Tag Archives: insulin

Hating the highs.

March 4, 2013 – 12:28 pm

All things being equal, yesterday was a pretty good day. Only things were not all equal… diabetes doesn’t play that way. Okay, well, maybe it wasn’t just the diabetes. Let me explain:

We woke up early (for a Sunday, anyway) at about 6:00 a.m. When I reached the kitchen, I did the normal stuff… make coffee, let the dog out, feed the dog and cat, and check my BG: 81 mg/dL. Great start to the day, right?

I promised to take The Great Spousal Unit over to Blackwater National Wildlife Refuge near Cambridge, Maryland on Sunday. So after breakfast, we took off for Maryland’s Eastern Shore– a little over 2 hours away by car. By the time we were nearly there, we stopped for gas and I also needed to make a pit stop (badly). I should have guessed something was going on.

So we go off to the refuge, and it’s beautiful even though we didn’t see much compared to most trips there. After we finished, I decided to make a quick side trip over a public road that goes right through the middle of the preserve. It was there that Maureen spotted the only bald eagle that we saw all day. Wish I had a photo, but he flew away before I could snap it off. After that, and an equally quick sighting of an osprey, we headed off to Cambridge for a late lunch.

Again, I really had to go, but I didn’t think too much of it because I knew where my BG was in the morning, I knew what I didn’t overdo breakfast, and I bloused accordingly. Also, my infusion set had already been in for going on four days, and it had been working well. It was surprising when I checked just before lunch and found a 237 mg/dL on my meter.

Okay, I’m frustrated, but again, I bloused accordingly. I made sure I would be good by about 5 o’clock at the latest. Wroooong.

We took our time coming home, and the way back over the Bay Bridge, through Annapolis, and up to Baltimore wound up taking about 3 hours. When we arrived home (and after I ducked into the bathroom), I checked my glucose again: 249 mg/dL.

Now I’m mad. I almost never have a consistently high day like this. I’m ready to bolus the living daylights out of anything that moves. But I regained my composure and decided to change my infusion site instead. After changing, and to be sure I’m getting all of my bolus this time, I decided to do an injection to cover where my BG was sitting, plus the very limited amount of carbs I was ingesting at what was really more of a grazing than dinner. At this point, I’m absolutely sure that everything will be fine, even with (or especially because of) a new infusion set. Wanna guess how that came out?

I wait until 8:00 to check, and whaddyaknow? I’ve hit a new high for the day! 331 mg/dL. This is where the term “rage blousing” comes from. If it weren’t so late in the day by now, I probably would have rage bloused my behind off. Instead, I decide to do two more things.

One was to do another injection, right away. I figured this still had to be my best option to bring my glucose down.

The other thing I did was something I should have done much earlier in the day. Instead, I waited until I tested again at around 10:30, and saw 348 mg/dL on the meter. When I changed my infusion site earlier, I did not change my reservoir. I had about 100 or so units left in there, and I didn’t want to just toss all that insulin into the trash. So I changed my site and hooked up the old reservoir. But by now I’m thinking, maybe the insulin is bad somehow. I don’t know how this happens… I can’t remember it ever happening before. But, of course, now I’m ready to try anything, so I filled a new reservoir and hooked it up. I know this isn’t how you’re supposed to do these things, but hey, sometimes things don’t go according to plan. Once this was complete, I had pretty much given up, and I went to bed.

And gloriosky, when I woke up this morning, I was right back at 81 mg/dL all over again. Fiiiinnnnaaalllly. Hmmm…. Bad insulin. Who would’ve thunk it? But then again: When you consider this diabetes beast we’re all fighting against, it seems to make perfect sense. In a crazy, don’t count on anything, not gonna play fair kind of way.
 
 
 

By StephenS | Posted in Random Glucose | Also tagged , , , | Comments (6)

It’s a numbers game anyway.

January 10, 2013 – 11:33 am

I was looking at the Baseball Hall of Fame voting from yesterday, and immediately my analytical mind starting crunching the numbers… baseball is a game loved by statisticians, anyway… Since blank ballots submitted count against players being considered, how would the voting change if those blank ballots were not submitted (then they wouldn’t count against the player)? How many more votes do Jack Morris and Craig Biggio need next year to crack the 75 percent threshold for enshrinement?

Then, since my mind has been on D overload the past several months, I started thinking about numbers and how they relate to diabetes. We all know that numbers are important. Hemoglobin A1c, meter readings, carb/insulin ratios, the whole bit.

But let’s look at some of the other stuff for a moment. I was diagnosed nearly 22 years ago. That’s a fair amount of time, and to the best of my calculation (these are approximations only), here are some overall numbers. I’m going with very conservative counts, so the amount of stuff used and the cost of everything is likely higher than this.

– I didn’t always do a great job of checking my blood glucose. So if I calculate only 2.5 times testing on average, per day, for 8,016 days since diagnosis, that’s 20,040 BG checks. At even 50 cents per strip (which is a very conservative number), that’s $10,020 spent on test strips alone.

– I was on multiple daily injections until almost 3 years ago. For most of that, I was on two injections per day. Then I was on one per day (Lantus) for a couple of years, then Lantus plus a bolus fast-acting insulin before each meal and snack. So again, let’s go with 2.5 per day as an average, for 19 years. That’s 17,350 injections! It’s hard to gauge the amount I spent on syringes, but I’ll try: 17,350 injections divided by 100 syringes in a box equals almost 174 boxes. The average cost per 100-count box is probably in the $24.00 per box range (a quick online check reveals it’s about $30.00 a box now). I’m counting the full price here because my various insurance coverages over the years mostly required me to pay 100 percent for them. So 174 boxes at $24.00 per box equals $4,176 spent on syringes.

– I can’t even begin to guess how much insulin I’ve used over the years, so I won’t even try here. But it’s a lot. And there’s no such thing as generic insulin in the U.S., so the cost is probably a lot. Though most of the cost has been covered through prescription plans. So let’s do it this way: My mail-order pharmacy dispenses 90 day supplies of insulin at an average cost to me over the last 22 years of $50.00 per 90 days. That’s 88 quarters of insulin at $50.00 per quarter, which comes to $4,400 dollars worth of life-giving juice.

– I’ve been on pump therapy for almost three years now. I’ve got a pretty good medical insurance plan at work, so the initial start-up cost for my MiniMed Paradigm® Revel™ pump was right around $500. The durable medical supplies portion of my plan helps me pay for infusion sets and reservoirs every 90 days, and my cost is about $90 per quarter. It’s been about 11 quarters since I started on the pump, so at that rate I’m at $990 for infusion sets and reservoirs and other incidentals (the inserter, IV prep, etc). I’m including the cost for the CGM that goes with my pump, even though I don’t use it all the time.

Total cost of everything above: $20,086

That’s just the big stuff. I could go on and on about doctor visits every 90 days, cost going to and fro seeing doctors and specialists and gathering stuff that I need, and that ill-timed emergency room visit in Dayton, Ohio a couple of years back.

What does all of this make you think about? How much everything costs over time? How about diabetes burnout? Does it make you want to do some number crunching of your own? Is there something I’ve left out? Feel free to add to the conversation by leaving a comment below.
 
 
 

By StephenS | Posted in Uncategorized | Also tagged , , , , | Comments (1)