Type 1 Sick Day Rules

A quite old but very informative video by Dr Stephen Ponder. He is about to produce an updated version but the info is still very useful for those with type 1 diabetes who may also be ill.

The 1976 Insulin pump

Another piece of diabetes related history that was developed at my work place a “refined version” of the insulin pump…. I cannot imagine this new tech being particularly popular with patients back then… During the early 1970s, Martin Wright in …

From the T1 Diabetes Archives

Some of you may know that I have worked at a medical research institue all of my working life. (The NIMR) Just recently the Institute celebrated a centenary of researching Science for Health. I was interested to learn that it …

Two days

Compare the two photos above. They show the 24 hour trace of my blood glucose levels over two consecutive days. The first a night of constant highs, needing correction boluses through the night to seemingly no effect until finally by …

Reading(s) Between the Lines

 

My Animas Vibe pump displays my cgm data in realtime (ok about 5-10 minutes behind realtime but its close enough for me).
Look at the photo below, you would think keeping my blood glucose “in Range” or as I like to think “between the lines” for just 12 hours is easy, so why should I need an expensive insulin pump to achieve this???

 

 

Out there in the real world dealing with T1D is always a challenge and rarely (if ever) ever easy.
Here is the backround to how I achieved my  12 hours of victory.

diasend download of my cgm, insulin and odd bg meter readings

I am still having issues with my pre wake-up control. I have convinced myself this is due to the early stages of gastroporesis. I had put a temporary basal rate on the pump at midnight as well as a correction bolus to try to get into range but it didn’t work. And not for the first time I tweaked my basal profile at 3:30am but  pre breakfast (porridge and coffee 31g of carbs) I was at 13.5, feeling tired and considering calling work to report in sick…
The weather was forecast to be a scorcher, I felt like a Zombie.
However I have become quite adept at dealing with these morning highs by bolusing the appropriate amount of insulin for my mornings work, taking my dog out for a quick walk and then having my porridge, washed down with coffee before setting off for the short cycle ride into work.
Once at work my first 1½ hrs were spent watering the various hanging baskets, planters a quick check on the pump showed I was still stuck in the 13’s but I had plenty of insulin on board so no correction dose needed.
Watering finished it was time to do some mowing, put into perspective, this is like going out for a steady walk for 4 hours, guaranteed to drop the high bgs. The weatherman was right and the temperature was soon over 28°C  I was melting in the heat but a quick pit stop to refuel the mower and have a cup of cold water allowed me to check the cgm screen Woo hoo! smack bang between the lines and a nice fat green horizontal arrow….
Lunch..  I had to think about what was ahead of me..4 hours of strimming.Lunch was  bowl of tomato soup, a “Jazz” apple plus coffee (42g of carbs) .. a quick release of energy from the soup combined with an extended release from the apple to see me through to home time at 5pm. My bolus worked out almost perfectly!
If you look at my basal profile you can see I cut it down from 4pm -6:30pm. When I was on MDI this time period corresponded to my evening Lantus dose wearing out, I always walk the dog at this time of day, and for whatever reason I used to nearly always have to eat a snack or have a hypo half way round the walk.. a gentle dog walk gave me no end of hypos… yet slogging all day at work strimming mowing etc I could keep reasonably controlled!! ???? ! The pump has allowed me to avoid my daily walkies hypo.
Pre CGM use I wasnt even aware of this! On MDI I was on between 12-20 hypos a week (I had no awareness left and needed to be below 1.8 mmol/l before I would get any physical warning signs from my body) For comparison now I`m pumping, in the last week I have had 1 yup 1 hypo, a 3.8 and that was my fault as I over-rode the pump’s reccomendation (I felt a proper idiot afterwards but I was convinced I knew better at the time lol)
Dinner was carribean chicken,  a “ChangeforLife” recipe, easy to carb count, not too high or low GI giving a nice flat evening trace on the pumps CGM.

The Result: 12 hours spent in range despite the got weather and an active day’s work!