I don't know where my towel is...

I seem to be having a day of over-reacting to things. I woke up to a lovely blood glucose reading of 16.7, which appeared out of nowhere. I was due a set change, and looking over my logs it occurred to me that I've woken up high on the third day of the last three sets. I'm normally ok changing every 3-4 days, so this is unusual for me, but maybe it's due to the heat or hayfever or something.

Anyway, I make a note of it, and change out the set. Now, the last couple of highs I've had like this have been stubborn, and it's taken extra corrections and an increased temp basal to bring them down, so I decide to be a bit aggressive and increase my correction by about 20%, and put on a temp basal of 140% for two hours, similar to what I'd ended up needing before.

Only, two hours later we're about to go for coffee, and I check my BG and discover I'm at 4. That's a drop of 12.7 in two hours, and I still have insulin kicking around... I grab a handful of skittles, bung some sugar in my tea and have a couple of slices of toast, since I missed breakfast, and underbolus for it all, ignoring the little voice in my head that's telling me that I'm usually quite sensitive to carbs for a while after a high like earlier.

Two hours after that and I'm sitting at 11.5. Damn that little voice, I should have listened to it. I correct, have lunch and bolus as usual, and three hours later I'm 12.9. Dammit.

If I hadn't overreacted to the morning high, I probably wouldn't have got the midmorning lowish number, and then I wouldn't have panicked and overfed it. I *know * that I tend to be insulin resistant for a while after waking up high, so the sensible part of me knew that I should have bolused for what I'd eaten at break. It's so hard to fight that panic when you think you're heading for a low, though.

Ah diabetes, it's never simple, is it?

Hypo treatments

Sam over at Talking blood Glucose posted today about how raspberry flavoured glucotabs have changed, which makes me sad. It got me to thinking about how I treat my lows, and how everyone seems to be a bit different in what works for them.

My favourite things for treating lows are Skittles and jelly beans. But not just any jelly beans. Jelly belly jelly beans. Oh man I love them. But they are not cheap or easily found, so I make do with skittles. The reason I like these is because I can count out how many I need, and I know that about four skittles/jelly beans will raise me about one mmol/l, so it's easy enough to work out. This means that there are skittle stashes everywhere - in bags, pockets, my drawer at work etc.

I also use glucotabs, for sheer convenience, and they work quickly. I have a little holder on my keyring that holds four of them, so it's easy to carry, and durable! They also last forever, and so I also have pots of them around. Only the raspberry ones though (the orange ones are horrible).

I'll use juice if I have to, particularly if I feel that I need to get my BG up quickly, as I think it works fastest in me. There's this weird thing when I'm low, though, where I feel the need to *chew* something. It's really odd, and I don't know if it's to do with me associating chewing=food=energy, and so my brain automatically wants to eat something. I find with juice, I always want to eat something afterwards, and it's much harder to control those hypo munchies, whereas if I use skittles or glucotabs, then I've satisfied that urge, and it's easier to stop when I know I've had enough.

Control

I've been thinking about control recently, or rather, other people's perceptions of control. Leaving aside the difference between controlling diabetes and managing it, because I think we do the latter and not the former (but that's a post for another day), I've been surprised on a couple of occasions recently by how non-diabetics understand it.

A girl in my lab recently went on a first aid course, and one of the things they learned was how to treat a diabetic having a hypo. When she came back we were chatting about it, and she said to me, "you must have really good control, because I've never seen you have low blood sugar or anything!" I had to laugh at this because I've had entire conversations with this girl while hypo, and she didn't have a clue. Further probing revealed that she thought a diabetic taking a hypo would be very, very obvious, and most likely involve passing out. It reminded me of Kerri from SixUntilMe's excellent vlog post while hypo, where she points out that even when quite sick, a diabetic can come across as being completely ok.

Another thing that occurred was a discussion with occupational health. I'm currently transitioning from being a PhD student to a post doc in my lab, and now that I'm a postdoc and actually employed, I have to go through all the things that new employees do, including checking in with occ. health. I've been through this before, so I knew what to expect. One of the questions I was asked was if I'd been hospitalised in the last year due to my diabetes, to which I replied "No, not in the last year." She then asked when I was last hospitalised, and I told her it was about 15 years ago (thanks to a nasty case of DKA, but again, a post for another day). She replied, "oh, so you're well controlled then!"

Both conversations made me boggle a little, if I'm honest. I work in a biochemistry lab, these are intelligent people who all have science degrees, so I always figured they would understand at least some of the science behind diabetes. But their idea of good control is not passing out or being hospitalised??

There is hope though. One of the guys made a comment about how diabetes was just about testing your BG and having a couple of injections a day. After I exploded explained to him that that was very much not the case, he became quite interested in it and we had a really good discussion. He did ask at the end "so what do you do if you're diabetic and you're not good at maths?" ;)

What a difference a site makes...

This is what my infusion site currently looks like:

Lovely, yes? :P I put in a new site yesterday, and it hurt, which isn't normal. It was one of those ones where I knew something was wrong immediately, so I took it out, it bled, I swore, and then I reloaded the set and put it in somewhere else. This one was absolutely fine, so I filled the cannula, and wandered off merrily to have dinner. I was sitting down about fifteen minutes later, when I twisted round to get something, and felt a funny sort of *tug* at my site. "Hmm, that's odd," I thought, and when I pulled my shirt up to look at it, the adhesive bit was peeling away at both sides. I tried in vain to encourage it to sick back down, and when that failed, I planted my hand over it and went in search of some plasters. And so I ended up with the patchwork job you see above. The site seems to be fine, and so far the plasters have held up to a shower and sleeping, so I think it'll be ok. It just doesn't look the prettiest of sites! ;)

Speaking of sites, these are my BGs for the last couple of days:

You can click on the image to get a clearer picture, but the blue and red are Monday and Tuesday's BGs, and the dark green is today. The orange background is results above 10 mmol/l, and the bottom axis is time starting from midnight. As you can see, I've been having lots of fun! I put a new site in on Sunday, which seemed to be ok, and then I woke up at 16 on Monday morning, a number that really did not want to come down. I pondered various reasons for it, and decided to keep an eye on things and see how they progressed. I wasn't making ketones, my BG came down eventually, and the site looked and felt fine. Tuesday morning I again woke up high, and wondered if my insulin requirements had suddenly and dramatically changed overnight. I decided to just change the site later that day when I changed my cartridge to see what happened first, and I'm very glad that I did!!

When I took out the old site, it bled rather a lot, so I figure that's what was giving me the problems. I also think the cannula was just a little bit kinked, probably contributing to the highs. I don't usually have any problems with sites (this post not withstanding!), so it's quite stunning to be able to have a visual representation of what a difference it can make. I've always been told that when a site goes wrong, it's very obvious, and the one time I had a bent cannula, I was able to tell within hours as my BG shot up and ketones started to appear. This time, however, while in hindsight I can tell the site was bad, it wasn't obvious to me that that was what was causing the problem. I'm sure we've all had days when we ride the BG rollercoaster for unknown reasons, and I wondered if I was sick, if it was hayfever, if it was hormones...so many things could have pushed my numbers up like that. The thing that really got me was that I wasn't making any ketones, so I knew I was getting *some* insulin. Oh well, live and learn I guess!

Let's give this blogging malarkey a try...

I've decided to create a new journal just for my diabetes stuff. I've fallen a bit out of touch with LJ, and I decided I wanted a fresh start. Blogger seems to be where all the cool kids hang out these days, so I figure I might as well give it a shot. ;) I'm not sure how much I'll actually update, but I like the idea of having a place to organise my diabetes-related thoughts.

So, I'm Angie, I've had type 1 diabetes for almost 22 years now (boy, does time fly when you're having fun...), and I don't really remember not being diabetic. I'm the proud owner of a blue Animas 2020 named Chuck, which I've been using for about five months now. I hang around a couple of diabetes forums, mainly www.diabetessupport.co.uk, where I go by the moniker randomange. I don't claim to be an expert of any kind on diabetes, I only know what works (or doesn't!) for me.

I'm a big fan of the diabetes online community. I spent the majority of my diabetic life knowing very few people with diabetes, and it's been fantastic to come online and meet people who know what living with diabetes is actually like. People are always happy to lend support, or wisdom, or even just an ear, and I've learned a lot, even though I've been diabetic for a while. If it wasn't for the DOC, I wouldn't have come out of my diabetes funk, my HbA1c would still be in double figures, and I wouldn't have Chuck. So I'm grateful, and I hope I can give something back. :)

Apart from being diabetic, I'm also a biochemistry graduate who's currently navigating the limbo land between finishing a PhD and starting a post-doc, a huge sci-fi loving, world of warcraft playing, internet geek, and despite living in England for five years have retained a fairly strong Glaswegian accent. *waves*