Insulin Addict?

Realized that I have not been blogging for coming to a year. Mooncake festival is coming again. Not sure if this year I am going to buy anymore mooncake because last year, we took quite a long while to finish that box of mooncake. Mom said sugarless mooncake not nice. :(
Anyway, why I am back now? Because I went to do my regular checkup with Dr Tan. As usual, I did not have food diary and no glucose readings for her and my dependency on insulin is still very high. Right now, my Glargine intake is 16 units every morning and my Humalog is 6,8,10 during the day. Sometimes I will have hypo in the mornings or when i am sleeping. Worst still, I might not even know I am having hypo when I am sleeping!! That's why Dr Tan keep asking me to cut down on my Glargine intake (bare in mind that i used to give myself 20 units of Glargine!!!!). The challenge here is, to cut down to 12 which is supposed to be the normal Glargine intake for me. But since I am so addicted to Insulin, then Dr Tan challenged me to reduce it to a 14 first.
I did that today. So let's monitor the results :-)

Can Diabetic Patients take Glucosamine?

Since I have jogging pretty regularly, I think I need to have some form of "protection" for my knees. Some of my friends who had been regular runners are not running anymore. Reason is because of their knees or rather, leg giving them problems. Some of my friends were also telling me that by taking Glucosamine, it can actually "protect" your knee and reduce the pain if you ever feel it. I never had this thought before but recently, had been feeling a little bit of pain on my knees when I exercise. I was wondering is this the sign telling me that I need to take care of my knees and take Glucosamine?

Since I am diabetic, I cannot take any medication without doing the right homework. Furthermore, I am sensitive to the word: "Gluco..." Hence, decided to check it out in the website......and this is what I found from the website:

There is some evidence suggesting that glucosamine, in doses used to treat osteoarthritis, may worsen blood sugar, insulin, and/or hemoglobin A1c (a test that measures how well blood sugar has been controlled during the previous three months) levels in people with diabetes or insulin resistance.

http://altmedicine.about.com/cs/herbsvitaminsek/a/Glucosamine.htm

Here is another report which says that:

Insulin levels with Glucosamine (HCL or Sulfate) can be subject to fluctuations, particularly in diabetics. Glucosamine is technically a carbohydrate (a sugar), but the body is not able to convert Glucosamine into Glucose. Hence, Glucosamine does not directly provide additional sources of Glucose. In diabetic patients, many factors can lead to changing blood levels and as a result it is very important to check with your doctor prior to initiating Glucosamine therapy and to be sure to be very careful about monitoring your blood sugar levels while on Glucosamine. Read the latest update on Glucosamine for Diabetics.

Another site that says Glucosamine safe for Diabetes: http://www.bastyrcenter.org/content/view/759/

At this moment, I think I better be careful with this. Maybe for a start, I should start drinking milk to build calcium.

Getting To Know Glycemic Index

The glycemic index itself is a ranking (0-100 score, the lower the better) which classifies foods based on the degree they raise blood sugar levels during digestion. Foods with a high glycemic index (GI) tend to be absorbed rapidly, which cause a dramatic rise in blood sugar levels since they're digested and broken down very quickly.
By contrast, foods with a low GI only have a mild effect on insulin and blood sugar, take longer to digest because they aren't comprised of simple carbohydrates or refined sugars, and have a more balanced digestion with only gradual rise in blood sugar and insulin. This makes you feel fuller for a longer period of time, prevents insulin crashes and binges, and promote healthy lipid and triglyceride levels.

This site tells us which are the food that has high, medium or low GI. Useful site for me, who is Type 1.

http://www.southbeach-diet-plan.com/glycemicfoodchart.htm

Basically, the idea is that low GI is good for us. However, when we have hypo, low GI food is definitely a no no....

Latest Check Up

This is a delayed post.

Went for my quarterly checkup at the hospital last week.
It was raining very heavily and gosh, there was still so many people in the hospital. Where did all these people come from?
Anyway, waited almost 1 hour (as usual) for doctor....She read out my HbA1c result....7....
Just managed to pass.....I am not satisfied with this result. Recently I have been very 'on' in monitoring my glucose level and will do adjustments to my insulin intake but why am I getting HbA1c of 7? Don't understand......I remembered I ever had a result of 6.3 before. Well, that was some years ago and that time, I seldom do blood test and not monitoring my blood test results very often. Obviously there are times when my glucose level went sky high without me noticing at that time but I still able to get <7 results.
Controlling glucose level is though look simple but it is actually not that simple. To get a good result, I will need to make sure I eat right, do exercise and right amount of insulin to be given.
My goal now is simple, HbA1c of < 7.
My next appointment with doctor is Sept. We shall see if there are any improvements.

Exercise Really Does Affect My Sugar Level

In my earlier post, I mentioned that there is a difference running in the gym and at the open park. Eversince that run in the gym, I have decided not to go gym anymore and diligently go East Coast Park for my regular jog. Been testing my sugar level everytime before and after my jog. For the past 2-3 weeks, it seems like the jog in the park did not have any effect to my sugar level. I was very panic....Been asking myself: What Happened??? Why I did not see any reduction in my readings? Not been eating anything special but why did I not see my sugar level maintaining at the moderate level?
This week, has been diligently recording my readings. On Wednesday, I went to East Coast Park again for my regular jog.......Before my jog, I took my readings: 16.9 (so high coz I took a slice of bread earlier). I jogged for almost half hour and tested my sugar immediately after my jog...oh, my god! It went up to 18.3!!! That was high........told myself to test again before I take my dinner.....So, before my porridge dinner, my sugar readings was 15.3. Hmmm...still high....but if I recall, the reaction of my sugar will probably kicks in like 5-8 hours after my jog.....
So, I tested the next morning when I wake up from bed....4.2! Phew....finally came down......
Subsequently, the readings for the day has been good....between 5.5 - 6.7....in between there is hypo of 3.2. After that, has been stable in the readings.....
So, exercise does help to stabilize my readings .... but what happened to the past 2-3 weeks?

Jogging in Gym vs Jogging in the Open

This is a delayed posting. Just wanted to share what I have found out last week.
It was my routine jogging day and planned to go East Coast with my colleagues for our regular jog. But it was raining heavily @ East Coast and we decided to head to our company gym.
Before the jog, I forgot to test my glucose level but I did remember that I had a slice of bread 1 hour before my jog. I ran for 30 minutes on the treadmill and it records a 4.17km. That's the usual distance and timing if I were to run at East Coast.....
After the run, we decided to head for dinner......before my dinner (which is ~ 50 minutes after my run), I tested my glucose level..... got a surprise! My meter read 16 mmol!!!
I recalled my CGMS readings that on my running time, my glucose level will actually drop....so, what happened? Guess, I did not do something right again..........
This week i will be going east coast for my regular jog (cross my fingers it wouldn't rain again) and will remember that i need to test before my run........

After My 5km run

Before my 5km run yesterday, I got the CGMS device removed. Gosh! So much relieved that this is removed. Else, I will be uncomfortable with my run.
Below will be my testing results before and after the run.

Pre-breakfast@ 5.58am 6.8 mmol. Gave myself 18 units of Glargine and 6 units of Humalog. Took 3 cream cracker biscuits and a bowl of Quaker oats.
After the run @ 9.45am 5.9 mmol. Went for snack with friends. Took 2 pieces of steamed yam cake and coffee "neat" (meaning, no milk and no sugar)
Pre-lunch @ 12.59 pm 7.4 mmol. Since I know that the run will make my sugar go low, I gave myself 8 units of Humalog eventhough the plate of fishball noodles looks like 3 CHO portions.
Pre-dinner @ 7.03 pm 4.2 mmol. Before this, I actually felt hypo @ around 5.45pm and took canned apple juice from vending machine. Gave myself 10 units of Humalog before dinner.
2.5 hrs later @ 9.32pm 3.3 mmol. Hypo again! Did not take sweet drinks this time round but I took around 4 pieces of raisin biscuits and a glass of milk.

After the run, I experienced hypo twice. If I run in the morning, the hypos will come late in the afternoon or evening. Since most the time I run in the evenings, then my hypo will come around 3-5 am in the morning. Maybe next time what I will need to do is to inject less Humalog for my dinner.

Day 3 of Continuous Glucose Monitoring

Finally it's Day 3! This morning, I realised that there's water in the dressing!! How did water get in there? Is it my perspiration from my jog or it went in after shower? Oh no, will it spoil the device? Need to change dressing?
Actually, I am very hesitant to touch anything or change dressing coz I am scared that I will screw it up and add pain to myself. I am even willing to endure the itch than to change the dressing. But the water inside is a little too much. If the device is spoilt and did not record the readings, then the previous 2 days of endurance is down the drain! No choice, I pluck up the courage to tear out the dressing. Ouch! A bit tight to remove and I pressed the device too hard to my stomach!!!
Think I pressed on the device a bit too hard to my stomach and I can feel the slight pain even after I have replaced with a new dressing. Whole day is so uncomfortable. Cannot wait to have it removed tomorrow!!!!
Wonder how is she going to remove it for me.......Pain again?

Day 2 of Continuous Monitoring

While I was in my dream land, my CGMS device "beeped"! I woke up sleepishly to see what happened....the screen showed "Memory Low". Again, not sure why it beeped, I just follow the steps to "turn" of the beeping.
I have to find a skirt with big pockets for me to put the huge device. Other than that, the day has been quite smooth with this device just a little uncomfortable and not able to stand straight because I am afraid it will be too obvious. The transparent dressing is not making me comfortable either. In fact, my skin starts to get sensitive to the dressing and it starts to itch at the area around the dressing. Just tell myself, ensure 1 more day and I will get this removed!
Went jogging with this device today. Other than the comfort level, everything is fine.
Went home for dinner after my jog. Took my pre-dinner testing with my meter and it reads 4.9 mmol.....at the low side. Inject myself with 10 units of Humalog and took my Hokkien noodles. Yummy......
So, while I am waiting to do my 6th calibration, I am blogging now. The device "beeped" again. This time round, it says "BG Meter Now". Not sure why this device just like to beep out of no reason. Anyway, time to go for bed and I need to do pre-bedtime calibration.

Day 1 of Continuous Glucose Monitoring

Today is the day that I am supposed to wear the CGMS device. Reached the medical center in the morning. At that time, I was still clueless about this thing and how they are going to use this to monitor my glucose level. The thing that kept ringing in my mind: Is it going to be painful? Is the needle going to stay in my stomach for 3 days? How to bathe since it is not really waterproof? Is it going to bring lots of inconveniences to me in terms of my daily work?

Very worried and scared when I went into the room. Guess the assistant is able to sense my fear from the questions I asked and my worried look. She told me that she is going to insert a needle to the stomach which will be taken out soon. So meaning to say, the thick long needle will not stay in my stomach. Instead it will be another so called "tube" that will be there. She explained to me what will be attached to my body will be a little device which you see in the picture which I took.

It's indeed small but still will be obvious if you wear tight clothes. So for the time being, I will avoid wearing these clothes. Then there will be another device which looks like a pager (in fact, I think it's bigger than a pager) which I need to carry it along with me all the time because it will be sensing the blood level from the small device. The distance between this small and big device cannot be too far apart. Even when I shower or sleep, I need to have this close to me. Sigh! Then I need to have this thing strapped to me coz I tend to move around all the time and might forgot to bring this along.

Finally, the time came when she is going to poke the needle to my stomach. Gosh! The pen is so huge and I kind of worried. Before she click on the pen, she told me not to look at her. So I took a deep breathe and within seconds, it's done. Ok, not that painful afterall. Just like my usual injection. To answer my question on how to shower with this thing? Well, she pasted a plastic over it to ensure that the device is well protected. After some instructions and explanation on the use of this device, I will be on my own.

Actually, I am kind of worried about using this device again. Why? Because they teach me basics only. What if there is any "out of the blue" condition that happens, what should I do? Guess I am more worried about spoiling the machine if I play around with it to get my problem fixed.

The first problem came for my first calibration. The device was not set to be in mmol. Gosh! How to input my readings? No choice, got to call the medical center in charge to help me. He has been very helpful and nice. Patient too coz I am a bit clumpsy with the buttons and he gave me step by step instructions. Phew.....done.

Second problem came for my third calibration. The device suddenly "beeped". Shit, what happened again. So, I got to call the medical rep again @ 9pm to ask him what happened? As usual, he is really patient and friendly. Explained to me not to worry about the CAL ERROR which I see on the device and how to fix this error.

Shower time! Hesitant to go shower coz not sure whether will it wet the device on my body. Ok, think i worry too much. Things went on fine. But I guess, I am sensitive to the plastic that is pasted on my stomach coz somehow I feel itchy.

Ok, me going to bed with this device and the "pager" is going to be near me under my pillow.

Tomorrow I will be back in the office and my jog. Might encounter something different again....

5km training @ East Coast 4 days before my Great Eastern Run...Glucose Level Crisis

Decided to go East Coast for my 5km training with my colleagues again. Before I left the office, I tested my glucose level. 15.3mmol. Hmm...should be ok thinking into consideration that I took a slice of bread 1 hour earlier. I remembered Dr Tan told me that my glucose level will go down after exercising.
I started running from Fort Road all the way to the Sea Food Center non stop. It's around 5km and I took around 30 minutes this time to complete this run. After which, we strolled back and decided to settle dinner at Sushi Teh near to Big Splash.
Without my meter with me, I do not know how much is my glucose level. Anyway, I just ordered my usual, Karakaige Udon and Diet Coke. Without my pen with me, I am not able to inject insulin as well.
After dinner, we walk back to our cars and I took the opportunity to inject myself 10 units of Humalog taking into consideration that the low glucose level will still be effective for 24 hours. I do not want to run into Hypos in the middle of the night. One and half hour later, pricked myself again. My meter gave me 15.4 mmol. Hmmm.....that is high considering it's 1.5hr after my injection and my run. But there is still possibility of me running into hypo later in the evening. So, I guess I will not inject anymore insulin to bring it down. I just cross my fingers that the readings will be normal when I test next morning......
CGMS tomorrow. Hope everything goes well.

Does CGMS Hurt?

When I told Dr Tan that I am now doing regular exercise, she suggested that I do CGMS. Not sure what that stands for but I know it's a device that is "hooked" onto my body and test my blood glucose level on a daily basis.
Finally, almost a month after my visit to Dr Tan, someone called me to arrange for CGMS. Still do not know what it stands for but he confirmed my understanding that it's a device that is "hooked" to my body and it's for 3-4 days. For this 3-4 days, it's going to cost me $300. But I think, it's good for me to use this because I am not able to test my blood sugar while I run. Dr Tan will then have the results to see if I am doing well with my glucose control. Maybe Dr Tan will tell me to reduce my insulin intake! Yeah! That will also reduce my risk of having cancer......
The arrangement will be best if one of the days is my exercise days. Just nice....it's 1 week before the run and I need to train myself up. Definitely will hit my jogging day.
Today received a call from Camdeen Medical Center. Confirmed my appointment with Dr Soh and I will be going down on Wed to get the device. Wondering how big is the device and will it be painful to have the needle poked to my stomach all the time (coz I need to wear it everyday even when I am sleeping!). So scared now. Guess the next time I need to know is: can I still shower? Cause doc said that this device is not water proof and might spoil if water gets into it.

Will get a pic of this device when I see it on Wed....... Scary....

New Hope For Type 1?

Was watching the News on Channel U today. It mentioned that an Australian Institution is experimenting on a new drug for Type 1 and there could be hope for Type 1s!!!! Right now, they are testing on white mice and will need another 2 more years of experiments before they can officially test on humans. And they need another 1o years before they can market it out. hmmm...By that time, I will be already in my 40s.......


Well, there are alot of reports about news drugs or cure for Type1. Till now, there is no concrete evidence or claim to proof that the drugs or cure that they are experimenting works for Type 1!

Will there really be a 100% cure for Type 1 which can end our agony of having to inject ourselves with needle?
Still waiting for real good news......

Below is a link to another so call new drug which was found in the internet.......

http://diabetes.webmd.com/news/20081008/type-1-diabetes-new-drug-shows-promise