Category: Diabetes

Before you panic and scroll past, this isn’t another post about my car. Evidently, my car is functioning quite well since its last visit to the mechanic. Now I get to focus my “repair” attentions to my newly-purchased cell phone, which I’ve already ranted about here. So I won’t bother getting into THAT again (at least until I get the phone back and find out if it’s working or not). You all know that I like puns in my post titles, and this one is no exception. The carburetor I’m referring to is the pancreas.

A real carburetor promotes the internal combustion process of a vehicle by injecting a mist of fuel with air. This is done to allow for the internal combustion process to “make the car go.” Much in the same way, the pancreas injects insulin and helps control the level of fuel (carbs) in the body in order to also “make it go.” On a slightly different playing field, but the comparison is sound. In the case of someone with Type-1 Diabetes, injections of insulin are required since the pancreas no longer produces insulin after having one’s own immune system attack and destroy the body’s insulin-producing cells.

Now that I’ve explained that definition for what seems like the millionth time in my life, let’s proceed with the post, shall we? I’m a big, big fan of believing that someone with Diabetes can do ANYTHING that someone who isn’t afflicted with the condition can do. This is especially true of food, so long as one’s blood sugar levels are well controlled and you can dose your insulin in such a way to properly deal with the food you’re eating. For many years, I was mostly of the opinion that I should eliminate carbs as much as I can to inject as few units of insulin as possible. But modern therapies, including the insulin pump, have made it possible for me to enjoy a significantly more “normal” lifestyle and eat the way I see fit. Almost.

Therapies and technologies are only as good as the users who maintain them and even I make mistakes sometimes, despite many decades of dealing with my condition. Take a particular day for example, where things slipped off the rails, ever so slightly. I skipped breakfast. Alright, not deadly on it’s own but never a good thing. I don’t know if it’s age, Diabetes, my specific biology or an unhappy combination of the three usually leaves me waking up with no appetite for much of anything but dropping my head back to the pillow.

That first meal of the day serves a number of purposes, which I’ve written about in previous posts. So I won’t beat a dead horse on this one, but one key point is that eating regularly can actually help to maintain your blood sugars throughout the day and can help prevent highs and lows. So grabbing that quick bagel on the way out the door is never a bad idea (or yogurt, since bagels are pretty high-carb). Nevertheless, I skipped breakfast on this particular day, which meant that by the time lunch rolled around, I was extremely hungry and my blood sugars were slightly out of whack. Go, me (sarcasm)!

I ended up being a bit on the naughty side and ordered out for lunch. It was an extremely high-carb lunch, which should have been no problem. As long as I could bolus appropriately for the food I was consuming. Did I bolus appropriately? What do YOU think? I always like to think that I do, but sometimes bolusing does involve a level of guess work, especially when you’re eating food that’s been ordered and have no immediate way of verifying the total carb count. That’s what happened in this instance and as a result, I faced blood sugar levels in the teens for a number of hours leading into dinner (or supper, depending on where you’re reading this).

By the time supper rolled around, my blood sugars were reasonably back into normal range. My wife and I prepared the delicious supper you see picture above. Chicken balls with a homemade sweet & sour sauce with warm, buttered biscuits. Comparable to Thanksgiving, this meal practically put me into a coma. Between the heaviness of the meal and the high carbohydrate content, I was ready for sleep by 6 pm. And in truth, once the boys were in bed, I joined them and crashed as well. And that’s where I made my next mistake.

Like most people with Diabetes, I’ve dealt with many years where I had to pay for my supplies out-of-pocket. I’m lucky enough to have some solid medical coverage now, but it wasn’t always so. And Diabetes supplies and therapies are surprisingly expensive for something that absolutely necessary for keeping people alive. As a result, I’m pretty thrifty when it comes to insulin, since I’ve often had to make the most out of every unit. As a result, I decided to go to bed with only 12 units remaining in my pump. Normally, this wouldn’t be such a big deal and I could change it in the morning.

But my overnight basal rate is about 1.5 units/hour. Since I crashed at about 8 pm and awoke at 5 am, that’s nine hours of sleep. According to new math, 1.5 units/hour x 9 hours of sleep is 13.5 units. I fell short and had an empty pump for over an hour when I awoke. This left my blood sugar readings in the high teens. Not a great way to start the day. It’s all the little details that make a proper balance so critical. I know and understand the reasoning behind everything I’ve described in this post, but it doesn’t prevent the occasional bad day or a day where one is unable to find a proper balance.

The important thing to remember is that you should always be vigilant in your dealing with Diabetes, but you should also cut yourself a break when things don’t go well. As long as you keep fighting the good fight, you’ll always get ahead. I know a lot of people with Type-1 Diabetes who eat what they want, do what they want and completely ignore their blood sugars and proper insulin dosing. The sad truth is that for those people who just don’t seem to care, it doesn’t take long for Diabetes to completely overtake them. It also doesn’t help that Diabetes can be exhausting. But as much as this post may feel like I’m simply complaining about my condition, it’s mainly to illustrate how even a well-balanced and controlled case of Diabetes can easily have a bad day where things slip out of hand. Monitor your blood sugars regularly, eat well and include exercise into your weekly routine. And stay strong. ☯

Once you get used to it, the worst part about using Diabetic equipment is changing it out or replacing the disposable aspects. For example, I use three main pieces of Diabetic equipment: my insulin pump, continuous glucose monitor and my glucometer. My pump gets changed out every three days (on average) to prevent issues with crystallization of insulin in the infusion set, leading to improper dosages of insulin. My continuous glucose monitor gets changed out every seven days. I’m uncertain as to the reason for that, although I’m sure there is one. My glucometer simply requires recharging.

Despite the differences in timing, it’s pretty rare that I have to deal with more than one of these items at the same time. But last Saturday morning, I found myself having to deal with all three at once. As near as memory can provide, I don’t believe this has ever happened. It can definitely take the “get-up-and-go” out of your morning; especially if you have to deal with all that equipment and doing the replacements, all at once. Although the replacements don’t take long, combining them all can be a bit more tedious. Much like a sable grain of sand on your back won’t hurt you; but a truckload dropped on you will be harmful.

If you want some idea of how quickly changing out the pumps’s infusion set or the continuous glucose monitoring can be, you can visit my YouTube channel and watch the videos where I demonstrate here.

It started on Friday night when the entire family was outside. I mowed the back lawn and the kids were playing. As I was doing things in the yard, my wife made a point of asking me when my sensor was supposed to expire. I explained to her that I had installed the current one later in the day than I usually do, resulting in calibrations and checks throughout the night. This resulted in a later change than the typical Thursday. She reminded me it was Friday. Shit. I checked my status screen on the pump and sure enough, there it was! There was about an hour and half left to the current sensor.

Since it was almost 8 o’clock in the evening, this would mean changing the sensor (no big deal) followed by a two-hour warm-up period (a bit bigger of a deal) followed by calibrations AT that two-hour mark and again at the four-to-six hour mark. Screw that noise! It was Friday night and I had no intention of being woken up every few hours to test my blood. I decided to do some writing and simply ride out the remaining time on the sensor then shut off auto mode and replace it in the morning. I carried on with my evening and at about 10 o’clock, the sensor expired, so I placed it in its charging dock and went to bed on manual mode.

The following morning, I awoke to an angry buzzing at my hip. It took me a few moments to remember that I was on manual mode and that I shouldn’t be getting alerts. The buzzing as because my insulin reservoir was empty. Well. Shit, again! So now I had to change out my infusion set AND my sensor. My wife was nice enough to help with the sensor replacement, since I put it on my tricep and it’s difficult to see. I then refilled my insulin. Since I had gone about eight hours without nay testing either by blood or sensor, I tested with the glucometer. hence, the “unholy trifecta.”

There’s really no point to today’s post. I just don’t recall it every happening where I had to change up everything and use all my equipment at the same time. And yes, lack of auto mode made a difference, throughout the night. I awoke to a blood sugar level of 12.6 mmol/L instead of my usual window of 6.0 to 6.5 mmol/L. So if nothing else, the experience demonstrated how effective the auto mode on my pump can be. ☯

Yesterday, I wrote a post about some of the medications that I’ve been prescribed. These medications started out as preventative, but as the years passed, it became apparent that they were no longer “preventative” and were playing an active support role in my overall health. One of those medications plays a role in helping to control high blood pressure. When people hears “Diabetes,” they don’t automatically think of high blood pressure. But as it turns out, it can be one of those inevitable side effects that eventually catch up to anyone with Diabetes, controlled or not.

it’s no secret that Diabetes damages the body’s blood vessels and causes atherosclerosis (hardening of the arteries). That hardening will eventually cause an increase in blood pressure, which is where the problems start. High blood pressure can lead to heart attack and renal failure as well as problems with circulation. An increase in blood pressure can also lead to various eye complications related to Diabetes.

According to a post by WebMD, “most people with Diabetes should have a blood pressure of no more than 130/80.” Although I can admit that my blood pressure is usually spot on or close to that (when it gets tested), I’m sure there are days when it ain’t so great. The article goes on to explain that good blood pressure control can be almost as important as proper blood sugar control.

One of the big problems is that unlike a lot of other complications, a person can run for quite a long period of time without ever knowing they have high blood pressure. This is why it’s important to test your blood pressure regularly. You can purchase your own blood pressure cuff at your local pharmacy for a reasonably low price. They usually run from anywhere in the low $20 all the way up to well over $100, depending on how fancy you want to get. Personally, my blood pressure cuff is about as old fashioned as you can get, without having the old style that also requires a stethoscope. It’s a simple arm cuff connected to a pneumatic tube, which runs into a reader that takes “AA” batteries.

There are a number of things, some obvious and some not, that you can do to help improve your blood pressure. Regular exercise and proper blood sugar monitoring and control are the common ones, of course. But a healthier diet, quit smoking, drinking alcohol and limiting your intake of salt are also important to maintaining good blood pressure. Your endocrinologist will usually smack your fingers if you allow your blood pressure to run rampant.

If you happen to fall under the category of folks who can’t afford or don’t want to pay for a personal blood pressure cuff, you can visit your local pharmacy or big box retail store. They usually have a publicly-available blood pressure machine that you can use. Moderation on some of the more common bad habits as well as healthy diet and exercise are key. Don’t let high blood pressure be your undoing. ☯

I can be a bit of a stubborn bastard at the best of times, which comes from a lifetime of having every adult around me dying to tell me how to eat, how to sleep, what medications to take and when to take them. As a child, I would often be resentful of having to wake up on the weekends to take insulin injections, to the point where my mother started getting into the habit of simply yanking down my pyjama bottom and injecting me in the buttock as she felt it simply wasn’t worth the fight. I’ve obviously gotten better as I’ve gotten older, but kids don’t usually understand the NECESSITY of the medication they may be on, and I was no exception.

In 2009, I faced a new aspect to my Diabetes therapy. I had just moved to Saskatchewan and got myself a new doctor. After a couple of appointments to “get to know each other,” he introduced something that I had promised I would never allow: pills. Don’t get me wrong; I have nothing against pills. They’re necessary, required and important. So long as they’re used for their intended purpose, that is. But I grew up watching my brother ingest dozen different pills, first thing in the morning and again around dinner time. And we all know how THAT ended as he passed away in 1991.

When it was suggested, I firmly told the doctor that I had no need or use for pills and that I had no intention starting on them. He then asked me if I took a multi-vitamin. Yes, I did. He was quick to point out that multi-vitamins were pills and I was voluntarily taking those, so why would I object to the ones he was proposing? Mostly, it was because I didn’t know what the pills he was suggesting did, so there was a fear of the unknown. This is where he actually took the time to explain the medications in detail and what they would be for, which if you’re even mildly familiar with doctors in recent years, they aren’t big fans of taking extra time when you visit.

Once they were explained, I learned that I would be taking a medication call “rosuvastain,” more commonly known as Crestor. This one helps prevent raising cholesterol. Not a problem I’ve ever know to have, but okay. The other one is Ramipril, which is commonly-used to treat high blood pressure and renal failure in folks with Diabetes. The explanation made sense until he the doctor pointed out that these were “preventative” measures… What the fuck?! So, I’m basically starting to take pills I don’t need? That’s like getting open-heart surgery IN CASE you eventually have heart disease…

I know, I was a little over-dramatic and it’s not really comparable, but what would think about starting to take medications you don’t need? Although renal issues are a recognized side effect of Diabetes, it seemed odd to me to take medication for it when, by all accounts, my kidneys were clear. Alright, he’s the doctor and I’m the patient, so I trusted him and accepted the prescription. I’ve been taking those two medications as part of my Diabetes therapy, ever since.

Flash forward to over ten years later. I’m still on both medications AND as of last year’s endocrinologist’s appointment, both medications have been increase to satisfy the demand of my body’s condition. In fact, during my last appointment with my endocrinologist, which was las February, tests showed that my kidneys showed some mild level of struggle, meaning that the medication was providing some active support. It kind of makes me wonder where I’d be at and how far gone I would be if I hadn’t accepted these “preventative” therapies.

I guess my point here today, is that it can be extremely important to take ownership of one’s health and be clear and understanding about what’s being put into one’s body. By the same token, preventative medicine can be an effective way of putting off some of the difficulties that one may face when dealing with Type-1 Diabetes. Although it can be difficult to take it on faith when it comes to taking pills, well-trained doctors will often be able to identify the need for such prevention early on, where the patient may miss it or be unaware. Food for thought…