Category: Diabetic Issues

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.

I have been conducting my own scientific study with a participant of one, and probably using very questionable research methods. But I have “figured” some things out when it comes to losing weight and the pump that work for me.

This is primarily for me, so I can go back and look at it. However, it would be interesting to find out if other people have had similar results.

Here’s what I have figured out (in the second person but it does apply to me).

You can eat whatever you want and control your blood sugar while on the pump. You also gain weight when you do that, and it doesn’t take much to push the envelope on controlling your blood sugar. You have to constantly track your corrections and blood sugar because eventually your TDD (Total Daily Dosage) of insulin will go, causing your carb ratios and/or basal rates to go up.

If you drop carbs you will drop insulin usage. Dropping carbs can often stabilize blood sugar, at least it does for me.

If you exercise, you will drop insulin usage. Strength seems to drop basal rates for me over a long term. I have stopped strength training occasionally and see my basal rates rise.

Cardio exercise only affects blood sugar temporarily. However, doing it every day, drops blood sugar and insulin usage every day.

Too much fat and too much protein does affect blood sugar levels and does affect weight loss. Just not as much.

When I am able to drop insulin usage down to a certain amount, I tend to lose weight. If my insulin usage is higher than a certain amount, I tend to gain weight. Weight gain tends to be faster than weight loss.

When I do drop insulin dosage, I tend to be able to decrease carb to insulin ratios. It tends to take several weeks to stabilize the insulin dosage, and I tend to go low then. It’s important to test more often, sometimes hourly to prevent the low.

By the way, you can’t play these games as easily with injections. In particular, you can’t fix the basal rate as easily — nor can you fix lows as easily. When I get the starts of a low (I try hard not to go low enough to be truly low), I turn on the temporary basal AND do two lifesavers. With shots, you have to wait until the next day, decrease the dosage and then correct all day.

Colorado Supreme Court Rules Low Blood Sugar Can Be Used As A Legal Defense

Colorado Supreme Court Rules Low Blood Sugar Can Be Used As A Legal Defense

Colorado Supreme Court Rules Low Blood Sugar Can Be Used As A Legal Defense

Colorado Supreme Court Rules Low Blood Sugar Can Be Used As A Legal Defense

Amy over at Diabetes Mine asked about hiding a pump. No one notices mine. In fact, people who know I wear one, often ask me if I have it on.

First it takes a small pump, this won’t work with the Minimed or the Cozmo. The Animas footprint is perfect for this.

Second, it takes a somewhat talented seamstress. I’m not, but I do business with a custom bra shop. Most large towns have them. Look for someone who specializes in breast cancer patients. That’s how I found mine.

Now the pocket that is in my bra is designed for the IR1000. Next time, I’ll get it made smaller for the IR1250.

So here’s the first picture, that’s the inside of my bra. As you can see, it’s on the top part of the cup, towards the strap. It’s made of the same material as the inside of my bra, which cuts down on the sweat. Trust me, if you put a bare Animas pump in your bra, it will get slick with sweat.

This one shows the pump in the pocket.

Hopefully you can see how low the profile is.

At dLife Today: War Stories the Dlife blog asks how we were told. I have posted this story before.

I was surprised when I was told. My family history indicates that I will be diabetic and my medical team and I have been watching for diabetes for years.

I had been told I was borderline the year before diagnosis, but that my lipid levels were worse, so the doctor wanted to watch the blood sugar levels first, and deal with the possible diabetes later. At the time, my faster blood sugar was around 125.

A year passed and we were still seeing faster blood sugar levels between 125 and 150. Nothing higher. So after the year was up, the doctor decided to send me for a glucose tolerance test.

Well, by the end of glucose tolerance test, I wasn’t. (that is tolerating the glucose).

I went through a weekend I was sicker than a dog (and I use that expression wisely, being a dog person). I got to school and realized that I couldn’t cope with the day by about 9:00 am. So I called for a emergency sub and called the doctors office and told them I was coming in. At the same time, they were calling all my numbers to tell me to get into the office now.

I’m honestly not sure if I told the doctor the diagnosis, or if he told me.

I really think I was lucky. I got drastically sick quickly from the glucose tolerance test so I had incentive to do something to get well.

I was feeling perfectly okay Friday morning, and by Friday noon, I was a snarling, nasty person, blurred vision, headaches, horrible thirst, you name it. To this day, I feel badly for the people who did my mammogram in the afternoon, as they didn’t deserve me at all.

At dLife Today: War Stories the Dlife blog asks how we were told. I have posted this story before.

I was surprised when I was told. My family history indicates that I will be diabetic and my medical team and I have been watching for diabetes for years.

I had been told I was borderline the year before diagnosis, but that my lipid levels were worse, so the doctor wanted to watch the blood sugar levels first, and deal with the possible diabetes later. At the time, my faster blood sugar was around 125.

A year passed and we were still seeing faster blood sugar levels between 125 and 150. Nothing higher. So after the year was up, the doctor decided to send me for a glucose tolerance test.

Well, by the end of glucose tolerance test, I wasn’t. (that is tolerating the glucose).

I went through a weekend I was sicker than a dog (and I use that expression wisely, being a dog person). I got to school and realized that I couldn’t cope with the day by about 9:00 am. So I called for a emergency sub and called the doctors office and told them I was coming in. At the same time, they were calling all my numbers to tell me to get into the office now.

I’m honestly not sure if I told the doctor the diagnosis, or if he told me.

I really think I was lucky. I got drastically sick quickly from the glucose tolerance test so I had incentive to do something to get well.

I was feeling perfectly okay Friday morning, and by Friday noon, I was a snarling, nasty person, blurred vision, headaches, horrible thirst, you name it. To this day, I feel badly for the people who did my mammogram in the afternoon, as they didn’t deserve me at all.

Life is funny — I was just going to post on a “mistake” another pumper made, when I just did something incredibly stupid — I lost the rubber cap on the top of my insulin pump. Probably because I had my mind on other things.

I’m fairly certain I threw it in the trash. The good news, because I am anal, I am not completely screwed. When I sent back my recalled pump, I kept the rubber cap. I ordered an extra battery cap (and kept the recalled one, so I have two), but I was waiting until my next supply order to get another rubber cap.

I’m fairly certain I threw it in the trash and I am looking for it now, in between posting.

And yes, that is exactly what I did — I had it in my hand with some trash and threw it all way.

Here’s the start of the original post:

I was reading another one of our pumper blogs the other day and felt really bad for her. I am not going to link to the post as I am afraid I’m going to come across critical.

One of the biggest problems with pumping insulin is obtaining supplies — meaning cartridges and infusion sets. This is not a item you can pick up at your local pharmacy. In a pinch, I could probably get some supplies from my endos, but that would only happen during office hours. Maybe even from my pump trainer, but I would also never presume to both her outside of “office hours”, even though she works out of her home.

This means you have to plan ahead. And planning ahead saved my rear today.

Because I had saved the plastic cap from my old pump, I could calmly go get it, put it on the pump, and then take a long time to search. You see there was a possibility it was laying on my desk. There was also a possibility it landed on the floor — which opens the possibility that a beagle ate it — though they usually don’t, but you never know. If I had a puppy, it surely would have been eaten if it had hit the floor.

SO NOW THE POINT.

I keep at least one spare of everything I need. I even have a spare CPAP machine these days. I keep at least 1 month’s worth of any medication I need on hand, and I get nervous if I go less than 2 weeks.

At the end of the 90 day period, I have at least one extra box of infusion sets and one extra box of cartridges. Back before I was covered on insurance, I bought those extras on ebay. (By the way, watch eBay and expiration dates, always ask, sellers aren’t always aware of expiration dates).

Same things goes with test strips.

I’m REALLY bad about meters. I keep an extra in my car — the old Freestyle, and keep an extra in my bag. If you go WAY back in time, I actually go to an agility trial without my meter. DUMB, DUMB, I dropped it on the street and a neighbor returned it.

Being anal isn’t always back.

Yesterday’s DLife episode was a LOT better. Pulling the cohost off with the guest and letting the two focus on each other was a vast improvement on 4 people firing questions without listening to each other.

I still think they are trying to give out too much information too fast. I think the segment on breakfast could have been a full show. They still hit and glance off the topic rather than go in depth. There was also much more to say about dealing with diabetes in the workplace. The ADA guide never said when it was okay to share with diabetes, just when you didn’t have to.

All in all, MUCH better.

I haven’t seen it all yet, but so far, this is the best DLife Episode I’ve seen.

The hosts seemed to be more in control. I think it helped that they took Gary Hall and Mother Hall out of the studio and by themselves.

I liked the way they took J. Anthony Brown on the exercise bike and had him test his blood sugar first.