Monthly Archives: May 2013

And now, back to our regularly scheduled research.

The clinical trial that I’ve been participating in since April has officially resumed after a brief hiatus.

The trial is designed to measure how patients handle their glucose levels while interacting with a specially-designed website. The purpose of the website is to produce data and information to patients based on daily logging of BGs, meal intake, exercise, and other factors. I’ll be uploading Dexcom™ G4 data every day too. The main goal of the study is to “improve glycemic outcome”. A lofty goal, and let’s hope it’s achieved. It’s really much more than I’ve just described. If you really want to find out everything that it’s about, check out the full description at the clinicaltrials.gov website:
http://www.clinicaltrials.gov/ct2/show/NCT01767831?term=ibolused&rank=1

So anyway, after taking a break so some web development issues could be ironed out, we’re back at it. I think the hardest thing about starting up again is going to be learning to swim with the Dexcom™ stuck in my gut. Those turns and pushing off the wall will feel funny at times, but I’m sure I can get over it. Besides, I only have to swim another two weeks anyway to get ready for my triathlon, and then I can take a break from it.

As before, I’ll try to give an update every week or so to let you know how it’s going. There’s only so much I can reveal while the study is ongoing, but I’ll let you in on as much as I can. Once the study is published, I’ll be able to talk about it in full if you’re still interested.

If you want to find out more about the kind of studies taking place out there, just go to the clinicaltrials.gov website and put Diabetes into the search box. A recent search found 9,688 separate entries.

I’m glad we’re starting this up again. And again, I hope it’s a big success.

P.S. This study is still recruiting participants! It’s a great way to get your feet wet in the clinical trials swimming pool, so to speak. Also, it’s a great opportunity to try out the Dexcom™ G4. If you think you might be interested in participating, send an e-mail to: mkm6x@virginia.edu
 
 
 

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DSMA May Blog Carnival. Strengths and Weaknesses.

Strengths and weaknesses… hmmm, let me see… I know they’re in there somewhere. Everyone has them. Why is it I have more trouble finding my strengths than I do finding my weaknesses?

Maybe that’s because I’m not really trying to find my strengths. I’m trying to find what you think my strengths are. That way we can all agree and be happy. Plus, like a lot of people, I tend not to focus on my strengths, preferring instead to focus on my weaknesses, in the hopes of (hopefully) making them go away.

So where was I? That’s right… strengths. Diabetes strengths. Here’s one for your consideration:

I like to believe that I’m a lot stronger than you might think when you see me in person. Stronger as in tougher. Able to get up from a terrible low in the morning, and go to work all day. Able to fight with my prescription provider for my regularly scheduled meds, hang up the phone, and go off to my appointment at the endocrinologist. Able to ride 100 miles on a hot day in June, collapse, and head back to the gym two days later. Able to handle multiple daily injections for 19 years before going on pump therapy, in addition to all of the finger sticks that come in 22 years with diabetes.

I guess you could call it perseverance as a strength. That’s something that I think all of us living with diabetes possess. Because really, do we have another choice? Sometimes this thing will try to knock us down, and sometimes it will, but the real victory is in getting back up and continuing to live meaningful lives, despite pump tube occlusions or a crazy metabolism that decides to suddenly kick in six hours after a hard workout and drop our BG into the 40s (or the 2s if you’re outside the USA), or a hemoglobin A1c that doesn’t reflect how amazingly hard we’ve worked in the last three months. Living well despite all that… that’s what I mean by strength.

Weaknesses? I’ve got ‘em. They’re not very fun to identify either.

I admit that I have a weakness for salty carbohydrates… chips, popcorn, stuff like that. Needless to say, carbs aren’t the best thing for People With Diabetes. Also, I’m not big on logging data. If logging data were as easy as breathing, I’d be the best logger ever. But since it’s not, I’m not good at logging data. Of course, the good news is that by admitting what my weaknesses are, I can get to work on being better at cutting out the carbs and uploading the data.

But whatever our weaknesses or our strengths are, two things remain important. First, that we continue to keep doing our best, showing an example for other PWDs by showing that nothing can keep us down. Second, we need to continue to support each other as we try to come up from our lows and come down from our highs. Trust me… you are an inspiration for someone. That’s a strength, and it’s even more of a strength the longer you persevere. Stay strong.

This post is my May entry in the DSMA Blog Carnival. If you’d like to participate too, you can get all of the information at http://diabetessocmed.com/2013/may-dsma-blog-carnival-3/
 
 
 

Recipe! Spring Goodness.

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Living on (or near) the east coast of the USA, you might get the impression that the environment around here is just a big concrete jungle. So I hope the photos above, from near Blackwater National Wildlife Refuge, of the peonies from The Great Spousal Unit’s garden, and the salad made from lettuce out of our vegetable garden, help to prove to you that not everything is paved over here.

In our little neighborhood, Spring is the magical season. When all of the azaleas finally bloom, the oak trees green up, and the homeowners looking to sell put the For Sale signs out on their lawns. I start the vegetable garden sometime in April, depending on when I feel like it won’t freeze anymore. I cheat a little, in that I purchase plants at the nursery rather than start the veg from seed.

The lettuce is always ready first. We’re just about finished with the 10 heads of lettuce we planted this Spring, but we still have some spinach that will keep going for a while. That’s a lot of salad. But when it’s this fresh, you start to feel like you could eat salad for breakfast as well as for lunch and dinner. Once the lettuce is totally finished, I’ll pull up the plants and replace the lettuce with red skin potatoes, which will take longer but can handle the hot Summer sun a lot better.

Eating out of the garden helps you to understand how good, how fresh this whole farm-to-table thing really is. If you’ve got a little space, I can tell you from about 20 years of experience that growing your own fruits, vegetables, and herbs is absolutely worth it. Even before we bought our house, we were growing tomatoes and peppers on the balconies of the apartments we lived in. If you’re interested in trying to garden, my only advice is to pick something that’s easy, give it plenty of sun, and enough water. That’s about all it takes.

So about the recipe… this is just a simple salad that includes all of the stuff that I like to put on a salad. Your Appetite May Vary (YAMV). We paired the salad with a veggie burger on a potato roll, with a little Frisch’s Tartar Sauce and pickles. The juice in the photo was because my BG was low before dinner and the only carbs in the meal were in the salad dressing, tartar sauce, tomato, and the potato roll.

So we started the salad with romaine and red leaf lettuce from the garden. We also threw in some of our fresh spinach, and a little fresh basil from the garden… unconventional, but who cares? Then I chopped up a spring onion that I got from a farmer’s stand nearby and threw that in. We added some sunflower seeds (which I’m completely addicted to), and chopped up some olives and added them too. After adding a fat slice of tomato on top of my burger, I chopped up the rest (it was a small tomato). Finally, we sprinkled some shredded cheddar on top. We enjoyed it with about 2 tablespoons of Ken’s Lite Caesar dressing.

Total Carb Count: 68 grams
2 grams from the dressing, 3 grams from the tartar sauce, 3 grams from the tomato, 31 grams from the potato roll, and 29 grams from the orange juice.

The best part about this delicious meal is that it’s only one of several like it that we’ll enjoy all summer long, with different ingredients as they ripen throughout the growing season. I hope you’ve got a good garden of your own, and if not, I hope you find a local farmer that can help you bring the bounty of locally grown produce to your table this summer.
 
 
 

Highs vs. Lows.

Seems to me there’s a disparity in dealing with high glucose versus dealing with low glucose. Okay, maybe it’s not as serious as a disparity, but I’m trying to keep this light here, okay?

When my BG is low, I find that there are many things that I can use (read: ingest) to get myself back into a safe range. Among them:
 
 
– Juice

Glucolifts (Cherry… yum)

– Honey

Goetze’s Caramel Creams (addictive)

– Fruit

Level Life Glucose Gel (kinda like the Mandarin Orange)

– Smarties (which are Rockets north of the border)

– Rockets (which are Smarties here in the USA)

– Insert your favorite here (Nutella, Maple Syrup, etc.)

– And, as a last resort, Glucagon
 
 
That’s at least nine items that I can use to bring up my glucose from an unsafe level. Having low BG is no picnic, of course. But those options almost feel like a reward for suffering through hypoglycemia. Almost. But not quite.

But what if my glucose is high? What if my pump has an issue delivering insulin, or it’s a hot day and the insulin loses its effectiveness, or I under-bolus for lunch? Now, I’m hovering near 300 mg/dL and I only have three options available to combat the high BG:
 
 
– Insulin

– Drink lots of water

– Exercise (while drinking lots of water)
 
 
That’s not a lot of options. And they’re not very appealing either. Also, if you have Type 2, you may not be on insulin therapy, so you may be left with only two options. Woo-freakin’-hoo.

In a way, having fewer choices when you’re high takes a lot of the guesswork out of what you need to do. You’ve just gotta do it, right? Using one, or two, or three methods. And it’s likely that you’ll have to wait to get yourself back into range. I mean, when you’re low you drink some juice, pop some glucose-laden product, and you’re often back in range within minutes. When you’re high, you can give a correction bolus of insulin, drink lots of water, and go for a run, and you’ll still have to wait some time before your BG comes back down.

I think this disparity in available options and time needed to correct explain why I absolutely hate being high, and why I try to do everything I can to avoid it. That doesn’t mean that I’m doing everything I can to be low. It just means that I don’t worry about being low as much as I worry about being high, if you know what I mean. Plus, I’ve got to admit, I hate how it makes me feel.

I suppose I could use this discussion to push for development and approval of faster-acting insulin. But I’m not thinking about that right now. I’m thinking about how high BG makes me feel, physically and mentally. And how that’s completely different from how I feel about low BG.

What about you? Do you worry more about high BG than low BG? Do you still worry about low BG, but secretly like the fact that it allows you some seemingly guilt-free indulgence? I’d love to hear what you think about both ends of the glucose spectrum.
 
 
 

Chesapeake Bay Tour de Cure.

I went to Maryland’s Eastern Shore (east of the Chesapeake Bay) again this past weekend. This time it was for Saturday’s Chesapeake Bay Tour de Cure.

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I rode the 55 mile route this time. Maureen was engaged with some dog walks at home, so she wasn’t able to be there. Even if she was, she wouldn’t have let me do the 100. That’s okay though.

So, how was it? More difficult than I thought. The weather, which was just about perfect on Friday, was pretty lousy on Saturday. The 55 mile ride started off at 9:00 under cloudy skies and temperatures around 63-64 degrees. It stayed cloudy, with a little rain too, all through the day.

My glucose wasn’t very cooperative either. I bolused less than normal for my high carb breakfast at 7:30, which I normally do. But when I checked my BG just before the ride started, I was at 312 mg/dL. Still, I was a little worried about correction bolusing and crashing too fast later on. So I didn’t bolus, and started the ride.

The first rest stop was about 12 miles into the ride, and I thought that it wasn’t worth checking my glucose because I had only been on the bike for about 40 minutes.

The next stop was at around mile 28, after the Bellevue to Oxford ferry. That’s right… our ride included a ferry ride across the Tred Avon River. Yes, it was a nice break in the ride. Especially since my BG at the Oxford rest stop checked in at 61 mg/dL. I loaded up with an energy bar, some grapes, and a couple of honey stingers. Then I was off to the next rest stop, about 10 miles away.

Once I got there, I checked my BG again: 71 mg/dL. Another bar, a bag of chips, and two more honey stingers. No bolus since about 7:30 in the morning. I stayed at this stop for about 20 minutes, which is 10 to 15 minutes longer than normal. Then I was off again.

I now have about 17 miles to go. I’m very concerned about going hypo at this point. Part of why I was worried was because I wasn’t riding with a pack. What I mean by that is there were about five or six people that passed me and disappeared quickly at around the 45 mile mark, and they were the only people I saw in the last 25 miles or so of this ride. ADA does a fantastic job of tracking riders and equipping everyone with emergency numbers, etc. But if you’re nursing your BG along in the last leg of the ride over mostly country roads, you don’t want to take any chances. I decided to suspend my pump.

At that point, I just kept reminding myself: Keep those legs moving, keep the wheels rolling. I managed to get back without an issue. When I checked my BG prior to partaking in the post-ride lunch, I was at 86 mg/dL. After suspending my pump for about an hour and twenty minutes up to then.

I finished the ride in about 4 1/2 hours, including time spent at rest stops. That’s faster than I thought I would go, but I didn’t feel like I was really pushing it. That’s a good sign.

All of the event volunteers were wonderful. They were helpful, informative, and always very nice. At the stop in Oxford I was helped by a volunteer with Type 2 who was putting together sandwiches, someone handing out grapes and chips who’s had Type 1 for twenty years, and her son, who also has Type 1 and a great service dog. They all looked happy, and they were doing great. How can you not feel empowered by that?

I’m glad I made the commitment to ride. I’m happier still that we were able to raise about $266,000 for the American Diabetes Association. That’s pretty good for a still-new ride with a relatively low turnout. Now, if they can just get the weather worked out next year, it will be a lot of fun.
 
 
 

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