Letter To A Diabetic

Or I Understand What You're Going Through

Tag: Blood sugar

A Tattoo for BGL Testing? A New Twist on the Idea.

I found this article and thought it was worth sharing. You can see the original here.

A Rub-On Tattoo for Diabetics Could Mean the End of Finger Pricking 

by Sarah Zhang

Pricking your finger for a blood glucose test will never, ever be fun. Thankfully, scientists have been hard at work on a bloodless and needleless alternative: a rub-on temporary tattoo that, as weird as it sounds, gently sucks glucose through the surface of the skin.

The thin, flexible device created by nanoengineers at UCSD is based on the much bulkierGlucoWatch, a now-discontinued wristband that worked through the same glucose-sucking principal. But the electric current GlucoWatch used to attract glucose to the surface of the skin was too high, and wearers were not keen on the discomfort. This temporary tattoo gets around the problem by using a gentler but still effective current.

It then detects glucose through an enzyme that breaks glucose down into oxygen and hydrogen peroxide. The amount of hydrogen peroxide is a proxy for blood glocal levels.

Now, if you follow the glucose tattoo space closely, you might know that a permanent glucose-sensing tattoo has been floated as an idea before. But this is a different type of device entirely. For one, it’s not an actual tattoo that involves needles driving glucose-sensing ink into the skin. And for two, it’s already been tested in humans. A proof-of-concept study published inAnalytical Chemistry found it accurate at measuring blood sugar levels in seven healthy volunteers.

Of course, there’s still plenty of work to be done to make it into a device people can use at home over the long term. But a bloodless blood sugar test will certainly be welcome.

CGM (Continuous Glucose Monitor)

After having too many low readings (30s – 50s) with no symptoms until feeling like I was going to pass out, I caved and got the Dexcom G4 continuous glucose monitor. I wish I would have gotten this thing earlier. It’s an awesome device. It spits out a bgl reading every five minutes. It’s user friendly, easy to insert, very small, and gives information on trending. Alarms can be set for highs and lows and I have been told there is an android app that allows users to get info off the monitor from great distances (think kids at school and such) though I haven’t verified this. It is tubeless, and comes in pink, blue, and black. Seriously folks, any T1 who has trouble keeping their bg where they want it should have one of these. Check out the Dexcom page about the CGM.

I have been in bed sick this week and normally in this situation keeping my bg in range is a futile endeavor but I have mostly been able to keep it in the 100s because I have known exactly what it is and where it is going. The information you get on trending with this monitor is invaluable. So take a look, and if you already have a CGM, share your thoughts on which devices and features you prefer.

 

How To Test Basal Insulin Levels

For five days in a row, I woke up with 200+ readings. Okay, a pattern. I get it. So back to basal testing to make the necessary adjustments to my pump settings. So I tested every two hours last night and ran low 100’s, then get up this morning with a 71. If anything, that indicates my basal insulin needs to be reduced a few hours before waking. Zoinks! So I’ll see what I wake up to tomorrow and retest if needed. But it brings up a good point: do you know how to test your basal insulin levels?

For pump users especially, because we can adjust our settings, this is a very important piece of info. Even if you are on MDI therapy, it is still a must-have piece of info. How it works:

Eat your normal dinner at least four hours before heading to bed. Then don’t eat again until the next day. No food! Not even a skittle. 🙂

Set an alarm to go off every two hours. Something annoying that can’t be ignored is good.

Test just before going to bed and write down your bgl. If it anywhere between 100 and 250, don’t do anything to correct.

Every two hours, when that super annoying alarm goes off, test and record your bgl.

If the numbers stay within a thirty point range, you’re great. Don’t make any changes.

If they drop or increase more than 30 points, talk to your doc about adjusting your basal levels.

My doc has me increase or decrease in 10% increments as needed to make adjustment. Example: I have my basal insulin set at .5 units/hour. A 10% decrease to lessen the amount of basal insulin (if my numbers drop more than 30 points between any two testings) would put me at .45 units/hour. The basal adjustment has to be set for somewhere between 1 and 2 hours prior to the change in bg readings to allow time for the adjustment to take place.

BUT REMEMBER! If this whole basal testing thing is new to you (or even if it isn’t), talk to your doc!!! before making changes to your regimen.

Happy Valentine’s Day (Yes, Diabetics Can Celebrate Too)!

i love youJust because it’s a holiday doesn’t mean we have to submit ourselves to feast or famine. We can still ride the blood glucose middle line and avoid both the crazy highs from indulging in too many of those sweets, and the frustration of feeling like we can’t eat anything at all. There’s a word for this. It’s called: moderation. And planning. Yeah, they’re both the word for it. Plan ahead, use moderation, and remember that, like always, those little chalky, heart shaped glucose chunks are NOT worth a 297 reading on the ol’ glucometer. And neither are all those delicious cupcakes and cookies. Sorry guys, but our feet and eyes are far more important. 😉 Besides, Valentine’s Day is all about love and that, my friends, is always carb free.

Take a look at this WebMD article for a little more on the topic.

Help Bring Attention to Diabetes in Dogs!

This is a little off from what I would normally post but since it is a personal and related event, I am hoping you’ll be so kind as to click and vote for Rocky! Rocky is my dog. When I adopted him from the shelter a year ago, he was well on his way to recovering from untreated diabetes. He was so sick when he arrived at the shelter 5 months earlier, I don’t how he managed to survive. But he did…and so they named him Rocky. Since then, he has gone from being diabetic to having hypoglycemia. We can’t figure out exactly what it going on but one thing in for sure: this pup does not have stable blood sugar values. I have entered him into this contest on the chance that he should win and help to bring attention to both special needs pups and how prevalent diabetes is in humans and dogs! Click on Rocky’s name above or here to vote.  The contest only goes through the 13th and you can vote daily so please click and vote today and everyday through the 13th!

Me and my Rock!

 

Thanks everyone,

Melissa

Gene Therapy for Diabetes in Dogs

I’ve had a nice break but I think it’s time I get back to sharing some info.

I heard about gene therapy for diabetic dogs and I went article searching. I found this. Diabetes in humans and canines is similar so there is hope that a similar therapy could be used in people with T1D as well. Of course, the dogs tested do not have naturally occurring diabetes. I’m personally not a fan of animal testing but in this particular case, I think that findings may be worth the research, especially given that at a four year check-in, the dogs were still free of diabetes.

 

Did You Hear That One About Diabetes…?

Hello out there everyone! I am looking for diabetes myths. I will soon be posting an article on them and I would like your contributions. What are some of the best (or worst) things you’ve heard about diabetes?

I’ve been told that I don’t “look” diabetic, that I eat well so I shouldn’t have it, that I am too old to have developed Type 1, and that since my pancreas “just stopped working” something should be able to make it “just start working”. Uh-huh. Yeah, right-o! That’ll be the day.

So, what have you heard slip out of people’s mouths that made you roll your eyes or dive into an explanation? Post as a comment or email me at lettertoadiabetic @ gmail dot com.

 

Why Is My Blood Sugar High In The Morning When It Was Perfect When I Went To Bed?

The rebounding blood sugar following undetecte...

The rebounding blood sugar following undetected diabetic hypoglycemia can easily become chronic when the high morning blood sugar data is misjudged to be due to insufficient nighttime insulin delivery. (Photo credit: Wikipedia)

I saw this question today and I’d like to give it  moment because it is an excellent and common question. The reason this happens is related to our bodies having a natural rhythm in which they release glucose into the system and at the same time, our bodies metabolize these sugars at different rates throughout the day.

Typically, someone on insulin therapy will need higher basal doses in the mornings. This happen for two reasons. One, in the early morning hours, our body starts to kick out glucose that we will need for things like waking up, moving around, conscious thought. Yes, thinking on purpose requires more fuel than daydreaming. The second reason is that our bodies generally metabolize those sugars at a slower rate in the morning.  Put the two together and your 107 mg/dL at bedtime can easily turn into 253 mg/dL at 8:00 am. Sucks, huh?

And, sometimes, you drop low in the night without knowing it and your body naturally “rebounds” to save itself. See photo at right. —>

So, what do you do about it?

Well, you can adjust your pump settings to a higher temp basal rate during those early morning hours.

You can change the time of day that you inject your basal insulin if you use multiple daily injection therapy (MDI).

I find that exercising in the evening hours helps to keep my numbers stable over night but this is not for everyone. It could very easily lead to a dangerous night-time low. Go back to photo at right.

Before you do any of these things, you MUST talk to your endo or diabetes educator. True, once you have goals, settings, and techniques set up, you can (and will have to) make adjustments on your own. If you are having trouble with unstable BGL readings, you aren’t there yet. Diabetes management is very serious and trying to go it alone can be deadly. No shame in admitting you need help. After all, we weren’t born with this disease and we certainly weren’t born knowing what to do with it. So, no worries, no shame. Work with your diabetes management team and stay alive. Survive and thrive!

Common Diabetes Terms Defined

English: Diagram shows insulin release from th...

English: Diagram shows insulin release from the Pancreas and how this lowers blood sugar leves. (Photo credit: Wikipedia)

Today we’re covering some basic terms. Many of these terms, terms which EVERY diabetic should know, were never explained to me. And with 90% of all Diabetics being Type 2, and most diabetes education classes be designed for Type 1, there’s a good chance that if you have diabetes, these haven’t been explained to you either. Let’s get started:

Bolus: A bolus is the dose of insulin give just prior to a meal (usually 15-20 minutes) to cover the carb count within the meal.

Basal: Basal refers to the “background” insulin. Basal insulin is a long-acting insulin that covers the insulin necessary to cover the glucose that your body naturally produces and uses throughout the day.

A1C: A test that measures average blood glucose levels for the previous three months.

Insulin/Bolus on Board (IOB, BOB): IOB or BOB refers to how much active insulin is in your system after a bolus. How long fast-acting insulin lasts in each person’s body varies and you must work with your endo and diabetes educator to determine IOB as well as correction factors and insulin to carb ratios.

Correction Factor: The amount of fast-acting insulin that covers a set decrease in BGL. For example, 1 unit of fast-acting insulin will bring my BGL down 50 points. Again, cover this with your doctor.

Insulin to Carb Ratio (I:C): This is the how many grams of carbs by covered by 1 unit of insulin.

Blood Glucose Value (BGL): The amount of glucose in a set amount of blood. It is measured in mg/dL.

Diabetic Ketoacidosis (DKA): An accumulation of ketones in the blood. Meters are available to check for ketones. This is a no-joke condition. If it is not treated, it can be fatal.

Hypoglycemia: Low blood sugar under 70 mg/dL.

Hyperglycemia: High blood sugar. Goals are different for everyone but as a rule, BGL levels should remain between 70 mg/dL and 130 mg/dL. Don’t be discouraged if your numbers run higher than this because they will. Set range limits with your endo and correct as needed.

Insulin Resistance: An inability to utilize available insulin in the body.

Lancet: A needle designed to fit into lancing device.

Lancing device: A spring loaded mechanism which contains a replaceable lancet that allows an easy draw of blood for use with a glucometer.

mg/dL: milligrams over deciliter, the measurement used to read the amount of glucose in a sample of blood.

For more terms, check out the American Diabetes Association glossary of common terms.

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Would You Like To Be A Part Of Something Special?

English: Prevalence of diabetes worldwide in 2...

English: Prevalence of diabetes worldwide in 2000 (per 1000 inhabitants). World average was 28.23‰. no data less than 7.5 7.5-15 15-22.5 22.5-30 30-37.5 37.5-45 45-52.5 52.5-60 60-67.5 67.5-75 75-82.5 more than 82.5 Note: I interpreted France in the data as including the overseas departments of Reunion, Guadeloupe, Martinique, and French Guiana as they are integral parts of France. China includes the SARs of Hong Kong and Macao. (Photo credit: Wikipedia)

Make a difference in the lives of others with diabetes!

Do you or someone you love have diabetes? How has it affected your life? Have you run into diabetes related complications? Has it put weight on and damaged your career, your relationships, your quality of life? Do you want to share your story?

Hello everyone. I am writing an ebook on diabetes and I would love to include stories, real stories, your stories. This is strictly a volunteer opportunity. You will be quoted with your story (or you can choose a pen name or choose to remain anonymous).

If you would like to take part in this ebook meant to be a starting place for those with diabetes, a place where they can begin to learn that being diabetic does not mean that they cannot LIVE, please send the following by October 31, 2013 to lettertoadiabetic@gmail.com:

-Name (use the name you want to be quoted as or type “anon” to remain anonymous
-Email address
-City and State of residence (optional)
Diabetes Type (1, 2, LADA, etc)
-Age
-Age at time of diagnosis
-Your diabetes story (no more than 1,000 words please)
-Include EVERYTHING in the body of your email – attachments will not be opened

I hope that you will take this opportunity to share your story and let others know that we are not alone. There are a lot of us out there and we don’t have to be smothered by the weight of a lonely diabetic life. Let’s get the word out. WE ARE ALL IN THIS TOGETHER!

JENN McCOLLUM

Victorianist. Scholar. Professor.

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