Mastering Diabetes: A1c Goals, Dual Wave with Insulin Pumps, Alcohol, Basal Logs
This is Day 2 of a 5 day intensive mastering your diabetes program that I participated in at the Diabetes Research Institute. Please read DRI-Mastering your diabetes, Day 1 first.
Every morning before we started our class we had to check in and go for our vitals, which included blood pressure and pulse. The only day that my blood pressure was on the higher side was on the first day at 120/90, but the rest of the time it was around 101/70.
After vitals, we started our first session of the day. Kellie and Jane, our CDEs, asked each one of us what our goals and wishes were as part of the mastering your diabetes program, as well as some background information on our diabetes history. Some of the questions included what our last A1C was, how long we have had diabetes, if we had any complications due to diabetes, any hospitalizations, what our current insulin regimen was, and what our hobbies were other than diabetes related. They wrote all of our responses up on colored pieces of paper on the wall in front of us.
I am not going to disclose any of my peers' information, but my main goal of the program was to achieve more stability in my numbers, and achieve an A1C in baby-conceiving range.
After hearing and seeing all of the responses written, I was confident that I could achieve my goal of a better A1C. It was so inspiring to hear my peers talk about their lives with diabetes and also non-diabetes related hobbies and activities that they do daily. I almost felt as though my life was totally boring compared to most of the people in the group!
That particular session was pretty long and it was already lunch time. Yay, pizza! We all got out our calorie king books to calculate how many carbs were in each slice, which were provided to us by Jane and Kellie in our binders. Someone from the group actually measured the pizza and weighed it, so we all took his word for it.
They taught us how to dual wave for the pizza before we ate it (which I already knew how to do). In case you don't know what a dual wave is, it is a feature in the pump that allows you to program a combination of an immediate bolus, followed by an extended [square wave] bolus. The dual wave option is used when eating meals that contain rapidly absorbed carbs with those that may be absorbed more slowly.
Examples of when to use dual waves: buffets, pizza, cream sauce pasta dishes, and other foods that may higher in fat.
The dual wave may also be used to correct a high blood sugar immediately, for example, and then the square function for pizza to follow.
Lunch was followed by a more in depth session about portion control, dining out, alcohol consumption and parties.
We also learned that fiber is our friend and is like the roto-rooter for the intestines. Nice, right? I know, I know - TMI - but, hey, fiber is good for the blood sugar!
Also, another good note: If you are going to consume any kind of alcohol, you must be smart about it. Make sure that you have eaten before, or have snacks while drinking. And, you need to check often. Something I did not know was that you don't have to take insulin to cover what you drink, and that it can actually cause you to go low.
During the next session, we reviewed our transparencies from before we came to the program, and evaluated our basal insulin levels. They split us into two groups of 5 and 4. My group was led by Jane Sparrow-Boddenmiller and she was a real toughy who would hit us with her pointer if our blood sugars were not in range (I am just kidding! shhh... don't tell the other group though, we made them think it was true!)
Anyway, we troubleshooted through everyone's blood sugar logs with Jane and an endocrinologist as well. There were two endos with us, Dr. Pilar Solano and Dr. Luz Marina Prieto, who were with my group. Based on my blood sugars and basal rates (I had 5 different rates throughout the day), we decided to start from scratch and give me one straight basal rate of 1.0 throughout the day to see what happened. This is what my blood sugar log looked like before going into the program and the change to my basal rate. Hopefully you can read it.
Jane and Dr. Prieto didn't make any changes to my carb-to-insulin or correction scale.
We were then sent home to keep logging our blood sugars on a fresh page of transparency paper that we would look over the next morning. Day 2 was over, and I was exhausted!
Day 3 coming soon...