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February 10th, 2012
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Diabetes is hard work. Everyday I use my brain to survive and thrive. Every day I'm a mathematician, nutritionist and doctor.
I add carbs together, often so naturally I never give it a second thought (until three hours later when my levels leap up to 250). I subtract and add boluses to achieve an accurate dose. I figure percentages of basal rates to achieve a better A1c. I find the averages of blood sugars, insulin totals and daily carb counts (or let my high tech meter and pump do it for me). My brain is full of numbers and levels just waiting to be added, divided and analyzed. (READ MORE)


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It's the end of my logging week again, so I'm sitting down to examine the logbook that I hold so dearly close to my diabetes management's heart. The time that I set apart for this goes something like this. First, I update the logbook with my most recent numbers, Lantus doses, and any important comments including new prescriptions, strange food choices, or exercise. Next, I tally daily averages as well as averages for time of day. After that, I analyze those averages compared to the last weeks averages and look for any resounding patterns that might need changing.

 

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Last week, I spent several days in Mexico on vacation and on a business trip. With the extra carbs and the change in normal routine, my averages went from the 140's to the high 150's. I had one or two severe lows and a handful of minor lows. I also had one day where my pump site went sour and sent me soaring into the 300's for several hours.

 

Coming back from Mexico has been interesting on my blood sugars. I've had a few lows, of course. But at the same time, I've decided not to try so hard to keep my numbers down. I'm not completely blowing it, but I'm just not stressing myself out over highs and off numbers.

 

So Monday night, I decided to order a pizza while working on a research paper. It was nice to eat the pizza, do a fairly normal bolus, but not stress about what my blood sugar might be in the next 12 hours. I didn't even freak out when I saw consistent 200's on my meter screen.

 

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Yesterday's endo and CDE appointments left me with plenty of new techniques that I'm ready to put into practice. Even though my A1c finally bumped from 7.3% (which I'd been stuck at with the pump for over 6 months) to a 7.1%, I know that I can do better. And despite the better A1c, I'm not seeing the types of patterns that I prefer to see. So here are all the tips that I'm setting into motion over the next weeks.

 

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I haven't realized how hectic the last week has been until tonight. School is picking up. I've had doctor's appointments and health concerns. Plus my social calendar has taken off like a rocket.

 

So I'm sitting down to do my averages tonight. And not liking what I'm seeing. But I'm also understanding that this may be an "uncontrollable" bump in my blood sugars.

 

My averages have jumped back up this week to the high 160 range. I'm perturbed at some of the results I see...like a 44 followed by a 56 or a 363 from slacking on my boluses. But I also know that some of these highs are my own doing...although I can't say much about the lows at this point.

 

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I'm currently on Ortho Tri Cyclen Lo, which is a low estrogen triphasic birth control. I picked this one years ago because it was low estrogen and had the same progestin that's known to decrease acne. Plus it comes in a pretty nifty diskette...mine has a flower on it in fact. I only stayed on it for six months back then though because it wasn't really helping with the cramping that I was having. Nor did my acne seem to improve.

 

I went back on it a few months ago because of the Accutane regimen that requires birth control use. It seemed the safest option after Seasonique left me with 21 days of breakthrough bleeding. This is my second completed pack. And I think I'm beginning to see a pattern with my blood sugars.

 

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My averages had been looking much better the last few weeks with the mix of keeping a stable schedule and eating a little better. I was having my usual bouts of lows (in the 50's) with the lower averages, but I was also working to correct those issues. So this week, I'm sad to report that my averages have soared back up with the onset of school.

 

The first week of school (or any time I get sincerely busy), I tend to let my diabetes slip. I check my blood sugar less often and at the most unusual times. I don't stay on top of my insulin, as in I let my Lantus doses fall outside the typical 12 hour range or delay my boluses. On top of all that, I tend to eat off schedule (since I'm still adjusting to the change in daily routine) and never decent meals.

 

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I've really been struggling with the Lantus and exercise mix. When I first started out, I did okay with a few lows here and there (nothing out of the ordinary for me). But as I added in new and different work outs and upped my intensity, I'm struggling to keep my blood sugars stable before, during, and after exercise.

 

With the pump, it was so easy to decrease my basal so I started my workout in the 180-200 range. I struggled with maintaining a higher level during exercise, often going low...but at least I wasn't concerned with those numbers completely wrecking my averages.

 

Now that I'm back on Lantus, I'm re-learning everything that I did five or six years ago (since high school held my hardest workouts). But I'm failing miserably. I can't get the range right before working out, often soaring to the 260's. And during, I'm flatlining in that same range.

 

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I got so frustrated with my A1c number and my recent averages that I started logging in detail again. I'd planned to start after finals (around December 14), but I just couldn't take another week or two of 200 level blood sugars. So I brought out my UltraSmart meter which logs carbs, insulin levels, and my blood sugars.

 

So for the past few days, I've been logging my carb intake to the best of my ability (and trying to pay closer attention to meals that I can accurately judge), every unit of insulin, and testing as much as possible. I've also been taking this opportunity to use a different carb ratio than normal, which seems to be helping. My averages are down with less fluctuation and far fewer nasty highs.

 

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Lindsey Guerin
Lindsey GuerinLindsey is a typical, yet unique, Texas girl who loves shopping, movies and reading. She loves to travel and take risks. She dreams of diabetes cures, never-ending cheesecake and her own airplane. The rest you can discover in her blog! (Read More)
Brenda Bell
Brenda BellBrenda was diagnosed with high blood pressure, high cholesterol, and Type 2 diabetes in July 2002. After a rocky start, her diabetes has been diet-controlled since January 2004 and she hopes to keep it that way for as long as possible. (Read More)
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