The morning high-low

DSC02260-1.jpgUp until about a month ago I had big problem controlling my post-breakfast and pre-lunch blood glucose. I would take 18 units of Levemir and 6 units of Novolog, wait 15 minutes, and then eat breakfast. Breakfast for me is a rotation of whole wheat toast, egg beaters, Morning Star meatless breakfast patty, steel cut oats, or Scottish oatmeal.

None of my portion sizes exceeded 60g of carbohydrate but my post-breakfast 2 hour BG would almost always be high; between 160 and 200 mg/dL. My pre-lunch BG would almost always be too low; between 60 and 70. I discussed this with my endocrinologist on my last trip ( I was being fitted with a trial Dexcom unit ) I mentioned this ti him. After “yelling” at me about the hypoglycemia, he recommended splitting my Levemir dosage into two; 8 in the morning and 10 in the evening.

I tried that for a week and my pre-lunch BG was much better ( between 80 and 90 ) but my post-break 2 hour BG was still high. I returned to the endocrinologist at the end of a week ( the length of time the Dexcom sensor was good for ) and we tweaked things further. He suggested waiting a full 30 minutes after taking the Novolog before eating. Within a few days my post-breakfast BG was within the 120-150 range and my pre-lunch BG was still within the 80-90 range. Success!! By carefully controlling the amount and timing of my insulin dosing I have achieved good BG control. My estimated A1c is 5.4 but I will wait for a doctor visit and test to confirm.

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Everyday diabetes everyday

I am participating in the Diabetes365 project on Flickr. The group project is to “show the world how Diabetes is something that we work at and live with all year round.” I have not posted regularly despite the group rules but I intend to starting today. My first two entries are about meals and blood glucose.BreakfastFor breakfast I normally eat one serving of steel cut oats, a Pepperidge Farm whole wheat muffin with egg beaters and a MorningStar Farms sausage patty. The muffin is toasted and one serving of spreadable butter make this … oh so delicious.With that combo, 6 units of Novolog ( I take 24 units of Levemir in the morning as well ) puts my two hour BG in the 120 range with a dip into the 60 and 70s just before lunch. But sometimes, eating the same thing each and every day can get boring. In fact, it is quite boring. My wife noticed too. She brought home some Pepperidge Farm 100% Whole Wheat mini bagel and some Philadelphia Low Fat cream cheese. I substituted that for my usual muffin. The result can be seen below.Control...or lack thereofWhen stuff like that happens I swing into “safe mode”. So for lunch I am having a Kash: Sweet and Sour Chicken. Safe because after eating this, my 2 hour and post BG is normally in the low 100s and 80s respectively.

Omega-3 and diabetes

Could this be true? I developed Type-1 diabetes very late in life but I grew up in the West Indies where I had fish for breakfast, lunch and dinner each day.

“The majority of kids with diabetes autoimmunity will go on to get diabetes, but it could be years before they do,” study author Jill Norris, Ph.D., professor of preventive medicine and biometrics at the University of Colorado in Denver, told Ivanhoe. “You can actually have autoimmunity for a while before you get clinical diabetes.” – via the Diabetes Channel on Ivanhoe

What next? Some new research indicating coffee causes kidney disease?

Normally, I am fine with my diabetes. I can live with the finger pricks (10 times a day) and the shots (4 a day) and the ever present concern over hypoglycemia. However, this little bit of news left me feeling a little lower than when I awoke this morning.

Metabolic syndrome in a can – The Diabetes Blog
a new study finds an intriguing link between drinking one or more sodas a day (diet or regular) and metabolic syndrome, a cluster of symptoms which increase the risk for heart disease — large waistlines, higher blood pressures, blood sugars, cholesterol and triglycerides. Yup, you heard right. Diet soda.

Because of diabetes I had to give up the delicious taste of Coca-Cola Blak (coffee + Coke) and get used to the aftertaste of Coke Zero.  So now I don’t get to drink soda at all? Someone just shoot me! What next? Some new research indicating coffee causes kidney disease?

Swing Low, sweet chariot

Since my endocrinologist put me back on Novolog I have been exercising very tight control of my blood glucose. My goal was a pre meal value of under 100 and a two hour post meal “high” or 150. So far I had not experience any real lows and since I no longer get the sweats and shakes I test often. It had to happen sooner or later. I had a scary low.

I had hot flashes followed by rapid heart beat. I recognized the symptoms immediately and fetched my meter from the kitchen cupboard. My hand shook as I pricked my finger and squeezed a drop of blood onto the test strip. 63. Well…not too low. I called out to my wife and she got me a glass of orange juice. Within 15 minutes I was back to my old self. Shaken, not stirred.

Not sure what caused this one. Maybe too much Novolog. I had only three (3) units to go with the 46g of carb I had for dinner just a half hour before. I had mashed potatotos, Birds Eye Asian mixed vegetables, a grilled steak ( I fired up the grill just for that ) and some texas toast.

The Calorie King Exercise and Nutrition Manager shows that I had 48g or carbohydrate ( before the orange juice and BD Glucose tablet ). What caused a low so quickly after a meal? I am not sure, perhaps the fat (29g) in the meal slowed down the absorption of the carbohydrates or perhaps…who the hell knows. I hate this shit of not knowing what the heck is going to happen.

UPDATE: Checked my BG on two different meters around 8:15 PM. BG is 63 on both. WTF? So what’s going on here? These meters must be failing.

UPDATE: Check BG again on different meter at 8:45. 85. It’s climbing! Yeah. Now let’s wait and see what happens at 10 PM.

UPDATE: 10 PM: BG is 116.

Comfortable

I am getting more comfortable with eating out. Now that more of the chain restaurants have posted nutritional information on-line I have found it much easy to make meal choices. I have also learned that calling in my meal to the restaurant at least 30 minutes prior to arrival helps in assuring that I can eat my food almost as soon as I am seated.

Of course not all restaurants provide nutritional information and most of the menu items are a heart attack away from killing you ( high fat and high sodium) but in general I am having a much better experience than earlier.