I confess…

I’ve been cheating on the DOC with Reddit.  Does anyone else read the Diabetes sub-reddit?  I really enjoy it.  Check it out!

After my awesome A1c results last week I, of course, had to share with my Reddit friends.  One person asked me to list 10 changes I’ve made to make such an improvement in my A1c (I went from 7.9 in April to 6.8 now, however a year ago, I was 8.7!)  Of course the first thing I thought when this person asked was: “Blog Post!”  I love to make lists.  If you ask the hubs, I make them for him pretty frequently – 10 Reasons why I miss him while he’s away (there’s no one around to kill spiders!), 10 reasons why I am excited for the weekend (Sitting on my butt is better than working, duh!), etc.  The lists.  I make them.

So, without further ado, here are 10 changes I made to improve my A1c:

1. I switched to sugar-free flavored creamer. When I first got my CGM I noticed that I was spiking big time after breakfast, even if I was bolusing to cover the carbs. Not willing to give up coffee, I switched to SF creamer and that has helped a lot.

2. I also gave up cereal. I eat a bagel and cream cheese for breakfast most mornings. I should have more protein but so far I’m doing OK, blood sugar-wise.

3. Getting the CGM period. It’s been amazing to know what my BG is doing at any given moment. I’ve been very attentive to it and adjusting my insulin when needed to keep me in range.

4. Baby-stepping my high alert on the CGM down. It started at 200 and I’ve gradually gotten it down to 160.  I think if I started with a high alert of 160 right out of the gate, I would have gotten frustrated with all the beeping.  If Bob can do it, so can I.

5. Communicating with my CDE a lot! I’m lucky in that she is very receptive to emails. I send her my reports every couple of weeks and she makes small tweaks. She’s noticed patterns I never would have noticed before.  She has quickly become my diabetes care BFF.

6. Getting back on the pump, in general.  For me, it’s much easier to correct those pesky high numbers with a couple mini boluses or temp basal.  A little more difficult and time-consuming to do on MDI.

7. Pre-bolusing for meals. It takes me about 30 minutes to get ready in the morning and halfway through I bolus for breakfast. Since I eat the same thing every day, it makes it easy.  I also pre-bolus for lunch and dinner too and I think it really helps prevent those after meal spikes.

8. Using combo boluses when I eat high fat meals.  I will master you, pizza.  I will.

9. Trying (although not always successful) to cut back on processed foods.

10. Really paying attention to the 15-15-15 rule when I’m low. Although this doesn’t always work (especially over night!).

It honestly hasn’t been a huge lifestyle adjustment or anything. I’ve just made diabetes a priority.  I know that I feel better physically and emotionally when I’m in better control of my blood sugars.

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Friday Five, 6/7

  • Running high for the past few days, changed pump site with 50 units of insulin left (HATE wasting insulin!), of course I pick a spot where I sit down and my jeans dig into it.  Site change fail.  At least it’s forcing me to sit up straight.  My mom would be so proud.
  • I picked the worst diabetes day I’ve had in a long time for my #dayofdiabetes on Twitter.  I still can’t figure out how to insert tweets into WordPress to make a pretty blog so I can summarize it.  Help?
  • It’s free donut day at Dunkin!  I was pleasantly surprised when I went to get my friday coffee and have enjoyed half of my chocolate glazed donut and am saving the other half for after lunch.  I really rock at dieting.  (Don’t worry, I’m counting the calories!)
  • Had my fourth overnight low in a row last night.  Very odd as my overnight sugars thus far have been great with my new pump.
  • I don’t understand this.  Is the lotion diabetic?  Wouldn’t it make more sense to be “Skin Relief lotion for diabetics?”
    diabeticlotion

    I sure hope this lotion gets it’s a1c in check.

    Have a great weekend!!!

Is it time to say goodbye to coffee?

I love coffee.  Coffee, however, does not seem to love me.  I have noticed in the 2 and a half weeks that I’ve been wearing my Dexcom that I seem to have a very high blood sugar spike after breakfast.  Despite taking my BG, Insulin to Carb ratio, and Insulin Sensitivity factor into account when I bolus, I am always spiking about 2-3 hours after breakfast, which I eat around 7:30 am.  Breakfast is usually a bowl of cereal (measured, 1 cup of multi grain Cheerios or corn flakes) and skim milk (3/4 cup), and my to-go coffee with flavored creamer (3 Tbs  – hey I drink a BIG cup!).  I usually drink my coffee over the course of 2 hours, finishing it around 9:30 am.  My blood sugar spikes seem to hit between 9:30 and 10:30 am.  However without taking a correction dose, I’m almost always back in normal range by lunchtime.  Take this morning for example:

  • Woke up with BG of 204
  • My new Ping told me to take 6.6 units for my BG, amount of carbs I was consuming, and correction factor.  My CDE wants me to do what the Ping says for the next few days as we figure out my basal rates and fine tune my Insulin:Carb ratio.
  • I spiked at about 9:30 am with a BG of 320.  Blech.  However, on the direction of my CDE, I did not take a correction dose and am now coming down, about 45 minutes before lunch.
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Who wants to go skiing on that peak?

 

This leads me to wonder if I need a different Insulin:Carb ratio or a higher basal rate.  Or, dare I say it, I should knock it off with the coffee.  I have read on the interwebs that caffeine can cause blood sugars to rise by blocking insulin or something medical like that.  But, it’s my coffeeeeee.  What is worse?  Blood sugar spike or crazy, cranky, half-asleep Laura?  My coworkers probably have a different answer than I do.

My thoughts are that perhaps I should increase my basal in the mornings to account for my coffee.  Or maybe set a square bolus (Or a “Combo Bolus” in Ping-speak) to account for my 2 hour long coffee drinkage.  Or change my Insulin:Carb ratio for breakfast so my bolus is higher, although this concerns me that I will drop by lunchtime.  Maybe next week I will try sugar-free creamer to see if that helps.  Perhaps all the sugars in the creamer are hitting me in a different way than other carbs?  Maybe I need a higher protein, lower carb breakfast in general?  Who wants to be my personal omelette chef?

I really don’t want to have to surrender my coffee to the D.  It’s warm.  It’s tasty.  It wakes me up and it makes me (and my coworkers) happy.

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This diabetes stuff is a tricky thing.