A brief history of ... my basals
I use an insulin pump. I love it! If anyone wanted to take it away from me they would have to pry it out of my dead, cold hands. When using a pump you can fine-adjust. With syringes you can only adjust.
One of the main things to adjust is the basal rates. With a well tuned basal rate, they say you can go for days without eating – and be in a constant, blissful state with a BG between 90 and 110. Just like where Buddha was. I’ve never done this because I get too hungry, and my BG values veers off and I feel I have to eat before the first day is over.
So, when I started to use the pump in 1999 I created a basal plan with my endocronologist. Since then I have changed it anytime I felt it was off, and rigourous testing showed it to be.
However, things improved little and I stuck to an advice I had heared to have only 2 or maximum 3 different rates per day.
Then things changed...In April 2005 I read the book ”Think Like a Pancreas” by Gary Scheiner. The book is really good! Gary is a diabetic himself, and in it he lays out in a clear, direct and funny style different tricks for improving your control. I started following his advice and things improved quite a bit. However, I found it difficult to find good basal rates
and went between changing them too much to never changing them.
So I contacted Gary and asked if he could help. It turns out Gary had just started a company (
Integrated Diabetes Services) doing just this sort of help. I signed up as his first remote patient in Europe. After the first consultancy I felt so refreshed! I’ve had so many doctors that a) don’t really know how to fine-tune, b) don’t really care about learning it, and c) don’t have the time to spend on it.
Since then we have changed my basal rates quite a bit, and I now have 7 different rates per day. The last change happened today: we reduced that morning basal rate from 6am to 10 am by .1 units per hour) to reduce the morning lows I have had.
So what does my basals look like you might ask? Well, take a look at the following
before (purple line) and
after (blue line) photo. I have also added the values of ”adult reference pumpers” there (green line, it’s the averaged basal rates of hundreds of different adult patients of Integrated Diabetes)
Hopefully, after the last change I am one step closer to the Buddha state...
Woozily harassed, anyone?
Thanks to all your comments to my last post. Yes, they are my actual numbers from the last 14 days. There's nothing extraordinary about them - the zigzagging has been there ever since I started measuring... Actually they were much bigger in the beginning. Like the difference between the zigzagging contours of the Appalachian mountains and the Austrian Alps. And yes, I love hearing that there’s other people out there with the same problem. Let’s call it the zigzag pathology...
And, oh yes Mr. Anonymous, I am also a member of the insulin pumper’s list. I find it a good resource for information (That's where I found the URL for Wil’s Guardian RT blog!), but like you I also find it a bit "alien" (imagine a spooky sound, please) when someone says that anything outside 90-110 mg/dl makes them feel like crap the whole next day. I recently read someone confessing to be completely bummed about a tatler (hba1c – see my previous post) above 5%. Oh well, I guess we all are at different levels. To me it just makes me crave better controll more: Wow, there's actually people out there that wake up with BG's between 90-110. Maybe one day I can be like them!? What kind of super-powers do i have to aquire?
As for now, if I am between 70 and 160 I am really content. And after one year of hard work my tatler is finally below 7%! At other times, outside this range I feel either culpably irritated or woozily harassed...
- Culpably irritated when I am above 200. I always ask myself: what did I do wrong!?! Did I eat too much junk? Was my carb count off? How many carbs are there in 100g’s of polenta (Italian dish) and how much did that stuff on my dish weigh, anyways? Why did I not bring my carb counting tools with me last night? Have I not exercised enough? Are my basal rates off?!
- Woozily harassed when I am below 60: After getting the harassed feeling away ("leave me alone, Mr. evil!") I always ask myself: did I drink too much wine last night? Or maybe I exercise too much? Are my basal rates off?
In any case, at least when I am below 60 the tatler won’t be tough on me:)
Tomorrow is another day...
.. and wouldn't it be nice to know some of what will happen? Like your BG!?
So tonight I used the "glucose trend" report of my Onetouch software. A 'trend' is according to webster "to have a general direction or tendency". However, looking at this zigzag graph there seems to be little direction.
I see one tendency, though: regular lows...
I count 12 of them (in 14 days)... Is that alot compared to others?
Anyhow, tomorrow I expect to hear from the tatler. I am cautiously optimistic. I think it'll be less than 7% but worse than my last one (the best one I've had in years) which was at 6.4%. I'll post the results here.
The Tatler: "What's goin' down?"
"What's goin' down?" is something we used to say in California when meeting someone. For me the response the last year has been "well, my HBA1c is goin' down!". I've spent alot of time on this %&#¤ disease and it's helped reduce my HBA1c scores abit over the last year (from 8.4% to 6.4% latest), however, this is not what concerns me now...
Let the name "HBA1c" roll on your tounge a while and then be honest: do you like it? What happened to "user friendly" names?!
I'd like to propose a new name for the HBA1c test:
The TatlerTattle means (from websters.com)
1) To reveal the plans or activities of another; gossip. See Synonyms at gossip.
2) To chatter aimlessly; prate.
The Tatler (a.k.a hba1c) tells you how your average blood glucose levels have been the last 3 months. If you have a few 'liberal' days or evenings (you know the ones: long greasy dinners with desert and too much wine..) it tells. Nothing is hidden. You simply cannot silence the tattler. It loves rousing your doctor up, specially the ones who have little clue of what it takes to live with this disease, let alone improve the control.
So, what do you think (about the name, not the doctors)?
another "standard" day...
I use the Lifescan Ultra Smart BG meter, and regularly download the results to my computer. Tonight I tried to make sense of the "standard day" report. In this report, each of the 90 last days of BG values are plotted as a seperate dot. In the chart a grey band of 'ideal' glucose values (in my case set between 70 and 160) are also shown. Apparently trends can be found from this. But all I seem to see when I look at this is a bunch of bullet holes from the wall behind Bonnie and Clyde during their last holdout against the thompson gunners of the police.
So the natural question is then: did the police shoot with any purpose? Please leave a comment if you see any meaning in this:)
News flash
Today I found the following snippets of news from a fellow pumper in the insulin-pumpers newsgroup:
NEWS FLASH:First Insulin Pump and CGMS Integrated System Launches: Medtronic, Inc andAli Bin Ali Medical, in Qatar, announced the launch of the MiniMed ParadigmReal-Time Insulin Pump and Guardian RT. It is the first integrated insulintherapy to display real-time continuous glucose reading and trend graphs,
their glucose control. The MiniMed Paradigm Real-Time System integrates anexternal insulin pump with Continuous Glucose Monitoring (CGM). The system9sglucose sensor takes as many as 288 daily glucose readings per day. Moreinfo next week.Wow! did I already say I am a big believer in CGMS?! This is rather good news, although abit short. I looked at Medtronic's homepage but could not find any additional information.
Welcome to my blog!
I'll use my blog to list the thoughts that I have around living with diabetes. I welcome any feedback and messages from fellow struggelers out there, and hope that you'll find some of theese posts interesting.
