Category: Diabetic Issues

I’ve blogged about this before, but a conversation came up today and it’s been rolling in my head for a while after reading someone else’s blog entry.

One thing that was covered in my diabetes training, but something I’m not sure diabetics think a lot about is Sharps Disposal. However, what I was taught in diabetes training is wrong for my community and it might be an issue for yours.

I was taught to do one of two things:

Buy a sharps container — which was my choice, because it was quick and easy.

Take an old laundry soap container, soak off the label and mark it sharps with a “sharpie” pen. When finished, tape the lid down.

Well neither works where I live. I got a cryptic note from the city the two times I put a sharps container in the trash, and when I finally figured out what was going on, I called. Come to find out, one of our city workers was injured because our city grinds up the trash. Okay, I don’t really get it, but the gist is, we can’t dispose of sharps in trash in my community. You might be able to in yours.

They thought that the local hospital would deal with it, but they won’t. I did find a guy that hauls sharps for the local doctors who said he’d take them at no charge but it’s a bit out of the way.

So here’s the solution I use:

You either contact your pharmacy and order a BD Sharps by Mail kit OR you can order them from an outfit online. The NDC number for the BC Sharps by Mail kid is 08290323488. If you give that number to your pharmacist, they can order it.

I really like these people though, because they have quart containers I can stash in various places: http://www.sharpsdisposal.com/

And everything we stick ourselves with is a sharp. Lancelets, syringes, pen needles and even the inseration part of sets. Though the Inset is designed to be disposed in regular trash and I haven’t gotten a nasty note about them.

City Officials Aim to Track How Diabetics Manage Illness – New York Times

I’m not sure I want anyone besides my doctor and I seeing my A1C results. If the data was reported without being linked to individual patients I would have less of a problem with this.

City Officials Aim to Track How Diabetics Manage Illness – New York Times

I’m not sure I want anyone besides my doctor and I seeing my A1C results. If the data was reported without being linked to individual patients I would have less of a problem with this.

A new commenter brought up the term “brittle” diabetic. Well, it reminded me of a comment today.

I just posted about how I hate teacher workshops, that sitting in one place all day always makes my blood sugar go up and that I’ve finally figured out that maybe 30%+ temporary basal might handle it.

Well, today, I didn’t have the pump cranked up high enough, so I was doing lots of corrections and lots of testing. Finally, middle of the afternoon, the person next to me asked if I were a “level 3” diabetic.

So I took a moment to explain that sitting still made me blood sugar go up, and makes me extremely ill when it does, so I was trying to keep it low.

I’ve got two days of workshops coming up in two weeks, and I’m planning on upping the temporary basal to 30%+ That means I’m going to have to do a lot of testing, just to make sure I don’t over do it.

Wonder what the person next to me will come up this time?

Unfortunately I missed last week. I think a lot of Dr. Bernstein, I’ve got two of his books.

I expected tonight to be a rerun, but was pleasantly surprised.

I think the words of the person who was bringing out the new products was the best piece of advice I’ve ever heard and something I live by — do the best you can with the tools at hand to control your diabetes, so you’ll live long enough to take advantage of the newer technologies.

Anyway, the latest episodes are heads above the beginning episodes.

Good advice here.

Cyber-Pancreas: Depression and Diabetes

This is half the reason I am seeing a CDE right now. I’m been to a couple of mental health care peaople, and they didn’t specialize in diabetes.

Well, one was diabetic himself, but not taking care of himself as well as I take care of me, and he was supposed to be helping me with some of my eating issues. Hard to take someone seriously who is gaining weight himself.

Next time I decide to see someone like that I’m going to be VERY specific on what I want.

Good advice here.

Cyber-Pancreas: Depression and Diabetes

This is half the reason I am seeing a CDE right now. I’m been to a couple of mental health care peaople, and they didn’t specialize in diabetes.

Well, one was diabetic himself, but not taking care of himself as well as I take care of me, and he was supposed to be helping me with some of my eating issues. Hard to take someone seriously who is gaining weight himself.

Next time I decide to see someone like that I’m going to be VERY specific on what I want.

An excellent list! I agree 100%

Scott’s Diabetes Journal: Pros & Cons fo Pumping

Pros & Cons fo Pumping

A commenter asked why don’t I go to bed under 150?

If you are on insulin, there is something called “Dead in Bed” Syndrome that you have to worry about — also you need to worry about hypoglycia — which may be what causes “Dead in Bed”.

Diabetics on insulin have been found “Dead in Bed” — cause of death has not always been determined.

Therefore, most CDE’s require their patients to eat a snack with 1 serving each of carb, protein, and fat. That is to keep the diabetic from becoming hypoglycmic. It is possible to sleep through a hypo.
Most parents of Type 1 diabetes test their children through the night as a result.

Since I has gastic reflux disease also, I often skip a snack, especially one with fat and protein. However, the few times I’ve been below 150 I have had some hypos, and I do need to start experimenting with that more. I suspect I could go a bit lower.

Amy, you did a really good job on this interview, but I do want to do back to the source at some point. Has he published his suggestions on the internet?

In case anyone is wondering, one of my hobbies is “Behavior Analysis”. Yep, dog agility is all about behavior analysis. I’ve even taken some basic graduate courses. Use it every day in my classroom and even tell my students how to use it.

So, from a behavior analysis standpoint, a lot of what he is saying makes sense, and is good concrete advice. It’s the type of advice I give others:

His points in bold

Find Out Where You Are
Very important. You can’t figure out where to do if you don’t know where you are now!

Decide What to Focus On
That’s Behavior Analysis 101 — you can’t change more than one behavior at a time. Actually we do that in dog training, but NOT in one training session. I always tell everyone pick one thing to do well, and do it real well. Once that thing is mastered pick the next one.

Also pick things that are measurable and that you can see progress in. I would also, in the beginning stages, pick something that you can see change. For example, I might not pick blood pressure to begin, because it will take a while for to see those changes. I might pick, testing and logging every morning, as that is something I can measure and see change immediately. Rewards come more immediately (an important part of behavior analysis). Blood pressure or even A1C are for people who have mastered the easy stuff.

Think of Your Diabetes as a Small Business, and Your Care Team as Your Consultants
Not a BA thing, but it is something we talk about on the insulin pumpers list. One thing I try to keep in mind is that the doctor is my employee, and if he doesn’t do what I am paying him to do, it’s time to fire him/her (In informal BA terms, it’s called “Shooting the Dog”)

Make Sure You See the Results
Again, a BA thing. If you to know if you are making progress.

By the way, if behavior analysis is of interest to you, the best source is Karen Pryor’s “The New Art of Teaching and Training”, subtitled as “Don’t Shoot the Dog!” (If you get the Second edition, I’m quoted).

“Shooting the Dog” is an abbreviated term for the most final of training solutions. Her example is a barking dog in a neighbor’s backyard and gives differing ways of solving the problem. The most extreme solution is of course, shooting the dog.