Gonna Go Low, Low, Low

Low blood sugar ("hypoglycemia") is when your glucose level is under 70 mg/dL.  This can happen for different reasons:  taking too much insulin, exercising or not eating.  Symptoms include: sweating, shaking, fast heart beat, hunger, confusion and feeling nervous or jittery.  Here is a chart which shows the categories of hypoglycemia:

Category	Blood Sugar Level
Normal	80 - 120 mg/dL
Border Line Hypoglycemia	70 mg/dL
Fasting Hypoglycemia	50 mg/dL
Insulin Shock	Less than 50 mg/dL

To treat hypoglycemia (and bring your blood sugar up to at least 70 mg/dL,) you need to consume a sugar that is easily absorbed so that it works in your body quickly.  Some ideas are: juice, non-diet pop, life savers or glucose tablets or gel.  I usually drink 8 oz. of orange juice, suck down a Capri Sun or eat 4 glucose tablets.  After 10 minutes you should check your blood sugar again and if it is still not above 70 mg/dL then you would treat again.  If it doesn't come back up after 3 treatments, it is probably time to take a trip to the ER.

Insulin shock occurs when your blood sugar level falls quickly and leads to unconsciousness.  It is the severest form of hypoglycemia and it is considered a diabetes emergency because if left untreated it can be fatal.

Like all diabetics I have experienced hypoglycemia at some point.  It is not a pleasant feeling.  I have had times where I get confused and can't think straight.  I remember a time right after I had started taking insulin that I woke up in the night and knew my blood sugar was low.  I knew that I needed to get a glass of orange juice.  But, I could not make myself go downstairs and get that stupid juice!  I woke my Mom up and told her I need o.j. and she and I went to the kitchen together.  If you are ever around me and notice that all of a sudden I get quiet, can't seem to focus or remember what our conversation is about, or if I tell you, "I can't remember what I was saying," my sugar is probably low.  Just ask me, "Are you low?  Do you need some juice?"  I won't mind you asking.

About 17% of T1 diabetics suffer from hypoglycemic unawareness (which simply means you do not feel any symptoms when your sugar gets low.)  I happen to fall into that 17% the majority of the time.

Now that you are educated on hypoglycemia (low blood sugar,) you can understand the name I chose for this blog.

"A Visit From the Sweat Fairy" is a diabetes term of endearment.  As I said earlier, a symptom of hypoglycemia (a "hypo") is sweating.  So a visit from the sweat fairy simply means that your blood sugar is low enough for you to feel sweaty.  When you get a visit from the sweat fairy during the night (a "nypo"), you wake up with your shirt and sheets soaking wet, and usually freezing cold.  Sounds pleasant, right?

Meter Reader

Yes, I moonlight as a Meter Reader.   My meter reads my blood glucose level.  I put a test strip into the meter, poke my finger with a small needle (lancet) and put a drop of blood on the test strip.  The blood gets sucked into the strip and in a few seconds the meter "reads" what my blood sugar level is and displays a number on the screen.  According to WebMD, a fasting blood sugar (not eating for 8 hours) should be 70-99 mg/dL, a postprandial blood sugar level (2 hours after eating) should be 70-145 mg/dL and a random blood sugar level should be 70-125 mg/dL.

My blood sugar goal is 100 mg/dL.  It seems like I rarely meet this goal.  OK, I hardly ever meet this goal.  In fact, I hardly ever meet any of those recommendations.  I am supposed to check my blood sugar 4 times a day (fasting, before lunch, before dinner, before bedtime.)  Some days I do this and some days I don't.  Let's just say that I do much better testing myself when I am on a schedule during the school year (having the summer off tends to make me get a little bit lazy!)

The wonderful thing about my meter-remote (One Touch ping) is that it works together with my insulin pump.  "Blood glucose results, bolus calculations, and bolus delivery instructions can be sent from the meter-remote to the insulin pump from approximately 10 feet away.  In fact, the meter-remote can actually calculate a bolus, and then tell the pump to deliver it - so your pump can be tucked away when you choose.  There is no need to pull out the pump - it can stay clipped to a belt, tucked in a pocket, or stashed under clothing" (http://www.onetouch.ca/english/prodsubpage_detail.asp?cat=1&gr=3&pid=60&prs=19.) 

Basically this means that I can give myself insulin by just using the buttons on my meter-remote, without even touching my pump!  This is a new feature to me, since I got my One Touch ping pump and meter in February.  I love, LoVe, LOVE this feature!!!

Here is my meter-remote

And here are my test strips (the bottom part goes into the meter and the blood goes into the top)

I'm a Pumper!

All quotes are taken directly from the American Diabetes Association (http://www.diabetes.org/.)

“In type 1 diabetes, the body does not produce insulin. Insulin is a hormone that is needed to convert sugar, starches and other food into energy needed for daily life. Only 5% of people with diabetes have this form of the disease.

Inside the pancreas, beta cells make the hormone insulin. With each meal, beta cells release insulin to help the body use or store the blood glucose it gets from food. In people with type 1 diabetes, the pancreas no longer makes insulin. The beta cells have been destroyed and they need insulin shots to use glucose from meals.”

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From 1999-August 2002 I took insulin shots.  I got married in June 2001 and became pregnant 2 months later.  I had our first son in May 2002.  Having diabetes and being pregnant is a whole other blog entry…I will get to that eventually.  My OB/GYN strongly suggested that I consider going on an insulin pump after the baby was born, especially if we wanted to have more children (which we did.)  So when Ethan was 3 months old, I started on my first insulin pump, a Mini Med Paradigm 511.

Insulin pumps are EXPENSIVE, just as about everything else having to do with diabetes.  My first pump was in the range of $6,500.00.  Luckily, since I had just had a baby, I had met all of my insurance deductibles and so my out of pocket cost was $0.00 and all of my other supplies were covered at 100% for the rest of the year.  Having a good insurance plan is a MUST for diabetics!

I got trained on my insulin pump and in no time I was pumping away!  It was much better than taking anywhere from 3-5 shots a day.  With an insulin pump, the insulin is given from the pump through a clear plastic tube into a catheter, which is under my skin.  You are supposed to “change the site” of the catheter every 3 days (called an “infusion set”; using a needle to insert the catheter) but I don’t do it that often.  The catheter can be placed in my stomach, love handles, or the top of my thighs.

I am on my third pump (they are warrantied for 4 years) and now I use a One Touch ping.

Here is how I am wearing my pump today, the catheter inserted into my right love handle. 

The tubing can be removed at the catheter site at any time (for showering, swimming, etc.)

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“An insulin pump can help you manage your diabetes. By using an insulin pump, you can match your insulin to your lifestyle, rather than getting an insulin injection and matching your life to how the insulin is working.

How do insulin pumps work?

Insulin pumps deliver rapid- or short-acting insulin 24 hours a day through a catheter placed under the skin. Your insulin doses are separated into:

• Basal rates
• Bolus doses to cover carbohydrate in meals
• Correction or supplemental doses

Basal insulin is delivered continuously over 24 hours, and keeps your blood glucose levels in range between meals and overnight. Often, you program different amounts of insulin at different times of the day and night.

When you eat, you use buttons on the insulin pump to give additional insulin called a bolus. You take a bolus to cover the carbohydrate in each meal or snack. If you eat more than you planned, you can simply program a larger bolus of insulin to cover it.

You also take a bolus to treat high blood glucose levels. If you have high blood glucose levels before you eat, you give a correction or supplemental bolus of insulin to bring it back to your target range.”

My Diabetes History

I have heard of people who keep a "food journal" while they are dieting, so I figure maybe I can keep a "diabetes journal" to help me keep better control of my sugar, and to help me cope with it.  It definitely can't hurt, so I am going to give it a try.  But first, some history about my diabetes.

I was diagnosed in 1998, when I was 22 years old.  It is kind of a strange age to be diagnosed.  Too old to have T1 (Type 1, previously known as "juvenile" diabetes) and too young to have T2 (Type 2, previously known as "adult-onset" diabetes.)  I was in a strange type of limbo.  My doctor put me on pills, and I went through Diabetes Education classes, to learn how to count my carbs (carbohydrates.)  I met with a Dietician, who came up with a meal plan for me, setting how many carbs per meal and snacks I could eat.  It worked for about a year, and then it didn't.  Next step, insulin shots, also following
my meal plan.  Giving myself shots was an adjustment, but I did it.  I saw a new doctor, who was also curious as to if I was T1 or T2, so she ordered a C-peptide test to confirm the diagnosis.  It came back that I am definitely a T1, which meant I would be taking insulin for the rest of my life.