Blog Entries With Tag: glucose

Posted: Sep 29, 2013
                            Ahhh the fashions in 1970

How many of us have been designated drivers?  As a diabetic, amongst my friends when I was younger, I would normally be the one a) that had a car (and could afford the gas/insurance); and/or b) didn’t drink to the point of total obliteration of the mind.  So, after having a good time, piling into the car to head back home (for more partying sometimes) – I would make sure that my friends were okay  - glass of water – few aspirins – then be on my way home if I wasn’t staying the night.

Sigh, the responsibilities of being a diabetic when your friends aren’t (I think we younger diagnosed diabetics have to grow up faster sometimes than our nondiabetic mates).  To some of you, it may seem like we miss out on all the fun – but in away – I never felt I did (well – hey I did indulge from time to time –I mean I’m no saint).  The main thing, I could remember EVERYTHING the next day, they couldn’t, and the stories I could relay to their kids today would be such a hoot - but I won't - don't worry.

The other day, a friend of mine, who immigrated to Quebec about 10 years ago, that I’ve known since the age of 7, called me up, inviting me over for coffee and cake (ohhh homemade cake .. NOT - they don't like to cook <lol>).  I actually hear and see less of them than when we lived further apart.  Their life is complicated (whose lie isn't?) – and boy oh boy – that could make for a whole other blog – but that’s their story to tell if they can write honestly.

At the time, I knew I had 4 units of insulin remaining in George Michael (my Animas 2020 insulin pump –still going strong into his 2nd year of being out of warranty – hope I don’t jinx him here by saying that).  I figured that I’d be okay – my BG (blood glucose/sugar) was acting stable that day (5.1 mmol/l – 92 mg/dl) – so I knew I’d not need to correct with multitudes of insulin if I went high – even with coffee and cake.

I stayed for an hour – chatting up on what had been happening in their life over the last 3 months (boy oh boy – what a soap opera).  Then Monsieur George went into ALARM mode – FEED ME NOW!!   No biggie, and I guess for some of you reading this, you’re thinking “why didn’t she bring back up? She preaches this to all of us!!”.  Well, I forgot, plain and simple.  I also knew, that going without insulin for less than an hour would not be the death of me (not like my DKA experience back in August – 6 hours without insulin – NOT GOOD).

So as I attempted to leave (hey –they like to talk – yap yap yappity yap) – my friend was reminiscing about the times I had been low (Hypoglycemia / low blood glucose).  If I could have captured the look on their face – of how I looked to them when I was “drunk” with a low – PRICELESS.  It was something that I forgot about – that they’d probably seen me that way many times over the past 45+ years – and it was actually kind of neat that they would remember those details – and I was seeing how I looked in their eyes. 

They work for a dentist – who is a Type 1 diabetic.  They told me that they had asked their boss – incase the he went low – where did they kept their insulin, etc.  The dentist was reluctant at first to tell them where it was kept in his office but in the end told them. That’s when my brakes came to an abrupt screech – and I said. 
Car braking hard 
“ You would have given them insulin when they’re low?  That’s the last thing you should be doing – they will go even lower!!! "

It actually freaked me that my friend, who is a Dental Assistant, who has known me for so long, would consider giving insulin to someone in that state - and would they know how to test their BG properly to access the situation?

I once again put on my “educators” cap like I seem to be doing alot lately when I'm out on the town – hoping that the simple explanation I gave to them, will ensure that any diabetic that they come across in future, that either may be going low or high (Hyperglycemia / high blood glucose/sugar).  I’m hoping it retains in their noggin’ – because obviously knowing me for so long – they still don’t get it (like my Mum who thinks apple juice is sugar free).

It also proves to me – why many of us are so anal about our control – and taking care of ourselves – rather than others (even “trained” nurses in a hospital – and I speak from experience).  We know what works best for us – and hope that we don’t get into the situation where we need someone to assist us – without full knowledge of what to do.

NB:  When I got back home after picking up a few groceries along the way - I was reading 8.1 mmol/l - l46 mg/dl.  Infusion change - fresh juice of life in my pump - back to regular programming!

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Posted: Feb 25, 2012
Last week, we discussed how allowing baby steps into our diabetes management plan can help us overcome some of the fogginess, and the fear, that a diabetes diagnosis can bring. We even went ahead and took our first baby step by discussing "What is Diabetes?" This week, I'd like to visit a few of the steps that we can take with all the knowledge and information that we gained by simply knowing what diabetes is, and learning about the basic problems and challenges that it can present.

If my readers might recall, we went into a little bit of detail about the basic concept of glucose. Glucose, is a type of sugar in which the body turns ALL the food that we eat (and not just sugary foods); it is the body's main source of energy. Nearly all (about 98%) of all the carbohydrates we consume will get turned into glucose, compared to 58% of proteins, and around a 10% of fats. 

This basic piece of information is the most powerful weapon we have against controlling high blood glucose levels. 

Because carbohydrates are the biggest contributors, by far, to our blood glucose levels and needs, it is paramount that we manage, and control their consumption with some care. By controlling our carbohydrate consumption levels, we are essentially, controlling our blood glucose levels.

Now, carbohydrates and starches may bring some confusion to persons trying to manage diabetes, and often... for the wrong reasons. Dietitians, nutritionists, and TV personalities love to focus on the roles of "good" and "bad" carbohydrates in our diets, and will always outline that we, as diabetics, need to focus on consuming good carbohydrates, instead of "bad ones..." and that's not a bad thing, in and of itself. (If we consume too many "fast burning", so called "bad" carbohydrates, we'll be left unfulfilled, and hungry, and often, with roller-coasting blood glucose levels.) But something folks always fail to mention is that, at the end of the day, it is not so much the quality of the carbohydrates we are consuming, but the AMOUNT of them.

Most Americans consume a seriously disproportionate amount of carbohydrates in their diets, and while some might argue that the average person needs to consume a diet that consists of 60% carbohydrates, the average American consumes much, much more than this. If, for example, we are consuming double the amount of recommended carbohydrates, and replaced all of those with supposed "good carbohydrates" (which we will discuss later), it won't negate that we were still consuming double the amount of recommended carbohydrates! We will still have high blood sugar... even if those carbohydrates were slower burning.   

So, how do we know how to make proper carbohydrate meal choices? What are our best alternatives? 

The truth of the mater is that there is NO diabetes diet out there. There is no real truth set in stone that says you have to follow any one person's plan to the letter; even a dietitian's plan. Your best guides in making meal planning decisions will ALWAYS be your glucose meter, moderation, and your own body. 

Which brings us to our second baby step: Using Our Glucose Meters.

Yes, that's right. We learn all of the information we need, and much more, one meal at a time, and one event at a time, with our glucose meters. 
  • By testing before, and 1 - 2 hours after a meal;
  • Before going to bed, and at rising;
  • Before, and during, or after exercising;
  • Throughout the day when we are ill, stressed out, or feeling unwell;
  • And as needed, when symptoms present which may indicate hypo or hyperglycemia (low, or high blood glucose.) 
I will note now that this is a lot more testing than the 1-2 strips a doctor, or insurance company, may allow for you, if you have Type 2 Diabetes. This is an expensive disease, and one in which you might have to invest in some extra, out of pocket, testing strips in order to help you make future confident decisions about your management, particularly, if you are not under any medications. Don't despair, though, bargain department stores often have some affordable, and generic, meters and strips. (By FDA standards, ALL meters must be within the same percentages of accuracy, regardless of brand, so they are no less reliable than more expensive ones... though this might be a topic of argument for many.) 

Set a Blood Glucose Goal

Most American and worldwide diabetic guideline organizations, including the American Association of Clinical Endocrinologists, recommend that diabetic patients keep their blood glucose levels at below 140 mg/dL (7.69 mmol/L) or less, 2 hours after meals, and below 110 mg/dL (6.04 mmol/L), fasting. These guidelines might be different for you, if you are pregnant, or if you have other health issues or complications that might make it risky to reach for these levels. When in doubt, always consult with your Endocrinologist, or your medical team.

Make meal decisions that help you reach these goals

  • Keep a journal, or a spreadsheet, that helps you keep track of what you ate, and how much of it you ate -- particularly, the TOTAL carbohydrate serving size in your meals. Research the nutritional information label of your foods, or meals, or look up foods on sites like NutritionData, or CalorieKing, for the necessary information. Some of these sites even have "recipe analyzers" which will allow you to get more precise information when meal planning. Always note the serving size, and adjust your total carbohydrate counts accordingly. 
  • Test your blood glucose levels before any meals, and 1-2 hours after meals. Write down these numbers on your spreadsheet, and note the amount of points your blood glucose levels "spiked" after you ate. If your levels rose more than 50 points, or they surpassed your blood glucose level goals, it might be time to cut back on the total amount of carbohydrates that you had for that meal, by either reducing your portions, or cutting out an item altogether. 
  • Make better food choices: By far, the best sources of fiber are non-starchy vegetables, and leafy greens. NOT starchy alternatives, like whole wheat breads, sweet potatoes, pastas, or grains and rices. While it is OKAY to enjoy some of these foods, in moderation, ALWAYS compliment them with non-starchy, fiber-rich, vegetables, and leafy greens. They will greatly slow down the absorption of glucose in your system, and help you attain control with more ease... as well as keep you full. If you allow your meals to consist of at least 50% non-starchy veggies, or leafy greens, you'll have an easier time at attaining control.
  • Rotate your testing: Never assume your evening numbers will translate to your morning numbers. Diabetics are the most insulin resistant in the mornings, and therefore, the most carbohydrate intolerant at those times. Consider making meals more centered around protein rich foods, like eggs, instead of cereals, breads, or starches. If you want to include some of these in your morning, be prepared to incorporate exercise into your routine. (Oatmeal might be good for Wilford Brimley, but it sure as heck is NOT good for me.) Never Assume - ALWAYS TEST. Test, test, test. I cannot stress this enough. Every diabetic is DIFFERENT. 
  • There are no good, or bad carbohydrates. Aside from outright junk foods, ie, foods that aren't even really foods, like ho-hos, or twinkies, there are NO good or bad carbohydrates. All carbohydrates have their proper place, in our diets. Use your meter to determine that place, the best. If you are exercising intensely, it is OKAY to pair a fast acting carbohydrate with a protein, and a fat, for strong, extended release. If you are experiencing a low blood glucose event, always consume a FAST acting carbohydrate, or simple carbohydrate -- ie, something made up of pure sugar or glucose -- BY ITSELF. Do *not* consume something that is slow, and complex, as it's digestion might not be fast enough to raise your blood glucose levels to a safe zone. In any other situation, simple carbohydrates are TREATS; and thus, they are meant to be consumed sparingly, and in moderation. They are not meant as "nutritional powerhouses." At meal times, strive to consume more complex, or slow burning carbohydrates. Try juggling, and spacing out your daily carbohydrate consumption, if you want to accommodate an occasional treat, such as ½ cup of ice cream, or a small cookie. Consider this: Often, a ½ cup of ice cream may have 17-20 grams of carbohydrate, but 1 serving of pasta may have well over 40 grams of carbohydrate. In this case, that pasta is more likely to spike you than that ice cream! (Perhaps, avoid having a starch at dinner, if you are planning for a dessert.)

Data is Power.

We have just examined a few of the baby steps that we can take to help us attain proper DATA, to make powerful decisions in our daily diabetes management routines. (Of course, this information is very basic, and it does not account for the impact that your medications, or insulin regimen, might have. If you are learning to manage insulin, it might be advisable to make an appointment with a Certified Diabetes Educator, or CDE, as well as investing in the book "Think like a Pancreas," by Gary Scheiner.) 

Try applying some of this knowledge, perhaps with just ONE MEAL a day. Visualize it! 

 What baby step will we discuss next week? Stay tuned to find out! 

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Posted: Nov 23, 2011

Freestyle Insulinx

After abit of playing the waiting game with Abbott Canada – then being sent over to Abbott USA – I finally have some exciting info for those of you who maybe are facing the same dilemma as I am – not being able to own an insulin pump.  I learned about this product from Marco Bianchi – who is a CDE at the Montreal Children’s Hospital.  I was Facebooking with him at the time to see if the province of Quebec had finally made the pump program for children legit – which it has – yee!haa!. Sadly, the pump program here in Quebec is only for ages up to 18 – and of course – you know me as an old fart pumping D – I’ll be once again writing to Premier Charest to have ALL age groups allowed to participate in the pump program. In the meantime, I’m preparing myself for the worst case scenario – of not having my faithful companion attached to me.  I searched the internet with the product name he'd given me and low and behold  I came across this press release from May 2011. 

I retire in about 5 years and without medical insurance from the work place, owning a pump will be a pipe dream (sorry - $6K is a lot of money – let alone average of $300/month for supplies). Currently I am covered 100% for pump supplies, the pump itself was 80% covered.  I'd written last year about my going on a pump break for 6 months when I went back to MDI (multiple dosage injecting) – so I know I can do alright with being on needles again.  Still it’s the programming functions of the pump for my I:C (insulin : carb ratio)m I:B (insulin on board) - and other little handy things that my pump has a history of.  Well, this device does that - except - no hook up with an infusion set and at an estimated price of $80 - more affordable for me in the long run.

The only information that Abbott USA (many thanks Gayle) and I could find (we were searching online together while on the phone which was a lot of fun – I was finding the info for the rep ) – was to go the the UK website – where you have a tutorial of what this meter can do for you – as well as other useful information (e.g. you can put your fav pic as your background on your pump – guess what I’ll be having on mine – meow, meow, meow). 

The touch screen meter (reminds me of an I-Phone) has just been released in the USA this past week (though you won't find it on any of their website at this time of writing). It has been available in Canada - but sadly - they have nothing at their website.  I'm interested in what my pharmacist  here in Quebec says when I inquire into it on my next legal drug run to them.

So, for now, go to this link, choose UK if you prefer English (the tutorial dude is so hilarious – trust me – you will fall in love with him).  If you prefer  another language just click on the different countries.  I am not sure when the USA / Canada will have the information linked up correctly – but for now – this is the only way I have of finding out more about the device.  Clicking on the Canada link just takes you to a general page – with no info on this product. 

What do you think?  Is this something that could help you better manage your diabetes?  Are you like me, willing to give it a try?  Hope so, I love being the continual revolving door guinea pig for diabetes products!  Bring it on I say, bring it on!!!  Now, Abbott, if only you'd let me have the device for free!!

NB:  Size of meter is 6.07 cm / 2 3/4 " Width - 9.5 cm / 3 3/4" Length - 1.5 cm / abit under 3/4" Depth

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Posted: Dec 20, 2010

NOT - like WHATEVER - is a term used by alot of people these days.  Since I try to write in proper English these two words sometimes make me wonder what is happening to the English language.  The definition of NOT as it's used in today's communication does not exist in my 2004 dictionary - but I did manage to find it of all places at Wikipedia.

Today is my first day back into the work force. I arrived back home mid-week from holidays that I spent with my hubby's family (more will follow on that - especially with my views of how CATSCA / TSA treated me at the airport).  All I had to do before starting to let my fingers flow across my keyboard was to get some groceries, Christmas stocking items, along with a gift for my family.

I am now realising - as my friend Diane said to me on Facebook - that I should arrive at the parking lot at 08h30 - otherwise you are fraked (my words, not hers). 

Entering onto the TransCanada I realised something was not right.  I only had to go by one exit and that was backed up at 11h30 as if it was rush hour traffic in the afternoon.  Shifting down into 3rd is not usual on a highway where the speed limit for me is usually 100-120 km/hr.  People were trying to skip over 3 lanes of traffic to get off at this exit.  Going by that exit, things cleared up for about 1/2 km - then bingo - my exit - Toys R Us and Costco - the two shops I had to go to in this neck of the Island of Montreal.  Not so bad for getting off, but I noticed people on the service road driving unreasonably calm as usually Montreal drivers are fast on our service roads, despite the speed limit (doesn't this happen everywhere?).  I easily went over the lanes to the Costco side street after realising that the line up ahead was for the Toys R Us.  The onslaught of Christmas shoppers were coming out of the woodwork - but it's not even the 24th December yet!

Costco was full of frustrated drivers in mini-vans, cars backing up, trying to jockey into position for any available parking spot they could find - scary stuff.  Now if some of the cars were Smarts like mine, there would be no problem - right?  I couldn't even see a spot for my little car.  So, I turned tail, weaved around cars, to slowly head back home while trying to figure out where to go that wouldn't be crowded.  I knew at this point, shopping anywhere on this Monday the 20th of December is a pretty futile mission. 

So, in the end, I went to a local grocery store near to my house, found what I needed at prices almost as good as Costco (I'm having second thoughts about renewing my membership there).  Gave up on buying any bread as it's so expensive at almost $4.00 a loaf, so I'll find time to make up my own this week.

The drive home was abit slow due to clearing snow off the streets from recent snow fall (it's like - nothing - I can drive through that - but the big trucks and snow eating machines might goggle me up).  I made it home, exhausted and by then a hypo had started where I was registering at 3.6 mmol/l (65 mg/dl). 

Shopping is stressful and as I've written in the past - I really hate shopping which is uncommon for a woman to say.  So, sorry to my hubby your stocking won't be filled with little things Christmas Day unless I get the gutts to go out again - but not to big box stores - I think small independent places are my choice for this time of the year.  I refuse to go to a big box store until mid-January - I'm all tuckered out (thank goodness we have enough staples to keep us going until then and that I like to cook from scratch).

I swear I wrote a similar Baa Humbug blog last year :)

Lamb made of a humbug by trevorandthea at Photobucket

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Posted: Nov 29, 2010
Sorry for the wait in finishing up this story (I had to tell my parents on the w/e as they were getting impatient).   Things have been crazy here at home, with trying to get meds all in order for upcoming holiday along with falling behind in work due to this latest eye glitch.  On top of that, trying to help out a diabetic friend with her new insulin regime of Lantus.  She's having a fun (NOT) time of dealing with roller coaster blood glucose (BG) rides.  I'm telling her to hang in there!

So, the final chapter begins - hopefully the wait was worth it .....

In the end, I saw the on call GP at 17h30 - by then I was about ready to flake out and go to sleep having had no food, water, and sitting on my plump buttocks all day (except for the ER drive home to change my infusion set/reload insulin cartridge into Salvador Dali).  Along with the two occulusion alarms (which I think probably was due to air bubbles in the tubing as all went well after priming the tubing again) I was literally toast. 

The GP was abit unsure about my eye at first as she didn't seem to see anything wrong (here I am with eyeball flooding out tears as she shines light in my eye).  She went off to consult with someone (maybe she went to the Internet) and came back first to place a topical anesthetic into my eyeball.  What a relief that was!  It felt like my eyeball was normal again, but she warned me that it would wear off.

At that point she placed some yellow drops ( with a strip of special paper that help detect damage to the eye.  From what I learned later on at home, at this point she would have used a fluorescent light to detect any abnormalties, but she just used a regular flashlight. 

In the end, she said I had a corneal imbrasion, handed me some drops to put in my eyes called Ciprodex to help counterbalance any infection I might get and said not to worry.

What did occur though when I got home over the next few days was that my eyesight didn't seem to be improving and when researching Ciprodex online I discovered that it's not recommended for eyes (it's for for ear infections).  I started to question what the GP had done - which I'm sure would be going through your mind as well. 

I had called up my
Ophthalmologist office on Monday to see if I could see her about my eye - and because of my diabetes they wanted to see me right away BUT only if I had an Emergency referral from the attending GP that I'd seen a few days before.   To make a long story short, in the end, between my endo's office trying to help out, I never was able to obtain the referral and can only see my Ophthalmologist in April which is my next 6-month check up.  Crazy medical system we have here in Quebec - but most of the times it does work - but can be frustrating as all hell at times.

In the end, I've spoken to my Optometrist, telling them of what had happened along with the use of the Ciprodex.  They told me that this is something they don't normally prescribe for eyes and said to stop using it.  Also, that normal eyesight with a corneal imbrasion takes from 1 - 4 weeks.  This was all done over the phone, and I am very lucky that I was not charged for this consultation!

So, as you can tell, I cannot wait to be able to see clearly out of that eye, so for now, I'm finding it difficult to work at my PC with the way my vision is.  I will be patient and that evil little eyelash separator brush that I posted a link for a picture of in my previous blog - gone to the land of trash - evil little tool of eyeball distruction - GONE!!!

To read more about corneal abrasions - you can go to this link - written by Nurse Practitioner, Sue Wingate.

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