Blog Entries With Tag: carb


Posted: Jul 18, 2013

When I first started to wear an insulin pump back in 2008, I didn’t realise that wearing one would restrict some of my clothing options.  Living in Montreal, the fashionista capital of Canada (okay – there’s Toronto – aka mini-me USA – but they just don’t have that French flair like we do ).

It was sort of nice since January, when I took a pump break, not to have to spend the extra time to pick out clothing that would not reveal a bulge of George Michael aka GM (pun intended there – remember – I grew up with Benny Hill) my insulin pump.  Now that I’ve been back on the pump for over a month now, I realise that I have to take extra time to figure out what to wear that will allow me easy access to George Michael.   Hmmm, should have I had added that time factor into my application for DTC?

I did the stint for almost a month of wearing the infusion set in my arms.  That was kind of neat – almost like I wasn’t wearing an infusion set except when I’d hit a muscle or nerve ending in my arm with the stainless steel infusion needle (found Contact Detach/Sure-T does this more than the Inset 2 sets). One thing I am going to try out if I can get some samples of shorter needle/cannula length for the infusion sets - just like I have done with the shorter 4mm pen needles I started to use back in April.  My absortion with the shorter pen needle created no change in my BG's - which I thought it would due to my not being a slim gal (as I had told the RN when she gave me some samples of the BD 4mm pen needles said skin depths for absortipon of insulin doesn't change in the human body).  Anyway, back to old GM, here  I was tucking him into a sports bra – where I couldn’t believe that despite how hot it gets inbetween the girls – the insulin would keep on performing 100%.  My fear, like other diabetics is that heat will deteriote our insulin – but after 3 days of using the same insulin in the cartridge – my blood sugars (BG) stayed stable.

Actually, stable isn’t the word I should be using here.  I’ve been experiencing hypos (low BG) more often - that almost reminded me of my days when I was MDI prior to going onto the pump (one of the reasons I went onto the pump in the first place was due to having frequent hypos.  I sort of didn't understand how to use my combinations of insulin properly pre-2008, I was trying to learn how to do the poor man's pump method - but not quite doing it correctly.  As I keep on telling pumpers who’ve never gone back to MDI since starting on the pump - being on the pump has taught me how to fine tune with ONE insulin and that with that knowledge - you can easily transferred over to using TWO insulins when doing MDI.  It really isn't that difficult - honest - you've just got to know how to use your insulin(s) - and their little quirks.

So, with the hypos I’ve been having – sometimes a few a day – the things I have planned to do – that usually involve some activity (even simple grocery shopping believe it or not) – have to be shelved.  I do NOT like to have my diabetes rule what I can or cannot do.  My poor DH has to put up with my having to tell him that I can’t do this / that – and he’s so far not really sad much – as I go “I’m so sorry, I’m so sorry” or “Get me some quick acting sugar NOW!!!”.  What a range of emotional outburst I put him through – that is so not me – that it makes me cringe if a fly is on a wall witnessing this (thank goodness they don’t have the ability to hold a video camera).

My basal rate has now been reduced by almost 20% - but I’m still needing to tweak it abit with some more basal testing since now I am going low in the afternoon (very rare for me).  If that doesn’t work and I’m still experiencing low blood sugars (hypos), then it’s looking at my carb ratio (I:C) – which I have slightly changed since I’m now understanding I’m insulin sensitive.  The other thing to look at is my Insulin Sensitivity Factor (ISF) - which to me is a trial and error type of test - since there are a few different formula's out there to deterimne what is best for "you".  

Ahh isn't diabetes control a fun puzzle or what?
 
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Posted: Jul 7, 2013
Image of high 5 cat from reallyfunnypictures.co.uk

I had attempted an overnight basal test on Friday - but that was a failure with going low (3.2/57) - but last night - with having tweaked basal rates abit was SUCCESSFUL!!  I went to bed at 6.2/112 and woke up to 5.4/97.  During the night around 5 AM I had gone to 4.2/75 - but according to Gary Scheiner's book 'Think Like a Pancreas' - he says staying within a 1.7/30 up/down range from your original starting BG (blood sugar) - I was in the good zone. 


I have to admit - I'd like to be abit higher overnight with my BG - more in the 6-7/108-126- - so will tweak basals eventually - but am so looking forward to having a solid sleep tonight - as last few nights have been very broken with getting up every hour.

I guess this would be where a Continuous Glucose Monitoring System (CGMS) would come in handy - I know of some US health centers loaning them out to patients - but when I asked my endo about whether this was possible here in Montreal - he said no.  Anyway, the good "old fashioned" way of testing with the blood meter went well.

So much more precise than the urine testing in my earlier days of diabets control as I'm sure many of you will agree on!

Curious - how often do you test your basal rates (pumper or MDI)?  I have to admit - I blog about it "how to do it" - but have never really done a full night one before until having had difficulties the past month with low BG's since starting back on the pump after my break from George Michael.

I know that due to not having a Certified Diabetic Educator (CDE) or endocrinologist (endo)  to show/tell me how to do these sort of tests - I've pretty well had to go with what I read in books that others have recommended within the DOC (diabeties online community).  I have to admit - this time I was using Gary Scheiner's book I mentioned above instead of the John Walsh book - 'Pumping Insulin'.  I actually found Gary's book abit easier to understand - he writes more from the heart with being a Type 1 diabetic (T1D) like myself - and a pumper as well.  Both books though are very good - so they have many dog earred pages!

Picture courtesy of Fiction Writers Review
                                                 Picture courtesy of Fiction Writers Review

There's a few more tests I'm going to be doing over the next few months - to get more use out of my pumps programming (e.g. I have a feeling due to my sensitivity to my insulin - that perhaps my carb ratio is set too low - there are tests in both books that talk you thru' how to perform this).  The pump as some people think doesn't mean you'll have better control of your diabetes if you DON'T use it properly.  The same applies to multiple dosage injections (MDI).  You are the brains behind these devices we use - they can only help - if you know how to use them - along with help from your health care team (provided they are up on all the latest and greatest).

I know some of you may think it's dangerous for me to be doing this on my own - but sadly - not all of us have the resources / services available to us - and this is the only route we can go.  I would LOVE to be able to have a CDE or endo that understood the fine tuning of the pump - but alas - I've not lucked in as of yet.  A few years ago my GP had referred me to an endo here in Montreal that does research in the diabetes field and works with pump patients.  Sadly, when I saw her (Dr. Natasha Garfield) - she told me that my A1C of 5.9% at the time was dangerouosly low if she was to take me on as a patient.  I had hoped due to her having a team of CDE's trained in the pump area - that I'd be able to go to them for help when I needed it.  So, I walked away with my tail inbetween my legs and carried on the way I always do.

The Cat that Walked by Himself - by Rudyard Kipling
The Cat That Walked By Himself - by Rudyard Kipling - picture courtesy of  -http://www.mainlesson.com

So, this is why I do my own thing - and again - some of you maybe in the same boat as I am.  So far though, I seem to be on the right track - despite the little roller coaster ride from time to time that we all have with this disease!
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Posted: Jan 4, 2012
I don't usually set NY goals - but this year - I've decided to give it a go - promising myself to eat breakfast in the AM - and hope that by doing this - it aids in losing that belly fat I have ( though it comes in handy for my infusion sets ).  I know - bad excuse to stay plump!!! 

One thing I've discovered with some of my fav shows I caught over the holidays since I had time to actually watch what I miss as a working stiff - is that missing out on meals does not help in losing weight.  Your body goes into panic mode and decides to hang onto those fat reserves when you don't eat on a regular basis.  Something I secretly have known all these years, but I hid it in the far regions of my sponge brain. 

I am like many of my friends, diabetic or not, that find consuming breakfast in the AM to be a chore at times.  It's been something that was always difficult for me and as a child I did eat breakfast, but leaving home, that all disappeared. 

So, my goal this year, is to try my best to eat something in the AM, rather then just a cup of coffee until I "find" the time to eat later in the afternoon (bad, bad, bad).  Take for exampe yesterday, I didn't have much of an appetite, but I managed to get 1/2 cup of cottage cheese into me, besides my regular java.  Amazingly enough, with grazing every 2-3 hours - my blood glucose (BG) averaged 5.0 (90).  That was even with eating a blonde brownie in the afternoon at break time.  Of course, giving the correct amount of insulin to cover the carbs as well as my basal rate I have set up on my insulin pump helps out alot.

I'm also trying out an "at home" A1C test and posting the results on my Facebook page called the Roller Coaster Ride of Diabetes and also Twitter .  I lucked in on getting the 10th edition of the book entitled "Diabetes Mellitus - A Practical Handbook" by Sue K. Milchovich and Barbara Dunn-Long.  In the chapter on Labratory Tests - they tell you to do an at home eAG (or A1c).  Not that I'm not going to have a lab test done anymore, but the instructions which I'm following by testing my BG before and 2 hours after a meal using your glucose meter will give me a bit of a heads up I feel.  I always thought that by averaging out ALL your BG results from your glucose meter would reveal similar lab results - but apparently not according to the authors of this book.  The main thing is, I really recommend this book for any newly diagnosed diabetic - or old fart one like myself - since I always am learning new ways to improve the control of my diabetes.  Check out your library - you never know - they might have it - if not - ask them!

Happy New Year!!!!

My healthy breakfast
NB: If the picture above doesn't show up on your screen -
you can view the picture at this link
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Posted: Oct 15, 2010


Unfortunately, I have no picture to post of this deliciouis EASY pumpkin pie I made last weekend to celebrate our Canadian Thanksgiving, but it was picture perfect (well - at least in my eyes and others that consumed it in record time).

I won't lie and say that this is a family secret recipe.  I was originally wanting to make a crumble pumpkin pie - but having difficulty finding something that was FatCat easy.  I am a lazy baker, I like something easy.  So, in my search of various online cooking websites, I came across this recipe at Allrecipes.com.  I've tweaked it due to what I had in my pantry - so you can either follow my version or the one that is shown in this link above.  This "pie" has no crust, which is great, as it cuts down on preparation time as well as carbs, which we diabetics and folks watching our wastelines adore.  Only I think I ruined any less carb/calories affect by pumping out more of the real whipped cream onto my pie (it also tastes good just by itself).

IMPOSSIBLE PUMPKIN PIE FATCATANNA STYLE


Ingredients:

2 eggs
1 (12 ounce) can of condensed milk or make your own from scratch
1 (15 ounce) can solid pack pumpkin (I used E.D. Smith)
1/4 cup sugar
1/2 cup Bisquick or biscuit/baking mix or your own homemade version
2 tablespoons butter or margarine, melted
1/2 teaspoon ginger
1 1/4 teaspoon cinnamon
1/2 teaspoon nutmeg
2 teaspoons vanilla extract
Whipped topping of your choice

Directions:

  1. You can either whirl all of the above ingredients (except for whipped topping) in a blender as the original recipe says to use OR I just dumped everything into a large mixed bowl and used my hand held mixer until all ingredients are thoroughly mixed.  Pour into a greased spring form pan that is lined with parchment paper.  I used  a 2 3/4 inch deep x 9 7/16 inch diameter one.  The original recipe calls for a 9-inch pie plate, but I like using a spring form pan for my cakes, easier to cut, looks more "pretty" to me.
  2. Bake at 350F for 60-75 minutes, or until a strand of spaghetti inserted near the center comes out clean.  Pull out of oven to cool and serve with whipped topping if desired.
  3. Yields 6-8 portions depending on how you cut it.

 

Happy Autumn from the Pumpkin Cat!!



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Posted: Apr 12, 2010




As most of you know from my scribbles yesterday, I've been having some issues with my blood sugars (BG's) lately.  To the point that on the Sunday I was close to going to ER due to high blood sugars in the 400 mg/dl (22 mmol/l).  On the advise of some of my online PWD's (People With Diabetes) - I went to my pharmacy to pick up some Chemstrips UGK to measure the amount of ketones in my system.  For diabetics, ketones in the blood makes it more acid and is poisonous to the brain if left undected for too long (coma and death can happen - ugh).  I've been thru'  Ketoacidosis as a teenager where I slipped into a coma. Not fun at all for either myself or my family.  So, with the way my blood sugars have been lately, I was scared to the point of running around like a chicken without it's head on, but I stayed "somewhat" calm.

The short and the sweet of it.  I'm now back to normal.  Went to bed with 270 mg/dl (15 mmol/l) and woke up (didn't sleep well of course) with 74 mg/dl (4.1 mmol/l).  Still it's going to be a waiting game, as I've not been MDI (multiple doseage injecting) for the past 3 years since being on the pump.  Like I did with the insulin pump, I'm relearning how to keep my BG's in control via needle injections - compared to my pump which had all the calculations for IOB (insulin on board), I:C (insulin to carb ratios), and some of the other goodies that help make insulin pumping in my opinion a "slice of cake".  In my case, I wasn't sure if I was having issues with scarring due to infusion sites, so decided to take a pump break.

I called up my GP's office this morning to discover she does not have any available appointments until .... July!!!  Three months from now. I explained the situation - only suggestion they gave to me - " come into the clinic ".  Clinics are my last resort, having to go thru' your history with a GP that doesn't know you, been there, done that.  Next option was my Endo, this is where I lucked in, cancellation on Thursday.  I'll have to work something out with my clients for that day, but as you're all probably saying ... "Your health comes first".

So, for now, as I finish this up, I feel my BG's coming down.  I probably overdosed in the NovoRapid for my breakfast (yes - I had a normal breakfast of toast/PB/OJ - oh joy).  Off I go to test, report my results on Twitter and the other areas that I report my daily roller coaster ride with diabetes.

UPDATE:  Just Tweeted this -  #bgnow 13.2 | 238 So much for thinking I'm low.Either I:C ratio or basal rate is not correct with MDI.Used to work with pump :S #diabetes 
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