30 Days With Diabetes: The Beach

The sun is my best friend in the midst of this new monsoon season in DC. But it’s more like a distant acquaintance with my insulin.

Heat aka long hours exposed to the sun can reduce the effectiveness of my insulin therefore impacting my blood sugar levels therefore impacting my overall quality of life.

Unfortunately, the pod that carries my insulin is usually exposed in a bathing suit. Today, it was under my left arm. Tomorrow, it could be on my stomach. Continue reading

30 Days With Diabetes: Insulin Breakthrough

Prior to this day 97 years ago, a future with a diabetes diagnosis looked pretty bleak.

As recently as 1920, doctors gave newly diagnosed diabetics mere weeks (or days) to live. Fortunate patients might break months, or, in rare cases, a year. But mostly, patients would enter diabetic ketoacidosis (DKA) and die soon after their diagnosis. (Beyond Type 1)

Even though I often tout the amazing advancements in diabetes management on this blog and advocate for access to those advancements, it’s nice on occasion to remember how far we’ve come and the transformation breakthroughs like insulin really provided for people like me. Continue reading

The Day My Insulin Pump Outsmarted Me

I stare at Gizmo, my insulin pump. I review its user settings, and basal and bolus rate set-up. But nothing within this gadget tells me how to change my reservoir numbers.

Yes my body is no longer producing enough insulin. And yes that means I must use more insulin to function on a daily basis. My basal rates have increased from .325 to .900, and my bolus rates have increased from 1 unit of insulin per 20 grams of carbs to 1 unit of insulin per 13 grams of carbs.

When my roommate a few years ago told me her basal rates were 1.000 unit, I scoffed and hoped I would never reach that level, at least not for another five years. But now having only had diabetes for six years I am now almost there.

The downside? I’ve been switching out my pump’s reservoir every two days. It used to be that 100 units of insulin would last me three days, if not four. And in the past month, it’s only lasted me two days. Continue reading

I’m Not Back… But My Pancreas Is (Sorta)

I’ve decided to take a break from my other writing projects to write this blog post. Because even though I may take a break from my blog, my diabetes does not take a break from my life. And upon learning some unexpected news recently, it seemed appropriate to mention it here.

So I’m not back to regular blogging but I may pop in every now and then.

Another Year in Cookietown

I’ve spent the past week and a half in Cookietown (aka my parents’ house during the holidays). And my blood sugar levels have never been so amazing. I even reached a no-hitter a couple of times (keeping my blood sugar levels within the lines for an entire day). That means no extreme highs (above 200) and no extreme lows (below 70).

No-Hitter-web

So how did I manage this? Well I’d like to think it’s because I’ve gotten better at managing this disease in the six and half years since I was diagnosed. But the real truth is completely based on biology.

Apparently my pancreas is still making insulin. Continue reading

Needles, Reservoirs, Cannulas, and More

The other day I was replacing my insulin pump reservoir. This requires a series of steps that I will reiterate for those who have never had to replace their insulin pump supply (as a side note, manufacturers, physicians, and researchers alike recommend switching this supply every three days although I sometimes stretch mine to four).

Replacing my Insulin Pump Reservoir

The first thing one needs is an alcohol swab, reservoir, infusion set, a blue cylinder-shaped device to inject the infusion set underneath the skin, and of course the insulin and pump. So after wiping the spot on my stomach with alcohol and then the top of the insulin vial, I use the reservoir to fill the plastic insulin container with insulin from the vial (it’s important to make sure you remove all air bubbles from the plastic container). And then of course my cat knocks the vial from my desk (it’s small enough this is harmless).

I then twist the reservoir into the end of the infusion set. I rewind the insulin pump so that it knows there is zero insulin inside and can essentially start to recount my usage (I tell it I use 100 units per new supply). I place the new reservoir into the insulin pump and then fill the 23-inch thin plastic tubing of the infusion set so that I know insulin will safely travel through the cannula from the pump to underneath my skin (this usually requires 6-9 units of insulin per fill). Continue reading

The Future of Diabetes Management

“I imagine being diagnosed as an adult would be harder because you remember life without it.”

“Yeah.” I nodded at the woman to my left, mother to an 11-year-old with Type 1 diabetes (T1D).

We were both first-timers to the JDRF TypeOneNational 2015 DC Research Summit yesterday. While many parents of children with diabetes attended the day-long event, I was among some of the adults who had been managing this disease for years.

I’m about to celebrate my sixth anniversary with this disease, one year closer to a decade. It’s hard to believe I’ve been managing the disease this long – it’s even harder to believe that I have many years to go. But like speaker Tom Brobson, national director of research investment opportunities at JDRF, reminded us, if we had all been diagnosed one hundred years ago, we wouldn’t have survived a month.

I’d like to believe on the starvation diet I would have lasted a little longer, but he was right about one thing – we’ve come a long way technology-wise. And for that I am thankful. William Tamborlane, chief of pediatric endocrinology at Yale University and deputy director of the Yale Center for Clinical Investigation, familiarized us with the “blue brick,” the first insulin pump device introduced in 1979. It would take another 20 years before the insulin pump would actually take off.

And Jessica Roth, senior director of health policy at JDRF, reminded us of the importance of advocacy. It’s not enough to have all these research advances such as ViaCyte, Smart Insulin, and the artificial pancreas without the ability for people living with this disease to have access to these treatments. It still pains me that Medicare refuses to cover the continuous glucose monitoring (CGM) system for those over 65. Continue reading

Basal and Bolus

Basal and Bolus are my lifeline, but they’ve recently hit puberty, and their hormones and emotions are all over the place. This does not make life easier for me, and no matter what I do, they don’t listen. I guess I should respect their independence, but sometimes I miss the obedient rates that never questioned me.

I try to be the healthiest person I can be, but there are days when the diabetes takes over. It’s not necessarily a result of anything wrong I’ve done in managing it, but whether it’s stress or hormones, sometimes my blood sugar levels have a mind of their own.

In a State of Flux

Blacktip Reef with wavy blue lineYesterday was one of those days. Since I went off birth control six months ago, I’ve struggled to balance my basal and bolus rates (basal is the long-lasting insulin I take continuously throughout the day; bolus is the fast-acting insulin I take before meals). My insulin sensitivity is constantly fluctuating. Continue reading

Gizmo aka My Insulin Pump Comes Back

It wasn’t a weekend of firsts. It wasn’t a weekend of lasts. But it was a weekend that changed my outlook on this whole “diabetes” situation.

I did more than survive a weekend without Gizmo, my insulin pump. I re-learned the challenges associated with counting carbs and calculating insulin dosages and how to listen to my body.

Sunday and Monday were good examples.

On Sunday night, my blood sugar felt high (159), but not high enough to warrant a correction dosage of one unit (the lowest increment my flex pen will allow). I had a vague recollection my syringes were divided into 0.5 increments. I only needed a 0.4 unit correction dosage.

I looked at the needle on the syringe – not much longer than my flex pen; I could do this. Now how do I get insulin from the vial to the syringe without breaking the needle? The last time I used a syringe was four and a half years ago, right after I was diagnosed.

Apparently, I needed to unscrew the bottom of the syringe to access the plastic extension that would allow me to fill the syringe. I couldn’t fill it to the 0.5 mark. How would I get out the air bubbles? I used the same method I use for the plastic vial I attach to my pump. I overfilled it and then used the extra space to rid of the bubbles.

Now I will just inject myself with the 0.5 increment and dump the rest back into the insulin vial, I thought. However, as soon as I inserted the needle into my skin, I realized how stupid this was, how easily I could accidentally inject myself with all 15 units of insulin. That means I would need to eat 300 grams of carbs to make up for it, which would totally defeat the purpose of this. Continue reading

My Weekend Without An Insulin Pump

When did I become afraid of needles? As a diabetic, this seems like a silly question.

But this past weekend, I decided to put Gizmo (my insulin pump) on the shelf and attempt to live off insulin injections via needles. It wasn’t my initial plan, but after a mishap involving leaving vital pump supplies at work, I decided to test it out.

Gizmo’s been by my side for the past two years. What would a day be like without it?

Day 1

When I twist my needle onto a flex pen I still happen to own after two years that still happens to have effective insulin in it, I feel nervous. I wet the skin around my belly button with an alcohol swab and wait for it to dry. The needle seems longer than I remember. At least it is shorter than my other back-up method – the syringe.

I used to do this for two years before I had Gizmo. Was it really this hard? I’ve never been afraid of needles. In fact, I was the kid who wanted to look when the nurse injected me with my annual shots so I knew when the pain was coming.

I know I’m less likely to feel pain if I inject into the fat around my stomach rather than my muscled thighs, skinny arms, or butt. Yes, but doesn’t my butt have the most fat, you may ask? That’s not something you need to know, but really the reason I don’t attempt this area is because it’s too difficult. Continue reading

Because I Have Type 1 Diabetes

I don’t know how I ended up here. 

“I submitted my payment two weeks ago. I just want my member ID cards. I’ve been covered since September 1st,” I say.

I’ve come directly from school, my backpack still attached. The insurance representative in front of me is wearing a white coat (I don’t know why). Her dark hair and pale complexion remind me of one of the robots from the movie, The World’s End.

“It takes 7 to 10 business days, sometimes more, for the initial payment to process,” she says matter-of-fact.

“But you did receive my documentation of continuous coverage?”

“Yes,” she says and then drops the bomb, “But we have a new rating system. If you don’t meet our health standards, and because you’re diabetic, you probably won’t, we don’t have to cover you.” Continue reading