Sensor challenges on a Monday morning

I'm lucky enough to be using a Medtronic Minimed insulin pump for the passed two years. This has made my life far easier (despite initial teething problems) and allows me to have a greater level of flexibility. At the beginning of this year I upgraded my pump to a Paradigm 754 which allows me to obtain glucose readings (from interstitial fluid) every 5 minutes! (Thank you Discovery Health :)

 

http://www.minimed.com/products/insulinpumps/features/

Some of the greatest features is the ability to have CGM (continuous glucose monitoring) and especially if you don't know what your blood sugars are doing between the times that you test, this is amazing :) I used to go high in the morning but I was never sure whether it was because I was going low or high the night before. I would wake up at 3am to test and it was fine but I discovered that I was going low at 4am. CGM just takes all the guess work out of getting good control. I've also worked really hard at getting good Hba1C levels but now I'm getting my results at 6.0 (woohoooo) without several lows and little variability (std deviation).

Source: http://www.minimed.com/

 

For this level of control, I need to wear a sensor as well. Granted it's not the most sexy looking device & it sticks out underneath my swimming costume (if you're the bikini wearing type it's time to consider a 1 piece lol) and everything else - making me look a bit like bionic woman BUT it's the best thing I could ever have done for myself. The level of control I can get is astounding and it works well with my type A personality even though it can get frustrating at times :) 

 

Yesterday morning I had to insert my sensor (it needs replacing every 7 days but mine lasts roughly 5 - 6 days). Given that a needle is used for insertion, sometimes there is some bleeding and it's not entirely painless (it is a needle after all). Yesterday morning - it bled. I put on some pressure to stop the bleeding but did not attach my transmittor (the device used to send my reading to my pump) as it's better to get the bleeding to stop first and wait a while. So I went to work later with my transmittor on charge and my transparent dressing (you wear the sensor all the time and therefore need to cover it with dressing that allows you to shower and/or swim).

You need to calibrate your pump with the readings from testing on your glucose meter every 12 hours. I've found that you get the best and most accurate results from your pump when you calibrate 4 times a day. I know that you're saying - 'BUT IT'S STILL FOUR TIMES!' but it means that you get 12 readings every hour for 24 hours every day so that saves you 284 pricks every day! (yes the maths is correct lol).

Back to my challenges: I ate a banana when my blood sugar was 3.5 and it shot right up to 10.0 (I received predictive high alerts and high alerts!) I gave insulin and then it went down quickly (getting low predictor alerts). I chatted to my husband about it (also a very logical and structured party) and he reminded me that the fructose in the banana would do that to my blood sugars (send it up quickly and take it down quickly too). Sometimes it's just better to stick to apples, like I do most times lol

Also my blood sugar was 2.3 last night and despite drinking juice (this usually works really quickly) it didn't show an improvement in my blood sugar readings. I tested on my glucose meter and it showed 2.4 (which I used to calibrate my pump) so that indicated that it wasn't too far off. However, this led me to eat some choc stix (still showing no improvement in readings) and before I ate the very, very high GI nougat I thought I'd test again and my blood sugar was 9.5 (this was at 2am).

Not being a very happy camper (being woken up every few minutes by low alerts or predictors and wanting to throw my pump against the wall at some points) I thought it was time for a reboot (it is technology afterall). So I reset it and needed to calibrate again. I thought 'ok, time to go to sleep' but my pump had other ideas when it gave me a 'cal error' warning and asked me to test again. WHAT??? At this point I had just had enough and turned my sensor off.

Being more rational in the morning I knew that my 'cal error' was due to the fact that my blood sugar was probably dropping after the juice and my value entered was not correlating (yes, I did stats - BADLY I might add lol) and it just wanted me to do it again. Despite the lack of sleep, LOTS OF AGGRAVATION I know that technology (even though I work in IT) sometimes BITES and this is just all part of life. Other times, well most times, my pump works merrily stopping me from going too low or too high and let's me live a normal and happy life.

'Don't sweat the small stuff'. I say that now, last night it would have been more 'french' lol

PS this blog really needs spell checker lol

A new tool to make managing my blood sugars easier :)

I thought that I'd do my blogs in chronological order (as in - from diagnosis) but that is about to change :) When I visited my endo I learnt about a new tool that would let me analyse (yes, I'm a type A, type 1 lol) the readings from my glucose meter.

Sr Anke put me in contact with the Accu-chek rep, Lisa and I met her today. She brought along the smart pix device reader that would allow me to download data from my testing machine and put it into various graphs. This would allow me to see daily views as well as trends. How brilliant is that? I mean, what is the use of having all your testing results saved when you can't make sense of it and most importantly not use it to change your diabetes management?!

We, (well me specifically) don't test just because we've lost our pin cushions and need some place to put a needle. No, we test so that we can better manage the condition we have. It means that we can  PROACTIVELY manage our blood sugars so that we can live happy and normal lives by reducing the risk of diabetic complications!

Come on, who wants to get gangrene and amputations and go blind, when you do have OPTIONS? I know that not everyone is into data analysis (yes, I am one of those kinds of people who likes to be in control) but this tool makes it as simple as just clicking a few buttons! You're already pricking your finger, you may as well put your bleeding to good use :)

So for the ones who like the detail - the smart pix device allows you to download the data aka the blood glucose reading from your glucose testing machine and puts it in easy to read graphs. Best of all, Lisa, set it all up on my laptop.

Now, some of you would say: 'Now show me!'. Well here it is:

If my pic doesn't show you can see samples of the reports on https://www.accu-chek.com/us/data-management/smart-pix.html

Now you can see when you're going high and when you're going low and this means that you can do many things such as changing insulin doses. This takes the guess work out of adjusting insulin and other medication e.g. metformin.  It also means that you can change your diet. Yes, I never said that it would be painless (you still have to prick your finger) but it does make it easier (note, I didn't say it would be totally easy and need absolutely NO work or effort) when you are managing your diabetes control with information :)

Here's to managing your diabetes proactively :) It is after all just a condition and not a death sentence unless you choose to do nothing!

The diagnosis

Like I said, I was seven years old, being bribed to go to the doctor. I went, only for my biggest fear to be realised - I was going to have to 'prick' myself for my ENTIRE LIFE! SHOCK AND HORROR!!! My blood sugar was in the 30 range and I was rushed off to hospital. My parents didn't have medical aid at the time, so I was admitted to Somerset hospital in Green Point, Cape Town. Actually at the time my parents needed to be educated about my condition - Google didn't exist yet lol Even though my great grand mother had it, the knowledge about her condition wasn't passed on, it seems.

 

 Source: blood-glucose-monitor.org

 

I was put on a drip and put in a ward with younger children, none of whom had diabetes. Even though it was 28 years ago (I'm giving my age away here lol), I still remember a little boy offering me his mini licourice all sorts (kind of sweet) and I said 'No' because I was told that I couldn't have unless my blood sugar was low. Sr Starke, from Red Cross Childrens Hospital, came late in the evening to bring me books about diabetes. I got to colour the characters in and learnt about taking insulin and not eating sweets (generally). Sr Starke still works today helping many other kids with type 1 diabetes. That's pretty amazing!

I think that my mom took the news worse than I did and she still freaks out about lows and highs all the time, even though I'm an adult already. Apparently it's because I don't know what it's like to see me in a hypoglaecemic coma and having convulsions on the bathroom floor.

For me, pricking my finger for testing and taking injections were the worst part! Not to mention the fact that I had to learn to inject myself. The one nurse though was kind enough to inject herself, through her pantihose, to show me that it wasn't so bad. I also got to practice on oranges and apples and made my fruit taste differently by injecting orange juice into my apple lol. Oh, and how could I forget that I wasn't going to be able to eat like I did before!! My life and my family's life was going to change from this day forward. 

(as it's Sunday and my masters thesis has been submitted, I now have time to blog twice in a day woohoooo :)

About me - you have to know what I have to offer :)

I visited my endo on Wednesday and we had a discussion about diabetes (of course lol) and the fact that most of his patients with type 1 diabetes did not get the HBa1c reading that I had received. Mine was 6.0 and something that I was really proud of as I had been working (as usual) very hard on controlling my blood sugars. This was down 0.5 from my last reading.

There are many challenges for people with type 1 diabetes, but nothing that the human spirit, education, medication, support and determination can not overcome! His recommendation was that I share my experiences with everyone (well at least the people who will read my blog). So if I assist just one person with my experiences, it will be worth it :)

I was diagnosed with type 1 diabetes at the age of seven. Frequent visits to the bathroom, drinking and eating a lot without gaining weight and general tiredness made my parents take me to the doctor. I refused, based on my assumption that they were going to 'prick me'. They bribed and and I went but little did I know that this would only be the start of my 'pricking days'. 

Diabetes runs in my family with my great grand mother and brother having type 1 diabetes and many others having type 2. However, the ones who are type 2 are so badly controlled that they are now using insulin as well. Some even have complications, such as kidney problems. My grand mother passed away from gangrene at the age of eighty four. She needed to get an amputation but felt that she was too old for that.

I've been through the highs (ketoacidosis) and lows (hypoglaecemic coma) but have to say that I can not take credit for the name of this blog. It came as a suggestion from someone else (whose name I can not remember while typing this) for the name of our facebook page. I'll go look it up, at work tomorrow, so that I can give credit where credit is due :)

I'll try to post as often as I can as I probably have something to say every day. I mean diabetes management is a daily necessity. I hope that it adds value, otherwise please let me know what you would prefer.

If you want to know even more about me - try viewing

http://za.linkedin.com/pub/fazlyn-petersen/b/623/831

or google (please no stalkers lol)

Have a fabulous day :)
Fazlyn