Heat and Diabetes

I had a bunch of really unusually good blood sugar days this week and when I talked to a friend with diabetes- so had she. I've been wondering about the affects of weather on diabetes. I searched on pubmed, and discovered a few things:
That keeping lab animals at room temperature gives them insulin resistance vs if there's temperature variation.
A bunch of articles on vitamin D deficiency and brown fat and developing diabetes.
An article about the 2006 California heat wave noting a 3% increase in hospitalizations due to diabetes during the heat wave.
Two articles about people with pumps going into DKA due to heat related damage of the insulin in the pumps.

In sum, it seems that moderately hot and cold weather decreases the amount of insulin people need, and that beyond that there isn't much research.

If you have multiple D householders, do you notice that their blood sugars tend to go high or low on the same days?
Does anybody know of any articles about daily weather- as opposed to seasonal- affecting blood sugar? Please comment.

Answer

Bernard got it. I forgot that the ice would account for a sizable volume, and that I did not in fact get 16 ounces. My guess is that I got less than half of 16 ounces of pineapple juice; I went hypo within the hour and despite treating the hypo, stayed hypo for over an hour and a half. Oops, hopefully won't make that mistake again. The next day I ordered tomato juice and injected for only half of the volume to better results.

Rookie Restaurant Mistake

I'm taking a course in wetland conservation and we had a field trip today to learn about wetland delineation. The school paid for the class to eat lunch in a classy restaurant.
So we go in, sit down, I go the bathroom and wash my hands, dry them, and check my blood sugar. 61. Okay, good thing it's lunchtime.
So I go sit back down, the waiter asks if we'd like a drink, tells us they've got water and colas. I ask about juice: he says they've got pineapple, cranberry, and lemonade. I ask for pineapple, and soon I get it; a tall glass of ice and pineapple juice with a straw. I ask for nutrition information and drink the whole glass.
The waiter comes back with a can of pineapple juice; the side says 8 oz is a serving and that there are 35 g of carbohydrates per serving. The waiter tells me I got 16 oz.
I wait until my dish, hummus and vegetables, arives, before I inject. I inject for 60 carbs.


Can you find the rookie mistake? Did I go high or low? Answer in next post.

Loser, loser, loser.

I'm always losing stuff.

On Wednesday night and Thursday was a Jewish fast day, the 9th of Av, and I managed to fast the whole day. I just cut the basal from 12.5 to 8.5 Lantus that night. I woke up 228, took a unit of insulin, was down to 130 by lunch, rose to 150 by midafternoon, dropped to 72 by 5 PM, and hovered there - with another reading of 72 and a reading of 68- until I broke the fast at 9 PM. Then I couldn't find my NovoPen Jr. I looked and looked to no avail, so I took out a cartridge and used a syringe to dose for supper. This, I think, makes the fourth one lost in under 3 years.

Still taking my Novolog out of cartridges with a rapidly dwindling syringe supply, Friday night I couldn't locate my Lantus. It's usually in the fridge. I looked and looked and then gave up for the night; decided to take some expired Lantus to hold me through the night. I took 4 units, and woke up around 2 AM. My blood sugar was 441 and my urine ketones were negative. I took 7 units of Novolog and went back to sleep.
In the morning my blood sugar was 252 and my ketones still negative. I decided to open a new vial of Lantus and just not worry about wasting the opened vial. So now I'm back to morning Lantus shots. Hope this works out.

I will be buying a new NovoPen Jr. or two ASAP.

I got sent the glucagon I've been waiting for, finally- but I got sent three glucagon kits instead of the one I was supposed to get. Since I was billed the same as if I was sent one (insurance paid the full price for the other two) and since they say nonreturnable on them, I think I will just let it be. Store them in different places and I'll have plenty!

My blood sugar's been pretty bouncy but still not bad at all. It turned out the Lantus had not gone bad. I wish my body was more consistant. I'm having a problem getting the Lantus dose right. It seems like I wake up either high or low most of the time- I woke up 203 and dehydrated this morning and 48 and psychotic the previous morning and I had not dropped the dose much at all. And no, it isn't Symogii.

2 for 12

Mike Lawson posts 12 pictures on the 12th of each month and I always think that's really cool.I was planning to do the same but am having trouble uploading pictures. So here are a mere two pictuers instead.

All Better Now, And Hoping It Stays That Way

Thyroid level tests all came in normal range, with the TSH, T3, T4 all being just above the bottom of normal. My endo says to call him if I get symptomatic of hypothyroidism, because he thinks that might be where I'm headed to.
The erythrocyte sedimentation rate came in at 3, which is low- not a symptom of inflammation, though it doesn't rule out the possibility. The lowness of it may be a continuing symptom of the polycythemia I had, I don't know.
The c reactive protein was too low to measure, also a sign that there wasn't inflammation.

My diabetes numbers continue to be nice and low, but my Novolog needs are falling dramatically again and I'm had a bad hypo on Wednesday like nobody's business. Ahhh- I'll take that over the highs. If this keeps up for another two months, I bet I'll see an A1c in the lower 6s or even (dare I hope?) upper 5s. My 7 day average is now 120! The 14 day is 138, and the 30 day is 150. I haven't seen a 7 day average of 120 since last fall. Heck, I haven't seen a 138 average since winter. I'm holding my breath, hoping this lasts.

Waiting, Waiting, Waiting

I saw the endo on Friday. He drew blood for thyroid hormone levels and erythrocyte sedimentation rate. He asked me if I'd like my A1c drawn and I said no. I hadn't been decided, but when I looked at the needle and the vial, I just didn't want the blood drawn when I knew it would have been an awful A1c. My 30 day average at that point was close to 170. Starting last week on Sunday, I've been running excellent blood sugars. My 7 day average is 123, my 14 day is 145, and my 30 day is 151. I'm loving it. The doctor said that my results would be in on Monday but hasn't gotten back to me. I don't like this pattern at all.

I'm at a sort of a camp for autistic people right now. My roommate's been curious about blood sugar and I've tested him three times, which I suppose affects my average, except his three tests were 145, 134, and 104, which I think averages to higher than my 7 day average anyhow. He's not diabetic. He says if he was, he wouldn't take shots, just could not do it, but he seems fascinated by the needles. I dunno what to make of that.

My iodine uptake is low. My thyroid antibodies have been retested and are negative still. My TSH is low. My T3 and T4 are normal. My thyroid is painful and tender. So. My endocrinologist has suggested that I may have subacute thyroiditis, although he says that that is not the only possibility. This will cure itself sooner or later, and in the meantime I just have to hold on and wait for the ride to end. My endo would like me to come in once per month for monitoring. That way, if I plunge from hyperthyroid to hypothyroid (a definite possibility) we can treat that as fast as possible, and if I go more severely hyperthyroid, we'll know and respond to that. Also, he mentioned that beta blockers may be an option if my cardiac symptoms become more pronounced.
All in all, I think this is confusing but mostly pretty good news.

Yesterday I had the unusual occurrance that I saw THREE other T1s. One person on the bus I saw with a minimed 722 pump; I went and sat next to her. She's had diabetes for 52 years. I was impressed. Then I met up with Carrie, who I know because of this blog, so that wasn't a random coincidence. And then towards the end of my day I was about to eat supper and I had taken out my Novopen Jr, and somebody said to me, "Hey, is that an insulin pen?" and I said Yeah, how'd you know? And she pulled out her humalog pen. A most unusual day.

The Uptake Scan That Wasn't

Tuesday night I lowered my insulin dose, checked when the early bus was leaving. Wednesday I caught the bus at 6:16 in the morning and headed to the hospital. Checked in around 7:15, filled out paperwork. A nurse took me into her office at around 7:40. We went over my papers and she asked me some questions about my health. Then she told me that I'd be swallowing a capsule. Stop right there.

I can't swallow pills. I can't swallow capsules either. For the medications I've had to take that were in those forms, we've either emptied the capsule and let me take it that way, or I've chewed it, or we've ordered an alternate form. Some of these things have been horrendously bitter and I've attempted to learn to swallow them- to no avail.

I informed the nurse that I can't swallow a capsule. She picked up the phone that was on her desk and called. "Marcy, I've got a young man here with orders for a 123 scan and he has grave doubts about his ability to swallow the capsule." Within minutes a meeting is convened: the nurse who I've been talking to, the head nurse, the pharmacist and me. We run through the options:

1) Could I attempt to chew this thing? No, that would render the test extremely inaccurate.
2) Is there a liquid form? No. The capsule can be melted, but nobody in the building has ever done that before, and they're not confident that they can do it right. There is a guy in the department who can, but he's on leave for the week.
3) Can we do the I131 scan instead? That's a liquid. No, because there's a suspicion of cancer and the 131's not nearly as accurate in that area.

So we rescheduled for a week later when the guy who melts the capsules will be back. They were really apologetic and offered me any time slot I might want and I stupidly picked a 10 AM time; I need to call and move it to earlier because they want me NPO from midnight until 2 hours after taking the thing, and I want to be able to eat lunch. Missing breakfast messes with my blood sugar plenty.