Mar 31
In all reality, not much has changed in preparation of exercising. COB, IOB are still the two items I am always conscious of – just how they get to me changes. While on the pump, I always disconnected before working out for 1.5 hours or less. This would tend to leave me in a basal deficit when I got out of the shower and reconnected and I would be forced to bolus immediately to both fill the cannula and get some insulin on board. However, now using Lantus, I do not have that insulin deficit when disconnecting. On the other hand, I do not start working out with a BG <180, Carbs-on-board and limited Insulin-on-board. I have purchased fun-sized candy that are 10 grams each – one or two candies are usually enough to get a BG <150 into my acceptable pre-workout range (also ensuring limited IOB). On the flip side, using the pump, I could be at any BG, and as long as I lowered my basal far enough in advance, I could raise my BG manually without additional carbs (however, I would end up going into further insulin deficit during the period of disconnect from the pump).
Not having to worry about the insulin deficit from disconnecting is a huge benefit for me during exercise – one reason why I am currently considering the OmniPod for my next pump.
As for the OmniPod in particular, I used a demo Pod for a few days over the weekend and I was somewhat impressed. Although the device is significantly large, it stays in place and has a smooth surface all around, unlike some of the MiniMed infusion sets I have used over the years. However, the inside information is calling for a 40-50% smaller Pod late 2010 or early 2011 (awaiting FDA approval). From the investor relations slides, it appears to retain its distinctive shape in a smaller package.
Mar 31
Since I went on a pump “vacation” back in February, I have been using Lantus/Novolog with decent results. However, one of the downsides has been leakage from the injection site. This tends to happen if you pull the pen away from the skin too early (the pen is still releasing insulin for several seconds after it clicks done).
However, for some reason I feel like I am getting a little more leakage than what is normal and my precision boluses that I used on the pump are getting bumped up 10-15% to cover leakage (this is true to both my Lantus and Novolog).
Experienced leakage woes? Just another part of living life as a diabetic and playing with the numbers.
Mar 09
I have never actually cared what my A1C number said when results came back from the lab. And this all started when I was a child and learn about variability. Ok, it may have been conveyed in a slightly different form.
As a kid, it was really quite easy to fake a good A1C by having a lot of variability in the numbers. For reference of variability, I would run 30-50 miles per week and could easily polish off an entire pizza by myself. As I got older, my A1C went up and unfortunately, the results of A1C became of little value to me. Over the past 20 years, what is considered a “normal” A1C for diabetics has changed up and down so many times that I made up my own system for determining how good I am doing.
First, we need to have a few baselines: my target BG is 115, I do not correct a BG below 180, my acceptable range is 75-190. Additionally, every BG usually has Carbs on Board, Insulin on Board, or Exercise on Board (BGs trending up or down) – so a correction (or asterisks) of the number is necessary, since the number on the meter may no longer tell the story.
Once you have this set I can find the number of highs, lows, avg, standard deviations, and how many of them have an asterisk next to it – with an additional story. If you take a look at a “good” A1C and find a lot of highs and lows in your adjustment, the A1C is not accurate. However, if I have an “ok” A1C and have few highs and lows, and my average is acceptable – I am far better off health wise and tend to ignore the A1C result altogether.
Nb. I am not advising against getting your A1C checked – as huge swings in your A1C can be problematic of a greater issue.
Recent Comments