I got new glasses in June (I'm near sighted). My prescription changed a lot in one eye, and I decided I wanted totally new glasses. A couple of days after I got my new glasses, I walked past a door and did a double take- it looked totally warped into a C shape. When I looked at it head-on, it was fine. After that I couldn't stop noticing that everything in my peripheral vision was warped. I use my peripheral vision less than most people do (sensory processing dysfunction- had an OT work with me for a long time trying to get me to track things and look at things without turning my head- I feel safer when I don't see things in my periphery). I went to the optometrist, who did something to my glasses and told me to give it a few days. It's still just as bad.
A few days after I came from my vacation, I started walking into things a lot, and kept injuring myself. In one day, I racked up four scrapes, one bruise, and one burn. The rate of injury has dropped off since then but I'm not doing so great.
A week ago Friday, in the evening I wanted to lie on my side and tried to prop myself up with my left hand. There was an excruciating pain across the top of my hand and I fell. I thought it was yet another stupid joint issue and didn't think too much of it, tried to just use my right. Kept hurting the left everytime something bumped it. Monday night, the hand started feeling the way it did when I had an IV infiltrate- tingly and swollen. So on Tuesday I went to see an orthopedic surgeon, figuring I had a sprain or a fracture. But he took a look at my hand and said, "Interesting- this is acute tarsal carpel tunnel syndrome". He says his tentative diagnosis is diabetic neuropathy with carpal tunnel syndrome. That is really depressing. I think he's wrong though- I wouldn't be surprised if I do have neuropathy (both hands and feet have been tingling in a non-painful way) and there's clearly some nerve involvement. But it's the wrist that's really been hurting and it's across the top of my hand, and it's as much on both sides of the hand (thumbward and pinkieward) and plus, I'm only 23 years old.
I'm now wearing a splint and applying a topical NSAID. My Dexcom has been performing pretty erratically and I wonder if it's the NSAID, which is Voltaren Gel (diclofenac sodium topical gel). I'm having a little difficulty in doing shots- I can easily do an injection one-handed, the hard part is drawing up the insulin. And taking the caps off the syringe. Tips welcome.
I'm also having an issue with extreme, sporadic, dizziness. Like everything around me is spinning, but I'm not hypo.
Also, on Friday morning I woke up a little high (218 mg/dl) and tested urine ketones, which were moderate. I tested blood ketones and got a 2.0!!! Unfortunately the strip was a month past the expiration date and I don't have anymore of them, so I couldn't confirm or disprove the result. I took a lot of insulin for breakfast and supper, and my urine was ketone free by evening.
My computer, a little Eee PC, is also having some issues and was giving me blue screen deaths. It works okay as long as I keep it in safe mode (with networking) but the sound won't work and if I go out of safe mode, it restarts.
Despite all that, I'm feeling okay. Have been enjoying finding work arounds, but hoping to return to the state my body was in a month ago.
Sunday, July 29, 2012
Tuesday, July 24, 2012
Side Effects
A while back, I got a comment on here asking if I'd accept guest posts. I said yes, if the guest post was relevant. This is the article written for this blog from drugwatch.com, a website that focuses on the risks in medications, and especially those that have been recalled. Although us type 1s do not really have much choice about taking insulin, I sometimes think we can use the reminder that it's not always a good idea to take other medications, or to advocate the use of medications in type 2 diabetes, even when it lowers blood sugar- there are worse things than high blood sugar. Anyways, here's the article. Please leave a comment if there's something you think somebody who is calling attention to the downsides of medications should know about diabetes.
The Benefits and Risks of Diabetes Medications
People with type 1 and type 2 diabetes have similarities and differences when it comes to their medications. People with type 1 diabetes rely mostly on insulin injections, and people with type 2 diabetes are usually prescribed oral medication to help manage the insulin their bodies still produce.
Type 2 patients may require insulin at some point, as well. And people with type 1 diabetes might use an oral medication like an alpha-glucosidase inhibitor to slow the flow of sugar into the bloodstream after a meal.
No matter which medication they take, people with diabetes must be familiar with the drug and possible side effects.
Many diabetes drugs are effective at controlling blood sugar. But they may be too effective, causing hypoglycemia. Both type 1 and type 2 patients need to be on the lookout for low blood sugar. Symptoms include:
* Hunger
* Shaking or trembling
* Blurry vision
* Rapid heartbeat
* Tiredness
* Nervousness
* Headache
* Sweating
* Tingling
If left untreated, hypoglycemia can lead to fainting, seizure or coma. When blood sugar drops, the best thing to do is to eat a piece of candy or drink some regular soda.
Many patients require insulin, which is one of the most powerful reducers of blood sugar. But when it is used in higher amounts than it should be, it can lead to hypoglycemia.
If a person fails to take enough insulin, however, their blood sugar levels can rise dangerously high — a condition known as hyperglycemia. Symptoms include: thirst, tiredness, frequent urination and an upset stomach. It is often treated by exercising, but a doctor would know the best treatment.
Actos is one of the most popular type 2 diabetes medications, and can lower long-term blood sugar (measured by glycated hemoglobin) by about 1.5 percent. It does this by making the cells more receptive to insulin.
Unfortunately, Actos (pioglitazone) also has been linked to serious side effects, including congestive heart failure, bladder cancer and liver disease which has led some patients to begin to file lawsuits. It has carried a black-box warning from the Food and Drug Administration (FDA) since 2007.
The positives and negatives of diabetes medications aren't always clear cut. It's important for people with diabetes to look at medical studies about diabetes drugs before they begin taking them. Look on FDA.gov to find a drug's warning labels to fully understand its risks.
William Richards researches and writes about prescription drugs and medical devices for
Drugwatch.com.
The Benefits and Risks of Diabetes Medications
People with type 1 and type 2 diabetes have similarities and differences when it comes to their medications. People with type 1 diabetes rely mostly on insulin injections, and people with type 2 diabetes are usually prescribed oral medication to help manage the insulin their bodies still produce.
Type 2 patients may require insulin at some point, as well. And people with type 1 diabetes might use an oral medication like an alpha-glucosidase inhibitor to slow the flow of sugar into the bloodstream after a meal.
No matter which medication they take, people with diabetes must be familiar with the drug and possible side effects.
Many diabetes drugs are effective at controlling blood sugar. But they may be too effective, causing hypoglycemia. Both type 1 and type 2 patients need to be on the lookout for low blood sugar. Symptoms include:
* Hunger
* Shaking or trembling
* Blurry vision
* Rapid heartbeat
* Tiredness
* Nervousness
* Headache
* Sweating
* Tingling
If left untreated, hypoglycemia can lead to fainting, seizure or coma. When blood sugar drops, the best thing to do is to eat a piece of candy or drink some regular soda.
Many patients require insulin, which is one of the most powerful reducers of blood sugar. But when it is used in higher amounts than it should be, it can lead to hypoglycemia.
If a person fails to take enough insulin, however, their blood sugar levels can rise dangerously high — a condition known as hyperglycemia. Symptoms include: thirst, tiredness, frequent urination and an upset stomach. It is often treated by exercising, but a doctor would know the best treatment.
Actos is one of the most popular type 2 diabetes medications, and can lower long-term blood sugar (measured by glycated hemoglobin) by about 1.5 percent. It does this by making the cells more receptive to insulin.
Unfortunately, Actos (pioglitazone) also has been linked to serious side effects, including congestive heart failure, bladder cancer and liver disease which has led some patients to begin to file lawsuits. It has carried a black-box warning from the Food and Drug Administration (FDA) since 2007.
The positives and negatives of diabetes medications aren't always clear cut. It's important for people with diabetes to look at medical studies about diabetes drugs before they begin taking them. Look on FDA.gov to find a drug's warning labels to fully understand its risks.
William Richards researches and writes about prescription drugs and medical devices for
Drugwatch.com.
Wednesday, July 11, 2012
I was on vacation July 1-8; left on the first and came back to Chicago on the 8th. I reduced my Lantus from 8u (which I'd been taking for the last week of June) to 6u, which I took on the evenings of July 1-6. I took 4 1/2 u Lantus on the evening of the 7th because the 8th was a fast day.
This was my first vacation with diabetes in which I managed to avoid severe, symptomatic, scary hypoglycemia. I did run a lot of lows in the 40s, but I didn't have any lows that made me woozy, panicky, or disoriented, and I didn't go lower than the 40s.
This was also the first time I tried packing a sensor. I've had two vacations in the past where I had been wearing a CGM; in one, I just left the CGM at home and took a sensor break, and in the second I changed sensors right before leaving. This time I took a sensor in the bag but not the box and put it in with my clothes. When I got where I was going the bag looked pretty beat up but the sensor looked okay, and two days later I changed sensors. It performed beautifully. Unfortunately, I'd forgotten to bring scissors to cut my hairs before applying the sensor, and it was a really hot week, so after a week I pulled the sensor because I didn't think it would stick on much longer. But it worked just fine. I will be less hesitant to pack sensors in the future.
One thing I must've done a bad job packing: pen needles. I currently use syringes for the Novolin R and testosterone and pen needles for Lantus. That means that on an 8 day vacation, I expect to use 7-8 pen needles and anywhere from 20-50 syringes. So I packed a box of a 100 syringes and counted out ten pen needles which I put in the box. Well, I guess that's not a good place to put them, because I had trouble finding the darn things. In the end I only could find five pen needles. I reused one of them and did the last Lantus shot by syringe. I guess if you have enough syringes, not having pen needles isn't really such a big deal.
I recently read a study that's made me think about how I store my insulin, even those vials in use. This study looked at Regular and 70/30 insulins made my Novo, Lilly, and Biocon (Biocon insulin is not available in the US and is a U-40 insulin for sale in India). So that's 6 types of insulin. They stored them in unopened vials in 5 different storage conditions (now we're looking at thirty different situations). They wanted to compare how the storage conditions affected degradation of the insulin over a period of two weeks, and over a period of one month.
They injected the insulins into rabbits to see how much the insulin lowered rabbits' blood sugar after being stored in different ways. The rabbits started out with blood sugars in the range of 100-108 mg/dl (apparently that's normal fasting blood sugar for rabbits). The insulin then made them hypo. It lowered blood sugar into really tight and predictable ranges with little standard deviation. It lowered blood sugar significantly less when the insulin had been stored at temperatures of 32 and 37 degrees Celcius (89.6 and 98.6 degrees Fahrenheit), as compared to when it had been stored at temperatures of 5 to 26 degrees Celcius (41 to 78.8 degrees Fahrenheit).
This strongly suggests, at least to me, that a person who carries around his short acting insulin during hot temperature days should carry it in something that will keep it at a temperature that is at least below 89 degrees Fahrenheit, lower if possible, unless the insulin will be used up in less than a two week time period. The Frio may be a good idea.
The full text of the study is available here: http://icmr.nic.in/ijmr/2009/august/0910.pdf
This was my first vacation with diabetes in which I managed to avoid severe, symptomatic, scary hypoglycemia. I did run a lot of lows in the 40s, but I didn't have any lows that made me woozy, panicky, or disoriented, and I didn't go lower than the 40s.
This was also the first time I tried packing a sensor. I've had two vacations in the past where I had been wearing a CGM; in one, I just left the CGM at home and took a sensor break, and in the second I changed sensors right before leaving. This time I took a sensor in the bag but not the box and put it in with my clothes. When I got where I was going the bag looked pretty beat up but the sensor looked okay, and two days later I changed sensors. It performed beautifully. Unfortunately, I'd forgotten to bring scissors to cut my hairs before applying the sensor, and it was a really hot week, so after a week I pulled the sensor because I didn't think it would stick on much longer. But it worked just fine. I will be less hesitant to pack sensors in the future.
One thing I must've done a bad job packing: pen needles. I currently use syringes for the Novolin R and testosterone and pen needles for Lantus. That means that on an 8 day vacation, I expect to use 7-8 pen needles and anywhere from 20-50 syringes. So I packed a box of a 100 syringes and counted out ten pen needles which I put in the box. Well, I guess that's not a good place to put them, because I had trouble finding the darn things. In the end I only could find five pen needles. I reused one of them and did the last Lantus shot by syringe. I guess if you have enough syringes, not having pen needles isn't really such a big deal.
I recently read a study that's made me think about how I store my insulin, even those vials in use. This study looked at Regular and 70/30 insulins made my Novo, Lilly, and Biocon (Biocon insulin is not available in the US and is a U-40 insulin for sale in India). So that's 6 types of insulin. They stored them in unopened vials in 5 different storage conditions (now we're looking at thirty different situations). They wanted to compare how the storage conditions affected degradation of the insulin over a period of two weeks, and over a period of one month.
They injected the insulins into rabbits to see how much the insulin lowered rabbits' blood sugar after being stored in different ways. The rabbits started out with blood sugars in the range of 100-108 mg/dl (apparently that's normal fasting blood sugar for rabbits). The insulin then made them hypo. It lowered blood sugar into really tight and predictable ranges with little standard deviation. It lowered blood sugar significantly less when the insulin had been stored at temperatures of 32 and 37 degrees Celcius (89.6 and 98.6 degrees Fahrenheit), as compared to when it had been stored at temperatures of 5 to 26 degrees Celcius (41 to 78.8 degrees Fahrenheit).
This strongly suggests, at least to me, that a person who carries around his short acting insulin during hot temperature days should carry it in something that will keep it at a temperature that is at least below 89 degrees Fahrenheit, lower if possible, unless the insulin will be used up in less than a two week time period. The Frio may be a good idea.
The full text of the study is available here: http://icmr.nic.in/ijmr/2009/august/0910.pdf
Subscribe to:
Posts (Atom)