  blurred vision.  Finally for me, what got me to call an ambulance, was nausea and vomiting, I was having pains in my chest, and it actually hurt to breath. I urge you, if you are not diagnosed, not to wait as long as I did, as soon as you see the first two symptoms, run, don’t walk to the nearest doctor. If you are older than 30 or so, and they tell you that you have Type 2, ask your doctor if they checked for Type 1 diagnosis too.  If there was not T1 tests done, insist on it.  There are reports of more older people being misdiagnosed with T2,  and it is assumed you have T2 because of your age, and “usually” T2 is what the problem is.  If you are treated for T2, and you have T1, that can cause more problems.

While a diabetic can learn to semi – control the disease, you cannot be perfect all the time.  There is so much the body does that our technology (as great as it is) cannot tell us.  As careful I try to be, there are times when no matter what I do, something just doesn’t work right.  I will get a high glucose levels, and simply will not be able to get it down, or I can eat something, and my glucose levels will go down, and I will not be able to get it back up.  One time the candy that I eat will get my glucose levels up just a little, the next time, the same candy will get my levels way to high. No real way to tell what is going to happen.  Got to be like a boy scout, always prepared.  One day I will get a picture of my “emergency” supplies that I have around all the time.

Here is a link for some interesting facts about diabetes.

Star Date: 2456157.969793

Facing the Future

The other morning I couldn’t sleep, was up way too early.  With the insomnia, I watched TV, Dobie Gillis was on. This episode,  Dobie is not far from graduating high school, one of the teachers gave his class an assignment on what they expect from the future. The whole show Dobie is wondering what to write his essay about.  The end shows a few students presenting their essays, and how great they were going to be once they were out of high school. Dobie ends up not writing his essay, but his explanation earned him an “A”.  He explained that he did not know where he was going, and how he was going to get there. He gave an example of a robin and her babies.  For several months he watched the robin leave the nest to bring back a worm for the babies. One morning the mother robin left but did not come back with a worm, trying to  teach her baby robins about leaving the nest to make a go of their life on their own and leaving them to fend for themselves. The baby robins reluctantly left one by one, not knowing for sure where they were going and how they were going to make a life for themselves.  The teacher asked Dobie, with no foresight of the future, if he was afraid, Dobie, referred back to the baby robins, saying they didn’t really know then, but they were ready for what ever came along.

I know that having diabetes, puts me at a greater risk for a myriad of other medical complications, shorter life expectancy,  and constant testing, counting carbs, and a whole bunch of insulin injections.  But if I am afraid of that, then I will live in fear and never find peace of mind.  If I dwell on it, then it will never get better.  If I ask why did this happen to me, then I will miss out on doing what I need to to to make the best of what I already have.

Everything happens for a reason, just got to find the good for what happens.

Star Date: 2456156.461459

Brief History, and What is New

In all of my looking around I never seen anything about the history of the treatment for T1D.  For anyone interested, a brief history of insulin.  Before the 1920’s if you had a T1D you pretty much did not have a chance to live very long. One of the first treatment was feeding pancreas to patients.   The first successful insulin used in humans was from dogs.   Later insulin came from stockyards, from slaughtered cows and pigs.  Because of allergic reactions many people could not use this insulin.  It was still difficult to manufacture in large amounts. It was not until 1978, that synthetic insulin was made using bacteria or yeast and human DNA, called recombinant DNA insulin. It was not until 1980 that this new treatment was widely available and it did not cause allergic reactions.

We live in amazing times. Glucose meters have gone for costing over $600 to many companies giving them to people for free (I got a free one a couple years ago, a OneTouch mini), to being able to communicate to insulin pumps.  Insulin pumps have gone from the size of bricks, and notoriously inaccurate, to the size of cell phones and incredibly accurate delivering insulin.

While I pray for a cure, being a hopeless techno-geek, I look forward to all the new developments that come along to make managing this until a cure is discovered.   I haven’t got a CGM (continuous glucose monitor) yet, I look forward to exploring that part.   Even if it means another needle stick every few days.  🙂  I also look forward to what is called Artificial Pancreas.  My understanding is AP is like a pump, but will be all self contained with insulin and glucagon* reservoirs, with a CGM will be able to auto deliver of both.

I encourage all reading this, with T1D, to explore all the possibilities to help you manage better, of course with your doctors guidance.

I know I didn’t put too many specifics in this post, I don’t want to bore people too much.  I just wanted to point out there is hope, looking at this, in less than 100 years, T1D’s (and all with diabetes) went from no hope of survival, and certain painful death, to living long and productive lives. If you are interested, Juvenile-diabetes-everyday has what I think is a good history of diabetes section.

Feel free to comment, and have a good day

Star Date: 2456154.421876

*Glucagon is a hormone that tells the liver to release stored glucose, when there is not enough sugar in the blood.

You Never Know How Strong You Are

I saw someone’s signature that read something like ” You never know how strong you are until being strong is the only choice you have”

I believe those words.  Diabetes is life long disease, requiring a lot of a person to live a normal, healthy life.  Type 1 requires daily injections of insulin, constant monitoring, learning, studying. And that is on top of what you do otherwise.

Some of the people that I admired because of their occupations are teachers and single parents among others.  I have stood helplessly by a couple of friends and relatives that have died of cancer.  I noticed almost universally with all, was the strength they seemed to have through out the ordeal.  They all seemed to have everything together, you know, the planning for after, the chemo, the many appointments for different things all of it.

When I told my mother about my diagnosis, she asked what I was going to do.  I said that I would learn how to live with it. With the exception of last year, I think I’ve done fairly well.  Even though I was not really sure how I was going to deal it.  The problem is, things change daily.  One day, 4 unit of insulin is good for the breakfast cereal, the next day, it will take 10 units, then the next 1 unit is too much for the same cereal.   You just have to be aware all the time of how you are feeling, decide if how you feel is just normal, or caused by your dis-ease.

You don’t know until you have no other choice.  I hope if you don’t have diabetes, you never have to test this.  But if you do have any kind of chronic disease , I am sure,  you will find the strength that you never thought you had.

Star Date:  2456153.469793

Why counting carbs is hard….. for me

When was first diagnosed with the big D, one of the first things I was taught about was counting carbs. Easy… not.  Almost any food that you buy in the store has a Nutrition Facts section.  It lists all of the nutrients in one serving of the food.  Everything is in really big letters, for instance, 1 serving of whole wheat pasta is 40 grams of carbs.  1 serving of cereal (that I eat) is 24 – 26 grams.  The one thing that I was overlooking is the little letters at the top that say what a serving size really is.
I figured that I was pretty normal, and that 1 serving is what I would normally eat, is what the Nutrition Facts was.  Looking back, I now remember the nutritionist did tell me to look at what those little letters said.  But I am normal I have got   to eat 1 serving.  My first 6 months, I could not figure out why my BG’s were always HIGH, huge even, after I ate.  I went back to looking at those labels.  40 grams of carbs in whole wheat pasta is 1/2 cup.   24 grams of carbs in my cereal is 1 cup.   I didn’t have a measuring cup, went to get one.  Those suckers are expensive, I thought. 1st time I measured carefully 1 cup of pasta, dripping with sauce, and poured the 1/2 filled measuring cup on my 12 inch plate. Not on the side of a plate like a real dieter, but right in the middle, in anticipation for a hearty meal.  I looked at the 3/4 empty (1/4 full for all the optimists) plate in disbelief.  I shook the measuring cup, just knowing the rest of my meal would pop out. Nothing.  Wow.  Determined to be a good diabetic, I measured my insulin in the syringe, gave me the shot.  I don’t remember what vegetables I ate, but probably corn, what I thought was normal.  Ate. Did the normal after meal stuff.  An hour or 2 later, I felt the hunger pangs. Upon checking my BG,  right where the doctor told me it should be. A three year old would still be hungry after eating that much.
Wow, did the same thing for breakfast. Same results.  This is going to be fun. I started thinking, and re-reading the pamphlets the nutritionist gave me. Really reading this time.  A serving of meat is about the size of a deck of cards.  I shopped everywhere,  I could not find a T-Bone steak the size of deck of cards, ditto for a breast of chicken, ham steaks, even a quarter pound hamburger barley makes the cut.  Investigations into everything I usually ate was the same way. Then here comes the really tricky ones.  I like M&M’s with peanuts, every once in a while, I like them. Ok, 35 grams of carbs, a lot, but manageable, just for a treat, once in a while. The trick, 1 bag, 2 servings. I could eat 2 bags every day, back when….
The real killer is popcorn, you know the microwave bags, it has been so long since I had one, I forgot how many carbs, but I remember 2.5  servings in a popped bag. I would lick the bag when the popcorn was gone,  way back when.
Enough of going way back when, keep on looking forward. I now use 6 inch plates, so no matter what I eat, the plate looks full, a full plate equals a full stomach, right.
Moral of the story, remember, to read the whole Nutrition Facts label, not just the carbs, what you would normally call a serving is way less than what is recommended on the label.  🙂

Star Date:  2456157.387154

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