Posts Tagged ‘bloodsugar’

My Breakfast Enigma

Something amazing happened yesterday.  Take a look:

(For the American folks, that 5.8 mmol/l is a 104 mg/dl.)

Can anyone guess what I had for breakfast?  I’ll tell you at the end of this post…

This is amazing because every every morning I eat a pretty low carb low GI breakfast, and every every morning I spike within the first two hours and then come down hard.  I’m doing everything I can insulin-wise, including an aggressive bolus (a superbolus, in fact) followed by a major decrease in basal to 0.05 u/hr for the next three hours.  Ideally I’d pre-bolus, but with 2 kids to feed and clothe in the mornings, I’m worried about the impact a delayed (or worse – forgotten!) breakfast would have.  Safety first!

When I was pregnant, I ate balkan yogurt (high protein, high fat) with berries and walnuts for virtually every breakfast, and it worked pretty darn well.  But it also made me pretty darn sick of balkan yogurt and walnuts.  (I’ll eat berries any day, any time!)  So that’s off the table, literally.

Low GI dry cereals are a disaster.  Low GI hot cereals are better, but still far from ideal.

It may be that a further reduction in breakfast carbs is necessary to eliminate that spike and reduce my insulin such that it doesn’t cause a crash, but I’ve been nervous to go below 20g of carbs.  This is partially because I’m breastfeeding and less comfortable with messing around with my nutrient profiles while doing so, but also because I haven’t yet wrapped my mind around how to get over that morning liver dump hump (why does that sound so gross?) with less insulin.  (To be fair, my version of an “aggressive” bolus at breakfast is 2-3 units for 20-30g of carbs, otherwise the mid-morning crash is even bigger.)

Maybe I’m missing something, though.  Maybe I just need to try lower carb.  But what does one eat for an uber-low, or even zero-carb breakfast that will stick with you until lunch but does not contain artificial sweeteners or involve eggs every morning.  I like eggs, but if I eat them every morning, I won’t anymore.  Also not interesting to me is “dinner for breakfast”.  No chicken breasts, thank you.

I’ve even tried a few meal replacement options – drinks and bars.  You know, Martinis and chocolate!  (Kidding.)  To be honest, this is where I’ve had the most luck.  They’re also really quick, which is great!  The downside is that I don’t recognize about 80% of the ingredients in either.  I’ve been able to avoid artificial sweeteners, but it’s hard to say for sure what else I’m not avoiding.

So I’m looking for breakfast options, preferably of the low-carb, low-GI variety.  Something really quick (or make-ahead) and healthy (including low-sodium).  I’d also play around with some zero-carb (or almost zero-carb) ideas…  Anyone?  Suggestions (of either food or food-related resources) are welcome!

So what was the breakfast that gave rise to this lack of a rise?  What perfect food was it that made me almost flatline (in a good way)?

This:

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Wordless Wednesday: Rough Night

Unexplained highs…3 set changes…default to syringe…then low. Whee!

Feeling Better About Bayer

Before we get into the Bayer issue, I should make mention of the OB appointment that I promised to tell you about and never delivered on.  The reason I didn’t post is that there wasn’t anything to post.  It was a super quick appointment with no new information.  Just the “all’s well” from the OB, and another chance to hear the baby’s heartbeat.  Great appointment, but it would have made for a pretty boring blog post.

So let’s talk about Bayer instead.  If you’re just joining us now, here’s what happened, and here’s the most recent status of the issue.

And now that you’re up to speed, here is what I’m hoping is the resolution of this story:

After my initial Bayer post, my CDE (Certified Diabetes Educator) spoke with her Bayer rep about my issue.  The Bayer rep was very apologetic, provided me with some test strips to make up for the ones I’d wasted with the problems I was having, and apparently also escalated my story to someone who could help me.  Shortly after this, I came home to find a message on my answering machine from a Customer Service Manager at Bayer, asking me to call her to discuss the issue.

I made several attempts to call this Customer Service Manager and kept getting her voicemail.  I was reluctant to leave a message because I haven’t been especially available myself lately, but after about a week and a half of failing to get her on the line, I did leave a message…which she responded to within about five minutes.

She was very understanding and accommodating and seemed less interested in the details of what wasn’t working with my meter than in the fact that I need a meter that functions all the time.  Ironically, at this point my meter is rarely malfunctioning.  I mentioned this to her, and she suggested that it may be just a piece of debris in the meter that has moved to a less problematic location, but she assured me that she would be replacing it regardless.

Two days later, I received a new Contour USB meter (my third) via courier, as well as another box of 50 test strips.

I think they get it now.

Maybe it’s just because I mentioned I’m an obsessive, pregnant Type 1 diabetic with a penchant for testing upwards of 15 times/day (while pregnant, anyway) – enough to make them want to keep me as a happy customer.  But it’s enough to have me feeling at least a little bit better about Bayer.

Now I’m just crossing my fingers that Meter #3 lasts longer than its predecessors…

Come on, Bayer

A while ago I mentioned that I had been having trouble with my Contour USB Meter.  Here’s the history in a nutshell:

  • I used to use the OneTouch UltraSmart meter.  I loved it.  But then I had the opportunity to get a Contour USB meter, and I took it.  The small size was great, the small drop of blood required was great, and the accompanying software was pretty impressive.  I started to love it too.
  • A few months ago, my USB meter started acting up.  Every now and then it would count down to zero, pause, and then give me an error message instead of my reading.
  • I called Bayer and was dealt with by a gentleman who was very polite, if not a bit slow to understand my problem.  In the end, he arranged for a new meter to be sent to me as a warranty replacement.  (Note: I had to send the malfunctioning one back.  I’m not collecting USB meters.)
  • Within a week of starting to use the replacement meter, I was finding that test strips were often “clicking” on insertion – as if something was catching inside.  When this would happen, the meter would not turn on.  In some cases I had to try to insert the strip so many times that I started to worry it wasn’t going to work at all – but then it would catch correctly and it would work and all would be fine.  It did, however, make me lose my trust in the meter’s ability to function when I needed it to, so I set it aside, started using a regular Contour meter I had on hand, and made myself a note to call Bayer again.

So finally last week I got around to calling them (don’t judge – I’ve been really busy!).  This time I dealt with a woman who really didn’t seem to understand my problem – nor the ins and outs of actually living with diabetes.  The first process with Bayer “Customer Service” is to go through the troubleshooting process.  I explained quite thoroughly that sometimes it worked and sometimes it didn’t, and that I couldn’t make it malfunction on command, but that this didn’t mean that it was working.  She seemed stumped by this, and continued to try to force me to prove that it currently wasn’t working.

Then she asked me about the vial of test strips: lot number, number of strips in the bottle, etc.  I explained that I had stopped using the meter weeks ago so this was not the same vial of strips that I had been using when I had the problem.  I also explained (when asked) that, no, I did not still have the vial from those strips – as I go through multiple vials a week and don’t hoard empty test strip vials.  (If anyone sees a Hoarders episode like that, someone has to let me know.)

She then told me that I should phone them back the next time it malfunctioned – and that they’re open from 9AM-9PM.  This got my blood boiling.  I’ll admit, it may not have all been her fault – I’m pregnant and had high bloodsugar at the time, plus I’m very sensitive about people in the D-Biz not understanding what it’s like to have D.  Still, come on.

I explained to her (less patiently at this point), that my meter was malfunctioning in the middle of the night, at the grocery store with my toddler, at work immediately prior to important meetings, right before sitting down for dinner with my family…etc…etc…etc.  All times that do not facilitate an immediate phone call, including troubleshooting, to Bayer.  Basically, I told her that it was unreasonable to expect me to use a faulty meter until it inconveniently malfunctioned again – particularly since it’s been so hit-or-miss.  After being put on hold for a while, I was told that there was nothing she could do.

Come on, Bayer.

I informed her that I would continue to use the USB meter until it malfunctioned again, but then instead of phoning Bayer, I would be switching back to my OneTouch UltraSmart and taking my business elsewhere.

She asked if there was anything else I needed.

There wasn’t.

I’ll admit that, once I cooled down a bit, I was able to partially (but only partially) understand Bayer’s side of things.  They don’t want to replace a meter if it’s not truly malfunctioning.  That’s fine.  And maybe my recent warranty replacement had flagged me as a trouble-maker or something.  (“Watch this one.  She’s shady!”)  I don’t know.  But really, when you consider the cost of a meter – even a sleek USB meter – compared to the huge cost of the strips (I go through about 100 strips/week – more when pregnant), doesn’t it make sense for them to just say, “Okay, reasonable or not, we want your business, so here’s a new meter”?  Doesn’t it?  The cost of that meter to them is probably no more than their revenues from 1 week of strips from me.  Seriously.

Come on, Bayer.

But I think what bothered me more was the major lack of understanding of what it’s like to really rely on these meters.  Especially now that I’m pregnant (but even when I wasn’t) I need that meter to work when I need it!  I can’t be guessing as to whether I’m low or as to how much I need to bolus with my lunch.  I need to know with certainty!  (Don’t even get me started on the meter accuracy issue.)  Plus, with all of my logging and trend analysis that I’m doing lately, I need all of my results on one machine – I can’t be switching back and forth when one doesn’t work.  This isn’t a television or a printer or a cell phone…it’s a medical device!  My health and the health of my baby are depending heavily on it right now.  “Call us next time it doesn’t work” isn’t an option for me.  I just need it to work.  All the time.  Right now.  Maybe it’s a lot to ask, but I feel like the people working in Bayer “Customer Service” should get that.

Come on, Bayer.

So, just in case it was a test strip problem instead of a meter problem (which, I’ll admit, I hadn’t considered), I’m going to give the Contour USB meter another try.  But I’ll happily switch back to my OneTouch UltraSmart that actually has some pretty cool features (even if it is a bit bulkier) the minute that USB meter even looks at me funny.

The Contour USB Meter

A while ago I promised you a review of my new Contour USB meter.  This has taken me longer than I intended and by now it’s not so “new” anymore, but I do have some notes and pictures for you finally! 

Before I start posting all of this, I want to address the fact that there is really no way for me to do this without showing you stats about my personal diabetes management.  While that doesn’t freak me out as much as it would have in the past, it does still make me a bit nervous.  I do ask that you try to focus on the format and the meter-related specifics and not on my numbers.  Please don’t compare me to you, and please don’t compare yourself to me.  We’re each fighting our own battle to control this thing! 

First of all, I have to say that I love this meter!  Prior to getting the USB, I was using the OneTouch UltraSmart.  I was very happy with that meter, especially with all of it’s available statistics (because I’m a math nerd and a micro-manager), but I really didn’t like the CareLink software for uploading or viewing reports.  Plus, small as the UltraSmart is, the thought of something even less bulky was definitely appealing.  

Enter the Contour USB Meter. 

The USB is great because it’s small, it’s fast (5 seconds), and it has the data logging and statistical capabilities that I want without a bunch of extra stuff that I don’t need.  Plus, it hooks right up to my computer and comes with its own user-friendly software to view and print reports for my own use or to share with my CDE or endo. 

Here’s what it looks like: 

Contour USB Meter

It comes with its own lancing device (the Microlet 2) that is depth-adjustable – a good feature for those of us with really calloused fingertips!  I love the size of all this (which, I guess, is kind of hard to tell from this picture – sorry), but I’m honestly not a huge fan of the Microlet 2.  It feels flimsy to me and I’m not holding my breath that it’ll last very long.  I guess we’ll see.  This may be a harsh premature judgment. 

Every time you test, it asks you to label the test as either “before meal”, “after meal” or “no mark”.  You can turn this feature off, but I’ve left it on because it lets me see your averages specific to “before meal” and “after meal”.  It also lets you see your overall average – but it’s nice to have the option to break it down a bit.  The average display then shows you how many of your tests have been in range, as well as above and below.  The bloodsugar ranges on the meter are pre-set but you can adjust them if you prefer.  I currently have mine on the pre-set ranges.  This is what the average screens looks like: 

Before Meal Average Screen

There is also a logbook that you can scroll through that looks like this: 

Logbook Display

When you test, the meter gives you the option of adding a “note” to the result – e.g. “Don’t feel right”, “sick”, “stress”, or “activity” – or setting a reminder to test again in a while.  I don’t have any shots of these, mainly because I don’t use them often. 

When you use the software (called GlucoFacts), you have the option of viewing/printing your logbook or a variety of charts/graphs.  If I were to post a full screenshot of these charts you wouldn’t be able to read anything on them, so I’ll just include some small sections of them for examples.  

The logbook is my least favourite, because it isn’t as chronological as I’d like.  It breaks the day into chunks of time (which you can customize) – e.g. “Early AM”, “Morning”, etc. – and in each chunk of time, your results are lumped into the categories of “Before Meal”, “After Meal” and “No Mark”, based on how you tagged them.  I find this view really difficult and not very informative, but maybe that’s just me.  Here’s an example: 

Logbook Excerpt

The Logbook page also includes a Data Analysis that breaks down some statistics for you in each category shown above.  The nice thing about both the Logbook and it’s Data Analysis is that it colour codes your problem areas.  Here’s an example of the Data Analysis: 

Logbook Data Analysis Excerpt

The next chart is the Trend chart.  It’s meant to give you an idea of where you’re trending (obviously, right?) in terms of readings in or out of range over the course of a number of days.  Here’s an excerpt: 

Trend Chart Excerpt

Next is the Standard Day Chart.  I like this one because it lets you see where the problem areas typically are in a day.  It also has a Data Analysis that breaks down a number of interesting statistics.  This is what the Chart and Analysis look like: 

Standard Day Chart Excerpt

Standard Day Data Analysis Excerpt

The Standard Week Chart is similar, but lets you see what your weeks look like rather than your days.  I don’t find this one as useful because most of my days are pretty similar.  I suppose it would be helpful, though, to analyze the difference between weekdays and weekends, or if you had some sort of athletic event every Wednesday or something like that.  It would probably come in handy for some folks.  As with the other charts, this one also comes with a Data Analysis.  I’ve only included an example of the chart: 

Standard Week Chart Excerpt

Finally, the Summary Chart and Data Analysis give you an idea of how you’re doing overall.  I’d say this is my favourite chart and analysis.  This is what they look like: 

Summary Chart Excerpt

Summary Data Analysis Excerpt

As a side note, when I was looking at these analyses to post here, I notice that the above analysis shows that I do an average of 8.3 tests per day.  I am a huge micro-manager, so this surprised me.  I thought, “Wow!  I’m doing better at being less obsessive about this!”  But then I realized that the data includes a large number of days during which I didn’t use the USB meter at all because I was finishing up my OneTouch test strips.  Oops.  I guess I”m still obsessive!

I also noticed that the day I’ve chosen for an excerpt was a pretty volatile day with readings in the 2s and in the 16s!  I’m usually in much tighter control, I swear!  (But you’re not supposed to be focused on that anyway, remember!)

Lastly, I haven’t done much saving or printing of these reports, but I did notice that the option to save to PDF format makes for a really big file with a lot of pages.  There may be a way to adjust this, but I haven’t explored it yet.   I would definitely advise only saving/printing the reports you expect to use, rather than doing the full conversion of all the reports to a PDF. 

Anyway, like I said, I’m really happy with this new meter!  I hope the above information is helpful, or at least a bit interesting!  If you have any questions, feel free to contact me!  Or if you have any comments on your experience with the meter, I’d love to hear them!

Diabetes Meme

It feels like a meme day, so I’m happy that there’s one going around!  This one’s from Kerri and it’s all about the D!

What type of diabetes do you have:  Type 1 

When were you diagnosed:  December 30, 1981.  Wow…I’m coming up on 30 years here.  Crazy!

What’s your current blood sugar:  I don’t know.  I’ve been low all morning.  My most recent test was about 4.5 mmol/l (81 mg/dl), but shortly after that I started getting the “whoa, I’m dropping fast” feeling, and my eyes started going blotchy, so I was clearly heading downward quite quickly.  Don’t worry, I’m okay now. 🙂

What kind of meter do you use:  I used to use the OneTouch UltraSmart, but I’ve recently switched to the Contour USB meter and I’m loving it!

How many times a day do you test your blood sugar:  It probably averages out to about 10 times a day.  Maybe 11.  A lot, anyway.

What’s a “high” number for you:  Well, it depends on the time of day, but I tend to get the bolus-itch around 8.0 mmol/l (144 mg/dl).  I’m uncomfortable with readings over 10.0 mmol/l (180 mg/dl), and I typically start to feel “icky” around 13.0 mmol/l (234 mg/dl)…or a bit lower if my bloodsugars have been really good and then suddenly go high.

What’s do you consider “low”:  Anything under 4.0 mmol/l (72 mg/dl). 

What’s your favorite low blood sugar reaction treater:  I generally use Dextro-Energy tabs (used to be called Dextrosol), but I sometimes use juice.  My favourite, though, would be Twizzlers!

Describe your dream endo:  Open-minded and empathetic, but enough of a hard-ass to remind me when I need to tighten things up.  Oh, also, super-informed on the pump front.

What’s your biggest diabetes achievement:  Getting through a challenging pregnancy to end up with my sweet little girl!

What’s your biggest diabetes-related fear:  Blindness.  It’s not that this is the complication that scares me the most overall, it’s just that this one currently presents the most real threat to me.  It scares the hell out of me, frankly.

Who’s on your support team:  Mainly my husband and CDE (and good friend!) Michelle, but also a great team of health professionals (my endo, my ophtho, my CDE (as mentioned), my dietician, my counsellor and my pharmacist, to name a few) as well as my friends and family.  It’s a big team 🙂

Do you think there will be a cure in your lifetime:  I really hope so, but I’m not holding my breath.  Honestly, I try not to think about it too much.  When something shows up on the research front that looks like a “definite” and has an ETA of within a couple of years, then I’ll get excited.

What is a “cure” to you:  A drug or procedures that lets my body, on its own, operate as though I don’t have diabetes.

The most annoying thing people say to you about your diabetes is:  (1) You must have it pretty bad. (2) My grandma/grandpa has diabetes too! (Not that this is a bad thing to say, but I get tired of hearing it.) (3) Are you allowed to eat that?!

What is the most common misconception about diabetes:  That Type 1 and Type 2 are the same. 

If you could say one thing to your pancreas, what would it be:  Nothing that I’m willing to repeat here!

Five Things

1. My bloodsugar sucks these days.  It’s a miserable mixture of too high and too low.  Usually I’m trending one way or the other, but this time it’s both.  I blame the fact that I started on a new med (non-D) recently.  Hopefully once my body adjusts, my bloodsugars will settle down.  I figure there’s not much point in trying to problem-solve during this adjustment period.  Also, I go back to work next week (after mat leave) so my schedule will be changing drastically, as will my activity levels (I have a desk job) – another reason that trying to solve my current wacky bloodsugars seems a little futile.  So I’m kind of playing the “let’s just correct when we need to” game.  I don’t feel good about it, but that’s what I’m doing.   Hopefully next week I can do some hard-core tracking, logging, and resolving of these issues. 

2. Closely related to #1 above is the fact that my bad bloodsugars are really irritating me.  Usually I can handle a less-than-ideal bloodsugar without getting too worked up, but lately I see a 9.0 mmol/l (162 mg/dl) when I’m expecting a 5.0 mmol/l (90 mg/dl) and I’m all “Come ON!!!!  Seriously?!?!” (or worse).  It’s just I feel like I try so hard and it’s frustrating to try so hard and still get crap results.  It’s frustrating to make your best, most educated guess about that delicate balance that is diabetes management, and fail. 

3. Today I bought a bikini.  I was wearing a CGMS sensor when I tried them on.  The saleslady didn’t ask about it.  They usually do.  It bothers me that, in order to wear a bikini, I either have to be willing to let my CGMS show (I always put my infusion sets out of sight) or not wear a CGMS.  Even if I opt for the latter, I’ll probably still have massive red holes in my abdomen from previous sensor-trauma.  But I’ve decided not to let that keep me from wearing a bikini.  My low(ish) carb diet has helped me lose my baby weight (and more), and I want to show off my new tattoo!

4. I think I’m having a music crisis.  I like music that really gets under my skin (in a good way) and stirs me to feel something…whatever that something may be.  Lately the music that can do this seems to be dwindling.  For the last few months I’ve been on a music high, listening to all kinds of new (for me) stuff, so maybe I’m just coming down off that high.  Maybe everything else is just going to seem boring now.  I need a music boost!

5. I was going to make a list of 5.  Then I decided to just make it 4 because I kind of got stalled at 4.  But then I looked back and noticed that my list was too glum and decided I wanted to end on a high note.  So here it is:  my little girl has learned how to give me a kiss!  When I say “Give Mommy a kiss” she puts her little slobbery lips to mine and then she smiles because it makes her happy.  It makes me happy too. 🙂   And there’s the high note….