Thursday, August 13, 2015

A Day in the Life

Unless you have type 1 diabetes,  it's impossible to know what we go through.  Even those that live with us who see a lot of it first hand don't know.  So I'm going to try and help.

6:40am alarm clock goes off.  Reach for blood glucose meter kit.  Take out a strip, place in meter.  Prick my finger.  Apply blood. Wait 5 seconds for results.  105 .  Take synthorid. (has to be taken on an empty stomach, and no food for an hour.  Important scheduling this especially with common morning lows.)

7:30am;  Time to leave the house for the train station:  Check insulin pump status.  Enough insulin?  Check!  Battery level ok? Check!   Extra supplies in work bag including insulin, pump site change, batteries, and glucose tablets? Check!  (other checks include train pass; work badge, keys, lunch, Kindle, mobile phone).

8:00am:  On the train, in the middle seat.  Dry mouth feeling so I check CGM (saying excuse me to those I elbowed by accident) and CGM shows steady line at 110.

8:30am:  In the office.  Check blood sugar level, it's 137 now with CGM showing similar with an up arrow (indicating steady increase in blood sugar level).  I'm having yogurt for breakfast, plus black tea.  I need to take 1.1 units of insulin to cover the carbohydrate in the yogurt and a little bit extra because caffeine in the morning makes me a little bit insulin resistant*.  

8:50am: Ugh. Not feeling the yogurt.  But I have to eat to cover the insulin I took.  Guess it's a protein bar for breakfast kind of day. Not ideal, but it is what it is.

11:00am. CGM blood sugar level up alert.  Yikes,  Up to 231.  The granola bar I ate contained the same amount of carbs as the yogurt. Something to add to my list of things to look into;monitor.  Glucose meter concurs.  I have .03 units of insulin on board from this morning.   Take a corrective bolus of insulin.  With lunch time approaching in an hour I'll most likely have to wait a bit for the correction to take place before eating.  

11:17am:  I keep reminding myself not to check my blood sugar again.  Don't do it. Don't to it.  I need to wait until the insulin I took does it's thing. Man I hate waiting.

11:56am:  Blood sugar down to 185.  Still a bit high but at least it's coming down.  Now to think about lunch...

12:35:  Blood sugar is 135 and CGM showing double down arrows indicating a quick drop.  Grumble.  I got a salad for lunch with some chips. I can't resist chips.  The bolus for lunch is a wild guess, but we'll see how I do.  The next few hours are going to be a bit of a roller coaster I believe.

1:30pm.  To be honest, I'm tired of writing about all that goes into managing diabetes and it's only the early afternoon.

Reflection: There are so many decisions a person with Type 1 diabetes has to make throughout the day and most of it is second nature and takes a split second to do.  Even after having diabetes for so long I know most of the time when I'm not making the best choice but I do it anyway.  For example I ate two cookies last night and bolused for them after I finished eating them.  Did I know that the sugar and carbs from the cookies would hit my system way ahead of my insulin? Yep.  And I did it anyway.  I am human after-all and not every single thing can be planned ahead.    

1:55pm.  End of sensor alert. Gah. I thought I had another day on this one.  Bummer.

3pm:  blood sugar not surprising 214 from too many chips.


bolus: insulin you can deliver “on demand” to match the food you are going to eat or to correct a high blood sugar

insulin on board: is the calculation that tells you how much insulin is still active in your body from previous bolus doses

CGM: continuous glucose monitor

insulin resistance: usually insulin resistance is used when people talk about Type 2 diabetes, where a person can still produce insulin but needs medication to help make the insulin they produce work better.  A Type 1 can have insulin resistance as well -- meaning the insulin taken isn't working as effectively as it should. 

correction bolus: extra insulin taken to lower blood sugar.  This is also known as correction factor which is usually worked out with either the endocrinologist or diabetes educator.  

how long it takes my bolused insulin to work: it takes about 15 minutes for my bolus insulin to start working  It  peaks at one to one and a half hours and is completely gone in about 4 hours.   

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