Blog Entries With Tag: bolus


Posted: Jan 18, 2013

So, here’s the deal.  Because of the problems with getting any response from Animas Corporation until Jan 28th (I’ve been switched back/forth from Canada/USA/Canada since the notices came out in Dec) on my out of warranty Animas 2020 pump aka George Michael with the little “minor” glitches with his stopping delivery of insulin.  I’m still continuing to relearn MDI to be prepared.  I’ve done it before (over 40 years prior to going onto the pump actually).   I KNOW I can do it again – despite my griping – but as before –my issues with MDI – has always been my basal rates with Lantus.  I wish I could use Levemir – I could do better – but sadly – last time I tried it – I had allergic reactions to it – and it was like I was injecting water for my basal portion of my insulin coverage.

Sadly, I’ve had responses (privately or via FB groups I belong to) from many T1D’s who have been pumping on average 20+ years.  They are terrified to go back to MDI.  They wouldn’t know how to do it – and have asked me how do I know what I’m doing?  I guess in away, I’m lucky that I only starting pumping later on in life, that I “sort of” had a handle on MDI prior to the pump, and with abit of head banging, and if you’ve got a good endo or medical team behind you (sadly, I can’t say I do), then YOU CAN DO IT!  Maybe taking a break from their pump once in awhile – to get back to their roots – might be something that endos should encourage their patients to do – so incase a) they no longer have insurance coverage for a pump; or b) flung into a situation where pump cannot be used for x amount of day/weeks/months – then taking these mini pump holidays is not such a bad thing.  Yes, I know, control may not be as good in the beginning, or it may never be as good as on the pump, but at least you will get over that fear of going off the pump, and with practise, might not mind it so much.  I know I don’t  - it’s nice not to have the tubing, pump clipped on my pants (dragging the waist band down to reveal my knickers).  It’s just a change of pace for me at the moment, relearning how to do (and saving some $$$’s at the same time – since pump supplies don’t come cheap (if you don’t have insurance or co-pays are high), etc.


I’m now into Week 3 – and getting used to it (oh – wait – I have to go check my BG’s – will be back in a sec) … okay – I’m back – BG was 9.9 ml/L (178 mg/dl) – did a correction with NovoRapid (aka bolus to you pumpers out there) – and hopefully my BG eventually levels out to my happy zone of 4.5-5.5 mmol/l (81-99 mg/dl). 

Back to my rambling,  on the pump, I rarely had to do corrections like I’m doing now – since on the pump – you can change your basal rate right away – compared to the 1 – 3 shots of basal insulin that some MDI folks do.  To me that’s one of the great things about the pump – the accuracy of how much you have going into your body for your basal insulin – it can be tweaked per hour – to reflect hormone issues, exercise, etc.  With MDI, once the basal rate is given – bing, bang, boom – you are slave to the slow acting insulin for your basal coverage – that’s if it works properly (like it does for me sometimes – then other times – not so good).  I really can now live up to my Facebook page of The Roller Coaster Ride of Diabetes with what I’m doing with MDI … but … MANY  do it this way, they are fine with what I feel is like being a slave to their condition (since starting MDI – I find I am constantly thinking about my diabetes – with my pump – it wasn’t so much).

The other thing, some MDI folks just don’t give a hoot, and just do the shots without much hoopla over their happy zone range for BG’s (hey, even folks using pumps are the same).    Sadly, or maybe I shouldn’t say this, I like to be in control, I don’t want to lose my eyesight, kidney function, put a strain on my heart due to continue up and down of BG’s, lose a leg due to infection … the list goes on when you have diabetes and don’t take your health care by the horns.  Remaining as stable as possible is my goal in my diabetes control – with as little convenience for my life as possible. 

I discovered after posting on my Facebook wall with the forum post from Diabetes1.org – about having another blood meter with them when they go on holidays – many folks have not just ONE – but sometimes FOUR spare meters with them.  Either it’s due to their 3 year old T1D Johnny Be Good fingers destroying one of the meters his Mum has packed in her bag – or it’s just for sanity sake that incase their regular meter goes on a walk about – they’ve got something to fall back on.  I know for myself, I’m lost without my meter, and would be probably housebound, unable to go anywhere.  That is not me, I won’t let diabetes stop me from doing what I want to do.

I have to admit – I’ve never EVER brought a spare blood meter with me – it’s usually all the insulin paraphernalia that I bring (with the pump – 3X the supplies you would use for the period you are away, insulin and needles, extra BG strips, glucose tabs, spare pump/meter batteries ….).  So, some of their replies back really got me thinking – I should consider bringing a spare meter with me – especially since the FreeStyle Lite I use – I’ve had for over 5 years (one Mum said – “ours only last 1 – 1 ½ years).  I guess  I’ve  been lucky that I’ve never had a problem with the meter – but like the pumps – do they ever need to be recalibrated?  Hmmm.

So, luckily, with the diabetic conventions I attend a few times a year – I have one meter that I know I can get strips for in Quebec  (other meters I have surprisingly enough – when I ask my pharmacist about purchasing strips – they can’t get them for me – or their distributor can’t for one reason or another).  So, this time I will be prepared on my holidays – and maybe I’ll do like other diabetics do – carry a spare one in their bag all the time.  Again, I’m not a big bag carrying type of gal – but I’m learning that maybe I should just swallow my pride, and start lugging more stuff with me – just incase.

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Posted: Jan 28, 2011

 

Last week I wrote a blog with a few details of my latest 6 month visit to my endocrinologist. I'm the opposite of many diabetics who fear the outcome of their A1C. I don't have that problem as I've pretty well got that one down pat especially since going onto the pump (but I still don't think I'm using that piece of equipment to it's full advantage - in April I finally get to see a endo and their team of experts to drill them with my questions). My problem is with that aging thing of inactivity, peri-menopause, yadda, yadda, yadda. I'm basically a lazy cow most of the times. Yes, I try to "walk the talk" when I can, use the stairs instead of lifts, I park my vehicle as far away from the shopping centre as possible to get abit of exercise. It's not enough - to me that is - and I'm trying to fit in at least 30 minutes of exercise a day - but it's tough - and I'm failing pretty miserable in that area.

So, my next goal in life is to shed that weight that's crept up on me since last August. My fav jeans that I love to wear feel like I'm squeezing my lower half of my body into a sausage skin. I refuse to become a more plump sausage (banger) in a frying pan - I MUST resist the heat of the frying pan. I'm hoping to have an online blog diary elsewhere other then here at Diabetes1.org because frankly, it could be pretty boring stuff for you to read. Main thing, I've just started a food diary when coming home today from the shops - and as you can see not that interesting - but I'm hoping by putting everything in the open for anyone to see and me too - that it'll help me stick to what I'm trying to accomplish. Shed at least 20 pounds - I have no time frame set in mind - but a year would be nice to accomplish this in - I just want to lose this weight - if I can shed more - even better!

Example of my food diary I just started a few hours ago (it's going to be abit of work typing this out - but I feel I need a 2 week record of what I "normally" eat to figure out where to go to shed the weight).

Friday, January 28, 2011 13:25:33

150 calories - - Red River Cereal - - 28 g carbs minus 6 g fibre = 22 g carbs

34 calories - 1 Tbsp - brown sugar = 9 g carbs

40 calories - Big dollop of coffee cream = 2 g carbs

55 calories -  - 2 Tbsp of protein soya powder = 13 g of protein

BG - 3.7 mmol/l  - Bolus? - pump saying I'm low - to not bolus - will check later


Yes, some of you who have met me say - "You're not overweight!". My Mum actually said this to me this week on the phone - very unusual for my Mum to compliment me! Just step me on the scales today - and I am topping abit over .... to say this in public ... 160 pounds. There said it - can't take it away - resist the Edit button.

Off I now go, away from my netbook (it was fun posting this blog thru' this device), to do abit of cycling on my stationery bike! Wish me luck! Oh and my BG is currently 5.5 mmol/l (99 mg/dl) - an hour after eating my cereal - so still no bolus - and good range to be in for exercise.

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Posted: Apr 13, 2010


Okay – I’ve got the tune (a remake from Le Braghe Corte a great SKA/punk band) going thru’ my head right now as I type this out.  Today is Day 3 of being on a pump break due to having some issues with high blood sugars the last week.  It has been a relearning experience with going back to MDI (multiple dosage injections) after almost 3 years of pumping insulin.  I’ve now got my basal rate of insulin (Lantus every 12 hours) sorted out and today haven’t had to do any corrections with NovoRapid in-between my meals (aka bolus).  I do inject for the amount of carbs I’m going to eat of course!! 

Now, this may all change as I’m seeing my endocrinologist on Thursday to get permission to go on Levemir, which thru’ the grape vine of other PWD’s is better at keeping the blood sugars more level, as 3 shots can be done during the day with this insulin.  Also, as my friend Doris Dickson pointed out, when I have to do a basal test with Levemir, it’ll be a shorter span of time then with Lantus. Sweet!  Though I'm not quite up to that point yet to do a basal test.

So, what am I enjoying right now?  I went clothing shopping for a skirt after seeing a woman in line at IKEA wearing a cute little denim skirt.  I asked her where she got it from, and viola, I was on a mission.  Shopping is something I really don’t like to do unless it’s food shopping.  Strange thing for a woman to say, but it’s never been high on my “what to do with myself today” thing (I’d rather be walking thru’ the woods, or by the ocean, or motorcycling thru’ the mountains).  Of course, my husband is probably very happy I’m this way, as he counts the pile of money under the bed at night.

The thing that was special today, not wearing my pump.  When I’ve gone shopping for clothing it’s always a drag having to unclip the pump, tuck it somewhere safe, while I try on various clothing.  Today my hands went to my waistband, and then I remembered … “no pump”.  All I can say is, I did quick changes, found what I wanted.  Bing, bang, boom – flash of the credit card – sold to the Happy Customer (who also got the skirt of sale – whoo! Haa!)!

So, after spending ½ the day just loafing around (haven’t done this in awhile).  My blood sugars have stayed on average between 4.7 - 7.0 mmol/l (85 – 126 mg/dl).  The only thing I have found with MDI, because of eating breakfast late (10:15 – and I usually eat at 8:00 – 9:00) due to my friend I think I have to be more diligent with eating meals at the correct time.  This was something I found I had more flexibility with when on the pump.  

Off to try on my new skirt and show off my hairy legs!  Oh I’m one Cool happy girl!

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Blog: WIDA

Posted: Feb 2, 2010

A rich, healthy breakfast is important for a good start of the day

The Canadian Diabetes Association guidelines suggests a blood glucose of 10.0 mmol/L (180 mg/dl) or less 2 hours after a meal (this target should be 8.0 mmol/L or less if you are not reaching your A1C target of 7.0 or less). Reaching this target after breakfast may be difficult because often this meal contains food with a high glycemic index. Examples of high glycemic index foods are: white bread, white bagel, Cheerios, Corn Flakes, Rice Krispies. Alternative low glycemic index choices would be 100% stone ground whole wheat bread, heavy mixed grain bread, pumpernickel, All BranTM, Bran Buds with PsylliumTM and Oat BranTM. More information about glycemic index and reference charts are found at http://www.carbs-information.com/glycemic-index.htm.

It is important to make sure that your breakfast is balanced and contains some protein and (good) fat to help slow down the absorption of the carbs and provide proper nutrition. Some suggestions are low fat yogurt, peanut butter, almonds, egg and cheese. For more information consult your dietitian.

Some authorities are suggesting to bolus about 20-25 minutes before eating breakfast as this would give the rapid acting insulin some time to start acting as blood glucose rises from these easily digested carbs. 

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Posted: Dec 16, 2009

Winter WonderlandI've got Baby It's Cold Out There  - a classic -  playing in the background as I type this out to you.  If you want the full effect of my scribbles below, click on the link, and enjoy the soothing voice of Dean Martin.

We're not getting the cold temperatures that Alberta is getting at present (-37C / -35F tonight for some of them - brrhhhh), but here in Montreal we are having unusually cooler temperatures then we usually do that this time of the year.  Usually February is when we hit the deep freeze of temperatures like this.  Anyone want to buy an island property in the sunny Caribbean with me?

Joking aside, all I know is that tonight, by accident, I left my blood monitor (I use the Freestyle Lite) in the side pocket of my little Smart when I went to see the movie 2012 (excellent movie - despite the critics reviews).  When I came outside a few hours later, to make sure I had bolused for the right amount of insulin for the nutritious dinner of "popcorn" - duh - meter not functioning!  This has happened to me once before, last year, and you would think I wouldn't do the same thing again! Scream!! At least I remembered what I did last time this happened to me, stuck the little monitor inside of my pants (plush tummy area <lol>).   Yuppers, that was the warmest place on me at the time as the theatre for some reason was cold. I was huddled with my down filled jacket on top of me, after pigging out on the popcorn of course!

Fifteen minutes later, the monitor was up and running again, but I seriously have to start bringing a handbag with me (I am not a lover of those things as some of you know),  to bring my medical supplies with me, even if it's for a few hours.  I must learn to be a real woman!

I know one thing I have to look into getting, is another blood monitor, as I only have the one.  That scares me sometimes that my current monitor may go on the fritz, at a time when I can't dash out to purchase another one.  Note to self - talk to the pharmacist  this week to see how to obtain another one, hopefully for free, since I go thru' an average of 10 strips a day ($1 / strip). I should own stock in Johnson and Johnson!

So, take care and stay warm everyone!  Winter is almost here, it starts officially December 21st!!! Ho! Ho! Ho!

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