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[IP] Records, Dates, Exercise,...



The information I have recieved from this digest has been terrific. Many
comments have been really helpful in letting me know that I'm not alone out
there. In addition I've lectured about diabetes for nearly 7 years, and have
run a support group for Type 1 adults at a local hospital. All these
activities have given me close connections with others in the same boat--a
great relief. 

Much of my life however, has been spent figuring out how to best deal with
diabetes and I think I've gotten such a good handle on it --especially through
use of the pump and Humalog--that it's really time to get on with my life.
I've delayed mairrage, having children, and just plain living life, for
years... I've had very good blood glucose levels for nearly 14 years and have
no complications at all after 28 years with Type 1--but I've missed a lot. And
I'm roaring to go now!

Because of this I've recently ended leadership of my support group (it will go
on), and will soon, no longer lecture---at least for a few years. That's why
I'm leaving the pumper's digest, as well. I guess the moral of the story here
is that support groups and other activities that help you cope and excel have
their place ( and they seem to be greatly underutilized ), but if you've got
enough support from home and with friends and know that your well-being is
growing in other directions, it's ok--even good--to drive off into other
directions. 

Now the I wag the Puppy Dog's (diabetes) tail you know--not the other way
around! 

I can't think of anything but positive thoughts regarding this group and
thought I'd close by sharing a some of my observations about Type 1 with the
group:

What has insulin pumping with Humalog, (combined with carbohydrate counting,
strategic bg testing, and accounting for the effects of exercise) done for me?
I almost never get a headache from a blood glucose swing these days. (Remeber
those nasty headaches we'd sometimes get if we weren't careful, you
experienced people?) I have far less hypoglycemia and when I do it is
corrected with less simple carbohydrate then when I was on injections. There
is far less stress, such as when injecting in public. Family gatherings are
much easier to handle--Mom finally understands that we don't "have to all eat
EXACTLY AT  12:00 NOON FOR GARY." Long periods of exercise are far easier to
manage, typically requiring less carbs to keep me going (even if I don't
reduce the basil rate ). I can delay or move meal times up. I can also skip
meals on occassion when I want to ( boy is that ever nice! I hate to stop for
a meal at times). No pain in the neck from Regular causing low bg 3 and a half
hours after it was injected! A lot less of that miserable lightheaddedness
from extra bits of NPH or regular hanging around...

In short, diabetes is a disease of HASSELS, and anything that simplifies it
while helping me keep bg normalized is welcome. That's what the pump has done:
help simplify and normalize life.

Continuing on the hassels theme...

Regarding record keeping: If you are on a well established program of bg
control and KNOW why a particular bg was high or low and know how to correct
it appropriately I recommend not writing down a thing as it is useless
information. ( You wouldn't skip your exercise session, go to the donut shop
and down 5 Cream Zappers and then have no idea why your bg was 410 would you?)
Record keeping is used most often to establish an insulin-carb counting-
exercise regimine. It isn't there to maintain it. When you notice bg levels
geting out of hand then you can start to record them to analyze things. Now
there are some exceptions to this such as during unstable turbulent times as
when pregnant or during adolesence, etc. where the body is changing so often
that records can be invaluable baselines for further analysis. 

Re-use of lancets, disposable insulin syringes etc. is common without problems
resulting. This is sometimes done to save money, but also eliminate hassels.
This is also true with pump supplies in some cases. This is up to you of
course but if you have no insurance coverage for supplies, as has occurred
with me, you can save money this way. For example, I have used the same Mini-
Med syringe for a month in my 506. No leaks, no infections. Just be clean. BE
CAREFUL. I know others who have done the same. YOUR RESULTS MAY VARY...

Dates and diabetes: I've never had much of a problem with dates because of
diabetes. Injections, blood tests, no problem. I do recommend being extra
clean when testing bg in public ( don't leave old bg strips on the table,
perhaps use an alcohol swab on your finger when in front of people so THEY
feel comfortable-- Remember, dried blood can carry contagious diseases ( like
hepatitis) for many days,etc).

Strategic Blood Glucose Testing: even professional medical journals will
sometimes tell you to "test, test, test" your bg levels to maintain good
control. Well, with some exceptions, I think that is "baloney, baloney,
baloney." The key to diabetes control is having a system in place that allows
you to effectively control bg levels. Intesive testing when trying to set up a
new regimine is fine and good. You may want or need to test 10 or 12 times a
day during that period. but unless you have a very crazy uncontrollable
schedual, are pregnant or have some other need, once you establish a regimine,
4-7 times a day seems to suit most people and allow for excellent bg levels. 

Diabetes and Detectives: Somebody said recently that having diabetes and
trying to control it well can make you feel like a detective. You bet! I can't
tell you how many times that used to happen in the past. This pumper's group
can help a lot in the area of detecting. 

Exercise and Type 1 : Everyone knows that those who can exercise must do so if
they want optimum health. However, there are times when you may not be able to
do so (For example a BIG kid on a big bike hits you and breaks your leg). Rest
assured that your bg levels don't have to get out of hand becuase of this. In
fact, a stable, established program of bg control can be thrown out of whack
by a new exercise regime if you don't pay attention. Extra insulin can cover
for lack of exercise and you can maintain very good bg levels without
exercise. Of course you won't have optimim health sitting on your behind--but
you're the boss. Remember that Type 2 is often very different from Type 1, and
with type 2 exercise may be a necessary part of treatment to control bg levels
well.

DEX Meter: I had a chance to test this meter recently. Liked it  a lot in most
respects except accuracy. I'm stickin with the One Touch Profile. When it gets
accurate I'll go DEX.

A closing thought: I feel now like I just want to keep on pumping until a real
"closedloop" system comes along to  carefully manage my bg levels without me
giving it a thought. I'll take that in place of a cure if it really works well
and is accessable to everyone. Maybe in the future companies will fight over
whose "encapsulated islet cells" last longer. Bayer's? Mini-Med's? K-Mart's?
We'll go to the drug store and buy a vial of the stuff and one shot a month
for $9.95 will give us responsive beta cells. You never know...


Well that's about it for me. I wish you all well. I'll be closing out of the
digest in a few days as I prepare to move for a new job. I'll come back and
check on you guys in a year or 2 if you're still here. 

Bye, 

Gary