Sunday, December 16, 2012

Gentle Jet, G4, Glycemia, and Vitamin D- A Hodgepodge Post

I've been using the jet injector for two weeks now.

Pro: No needles to keep track of or accidentally poke myself with or pay for or pack.
Pro: Faster onset and action time.
Pro: No soreness after injection.
Pro: Can do shots totally in the dark without using my sight.

Con: More things to keep track of while injecting- especially the caps to both the insulin vial and the injector itself.
Con: Faster onset and action time (I keep going hypo while I'm still eating the meal I injected for- and I'm using Regular for pete's sake!)
Con: More frequent visible bruising, even when shots are not more painful.
Con: All the twisting to load the jet injector is hard on my hands, which have not entirely recovered from this summer's neuritis.

My G4 has arrived but because of how long it took I got more sensors to keep me going. I just put in the last of my 7+ sensors, so I guess I'll be starting on the G4 in the week of New Year's.

I'm having difficulty with my overnight blood sugars- have been for over a month (so not caused by jet injector). I'm having hard to predict and rapid onset extreme night time hyperglycemia. For a couple of weeks I had numbers above 300 roughly every other night, and was hesitant to raise doses much because some nights I'd go low. Then I raised the Lantus dose, and things got a lot better. But the night before last, I once again went to bed with a nice stable 120 (at 9 PM- I was really tired), and woke up at 3 AM with a blood sugar of 330, feeling pretty awful. During the daytime I'm tending to run low. I'm not sure if my issue is delayed absorption or not, because not all of the night time highs happened with a meal within hours of bedtime; OTOH it's a really large rise for just a basal drift. And I have been having issues in that I'm going low after some meals as if I haven't eaten.

I'm also noticing a very predictable pattern where my blood sugar shoots up after exercise. This is especially noticeable after swimming, juggling, or biking, where about ten to twenty minutes after I stop exercising, my blood sugar starts going up- on the Dexcom there's usually a straight up arrow, not even a mere angled one. My blood sugar has been dropping or stable during exercise, but afterwards... ugh.

Two interesting studies I came across:
One on risk of stroke, heart attack, and death from cardiovascular disease that looked especially at diabetes and weight. I thought it was interesting that the average diabetic (they don't differentiate between types but the average age is 58) was not underweight in this large study. It is also sobering that the increase in death was entirely in people whose weight was low or low normal.
Another is just a case series.  I am always paying attention to what's happening with the whole vitamin D thing, because my own experience was so contrary to what's reported. In this study, the authors merely report on the most recent fifteen patients they'd seen with vitamin D mediated hypercalcemia. In all cases, the people had severe cognitive symptoms, did not have a disorder affecting vitamin D metabolism (unlike me), and had been given injections of very high dose vitamin D by a licensed physician. These are interesting to me because these are people whose bad effects are due only to how much they took and not because of taking them without a doctor's approval or despite a disease that makes it a bad idea. These people did not have mild side effects; they were hospitalized for an average of over two weeks.
Their vitamin D levels overlap with how high mine have been, they all had higher calcium levels than I've had, their PTH levels overlap with mine (my PTH was measured at the bottom of normal), and they're all older than me and took more than ten times the dose that I took.

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