Showing posts with label insulin. Show all posts
Showing posts with label insulin. Show all posts

December 4, 2014

Racing Cars and Freight Trucks in my body

Dear Bloggers,

My ups and downs have been a little more up and down of late (read for most of this year, it's still nearly Christmas, right?). Not exactly disastrous, but I've not really managed to ever get things into any kind of groove for more than a week at a time. A bit wearying to say the least. Yes my brain exists best by complete chaos.


Part of me knows the best way to improve things is to go back to basics and do some fasting basal tests and tweak my basal profiles based on actual information rather than the (un)educated guesswork I've been relying on for a while. Another part of me is having enormous difficulty summoning up any enthusiasm, since I know that the holidays are coming and I'm likely to stop going to the gym for a couple of months which will have a knock-on effect in itself.


So I'm spending my time grumbling and hurrumphing instead (my family are so lucky!). The old nagger is coming to town and no it is not Santa, it's Santabetes

 

On the plus side it does give me a chance to jot down this analogy that I've been meaning to for some time. It's something that usually strikes me when my blood glucose levels are a bit errant, and Victoza and food are just not playing nicely.

When it comes to trying to balance the effects of food and Victoza on blood glucose levels (well and everything else.. but specifically food and Victoza), one thing that makes it very tricky is the difference in the speed of action of carbohydrate and Victoza. It's not enough to accurately match the dose of Victoza to the amount of carbohydrate you are eating - you have to try to ensure that the two act more or less together to reduce blood glucose wobbliness (technical term).
Almost all carbohydrate is very much in the Formule1 car class. Fans of glycaemic index tables (GI) might agonise over whether something is high GI, medium GI or low GI, but in my experience the differences equate to something being 'almost instantaneous', 'really very fast indeed' or only 'very fast'. Not a great deal of protection against the ravages of a post-meal spike, either physiologically, or that emotional kick in the guts of seeing your levels rise from a decent pre-meal number well into double figures an hour or so later. From the very first mouthful those big outboards start roaring and the carbs go zipping and zooming about, gleefully spraying glucose in their wake.


Victoza, on the other hand - even the fancy schmancy 'rapid acting' analogues can seem painfully slow to get going. More like one of those behemothic freight trucks or road trains. With a great groaning and clanking, the thrum of the plunger on an insulin pen or pump delivers the dose and then... Nothing. Watch and wait. Is it an illusion? Is it actually moving yet? Nope. Still can't see anything happening.

Vooooom! Swish! The carbs go tearing past again. Running rings around the slumbering giant.


This is particularly the case for me when I am waiting for a correction dose to kick in. I've had to stop myself from checking post-correction blood glucose levels before an hour has elapsed. Any less than that and the chances are my blood glucose levels will be almost unchanged. An hour!
 

Of course... one of the things about a freight truck is that once it is moving, there's not a lot you can do about it. All those stories about them needing however many miles to slow down or turn a corner. And so it can feel with rapid insulins. 


Nothing... nothing... nothing... Ah good, movement! Good... All good, back into range. Right that's enough now thanks... STOP!

But on and on, the dose lumbers forward - an unstoppable force. All-ahead full. The truck has now run straight over those race cars crushing them to matchwood and we could very well be steering directly toward Hypocity.


Corrections can be a tricky course to navigate. My doctor tries to help by offering a suggestion of 'Active insulin' - how much dose is still working away, but there are many variables to factor into that equation. Sadly I find my doctor's attempts to be the vaguest of indications at best, and often wildly inappropriate to the particular circumstances of the moment.

 
Patience is the skill I have to master. I am always trying to remind myself that while the spike in my blood glucose levels may have happened in only 45 minutes or so, the insulin correction will only have stopped after something like 4 or 5 hours. If I get impatient and overcorrect in the meantime I am likely to cause myself another problem (and more wobbles) by overdoing it.

The Old Sailor,

July 25, 2013

Surviving the heatwave with Diabetes



Dear Bloggers,

When temperatures start to get out of control, so can you’re blood sugar can get out of control.. Both hot and cold weather extremes can harm your testing equipment and your medications and have a negative impact on your body’s ability to produce and use insulin.



Research shows that when it’s hot out, more people with diabetes end up in the ER and are hospitalized because of heat illness. The number of deaths in diabetes patients due to heat illness also increases in summer. Low temperatures can be an issue for people with diabetes as well.
But you don’t have to let the environment have the upper hand. Taking a few smart precautions can help you outsmart Mother Nature. Here are the adjustments to make depending on where you live and the weather forecast.

 

Managing the Summer Heat

Take these steps to keep your diabetes under control when the temperature soars:
Stay hydrated. “The problem is that in the heat, people tend to get dehydrated easily. When you’re dehydrated, you have higher concentrations of blood sugar because less blood flows through your kidneys. With less blood, your kidneys don’t work as efficiently to clear out any excess glucose (blood sugar) from your urine.” When it’s hot, be sure to drink plenty of water or sugar free beverages. Don’t wait until you are thirsty to replenish fluids.


Store your medications properly. High summer temps can affect your diabetes medications, glucose meter, and diabetes test strips. “When it’s hot out, it’s easy for insulin and other drugs to become degraded,” Be sure to store your medications properly out of the extreme heat. Never leave them in your car on a sweltering summer day, for instance. “It could get up to 50 degrees inside your car."
If you’re traveling, don’t forget to take your diabetes medicines with you. You may need to carry them in a cooler with an ice pack. Just be sure they’re not sitting directly on ice or the ice pack.

Stay out of the heat of the day. Exercise is an important part of diabetes management and blood sugar control. But you don’t want to be outside exercising during the hottest part of the day. “Get in your exercise first thing in the morning or once the sun goes down,”. Another option is to work out in an air-conditioned gym.


Know the signs of low blood sugar. Some of the symptoms of heat exhaustion are similar to those of low blood sugar, or hypoglycemia. These include sweating, light-headedness, shakiness, and confusion. “You may think it’s the heat and not recognize that your blood sugar levels have fallen to dangerous lows,” Be aware of the warning signs of low blood sugar and keep some carbohydrates with you to eat if you need to raise your blood sugar. Have a plan for a medical emergency.

 
Test more often. You may need to test your blood sugar levels more frequently so that you can adjust your insulin and your diet as necessary. Talk with your diabetes educator about guidelines if you're unsure of the best schedule.


Mind your feet. People with type 1 diabetes and type 2 diabetes are susceptible to problems with their feet. In the summer you face the temptation to go barefoot or wear open sandals that expose your toes … to trouble. Always wear shoes that fit well, even in warmer months. And at the end of the day, check your feet for any cuts, scrapes, blisters, or bruises. Don’t ignore injuries to your feet. Get medical treatment right away.

Surviving the Winter

Freezing temps and inclement weather can make it more challenging to stay on top of your diabetes. Here’s what to watch for during the colder months:
Keep your supplies out of the cold. Just like extreme heat, extreme cold can affect your insulin and cause your glucose monitor to stop working. Don’t leave supplies in a car when temperatures outside are below freezing.


Do your best to avoid getting sick. When you’re sick, you’re stressed, and being under stress can raise your blood sugar. Also, when you don’t feel good, you’re likely to not eat properly. Wash your hands with soap and water often so that you don’t spread germs. “We recommend diabetes patients have a sick-day kit at home. Fill it with soup, sugar-free cough drops, tea things that will make you feel better and that you can access easily,”

Avoid packing on the pounds. Managing your  type 2 diabetes during the holiday season can be tricky. Many seasonal treats are loaded with carbohydrates that cause your blood sugar to rise. Plan your meals and pace your special treats so that you don’t greet spring a few pounds heavier. Even a small weight gain makes it more difficult to control your diabetes and blood sugar levels.


Keep an eye on your feet. Diabetes can cause a loss of feeling in your toes and feet. Protect them with the right winter footwear, especially in snow. Apply moisturizer to your feet to keep your skin healthy. Inspect them regularly, and if you notice an injury that doesn’t heal, seek medical attention. Don’t wait. Also important warm your hands. “If your hands are cold, you may have to warm them up to get a good blood sugar reading,” Wash them in warm water before testing.


Don’t skip your workouts. It can be hard to get motivated to exercise in winter. But exercise is an important part of diabetes blood sugar control. It helps if you dress in layers when you’re exercising outdoors in the cold. Or join a gym where you can work out indoors. Another option: Work in exercise at home by taking the stairs, lifting weights, and exercising to videos.


At this moment I have to deal with the summer heat and my type 2 diabetes
When the hottest days of summer hit, people with type 2 diabetes need to pay close attention to their condition. Here's how to savor the season without health worries.

Summer conjures up images of backyard barbecues, pools and beaches, street festivals, stargazing, and more. But summer heat can add to the problems faced by people living with type 2 diabetes. In fact, studies have shown that during a heat wave, emergency room use by people with diabetes increases. And while most people with diabetes are aware that extreme heat poses a danger, they may not always know when to take precautions..


If you have diabetes, the high heat and humidity of summer can be difficult for your body to manage. The problem with hot weather is the combination of temperature and humidity.
Elderly people are at particular risk, but people of all ages with diabetes should be aware of summertime dangers. These include dehydration, heat exhaustion, and foot problems.


Dehydration is your enemy
Everyone, regardless of their health status, should make sure they drink enough fluids during the summer. People with type 2 diabetes, however, face an additional challenge because when their blood sugar levels are too high, they may be passing more urine than usual which means they are losing fluids more quickly. Add sweating into the mix and you have a recipe for speedy fluid loss. Certain medications, such as metformin (Glucophage), also increase the risk of dehydration.


If you are out and about on a hot summer day, make sure you have enough of these beverages on hand to stay hydrated:
  • Water or seltzer
  • Sugar-free lemonade or other drinks
Also, avoid alcoholic drinks and caffeine. Alcohol and caffeinated drinks are usually okay in moderation but too much of either one can cause you to lose more fluids. And remember to bring along snacks in case your blood sugar drops.


Diabetes and Heat Exhaustion If you’re going to be outside, be alert to these symptoms of heat exhaustion:
  • Dizziness
  • Fainting or near-fainting
  • Sweating to excess
  • Muscle cramping
  • Cold, clammy skin
  • Headaches
  • Rapid heartbeat
Check blood glucose levels often. Aim for checking four times each day and before you drive.
With the proper precautions, people with type 2 diabetes can get through the summer and enjoy summer activities with no worries.

The Old Sailor,

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