Wednesday, January 15, 2014

Change in Focus

As diabetes-related paraphernalia evolves so do the things that I focus on in my diabetes care. 

When I started out down the diabetes road, I was armed with a glucometer that took 30 seconds to give me a blood sugar reading and two needles. One that I used twice a day to take long-acting insulin and one that I used up to 8 times a day to take insulin before meals and when my blood sugar was too high. 

My goal: avoid high blood sugar at all costs. By default that meant that I had a lot of lows. 

A few years later, I had a glucometer that took 5 seconds to give me a reading and I had an insulin pump that allowed me to fine tune my insulin doses and adjust for things like exercise and illness. 

My goal: avoid high blood sugar at all costs and try not to go low either. By default that meant that I would go high, bolus, go low, eat, go high, bolus and so on. Not always that up and down but I did go  through a lot of fast-acting carbs.

Today, my diabetes army includes a glucometer that tells me my result in 5 seconds and that I can use to remotely control my pump. I have a waterproof insulin pump that I wear every second of the day except when I shower (because even though it's waterproof, there is nothing to 'clip' it to when I'm in the shower). I also have Dexter who shows me a graph of what my blood sugar is doing minute by minute. He buzzes when I'm over 12.0. He buzzes when I'm under 4.0. He also buzzes when I'm climbing or dropping too quickly. 

My goal: avoid highs and lows but also, for the first time ever, try to keep a steady blood sugar as much as possible to avoid any unnecessary ups and downs. 

Avoiding high blood sugars at all costs doesn't mean that I never had them. Heck no, I had them all the time. 

Avoiding highs and lows was also impossible because I had those regularly too. 

The point was never to not have them - that is impossible and would only lead to insanity if I tried. 

There is no way I can avoid ups and downs. There is also no way I can keep a steady blood sugar for more than a few hours no matter how hard I work. Diabetes, by its very nature, makes that impossible. 

The difference is that, before Dexter, before my waterproof pump and my snazzy glucometer - it wasn't even an option. 

Now it is. Now I know by looking at Dexter that, if I wait fifteen minutes after bolusing before I eat, I actually can stop my blood sugar from spiking. Now I know that, by watching Dexter like a hawk, I can prevent a lot of highs or, if they do happen, I can deal with them much faster than I used to when I relied on blood sugar checks and 'how I felt'. And now I stop most lows before they happen because as soon as I start dipping below 5.0 or as soon as I start showing a fast drop, I deal with it. 

I don't feel any different than I did before Dexter came into my life. I can only guess that the more time I spend in a 'steady state' the easier it is on my body. I don't use any less insulin than I did before Dexter came to town but I don't go through nearly as many fast-acting carbs either. In fact I haven't restocked since he arrived. 

I am due to go for my A1C blood work in a few weeks. By then I will have been using Dexter for two months. I wonder if he will have made enough of a difference to affect my A1C. Even if nothing changes in that department, it just feels better to know that I'm a little less up and down that I used to be. 

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