The Diabetes Detective
DIY Diabetes Self-Care
By Ilene Raymond Rush
December 2009 — Diabetes is the original DIY (do-it-yourself) disease.
While having an endocrinologist who is both sympathetic and responsive is of the utmost importance to good type 2 diabetes, the months between regular visits are often a diabetes self-care, self-service, operation, where via diet, exercise and careful blood sugar monitoring, you are in charge of preventing the development of future complications.
It's a lot of responsibility. And after years of diabetes self-care, I like to think that on most days, I'm on top of the situation. But then arrive other days, when confronted by an unexplained low or high blood sugar reading, I'm reminded of an old advertisement where a white-coated actor faced the camera to admit: "I'm not a doctor, but I play one on TV." Recently, this was brought a little too close to home.
In February, I started to inject Byetta, which has pretty much proved a miracle drug for my metabolism. Ten, then fifteen pounds melted away, and my blood sugar readings, which had been wildly fluctuating even on a very low carbohydrate diet, stabilized until my A1C dropped to 6.1. I had plenty of energy. I could eat limited carbs without sending my sugars into the stratosphere. I got to buy size 8 jeans. Everything was copacetic until -- wait for it -- I started to throw up.
At first, I ignored it. The label on the drug and my doctor had warned of nausea, particularly upon starting the drug and when a patient moved from a 5mg to 10 mg dose.
But seven months into the drug, my reactions were unexpected. I thought of calling my doctor, but having moonlighted as an unlicensed diabetes detective for years, I wondered if I might puzzle things out on my own. My first suspect was high fat food, so out went my Friday night slice of white pizza. Then, I moved to the amount of food I was consuming. I cut my daily carbohydrate serving back and wrote down everything I ate. I chewed peppermint gum, sucked hard candies. No luck.
Nothing seemed to help. I faced a tough choice: abandon my new miracle drug, or regain my health. Finally, after a week of feeling miserable, I broke down and phoned my doctor's office. Ten minutes later he was on the phone to recommend dialing down the dosage to 5 mg from 10.
That didn't help, either.
At this point, it probably seems a no-brainer: ditch the drug. But it wasn't that simple. I had good results on the Byetta, with better blood sugar readings than I had in years. I was able to eat a wider variety of foods and the weight loss didn't hurt. And my DIY brain, wired by so many years of self-care, wondered if I had hit bottom on the problem. I put on my detective's hat: what else had changed since I went on the Byetta?
I was chewing on my two a day Metamucil wafers, when I had the brainstorm – I had taken up the extra fiber habit about the time I began to feel woozy. I had long resisted Metamucil (which seems to be the rage in the boomer set these days) but had decided it was a fast way of upping my fiber intake. I looked a little closer at the box and realized that without adequate fluid this might cause all of the symptoms that I had been granting to Byetta.
Curiosity piqued, I wondered, was it Byetta or the Metamucil wafers backfiring on my system? So I ran a little experiment: I gave up the wafers and kept the Byetta.
Nausea, vomiting, everything, vanished. I returned to 10 mg. without a problem. And after a visit with my doctor, my sugars remain at a normal 6.1.
What's the moral of this tale? Not to play around with your medications, certainly. My doctor was with me every step of the way. No amount of sleuthing can take the place of a doctor's care. But when it comes to managing a chronic condition like diabetes, you know your own body better than anyone, and all things considered, you're the expert here.
dLife's Viewpoints columnists are not all medical experts, but everyday people living with diabetes and sharing their personal experiences, most often at a set point in time. While their method of diabetes management may work for them, everyone is different. Please consult with your diabetes care team before acting on anything you read here to find out what will work best for you.
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As I mentioned in an earlier post, one of the benefits that made it cost-effective for me to go with the real healthcare (HSA) plan rather than the phony (HRA) plan is that my company is now covering "preventative" medicines at $0 copay. The formulary for these, as stated by CVS/Caremark (my pharmacy benefits provider), covers all test strips, lancets, and control solutions. I dutifully get my doctor to write up prescriptions for all of my testing needs, submit...