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March 22nd, 2010
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Up and down. That's the way it's been lately. Numbers are up, numbers are down, nothing is making sense, patterns are confusing, emotions are frustrating. I've seen some wildly high numbers in the past week or two that are completely blowing my mind. Go to bed at 109 mg/dl, but wake up at 5 am in the 300's.
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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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Saturday night, I raised my evening Lantus dose to 16 units and kept my morning dosage at 13 units. I also moved the evening dose up by about three hours, hoping to stop those highs that sent me into sleep at 218 and 241. I also took the plunge and decided to do a trial run of boluses with the pump instead of pen or syringe. And I'm still as perplexed, but this time for the opposite reason.

 

Within a few hours of bolusing with the pump, I saw a 55 that bounced up to 114, 131, and back down to 93. Several snacks throughout the night left me at a morning number of 130. For most of Sunday, I stayed under 150 with a brief spike after working out. After dinner on Sunday night, I dropped to 84 then 69. And after about an hour, I was 146. But at 4am, I woke to an unexpected 47. I also lowered my evening Lantus to 15 units since I'd seen a rise in lows after the 16 units.

 

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Right now, I'm a complete bundle of nerves. Last night, I suddenly decided that today I would go off the pump. I know that I've been talking about it, but I assumed that I'd get it all straightened out and be back into "normalcy" before April 1st came around.

 

But you'd be surprised to find that poor control is actually NOT the reason why I'm going off the pump. In the past two weeks, I've had some highs and far fewer lows (which is just amazing). My averages are still in the 150 range though, which is what I'd settle for to get down to the 130 range (slowly, without lows).

 

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I am sincerely hoping that my blood sugars stabilize in the next week. Since my most recent Accutane increase (in the last week of December), everything has been all over the place. 200s, 300s, even hitting the 400s. It hasn't been pretty.

 

The previous two increases in Accutane shot my blood sugars into the 200 or 300 range for a week or two. But after those initial bumps and just a few insulin adjustments, things would die down some leaving me feeling a little more relieved and a little less anxious about every number.

 

This time, it feels like it might not be that way. Since we're already so far into the increase and still seeing horrible numbers. Numbers that have jumped my insulin requirements from their pre-Accutane totals of about 45 units to a whopping (for me) 70 units.

 

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It's been close to 36 hours since I went off the pump and back on the Lantus and Humalog routine. Luckily, I'm still alive and kicking. Sure there have been a few bumps in the road, but overall it hasn't been that bad at all.

 

I started out with 10 units of Lantus on Wednesday morning, but stayed between 220 and 250 the entire day. So when the evening injection came around, I decided to increase the Lantus to 12 units. But I still woke up at 223 after a pre-bed reading of 255. So I raised the Lantus again this morning to 14 units.

 

After breakfast, I saw the highest number yet: 371. I wasn't so excited, and didn't feel so well. I bolused for the number and waited for the decline. And a few hours later, I was 176 after eating a banana.

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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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Tuesday night, I switched my Lantus over to a once-per-day shot instead of the split doses I'd been using previously. I started with 22 units of Lantus at 8pm. I knew I'd see some highs, but I didn't want to risk an unexpected night low after making the first switch.

 

And I did see some elevation. I ran mostly in the 180-290 range all through Wednesday, which wasn't as high as I was expecting really. I made sure to consider food in the highs, along with the usual post-breakfast spike. And I was confident that a few more units of Lantus might do the trick (or at least get me closer).

 

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I've had quite a few decent numbers since I've started the whole Lantus switch from the pump. Wednesday was a bit rocky, as well as the first part of Thursday. But by two PM on Thursday, I was seeing stable levels close to range. It hasn't been completely stable or all that easy, but it's been comforting to already see numbers like 120 pop up on the meter screen.

 

Getting the night numbers to cooperate has been a bit challenging. For Friday morning, I woke up at 171 after 16 units of Lantus the night before. But Saturday morning, I woke up at 66 after 16 units of Lantus the previous night. Last night, I did 17 units of Lantus at 10PM, dropped to 69 at 3AM, but woke up at a nice round 110. So obviously, I need tweaking.

 

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Michelle Kowalski
Michelle KowalskiMichelle Kowalski, a writer, editor and photography hobbiest living in Phoenix, was diagnosed with Type 2 diabetes in February 2005. In January 2008, as part of her quest to start on an insulin pump, Michelle learned that she actually has type 1 diabetes. (Read More)
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)
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