SugabeticMe

Walking to Stars Hollow

Well, in a sense, anyway…

I’ve known for a while that I needed to get back to walking for some time now, I’ve just been making up excuse after excuse as to why I couldn’t:

the treadmill was cluttered
I’m too tired, I’ve worked/cleaned/chased kids all day
Photo credit: Pixabay – geralt

I don’t want to deal with basal rates right now
I’m doing too well with my glucose control and exercise right now would just screw it up
I’m too busy with the kids, work, blahhhh blaahhh..
Exercise helps the most in the morning, and I’m too tired in the morning since the toddler still won’t sleep through the night.
I don’t need to, I walk enough keeping up with the toddler now since she walks everywhere and gets into everything

On and on and on. Seriously. And on…

But I finally just took a deep breath and made myself realize that:

my diabetes will always be here (hello, no cure yet… still waiting,) so therefore, the challenges around balancing insulin requirements will always be here,
Photo credit: Pixabay – Clker-Free-Vector-Images

exercise is a weird thing in that if you don’t have energy, exercise will help give you energy. Unless there’s some other underlying cause like hypothyroidism (which I have, and also just had medication adjusted for this week) as well as things like anemia (which I have had, and it is a tired feeling beyond belief.)
exercise, while it is helpful for your day if you can do it in the morning and you do burn more calories, does not have to be in the morning. Fit it in whenever you can, just do it.
I have two kids… they need to see me exercising to take care of my body so that they know it’s a very important part of staying healthy, even if it’s just for 20-30 minutes a day.

I love watching Gilmore Girls. I’m a total geek. I’ve watched it through THREE times since it’s been on Netflix. It’s one of those shows that just draws you in, and you wonder what it would be like to live in a dreamy town like that. I get lost in the episode and time is up before I realize it. I love watching the show, and I know that each episode runs at least 40 minutes.

My solution? Rather than spend that 40 minutes doing nothing, I’m going to walk and watch. People walk to music, I walk to Gilmore Girls episodes. For those 40 minutes, I walk step by step to a little imaginary town of Stars Hollow so that being on the treadmill isn’t so boring.

40 minutes on a treadmill will be just over 2 miles if you walk at a 3 mph pace. My goal? 35/3.5/3.5 (because I like ratios.) 35 minutes at 3.5 mph, at a 3.5 percent incline. This gives 5 minutes left over, to be split between beginning and end for warm up and cool down, which is important for your heart and muscles; and I still get my 2 miles in.

After I’m comfortable with that, I plan on upping to 40/4/4, and just doing my warm up/cool down outside of watching the show. I’ve actually been going over my time limit a bit in efforts to knock down some highs by walking.

I’ve actually been going over my time limit a bit in efforts to knock down some highs by walking. Not that taking insulin for a high is bad (it’s NOT,) but if a simple 10-minute burst of walking can help curb the spike, I’m all for it.

Now, I’m on a mission. I know how much I want to exercise. Now, I just have to fit it in with life with diabetes, which can be hard. Meltdowns from frustration due to lows and timing have happened and probably will happen again. But I’m not going to let it stop me.

I can do this and I will do this.

Pump to MDI: Pleasantly Surprised

I know I haven’t written in quite a while, and mostly because I haven’t had time. I’ve had plenty to say, though, trust me. So I’ll try to spare you and give you the Cliff’s Notes version of what’s been going on the last two months since starting on MDI (multiple daily injections).

When I came home from the beach that day, I had no idea how long I would actually take a pump break for. Usually, it would only be for the weekend… if that long. I always felt much safer using an insulin pump for reasons like temp basals and such.

But in addition to feeling safer, I felt unashamed. It’s crazy — me, the advocate for those who prefer MDI and wish to inject anywhere they want to — was suddenly the one who felt too self-conscious to dose in public. With an insulin pump, I didn’t care. No matter where it was stashed, I would pull, shake, or shimmy that bad boy out and bolus without batting an eye to see who may be staring. Now? I find myself injecting in the car before going into a restaurant… or ducking into the bathroom. In my mind, others are staring at me and judging me for taking my shot in public. I’m slowly getting out of this mindset though, and trying to move past it.

But, I’ve loved being tube-free. I went back on my pump last weekend because we were going to have pizza, which is something I have no idea how to dose for on MDI, and I wanted to be able to extend my bolus like I’ve always done. And, not wanting to waste the insulin, I stayed on the pump for 2 days before taking it off again. During which time, I constantly fumbled with where to put it and I almost ripped my site out practically every time I went to the restroom. It’s crazy how quickly I adjusted to being without an insulin pump. The freedom feels amazing.

My numbers aren’t worse on MDI as I expected either, but quite the contrary. My averages are roughly 10-15mg/dL lower than what they are on my insulin pump, to which I have been pleasantly surprised. I have no idea why there is a difference, but part of me wonders if actually injecting the insulin is better for my skin and metabolism verses an infusion.

Of course, it could be because of the awesomeness of the basal insulin that I’ve been using, Tresiba. I honestly love it. Out of all of the ones I’ve tried (Levemir, Toujeo, and Tresiba), it’s been the most steady, and as long as I bolus correctly for meals, my BG is not nearly as “swingy” as it is with other basal insulins. I don’t notice any peaks, and I can take it every 24 hours without worrying about it running out in my system.

Now, my pump warranty is up in 5 months. I’ve been on the fence about what to do — to get a new pump or simply keep going with MDI and use my current pump as a backup or if I wanted to switch over for a break or anything. Then comes the question of which pump to go with… to stay with Tandem, or go back to Animas or Minimed, or go with Accu-chek since I love their Expert and Connect system. I mean, it’s a big decision. It’s one that I have to be confident that I’ll be happy I’ve made as I’ll have that pump for another 4 years.

Either way… I’m happy and comfortable currently with my MDI treatment. It’s going well, and for the first time, I don’t feel the urgency to run and put my pump back on. It’s almost like… freedom.

Bolus Advice: MDI With Less Math

A couple of weeks ago, my husband and I went to the beach for the day after church. It was a nice, cool, breezy day and it was good to get away and relax for a bit.

We were on our way home, and we stopped to get a frozen yogurt treat with the kids. I bolused with my pump, and half way through, I received an occlusion. The second one for that weekend.

True, this may not be a big deal, but it was the final straw for me. It’s true — occlusions are things that come with the territory when using an insulin pump, and that specific event isn’t what had me frustrated. It was a lot of things: having a curious baby who likes to pull on my tubing, sites that were seeming to fail after just 2 days, and the more and more frequent “bleeder” sites.

That last occlusion was it. We made it home and I pulled out my Levemir backup pen that my endocrinologist always gives me to keep on hand in the case of pump failure. I had no idea how this was going to go, but my frustration outweighed my fear of the unknown-to-me territory of MDI (multiple daily injections).

I took my total basal amount, added 20%, took the injection, and unhooked my pump. It’s been in my desk drawer ever since.

As soon as I injected the Levemir and started to get ready to inject for supper, I felt overwhelmed by things like accurately calculating doses and keeping up with IOB (insulin on board), and I quickly emailed my Accu-Chek rep and pleaded with her to chat with me that night or the next day to set up my Connect App in my phone.

Why would I need her?

See, Accu-Chek now has a meter, the Accu-Chek Connect, that connects to your phone via Bluetooth, and you can see your readings, log food and insulin doses, and even program the app to text your readings to a family member if you need help.

It also has an option for Bolus Advice. With this enabled (via prescription from your health care professional), you can use the glucose number that is sent to your phone to calculate insulin doses if you are a MDI user. To me, this is great because it’s like having the best part of the pump without the pump!

The app even lets you see how the calculation works, and whether you need to increase for correction, decrease for active insulin, or if you’re low — how much food to eat. It’s really intuitive.

I honestly don’t know that I would still be on MDI if it weren’t for this app. I’m loving being pump-free without having to be bogged down with math.

I don’t know how much longer I’ll be on MDI, but I don’t feel as if I need to rush. I feel comfortable to be pump free as long as I have help calculating my doses and keeping up with active insulin — which is exactly what this system does.

While the meter was provided to me at no charge, I was not asked to review it. This is my honest opinion from the bottom of my heart. I cannot be more thankful that there is a company that not only wants to create an insulin pump product, but also to help those on MDI to have the best care possible.

Why a CGM is Important to Me

I didn’t know I was low.

I was sleeping peacefully.

My Dexcom started alarming that I was low, but somehow in my brain I just knew it was wrong. I had no symptoms. No rapid heartbeat. No sweat. No confusion. No anything.

If I hadn’t had the Dexcom, I don’t know if I would have woken up.

I am a firm believer that a CGM system should be standard of care with any diabetic taking insulin. When I had tighter control, I had hypoglycemia unawareness, but now that I’m a bit more relaxed, I’m usually able to catch the lows in the 60’s. But not this time.

All it takes is one time.

One time to not feel it.

One time to not have symptoms.

One time to not wake up.

I’m ok now, just dealing with the aftermath with a low-induced headache and feeling overall draggy today (both from the low and my daughter who is my little night owl / early bird). But times like this? Rock me to my core. It’s times like this that make me wonder and think of how insurance companies can deny, any diabetic on insulin who has been prescribed this device, access to it. It shouldn’t be their call. Something needs to be done.

CGMs shouldn’t be considered a luxury item – they should be as standard as a glucose meter itself.

And The PumpPeelz Giftcard Winners Are…

Hey everyone!! I’m sorry I didn’t get a chance to post the winners of the PumpPeelz giftcard Giveaway yesterday. Things got a little hectic around here and I didn’t get a chance.

Today, I used a random number generator online to choose 3 winners, and here they are:

Screen Shot 2016-02-24 at 4.44.33 PM

PP Giveaway Winners

Congratulations to Isela, Erika, and Megan!!! You guys will be getting an email from PumpPeelz with your gift card code.

Thank you to everyone who entered!!!

Decorating the Contour Next USB Meter with Pump Peelz!

It’s no secret that I love PumpPeelz. Scott and Emily have successfully created a business that allows a diabetic to, if they wish, decorate and customize their diabetes management devices in fun prints and patterns. Now, this may not seem like a big deal to many, and down right ridiculous to some, but to a lot of people, it’s a godsend. Why? Because diabetes is depressing enough – if seeing something as simple as a sticker brightens your mood around testing your sugar or bolusing your next meal dose, then why not?

Anyway, at the beginning of the year I spoke with Scott and Emily over the phone about their new ideas for the year and one thing I asked for was a Contour Next USB peel. This meter has been my friend for over a year now (more on why later, but the Cliffs Notes version is that I feel it’s more consistent reading-to-reading when tests are run simultaneously, something very important when calibrating my CGM), and it’s not a mainstream meter like the Verio… Except to those who use the Medtronic pump. I’ve been using the standard, non-Medtronic linking one, but it’s the same size and shape. So I thought it would be a good idea to have a peel option for them since they have them for their pumps. After all, most who have the Animas or t:slim and use the Verio line get to do that now. I told Scott and Emily my idea and they loved it.

So, here we are! I’ve gotten quite a few questions on Instagram and lots of “OOO! I want one!” or “I NEED these!!” comments, so here’s YOUR chance to get a free $10 gift card to PumpPeelz to use as soon as they launch (a little birdy told me it would be later this month 😉). Plus, they already have the option for it in the Custom Designer Tool as well, so if you don’t want to wait for their designs, you can create your own! All you need to do is enter here by Monday and I’ll let you know on Tuesday who the winners are! Good luck!!!

Glooko, t:slim, and Dexcom = My Dream d-Data System

I remember using Glooko way back when I had the old iPhone 4s cable (I actually found it in one of my supply boxes yesterday) that connected to my freestyle meter. I honestly don’t know how long I’ve had that account, but I’m glad that I do.

When I first had my t:slim, Glooko and mySugr were the two apps I kept my data in before t:connect was approved by the FDA. In a way, I hated it because I *had* to manually log everything. But, in a way, it was good because I had to pay attention to everything. I think that was the only time I had the lowest A1c ever because I had to think about it and manually log, so I kept everything in check regularly. But, I always liked their reports, and the app interface.

Now, Glooko has come a long way from how it looked back then. There is so much more to the app, and we can connect more things. I like that I can upload my Bayer Contour Next meter into the system with my Nexus tablet, and that I can set Glooko to pull my Dexcom data from the Dexcom “cloud” via my Apple Healthkit. They are also making strides to also include pumps into the upload process. Just recently, they were able to add the Omnipod and they’re working on a way to add the Medtronic pumps into the lineup.

I have gone back to logging and have downloaded my own reports just to see how they compare to other sites such as the t:connect and Diasend online apps. Honestly, I have to say, I like the Glooko app’s reports SO much better. They are simple yet comprehensive. They are easy to glance over or delve into – however you need them, they have it; they are the perfect combination.

With t:connect, you’re limited on the meters you’re allowed to upload with, and if you don’t use the t:slim G4, you can’t upload your Dexcom into the system – which I think is absolutely crazy. I like their reports too, but without Dexcom in it, I feel like I’m not getting the whole picture. I might would consider changing meters otherwise if they did, but they don’t, and I don’t think they will.

While I like Diasend (I don’t *love* it) because I can practically use any meter I want to use (a.k.a., my beloved Bayer Contour Next USB). Currently, Diasend does not pull data from Dexcom if you have the G5 – neither from the receiver itself nor the Dexcom Cloud if you are in the US, which I am. So since upgrading to the G5 system, I no longer have access to full-data reports, and I’m back at being as frustrated as ever.

Glooko App and tslim After seeing the Glooko reports, I really want Glooko to be my go-to web service for all of my diabetes devices. The reports are easy to read and understand, and don’t look like they are from 1990. Since I can’t manually log my basal rates and temp basals and things like that (they say it’s so that records stay consistent, yet I can manually log boluses…. which if I don’t, that would be an inconsistent record as well… so I don’t really follow that logic), I only get 3/4 of the picture. I want my t:slim to be able to upload so that I can get the full report. The reports look to be really comprehensive but I can’t take advantage of it until I can upload my pump.

So, with that being said, I’ve talked with people from Glooko and they are willing to work with Tandem if Tandem is willing to work with them. And, of course, this is something we have to bring up to the companies. Sometimes they will work on things a little faster if their customer base raises their voice and gives them a nudge.

When I called Tandem earlier this week, someone else had already called and put in a request too, so it’s something that not only I am wanting as well. If you don’t want to call them, that’s ok. There is a web form as well that you can fill out and request it – easy peasy.

So, ladies and gentlemen… can I ask a favor? If you use a t:slim, can you go online to Tandem’s contact form (or call and personally request it if you happen to have to call them anyway) and request that Tandem work with Glooko? Pleeeaase??? With a cherry on top?? Thanks!!

What I’ve Learned In 27 Years With Diabetes

Okay, so the end of last year was a blur to say the least. I only blogged once in November, and that was to say that I was determined to put diabetes back into my life. And I am. It’s taking a bit longer than usual, but I’m learning to balance all the things in my life that is going on while trying my best to keep from putting my diabetes on the back burner and leaving it there.

On the 22nd of November, I celebrated 27 years with Type 1 diabetes. Yes, you read that right. I celebrated it. I may not have written a whole post or had cake or thrown a party, but I did in my own mind, celebrate it. Having diabetes has taught me a lot of things, but namely, it has taught me to be thankful for the health that I do have. (And what a month to have to celebrate it in, right?!)

Many people think that I am crazy, but I count myself so blessed to be a diabetic in that it is one of the biggest things that has taught me to roll with the punches, to try my hardest, when the going gets tough to push harder, but that it’s okay to take a break and rest at times when burnout is at it’s peak. As crappy of a disease diabetes is, it has helped to shape me into the person I am today, and for that, I’m thankful.

It has taught me humility in knowing that I can’t do it all, all of the time. Diabetes is a sucky disease that I wouldn’t wish on anyone. But coming from someone who hates to ask for help for anything, it has taught me that sometimes I have to suck it up and ask, and not be embarrased to do so. It’s not just my life anymore that depends on my health, I have two beautiful children and a loving husband that depend on me as well. So, I have to tell my self to “suck it up buttercup” and ask for help when I need it.

And help doesn’t need to be constricted to physical help – I mean mental help as well. This disease is a 24/7 monkey that can wear at anyone, and asking for help from either a friend, professional, or both, is completely ok… in fact, I encourage it.

I’ve had to learn that even though I have diabetes and my pancreas does not work correctly, it doesn’t mean that I am broken. It took me years to not feel like I was broken, a dud, malformed… It took a very long time for me to realize that I’m still a person. I am not defined by the non-functioning status of an organ that is taking up residence in my body. It causes a lot of havoc at times, yes, but I am not my pancreas, nor am I the disease that caused it to be a bum. I am still the person who loves music, who loves to write, who is constantly paranoid about how clean or dirty her house is, or who is completely mesmerized by how quickly kids can grow and loves to kiss and tickle them every minute I can. I simply have one organ (well, technically two if you count my slacker thyroid) that doesn’t work.

As a tech guru, I’ve been on many different pumps and used many different meters – and I used to be one to tell you which one I thought was the greatest thing to ever hit the market in my opinion at that time. Now, my thoughts have changed a bit to moreso encourage people to do a lot of research on their own. It’s true that what works for me may not work for you – and what works for us, may not work for the person next to us. All pumps have their drawbacks, and so do all meters. No one fits everyone, and it’s a great thing that we have all of these options on the market. I will still give you pointers and tell you pros and cons if asked, but for the most part, I’ve learned that even with diabetes, each one of us has a different experience so what I say works for me will more than likely be completely different for you and your needs.

I’ve also learned that diabetes is ever evolving… even in me, it’s constantly morphing, and to me, as someone who has loved the human anatomy, it astounds me. Even as frustrating as it is to constantly have to monitor and adjust, just to see how my body and insulin needs has changed and waved through insulin sensitivity to insulin resistance and all areas in between through 2 pregnancies and just regular life – it’s just utterly amazing to me. And that is one reason why I will never tell anyone how to manage their diabetes. Heck, I can’t keep up with mine most of the time, so I have no place pointing fingers or telling someone else what they should do or how they should do it in regards to their own personal diabetes management.

Let Your Light Shine

In the end, I am a person that happens to have a bum pancreas (and thyroid)… but I’m thankful for all that having it has taught me and for shaping me into who I am today.

It is my goal and passion to at least try to help others and encourage them in their own diabetes journey – whether you’ve lived with it one day, one year, or too many years to count.

Dexcom G5 – A Month Later

So, I’m finally getting to write some of my thoughts around the Dexcom G5 Mobile system. While I do see it as an upgrade to the G4, I don’t see it as a must-have.

Unlike when we went from the Seven+ to the G4, there wasn’t a huge hardware change other than the transmitter is now Bluetooth and can talk to a phone without the constant need of a receiver. However, notice I said “constant” need. There are times when the phone seems to not pick up signal very well for me, even when I’m holding my phone not even 2 feet away from the transmitter. Other times, it’s great at picking up signal. Mostly, I lose signal at night, so I keep my G5 receiver by my bed or in my bed with me. Otherwise, I will take it with me if we’re going on a long trip just so I know if my phone dies, I have a backup. I tend to stash it in my bra under my arm in the band so it has a comfy home. I’m used to storing my pump there when I wear a dress, so it’s no big deal to keep it there too.

On the side of whether or not the signal length is shorter or longer, technically, they both were rated to have signal for up to 20 feet – however, the G4 seemed to get much greater distance than that. I guess I got spoiled. Now it seems I have to almost always have my phone attached to my hand or butt (it stays in my back pocket mostly).

It is pretty nice to be able to have my Dexcom in my phone though when I have to make a quick trip somewhere – just grab the phone, ID and debit card and go.

And I like that when I calibrate on my phone, it carries over to the receiver when I get in range of it. No need to calibrate both devices, and both devices also show the same sensor glucose value. Now, with that being said, I wish that they synced missing data between the two when they were in range. So, if I’m out of range of my receiver for a while, it would fill in gaps from my phone.. and vice-versa.

I almost miss my G4 at times, simply because I don’t like having to use the Follow app to view the data on my Apple watch. I like that there is a separate app for the Share2 app. It seems they could make the Share2 app fill-in the gap like it used to do when the receiver was out of range and then brought back in range for the G4.

I ran both the G4 and the G5 side-by-side for a week as many were stating they felt they were getting better accuracy (Need a diabetes device guinea pig? Call me!). I even did myself. But, after watching it on both screens and calibrating with the same numbers, they were both relatively the same over time, so I don’t really feel one was more accurate than the other (unless you were going from the pediatric version of the G4, which did not have the 505 software, to the G5 which does – then, yes, I could see that being more accurate).

As far as the Clarity app, I still don’t like it. But, one thing I saw a lot of people having an issue with was the Estimated A1c and feeling that it could be off from their actual A1c. Two things come to mind with this – 1) they’re not really supposed to exactly match because what Clarity gives you is a rough estimate based on your sensor average… which leads me to…

2) (yes, I feel I need a separate paragraph for this one) Your estimated A1c and estimated sensor average are only going to be as accurate as your meter. I know, I know, a lot of people say that if the FDA approved it, it’s accurate enough. I call baloney. I’ve done my own testing of several meters on the market, as well as several other people, and I’ve read many different charts with statistics of different meters available, and I personally have chosen the Bayer Contour Next line of meters for my own peace of mind. Why? It’s not about testing them against each other with the same drop of blood for me, but how they test when ran two or three times back to back. If I have a meter that runs numbers of 136, 178 and 154 in succession, then I tend to raise an eyebrow. However, if I find one that runs 136, 131 and 138 in succession for three drops, it tends to make me feel more confident about the readings that meter is giving me when testing just one drop for a bolus. Out of all of the ones I’ve tried, the Contour Next brand worked better and had tighter deviations, so it’s what I’ve stuck with. But, as always, I’m not a medical doctor or medical scientist, so my own thoughts and testing are simply to appease me. Don’t take my word for it – if you’re curious, do your own testing and research.

And, back to Clarity and the A1c Estimation and the actual A1c correlation… here’s mine:

All in all, the G4 is still a good, solid, reliable product. The G5 is more a convenience system that gives you options. And options are good. 🙂

G5: Clarity’s Not So Clear

I have always been one who, when analyzing my diabetes data reports, I like to see everything. The overview, the snippets and the nitty-gritty of the matter. I don’t know about you, but my diabetes is not always crappy, nor is it sunshine and rainbows, so I need to be able to look at the whole picture together as well as be able to zoom in and identify the things I did right verses the things I did wrong.

dexcom clarity Looking back in my Dexcom G5 Mobile app, I started on the G5 on 12/10… 4 weeks ago today. I have many thoughts on my first month of the G5 but that will be in another post. This one is strictly to write on the companion app, Clarity. It is, in my opinion, the most irritating thing ever… and is not clear at all, maybe cloudy at best. It does give me an overview, I’ll give you that. But I don’t see everything in it.

For the past couple of weeks, I’ve had a horrible time with my blood sugars going everywhere – even up to 400 at times and that is not like me. I tried to look at the reports, but it just made me frustrated because I no longer have all of the options that I do with Studio or even Diasend to mull over each day’s progression. And for a while, I was even logging everything in to my Dexcom G5 Mobile app thinking it would carry over into Clarity for when I did have time for my nitty-gritty day-by-day data munching, but it wasn’t there. So, I feel as though all of that effort is in vain. *edit: Apparently you can see the day-by-day if you access it from the web, but not from the report downloaded to the phone. Still not sold on it, though, because while you can see what you logged online, if you print it to take to your doctor, none of the facts of what was actually logged is printed.

And my biggest gripe that really gets me hot under the collar is knowing that there are two versions – one for home use and one for “professional” doctor use. This burns me up. The fact of the matter is, this is MY data. I should have access to all of it, in whatever manner I need it. If I had access to seeing it in all sorts of ways before in Studio, why cut me off now and give it only to my CDE or Endo? This mentality reminds me of a parent/child relationship and makes me feel as if they don’t believe we are responsible enough to handle our own data. The problem with that, though, is that if we are to be more informed, responsible patients, then give us the tools to do so, not cut them out. Dictating what you believe is too advanced for us is taking the power out of our hands to control OUR disease for those of us who choose to work our tails off to do so. *edit: From what I can gather, the Professional side has what you see, but with a bit more anonymity? I’m still confused on that point. Still, I don’t see the point of having two different ways of signing in. My endo needs to have my login for my Diasend account and needed it for my Medtronic account when I had it, so sharing my Dexcom user info would not be an issue. Generating a code would just make it more cumbersome than if they were able to have access at any time.

So, for now, I won’t be using Dexcom’s Clarity app or reports. I’ll continue to use Diasend for that (which means I have to go back to the G4 until Diasend at least gets the receiver to upload for now).

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