Wednesday, June 27, 2012

Who Dunnit?

Welcome to the point where 'being high' has nothing to do with illicit substances and everything to do with an elevated blood sugar

I have had a week of very ugly numbers.  High blood sugars, over and over!  I dose myself with additional insulin all over the place to correct and avoid these 'highs' but success is minimal.  Here are the suspects:

1. I think the shock of air conditioning vs stifling heat and humidity gave me a chest cold.  When a person with diabetes is getting sick and their body is trying to fight off a cold, this effect manifests as elevated blood sugars
   - Eee, I have a cough and my chest hurts 

2. I am now 35 weeks pregnant.  As the pregnancy progresses my insulin needs climb exponentially. I count my carbs, and eat and give the corresponding dose of insulin.  Perhaps I need more?  I used to use 35 units of Novorapid insulin a day.  I am now up to 76 units per day.  Since my insulin pump 'reservoir' (the little bottle that I fill with insulin and insert into my pump) can hold a maximum of 1.8 ml of insulin, I need to replenish quite frequently lately.

3. I'm running out of good injection sites on my abdomen.  When you wear an insulin pump, you inject an infusion set (a Teflon needle/catheter) into your skin.  After 3 days, you inject a fresh infusion set elsewhere -like 1-2cm next to the previous site.  Basically, I go round and round my abdomen like a race track.  You do not want to overuse a site and cause scar tissue.  Scar tissue does not absorb insulin well, at all!  But I've gone round and round so often I've run out of real estate, so I've moved onto the back of my upper arm.  
   - The arms don't seem to absorb as well as the abdomen though

So, why am I high?  This is really bad when you're pregnant.  It means that you are giving the baby too much sugar and the baby is at risk of being too big.  Need to bring those blood sugars back in range!!!
In the end, the reason doesn't even matter.  It's just a thought process with which I can drive myself crazy.
Fact is, the solution is the following:
- Reprogram all the background insulin at a higher setting
- Reprogram all the food calculations to give me more insulin
- Reprogram all the correction calculations to give me more insulin
- Get used to injecting into my arms, that's what it's got to be
- Test my blood sugar often, write down the numbers, and reprogram as needed.

 And after that?  Keep on living, and laughing, and loving!

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