Thursday, August 14, 2008

Oy, Lantus

Sometimes I forget that Lantus really loses effectiveness over the course of a month. Yesterday morning I woke up with a bloodsugar of about 250, having taken two Novolog shots during the night. I had been going a little high in the mornings after fairly stable nights for about a week. I decided to open a new vial, since I'd been using the previous one for 34 days or something like that. I took the same dose. Last night, I was hypo, snacked, checked in another hour, was 75, ate a plum and a butterscotch candy (together 15-20 carbs) and went to sleep. When my father came by to tell me to get up, my blood sugar was 81 and by the time I actually got up two hours later it was 79. Wow. Lantus, you fiend!

In other news, I reordered my supplies yesterday, and there must have been some snafu, because my insulin and glucagon and test strips arrived today, shipped by overnight mail. Which I hope I'm not paying for. The polar packs were still frozen when they got to my house! That hasn't happened before. The stuff arrived in two boxes. The smaller one is about one cubic foot, and I was startled to find that the only thing inside was styrofoam, two polar packs, and a glucagon. The glucagon could easily have fit with the insulin in the other box. My syringes and needles have not arrived yet. I think I decided not to reorder lancets, since I seem to have enough of those. I am really running low on pen needles- I've been doing an unprecedented number of shots lately.

And in the final stretch of medical news, my testosterone levels were discovered to be way too high. I inject testosterone under medical supervision, and it appears that my dose was about 3x where it ought to have been. Maybe more. I am fantasizing that this means I don't really need to inject it. In the meantime however, my dose has been lowered and I have to get more blood drawn. Ouch! Last time it was drawn from my hand, and my hand looked like I had a mosquito bite. It hurt a lot, but it healed pretty well.

Sunday, August 03, 2008

After the 594

That evening, I went hypo. I ate about 30 carbs. Stayed hypo. Ate another 20 carbs, and went to sleep. Woke up with a blood sugar in the 180-210 range. The ISIG on my CGMS wasn't all that high at the time (something like 8), so I pulled the sensor. Less than 24 hours after the 594, in the dentist's office, my blood sugar came in at 36. What a range!

I'm feeling a little less happy about the CGMS. I mean, I said no the IPORT partly because my first day on the IPORT, I had a bad site that resulted in a blood sugar of almost 400, which was the first time in over six months I'd been that high. That I was wearing the CGMS when I had my high score blood sugar makes me frustrated. I mean, it hadn't appeared that the sensor was going bad- the ISIG was something like 10, and it had been less than 2% off both of the earlier times that day that I'd checked.

During my first nine months managing diabetes, I counted every carb. I took a food scale with me wherever I went and I weighed and measured and I memorized the carb percentages by weight for over a hundred beans, grains, fruits and vegetables. I did most of my own cooking (I lived alone) and I measured everything going into the pot. I followed pretty strict carb ratios, which I adjusted on a weekly basis. I acheived A1cs of 6.5 and 6.3. My blood sugar didn't hit 300 for over five months, but it frequently went below forty.
These days, I have a much more relaxed attitude towards diabetes management. I don't have any carb ratios. I keep track like this well yesterday I ate about two thirds of this at this time and I took x amount of Novolog so and I ended up a little hypo so today maybe x+1 units would be right? Maybe? Eh, sure, why not. And the amazing thing is that I'm usually right. My blood sugar has hit 300 more often these days, but not that often, and I'm still in range for most of the day, whether or not I use the CGMS. My last A1c was 6.3.
My blood sugar spikes more now than it used to. I suspect that this is because of both my less attentive attitude (giving rise to more mistakes), and because the last of my beta cell function is done for.

In less than a month, I will have been on insulin for two years. I intend to write a list of 100 ways I've changed then. Right now though, I figure I'm at the best part of the diabetes journey. It's old enough that I really feel that I know what I'm doing and I'm comfortable doing it, and it's new enough that I don't have any major complications.