Posts filed under ‘insulin pen’
The following headline on the Diabetes Blog caught my eye this AM: Type 2 diabetes directly linked to one gene causing Parkinson’s. According to this article, the scientists concluded that biochemical changes brought on by diabetes can switch off functionality of a the PINK1 gene, causing Parkinson’s. I’d be interested to see the study itself to find out which biochemical changes they are referring to – are they the result of high blood sugars or perhaps related to insulin resistance? Is Type 2 only mentioned because there were no study participants with other kinds of diabetes? My father was diagnosed with Parkinsons shortly after I was diagnosed with diabetes, so this link gives me even more reasons to keep those sugars in tight check.
How is everyone? Things are good here – just chugging along with low-carbing and the occasional correction dose with insulin. Life is busy and I’ve fallen off the obsessive record-keeping and food-measuring wagon, but am still testing frequently and exercising. My numbers are looking good, save the occasional morning when I hover in the “helpless zone” of 130-140. 140 and above are fixable, but 130 is a tricky number for me because it’s too low to correct with the 1 unit minimum that my Humapen can do, but high enough that I want to do something about it. At my next appointment I plan to ask for a prescription for and a lesson on good old fashioned syringes and insulin vials. I love the convenience of the HumaPen, but now that I’m mostly using insulin for post-meal corrections, 1 unit doses are more often than not too large. Why Lilly would make a pen that allows half-unit increments only after the 1st unit is beyond me.
I messed up big, big time last night. I thought I was ready to attempt to cover pizza with insulin, but my body thought otherwise and I payed the price – mentally, physically and in cash at the rate of the eight dollars worth of Freestyle test strips I used testing and re-testing on my backup meter. I struggled the rest of the night to get back down from the high 200s. I was injecting directly (no I-Port in the equation – I’d attempted an upper-backside install but it left me in tears so I threw it away) yet it was as if the insulin couldn’t keep up with the digesting pizza (or my lack of patience). It was getting late so I set my alarm to wake me up an hour and a half after I went to sleep so I could check and make sure I wasn’t still high or going too low too fast, and it was back down to 140, so I gave up and went back to sleep because I was too tired to change my suspect Humalog cartridge and I knew my own basal insulin would eventually take care of the rest anyway.
I woke up this morning with an elevated fasting of 108, but I was ready to start clean – clean diet, exercise, new insulin cartridge, new I-Port… but I can’t get my head in the right place. I’m mad at myself and don’t feel like doing anything productive, and I am dreading the blood sugar see-saw that I’ll likely experience today. Writing about my mistakes always helps me move on, so now that I’ve confessed, I’ll make myself go lift some weights and try to make up for whatever horrible things I did to my poor body with that (to borrow a word from Monday) insidious pizza last night – which, by the way, left even my non-diabetic husband at 130 mg/dl an hour and a half after! How did I stand a chance? 😛
Things are continuing to improve on the insulin front. I had a follow-up with both the dietitian and PA last Wednesday, and left with two prizes: an A1C of 5.8 (I was expecting higher) and an I-Port.
For those of you not familiar, the I-Port is a neat-o insulin delivery device that gives you one place to inject into for 72 hours, after which it is disposed of and a new one is installed. You inject into it rather than your skin, so there is no pain involved other than the normal sting associated with the insulin hitting your tissue.
I’m on my fourth day and second I-Port, and the novelty of feeling a bit bionic has not yet begun to wear off. I adore not having to hunt for injection sites, endure bruises, and remember to rotate. It’s too soon to say whether its having any affect on my BG control, but expect a full review and more photos after I’ve spent a bit more time with my new, button-esque friend.
Every time I’ve injected and every time I’ve changed clothes and looked in the mirror over the past 48 hours or so, I’ve found myself on the verge of tears. I’m ashamed of feeling so sorry for myself, but my abdomen is spotted with yellow and blue bruises and every injection I’ve given myself in the past 48 hours has hurt, either during or after, bled. Some (like the one I just did) itch! I went a week without a painful injection – what happened? I feel once again like I have no idea what I’m doing. Am I supposed to be coming in at an angle? Am I even using the right places? What is the consequence of not picking a “fat” enough place to inject? Is there some sort of system or pattern I can use to help me remember where to inject? I’m reserving some time this afternoon to research, but if any experienced insulin users out there have any advice, please please leave a comment – my bruised abdomen will thank you.
Nothing much to report on the insulin front. Some days I feel like a lab rat with all these charts, graphs and needles, but I do like labs and some rats are pretty cute, so that’s OK.
The first few days of high blood sugar readings were tiring, both physically and mentally, but I think I’m starting to get a better feel for dosages and timing. It’s tempting to draw conclusions about carb intake right now based on the fact that the only good numbers I’ve seen this week have been after lower-carb meals, but I will hold my tongue and give it some time.
For my diet and blood sugar tracking, I’ve gone low-tech and started using some photocopied worksheets that the dietitian gave me. The upper third of the page is an area to plot my BG on,the middle third is a chart with a column for each hour of the day and rows for blood glucose, carbohydrates, exercise, insulin doses, stress, ketones, etc. The bottom third is for food and other notes. This format will be the easiest to fax back to my PA at the end of each week, plus I really enjoy connecting the dots on the glucose plot at the end of the day. I’m thinking of enlisting my husband to makes some improvements, notably a place to record where I injected. Right now I just randomly pick an injection site and hope I don’t hit the same place twice.
I’ve returned to FitDay for my diet tracking. Combined with the occasional quick lookup on CalorieKing.com and the handy recipe analyzer on Calorie-count.com, I have a decent system for carb counting and making sure I’m getting enough calories each day. I would still like to get some sort of pocket-sized nutrition handbook to carry with me and to keep in the kitchen so I don’t need a computer when I’m planning meals and doses – any recommendations?
These How-To articles on Dsolve.com have been quite helpful in helping me understand that only time, patience and diligent testing and documentation will lead the way to normal blood sugars with insulin. Even though I have a newfound appreciation for the ease, simplicity and efficiency of Starlix, I haven’t resorted back to it – I’m just too determined to get the insulin to work.
Friday night I injected my very first dose of insulin. Before dinner I decided to check the Lilly and Humalog sites one last time for some updated Luxura information and found a video tutorial on how to use the Luxura. Fabulous – the video was excellent – clear, easy to follow, and almost as good as having someone in the house showing me what to do.
After carefully (or so I thought) calculating the carbs in the meal, I rewound the tutorial, had my husband put the pizza in the oven, then went for it.
Closeup of the dose dial
My instructor for the evening
Spread of equipment
Priming the pen
Injecting and counting to five
Success (and a little red dot)!
Since I knew my food was cooking and the clock was ticking, I had no problems pushing the needle in. Once it was over I did have that kind of post-adrenalin rush shakey/cold-sweat feeling, but otherwise was A-OK. Simple as pie and didn’t hurt one bit.
I only wish that calculating the dose was as easy as administering it. After five pre-meal injections, I have still not been able to replicate the excellent one-hour post-prandial BGs that Starlix gave me. I just have to be patient and remind myself that it takes time to figure out insulin/carb ratios. I don’t like spending the day with post-meals in the 150s-200s and resting BGs in the 110-120s instead of my usual constant 80s and 90s though – it makes me anxious and physically tired. One thing I’m noticing is that whatever my BG is at the 1 hour mark, it will be at the 2 hour mark, which is discouraging – is the Humalog even doing anything? Edit: I’m also seeing my BG hit a good target at one hour, then rise up to 130-150 at the two-hour mark. 😦
I’m not sure if the error is in my a) timing b) carbohydrate counting or c) insulin to carb ratio. Right now I’m using 1 unit per 20 carbohydrates, which so far doesn’t seem to be enough. I’m also unclear on whether I’m supposed to cover proteins – my PA didn’t mention it, but Dr. Bernstein does.
I had one low on Saturday one hour after dinner (65), which I treated with three dex-4 glucose tablets per the dietician’s “rule of 15” instructions. I waited 15 minutes and tested again to find it had doubled my BG – yikes! Next time I try ONE tablet and wait 15 minutes.
So far I really like the pen. It has a nice weight and feels like it is built to last. The only thing I dislike about it for now is having to waste two units of insulin to prime the pen before every dose. Squirting 2 units into the air is also a bit messy – what happens if insulin gets on your furniture? Clothes? Floors?
Wish me luck (and patience) getting this whole dosing thing down straight.
No surprise here, but my pharmacy had no record of the Humapen Luxura existing, much less one in stock. While on hold with the pharmacist, I went to Humalog.com to see if I could find any info on my soon-to-be pen:
Not a good sign, although I suspect much of the information for the HumaPen Memoir will be relevant to the Luxura.
Update: The pharmacy did call me back to tell me they can order one from their warehouse, so maybe by this weekend I’ll be equipped to inject.