adjusting to a new schedule

Keeping good control over diabetes means making frequent adjustments.  A friend of mine, and diabetes podcaster recently asked the question; "How often do you make changes to your basal rates?"  This questions means making adjustments to the amount of insulin your body receives throughout the day.  Basal rates are the amount of insulin your body requires at different times in a 24 hour period.  Each time I visit my Endochronologist, like I did about 2 weeks ago, we look at my blood sugars, analyze my A1c, and examine my basal rates.  Usually, we make some little adjustments.  My doctor has taught me that there needs to be a minimum of a 10% change in basal rate for an effect to take place.  I see my doctor every 3 months.  Occasionally we don't make any changes, most of the time however, we do.  I rarely make adjustments to my carbohydrate ratio (the amount of insulin I take for the amount of carbohydrates I consume) but in the beginning I made those changes more frequently.  I also made carb ratio changes when I was pregnant because EVERYTHING changes and gets really wacky when you're pregnant and diabetic.

Anyway, recently, my weekend schedule has changed.  I wouldn't say that it has changed dramatically but it has changed enough for me to notice a pattern of change- for the worse.  So, I've got to decide what I'm going to do to make some changes and adjust to this new change.

Each year, our church schedule changes.  We attend church for a three hour block of time.  Each "ward" or congregation, is assigned a different start time so that the buildings may be shared by more than one ward.  This year, its our turn to attend the 12:30-3:30 block.  AND I HATE IT!  I absolutely detest this schedule.  It's not good for me, and it's not good for anyone else in my family.  Last year we were lucky enough to attend the 9-12 block.  Yeah, it's nice to sleep in on Sundays but I'd much rather be finished with church by noon.  Also, when do you eat?  Either you sleep in and eat a big, late breakfast; or you wake up early and eat two small meals before attending church.  This is what has been really whacking out my blood sugars.  In the 5 weeks we've attended church in 2012, I've had ONE Sunday where my sugars were under control.  The other weeks, I've had one issue or another.  I've been high, I've been low, I've been quickly rising and falling fast.  Ugh.  I cannot figure out this schedule.

Yesterday, it finally clicked that something had been off for five straight weeks, each and every Sunday.  Yesterday I took the day to sleep in.  I slept until 9:00 am like a total slob (for a mom) and didn't eat breakfast until 9:50am.  At that time, my blood sugar had dropped to 59.  I didn't even feel it.  I almost always feel lows. Not this one.  So I ate.  And I ate.  And I probably did eat too much.  And I didn't take any insulin.  So, 2 hours later, my sugar was like 280.  Then I got to take my naked and free shower (where you aren't wearing a pump site or sensor) and put in a new site after my shower.  I bolused and figured I'd come right on down.  Only no.  1 hour after my bolus I checked my sugar and it was 316.  I felt super dizzy.  And super thirsty.  And it just happened to be the first week of the month which means that everyone is fasting.  So I'm taking down at the water fountain when all the adults around me are fasting from food and drink, including water, for 24 hours.  Ugh.  But you do what you have to to take care of yourself, right?
Eventually my sugar came down and I spent the rest of the day fighting lows.  Which leads me to tomorrow's post.

So, let me get to the point here, I know I've got to make a change.  And I hope it will be an easy one.  I just need to wake up earlier.  No more enjoying the ONE BENEFIT of this stupid late schedule, I've got to get up at my regular time and eat breakfast at my regular time.  As for lunch, I don't know.  I think I'll just go for a little carbohydrate and protein combo snack before church and maybe another portion when I get home and then have dinner at the regular time.  That should do it.

I'll let you know how it goes.

10 Facts about Diabetes

Having to test my blood sugar 4-10 times a day is a real pain.

Having to change my site every three days is annoying.

When the batteries in my pump die, replacing them can be inconvenient.

Dealing with the symptoms of low blood sugars is frustrating.

Hyperglycemia side-effects are nauseating and can be life threatening.

However, the thing that bothers me most about having diabetes is others' ignorance about it. AND, the stupid things they say to us.

I've had people ask me questions about my pump, my blood sugars, my insulin, and even my diet. Most of the time people are just trying to find out more, they're curious, and I REALLY don't mind telling them more about it. But when people throw out their opinion when they're uneducated on the topic, that's when I get mad. Maybe mad isn't the right word. Just frustrated or annoyed.

Probably the worst question I've received is one that I hear quite frequently, "Can you eat that?" or, "Are you allowed to have that?" or, "Should you eat this?"

I've also heard, "You're a diabetic, does that mean you can't have any sugar?"

"I could NEVER give myself a shot"

"Do you always wear your pump?"

"Did you bring your food supply?" (this person was referring to my pump)

"Do you need your medicine?" (when I'm low)

"Do you need something to eat?" (when I'm high)

"Don't you think you'll be able to get rid of your diabetes since you're exercising more?"

"You're not too fat for a diabetic"

"You have diabetes? But you're not overweight."

There are some SIMPLE things that I wish ALL people knew about diabetes. I'll be the first to admit that I knew very little about diabetes before I was diagnosed. I also know that for the most part, people are just curious and that their comments aren't meant to be malicious in any way. However, it's pretty much NEVER socially acceptable to talk about another persons weight. Or diet. And if you don't know the way something works, don't be afraid to ASK a question so that you CAN understand.

1. Your pancreas is the organ in your body that makes insulin which controls the blood sugar levels in your body. A normal pancreas delivers insulin when you need it, and does not when you do not need it.

2. Diabetes means you have too much sugar in your blood- Hyperglycemia.

3. Usually a diabetic's blood sugars are too high. To bring them down, they must take their medication; either insulin or pills.

4. Sometimes a diabetic's blood sugars are too low. To bring them up, they must take in glucose by way of eating or drinking something with sugar in it.

5. Neither low blood sugars or high blood sugars are good. Lows can make a person pass out if extreme. Highs are more dangerous in the long run and cause complications like heart disease.

6. There are 2 different kinds of diabetes.

-Type 1: USED to be referred to as juvenile or childhood diabetes. This type of diabetes means that the person's pancreas no longer works and that to STAY ALIVE they must inject insulin; either through a syringe or a pump.

- Type 2: USED to be called Adult Onset diabetes. This type of diabetes means that the insulin your body makes is no longer effective, or as effective as it should be. This type is usually treated with oral medication but some patients also inject insulin.

7. Adults can be diagnosed as Type 1.

8. Children can be diagnosed as Type 2.

9. Currently, there is no cure for diabetes.

10. You could give yourself shots if you had to do so to survive.

I know this post sounds negative, and I'm sorry for that. I'm really not angry or anything, my purpose is really to get more information out about diabetes.

Out of Control

Post originally written on October 11, 2008

So my blood sugars have gotten a bit out of control lately. Waking up high several mornings in a row- random high and low sugars. I decided it was time to put the CGM on for a while. On Wednesday of this week my sugars went like this:

6 am: 130 - okay normal

12 pm: 80- wonderful

4 pm: 256- arg

9 pm: 405! what?!

So I had my sensor in that day but it ended at lunch and I didn't feel like starting it up again because it had kept me up in the night for 2 nights in a row beeping every 40 minutes to tell me my sugar was high- 305!

I was hoping to sleep well this night so I was just going to start it back up in the morning. Well, apparently that was a bad idea because when I changed my site around 5pm I guess that's what gave me the dramatic high. So I bloused 9.5 units and then changed my site. When I pulled it out it looked fine- so I'm sure that's just a wasted site- arg. I've been having this problem when I change to a new site that about 2 or 3 hours later I'll be up in the 300's. So I started doing more sites in my tummy instead of in my hips like I always do thinking that those areas of my body might have too much scar tissue or something like that. But, this site was also in my tummy so that shouldn't have been the case- who knows!

I just hate it when I have a high blood sugar and its just 10 times worse when I can't quite figure out what it was that made my sugar go up so stinking high.

The last couple of days have been so much better. The graph on my pump for the last 24 hours has nearly been a straight line. I think I'll probably just wear this sensor until it dies and then evaluate my settings further and move on with those.

HI

Post originally written on May 23, 2008

So last night was pretty scary as it goes for diabetes. I had the highest high I've ever had since the day I was diagnosed (actually it was higher last night). So here were the events leading up to this high.

I hadn't gotten much rest on Wednesday night because baby decided he wanted to stay up all night long. I started feeling pretty tired and kinda ill. So I laid down and then I decided I'd get ready for bed. I checked my sugar and it read "HI".

That's bad.

So I checked again and got the same reading. Well, since I didn't exactly know how high "hi" was, I decided to try to bolus about 9 units. I guzzled a bunch of water down and went back to bed. While lying there, I checked on my site and realized that it had completely come out. So, I wasn't getting any insulin. That's bad on a normal night, but this particular night I had decided to get a mango drink at Taco Bell to go with my dinner (free coupons online btw). I usually NEVER eat more than 70 carbs at any given meal, but last night I was feeling saucy or, rather sugary, and so I had 120 carb meal.

Anyway, I decided I'd better pull out my better meter and test to see if it would give me a number. It read 578!!! Yeah, that's the highest I've ever been. So, I changed my site and let my pump do the math, I needed to take 15 units of insulin. So I bloused 5 and took a 10 unit shot. I then checked my sugar every half hour for the first two hours. I decided that after it had only come down 6 points in the first hour that I should take another 5 unit shot.

Then I tested my keytones and they were luckily negative. My blood sugar had just dramatically risen because of the meal and no insulin. So I drank some more water and went to bed.

I checked my sugar ever hour or two until it finally came down to about 250. I decided it would be okay to take more insulin at that time and bloused 5 more units. By 5:45am when baby woke up to eat again I was at 48.

Husband brought me some apple juice and my sugars were surprisingly normal today.

Gave us quite a fright last night though. I'm just glad I wasn't feeling really ill throughout the whole thing, and I did get SOME sleep.

Crazy Blood sugars

This post was originally written on May 16, 2007. It is just ONE example of the many times I've had crazy blood sugar levels.

Last night I changed my pump site; took out the old one, and put in a new one. When I put in the site it hurt a little but it felt like an okay site. This was at about 10pm. At 1:30am I got up and went to the bathroom. I was hot so I took off one layer. I felt sick to my stomach and worried I'd gotten sick from one my three students who went home sick on Tuesday. At 5:00am I got up and went to the batrhoom again. This time I was less groggy and thought about testing my blood sugar. I did and it was 375. I bolused 8.8 units.

At 6:15am when Colin got up I had him bring me my meter and checked again, this time it was 490. I took an injection of 15 units and stayed in bed until 6:30. I decided to get into the shower and thought about testing my keytones. I did and they read out at the highest level. By this time I was feeling really sick and decided to call in a substitute. I called the sub line, wrote my lesson plans, called the secretary, emailed in my lesson plans, called the baby sitter, then called Colin to let everyone know I wasn't going to work.

I called the answering service of Dr. Day and she put me through to him. I told him the story. His advice was to drink lots of fluids, try to get the sugar down in the next three hours. He said that if there was vomiting that I should go to the ER for fluids, and to call him if things weren't going well in three hours.

By 9 am my sugar was still at 450 and I spoke with the nurse about correct dosing when keytones are present. By 10 am my sugar was still 454. I took another injectoin of 17 units and things finally started turning around. At 11:00 am I was down to 268. 11:30 no keytones and 168. I ate lunch and took a nap.

When I woke up my sugar was 96- finally back to normal. By 2pm I had a low-62. I figured that this would happen because of all the insulin that was in my system.

I feel a lot better and am glad that my sugars are back under control again.