You Try It (testing in the dark)

You need to test your blood sugar.

It’s the middle of the night.

This is what you see.

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You have your testing kit. But now what?

You need to get a test strip. Not too hard.

You need to insert the correct end into the meter with the right side up. What’s that? You can’t see? How can you tell if the strip is in right?

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Poke your finger and squeeze out a drop of blood. Did your poke work? Do you have enough blood? Do you have TOO MUCH blood? Your not bleeding all over your bedding, are you?

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Now apply the blood sample to the correct spot on the strip. What? You can’t see? How will you know if you’re getting the strip anywhere near the drop of blood?

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Device manufacturers, I ask you to imagine interacting with your diabetes devices in many different scenarios. Imagine needing to test your blood sugar at 3:00 AM. If you are a parent, imagine needing to test your child’s blood sugar at 3:00 AM. You expect US to be able to pull this off.

Turning on a light is not always feasible.

And what about those who are visually impaired? Aren’t they “testing in the dark” all of the time?

28% Interested (a.k.a. Distracted!)

I recently had a dream that I was attending the ‘Design of Medical Devices‘ conference at the University of Minnesota.  I had no idea such a thing existed until somebody signed me up to their mailing list. I was hoping for a free invitation, but nothing ever came of it.  Must have been someone’s idea of advertising.

In my dream, I was sitting at a table with a number of other people, all of us listening to presentations.  One guy had designed a wireless blood sugar interest monitor.  That’s right, interest.  As in, how interested are you with your current blood sugar?

It looked just like a wireless router, hanging high on the wall just above a light, and it was giving this guy a readout of everyone at the table.

Sketch of my dream image

0% interested, 0.01% interested, 0% interested, then he got to me.  28% interested.  Almost a third of my active brainpower was being consumed just worrying about my blood sugar.

I know it was just a dream, but I’d say there’s a pretty good slice of reality in there somewhere.

Diabetes and Basketball

Diabetes and exercise is something incredibly hard to manage.  It is difficult to get my blood sugar where I want it for exercise, and even harder to get it to stay there.  For many people, managing blood sugars before, during, and after, is so hard that they just don’t exercise.  I don’t blame them.  It introduces a million new variables.

I shot some video during basketball of me checking my blood sugars and talking about what was going through my head at the time.

I still ended the day at 277 mg/dl.  Do I blame it on a few too many gulps of Gatorade?  Maybe a temporary basal rate reduction that was too aggressive? Who knows.  I’m extremely lucky that I enjoy basketball enough to keep working through the hard blood sugars to find a way to play.

What’s That Thing on Your Arm?

Yesterday I didn’t get into the gym until around 8:30 PM.  I had been in the car all day.  As I was getting close to the gym I started really feeling excited about lifting weights (I know, weird, right?).  I felt strong, and I was probably just feeling pretty antsy from being cooped up in my car all day.

My blood sugar was in the low 200’s, which is not where I wanted it.  I had some insulin working from a bit ago, and was a bit worried about dropping too much while exercising.  Well, sure enough, after warming up and doing about half of my workout, I was dropping fast.  I had my Navigator CGM with me and was watching the action on the screen.  Not too long after I hit 120 mg/dl with a straight down arrow, I knew I had to stop and get some glucose into me.

I headed down to the locker room and did a blood sugar test.  63 mg/dl.  I treated the low and thought about going back upstairs to finish my workout.  But I was really wiped out.  That low had come fast and furious.  It couldn’t have been more than 30-35 minutes of exercising.  Maybe because I dropped so fast I felt wiped out?  Who knows.  I just didn’t have the energy, mentally or physically, to go up and finish.  I wrote the rest of the workout off to the “win some lose some” scorecard of diabetes.

I was heading to the showers and one of the other guys passing by was looking at my arm with the Navigator sensor.  He asked “Hey, what’s that deal on your arm?”.  I said “It’s my first day out of the Level-5 Max prison in Stillwater — they’re trying to keep an eye on me…” and kept walking right on towards the showers.

I thought it was pretty sweet how my CGM helped me be safe in the gym and also provided a little slice of entertainment for me in the locker room.

A “Wake Up” Bolus?

Is there something more than Dawn Phenomenon?

The dawn phenomenon is typically described as the body releasing a handful of hormones overnight that cause some insulin resistance.  You see this as higher blood sugars in the morning, even though you went to bed with a great blood sugar.

I do experience the dawn phenomenon, and have been able to adjust my pump to deliver a bit more basal, or background, insulin during the early morning hours.

wakeupBut I’ve also got something else going on.  When I get up for the day, no matter what time it is, my blood sugar goes up.  If I wake up at 4:00 AM, it goes up.  If I wake up at noon, it goes up.  If I wake up anywhere in-between there, it goes up.  I’ve come to think that my body just hates waking up and squirts out some extra dawn phenomenon hormones to get me moving.

This is not something I can program my pump around because I wake up at different times almost every day (the “joys” of being self (partially) employed?).

Once last week I woke up with a low blood sugar.  I didn’t treat it because I knew that just waking up would make it rise.  I went from a 71 mg/dl on waking to a 92 mg/dl less than an hour later.  It didn’t stop there though.  It was on a fast road to hyperglycemia if I didn’t do something.

I’ve not gone as far as to track and measure the rise, which would be the smart thing to do.  But I have made a habit of taking a couple units of insulin when I get up, trying to keep my blood sugar level.  Sometimes it works, sometimes I’ve given too much, sometimes too little (a popular problem when living with diabetes!).

This wake up rise complicates a handful of things for me though.  My insulin needs are different for both meal and correction doses in the morning, and it really exaggerates the troubles I have with my infusion site changes in the morning.

One thing I learned in writing this, is that breakfast is critical.  According to this article from Theresa Garnero at dLife.com, eating breakfast signals the bodies counter-regulatory hormones to turn off.  Since I think those are the hormones messing with me, turning them off would be good.  I know that I am often guilty of skipping breakfast, so this is one thing for me to work on.

I would love to know, does this happen to anyone else?