Category Archives: Diabetes

Wounded. But tougher.

September 25, 2013 – 10:43 am

I don’t know why, but it occurred to me recently that People With Diabetes get wounded a lot. Not a shocker there. We are wounded daily on a physical basis, and wounded occasionally on an emotional basis. But either way you look at it, we’re wounded a lot:
 
 
– Wounded when we prick our fingers multiple times per day.

– Wounded when we inject ourselves with life-sustaining insulin.

– Wounded when we change out the infusion sets on our insulin pumps.

– Wounded when we change out the sensors for our continuous glucose monitor (CGM).

That seems like a lot right there. Our bodies are constantly poked, with various devices, to varying degrees, in the pursuit of perfect glucose nirvana. Oddly, better technology means getting jabbed more often than ever before. Any veteran PWD can show you multiple sites on their bodies where they can hardly remember what it looked like before their diabetes care forced a sort of self-mutilation. But I can keep going, and I’ll bet you can too:

– Wounded when we go to the doctor (usually multiple doctors) and blood is drawn for testing.

– Wounded if we fall into hypoglycemia and need to be revived by EMTs who start an IV with glucagon.
Here’s hoping this never happens to you.

– I’m wounded each time I donate blood and a large needle is inserted into my arm.
This is something I’m happy and proud to do, so I really don’t mind this one.
 
 
Then there’s the emotional side of diabetes. Unfortunately, many of us have experienced something like this:

– Wounded when someone asks “Can you eat that?”.

– Wounded when someone treats you like you’re responsible for your diabetes diagnosis.

– Wounded when the boss calls you in and says “What are we going to do to stop these low blood sugar episodes?”. Like a simple rewrite can avoid another installment of must-not-see TV at the office.

– Wounded when stubborn lows won’t come up and stubborn highs won’t come down.

– Wounded when our hemoglobin A1c number doesn’t reflect our expectations or how hard we’ve worked in the past three months.
 
 
I wouldn’t think of trading the better care (and much better awareness) of diabetes today for what it was like when I was diagnosed two decades ago. But there’s no denying the fact that better care and awareness (or lack of awareness) comes with additional punctures, both to our bodies and our hearts. Sometimes, the enormity of it all makes it difficult to imagine continuing in such a way. And yet sometimes, in a perverse kind of way, it seems to make us tougher. I like to think that with all of our holes, we’re even stronger than ever. I think I’ll cling to that today as I check my glucose and change my infusion set.

What about you? What wounds you today? What makes you tougher? Feel free to share your thoughts.
 
 
 

By StephenS | Tagged , , , | Comments (9)

Keep swinging, Slugger.

September 16, 2013 – 1:09 pm

Athletes… Do you get this feeling too?

Do you get that feeling, when (you think) you’re nearly finished with your workouts, when you can see the goal in sight, and you just feel… tired? When you just want it to be over?

Okay, maybe not that bad. I don’t really want the bike riding to be over. But seeing my 55-miler coming up this weekend, I have to say that I’m really feeling like I just want the training to end. I want to enjoy the ride again.

It’s probably because this is the last event for me this year. Nothing on the athletic schedule after Saturday. When I can see the end of the serious training for the year, often my mind will start to think about the week after this one, when I don’t have to get up early in the morning and get into the spin class at 6:00 a.m. if I don’t want to. When I’m not out on the road at 7:00 a.m. on Saturday or Sunday morning.

But this is also when the most progress is made. True, I only have today and tomorrow to work as hard as I can, then rest until the event. But grinding it out now will undoubtedly mean working less hard once the weekend gets here. If I run into trouble, the hard work put in the last couple of weeks means I’ll be able to overcome difficulties on the fly. If everything goes smoothly, it means I’ll be able to enjoy the whole thing a little bit more.

Does this sound a little like diabetes? I know that if I can just tough it out even when I have unexplained high BGs or energy-sapping low BGs, I’ll be happier in the long run. And believe me, it’s hard to see beyond those moments sometimes. It’s not fun to keep trying when you just want to call it a day and give in to those highs and lows.

But unlike my biking, I can’t just skip a regularly scheduled item on my diabetes calendar. I can’t meet a goal, then take it easy for a few weeks. Diabetes doesn’t play that way. It’s relentless. So just like my workouts this week, I’ll keep reminding myself that trying when it’s hard makes me stronger. I may have to tell myself thousands of times over the course of my life with diabetes, but that’s okay. The people who depend on me make the effort worthwhile.

Are there people in your life who make the effort worthwhile? Tell me about them.
 
 
 

By StephenS | Tagged , | Comments (1)

This movement is gaining momentum. Climb aboard the steamroller NOW.

August 20, 2013 – 12:01 pm

If you’re a Person With Diabetes, you know the importance of seeing accurate readings on your glucose meter. In a public meeting last May, officials from the U.S. Food and Drug Administration admitted that there are some glucose meters and test strips out in the marketplace that no longer meet the standards that they were approved for in the first place.

What were they approved for in the first place? In testing with the FDA, test strips are required to meet an accuracy of +/- 20%. That means if my meter says 180 mg/dL, it could actually be as high as 216 and still pass the test. Or it could be as low as 144… and still pass the test. That’s a 72 point difference! That’s a window big enough to drive a truck through. And that’s what is required to pass the test and win approval.

To their credit, the FDA is working to lower the threshold and make test strips even more accurate. So what’s the problem?

Well, once the test strips are approved for use in the USA, they aren’t subject to further scrutiny. In other words, there is no program in place to ensure the continued accuracy of test strips once they’re approved. So the test strips I’m using, that met a 20% standard of accuracy when approved, might now have an accuracy of +/- 40%, according to some experts. At that measure of accuracy, my 180 mg/dL reading might actually be 252. Or 108. A difference of 144 mg/dL.

Since dosing insulin is dependent on my blood glucose reading and how many grams of carbohydrates I’m eating, if there are 45 grams of carbs in my meal:

– That 20 percent standard means a dose as low as 3.3 units. Or a dose as high as 5.1 units.

– That 40 percent deviation could mean a dose of 3.0 units. Or a dose of as much as 6.0 units of insulin.

Imagine if my dinner bolus is 6.0 units, but it should have been 3.0 units. Since my target is to get back to 100 mg/dL, and one unit of insulin should drop me about 40 mg/dL, an over-bolus of 3 units means I could drop 120 points lower than expected, resulting in severe hypoglycemia or even death. Are you with me so far? Do you understand how critical test strip accuracy really is? Good.

This is why the Strip Safely (http://www.stripsafely.com) campaign is in full force, helping to spread the word about the importance of test strip accuracy. You can do your part too, by sending a letter, either by snail mail or by e-mail, to your elected officials in Washington. Need a little help getting started?

– A sample letter you can use is available here.

– You can find your elected officials HERE.

Hint: Our elected officials have Twitter and Facebook accounts too. So does the FDA. In fact, they have many Twitter handles, including @US_FDA, @FDADeviceInfo, and @FDAMedWatch. If you decide to send something via Twitter, be sure to include the hashtag #StripSafely.

You might be saying, “Hey Steevo, you wrote about this before… why bring it up again?”. Because it’s that important. Let’s keep the momentum going. Let’s help improve the safety of people living with diabetes, and improve the peace of mind of our loved ones affected by diabetes. It’s that important. And your help is needed and appreciated and keeps the momentum going.
 
 
 

By StephenS | Tagged , , , | Comments (0)

Keeping the diabetes monster in check.

August 14, 2013 – 5:00 pm

Hello everyone! I know I haven’t really talked about my diabetes much in the past couple of weeks. That’s because I haven’t really had any crazy highs or scary lows to talk about. Or anything else diabetes-wacky-that’s-me-specific.

During last week’s DSMA Live/Twitter Chat event, someone (I wish I could remember who) made a great point by saying that we all tend to post when bad things happen. As a result, sometimes it may look like we’re not doing well, when in fact we are. I would like to change that perception with this post.

In other words, the diabetes is playing nice for a change. Everything seems to be going well in Stephen’s D-world.

The infusion sites for my insulin pump have been really good and insulin-absorbent. When they’re in, they’re in, and they’ve been lasting for five and six days at a time.

While I’m at it, with cooler than normal weather during July and August, I haven’t had to contend so much with keeping the insulin from spoiling in the heat.

Despite the fact that I’ve traveled a bit in the past week, I never notched a number above 257 mg/dL on my meter, and that was way above what my BG was usually running. That was when I was on the road from Ohio to Maryland at the end of the trip. I have a bad habit of grazing on crap during these rides, and even though I did some of that, I was able to come down from the 257 with minimal effort and without crashing later.

Lows have been minimal lately, and not too low. Handled with a simple 15-20 grams of carbohydrates and a little patience. My basal rates, updated at my last visit with my endocrinologist, seem to be doing the trick.

This isn’t totally diabetes related, but my new glasses (both pair) have been helping me see better than I have in years. Not that my eyesight was really poor, but I love that I can read the fine print on things without getting a headache.

I haven’t had test strips lately that didn’t want to work because they didn’t have enough blood on them, even though you know you put enough blood on them, and you’re tired of lancing the end of your finger and dripping and smearing blood everywhere just so your meter can give you an error because it thinks you’re not bleeding enough for it today. None of that is occurring right now.

I do have to order a new belt clip for my pump. But hey… when things are going so well that this is the only thing I have to complain about, I can’t really complain. Don’t you just love it when things work the way they’re supposed to? Take that, diabetes!

I hope I didn’t jinx the whole thing by writing about it, but I don’t believe in superstitions anyway. Just in case, I think I’ll bookmark this post so I can refer back to it during those times that things aren’t quite going as well as they have been of late. How are things with you right now? Here’s wishing your diabetes is as gentle as a summer breeze.
 
 
 

By StephenS | Tagged | Comments (9)

#StripSafely Update. And a question.

August 5, 2013 – 9:34 am

Safety of the test strips we use, and the meters we plug them into, is a great big deal to everyone living with diabetes. It also means a lot to the people who love me and count on me to be there for them.

So I aligned my views with those in the Diabetes Online Community who also believe that A) The 20 percent +/- factor that’s currently allowed for test strips is NOT NEARLY GOOD ENOUGH, and B) The fact that the FDA has no post-approval mechanism in place to verify the continued accuracy of test strips they approved earlier, or pull them from the market if they’re not, IS NOT OKAY.

As a measure of support, and to help in getting these wrongs righted, I wrote my elected officials in Washington. U.S. Representative Dutch Ruppersberger, D-MD, and U.S. Senators Barbara Mikulski and Ben Cardin, also D-MD, received e-mails from me expressing my concern and asking them to assist.

That was nearly three weeks ago.

But hey– a week ago I received an e-mail response from Senator Mikulski, the longest-serving woman in United States Senate history. I’ll share it right here, but be sure to come back after reading, because I want to ask about something.

Letter

Other than the fact that this was pretty much a form letter, I was actually happy to have received a response at all. Seriously, even if they’re not busy all the time, senators get requests from a seemingly endless stream of attention-grabbers and favor-seekers on a constant basis.

No, what really struck me were the two images at the bottom of the letter. You know, the Facebook and Twitter icons.

So I want to ask: What if a coordinated effort was put together to bombard Facebook and Twitter accounts of U.S. Representatives and U.S. Senators for the #StripSafely cause? It could start with House and Senate committee members responsible for FDA oversight, and perhaps move on to people with oversight of the U.S. Commerce department. Somewhere in there, we could get around to House Speaker John Boehner and Senate Majority Leader Harry Reid.

I don’t know… Maybe it all sounds a little too “Mr. Smith Goes to Washington”. But don’t we believe in our own cause just as much as Jimmy Stewart did in that movie? And I have to ask: Don’t you think that together, we could make some kind of impact? If there are so many people in on the #DSMA Twitter Chats every Wednesday, wouldn’t the same kind of numbers all tweeting or messaging at the same time, about the same thing, to the same people, get an elected official to take notice?

What do you think, Diabetes Online Community? Good idea? Bad idea? Feel free to leave your ideas below.

For more on this important issue, visit the Strip Safely central at www.stripsafely.com
 
 
 

By StephenS | Tagged , , , , , | Comments (2)