Over the years, I have been fortunate to be active and body conscious, which in the long run has paid off with no diabetes complications. While many people say complications are looming around the corner, I have yet to experience them. With the invention of the insulin pump, many people with diabetes have changed their lives for the better, because they could better adjust their insulin needs by a finite amount, making for a huge difference in their A1c hemoglobin. But is it the pump or knowing the pattern of blood sugar that makes the change for the better?
For people like myself, a 40 year veteran of diabetes, the magic A1c number desired by doctors appears to be from around 6.2 to 6.5. Most of the time, I have been between 6.5 and 6.8, which is still a healthy range. But, I hit a snag when I moved to the pump and I rose to an A1c of 7 and then when I transitioned back to the pump, I failed to do the work and rose again to 7.9. For me, that is unacceptable! So, last month, I called my CDE, Judy, and said, "Let's start with re-educating my brain to work with my diabetes." During that discussion, we decided that it wasn't the pump that I needed, but a continuous glucose monitor (CGM). I chose a Dexcom, and must admit that my experience was seamless and I want to share with you what I've already learned.
After 40 years, I'm taking roughly 30 units of insulin a day. At the moment, I take 7 units of Levemir in the morning and 6 units of Levemir at night. The rest is Apidra, or short acting insulin, depending on carb counts and other factors. On a bad day, I can double a short-acting dosage. Insulin sensitivity is always a crapshoot for me, which creates the variation in short-acting insulin requirements. More exercise, less insulin, more blogging, more Apidra!
Sometimes, a low-carb day with exercise can often mean no Apidra for most of the day. When I hiked Mount Washington several years ago, I remember stopping and eating a power bar and a peanut butter and jelly sandwich and an hour later on the trail, I was at 110. I made it through my day with only basal, or background, insulin. I tested a lot because I was blind to the trend to know when I needed something, but every time I tested, the meter indicated that I was not having any spikes, just a low threshold of 70-122. My endo was sure there had been spikes I missed and I probably had needed some amount of short acting insulin, but if I did, I never saw it in the test! This is what I call the "blind side" to diabetes management.
I've been wearing my Dexcom for about 10 days and I must confess, I'm sold! The first two days I wore the Dexcom, my trend wasn't a "trend" - it was a roller coaster. At my CDE's suggestion, I set my target range for 70-240. The first day, my graph looked like a random setting on a treadmill for someone training for a seriously hard event! (A good analogy when you think about diabetes and what it can do to your body).