Considering the switch

For the past week or so I’ve been thinking a lot about LADA and its treatment. I touched base with others who share my diagnosis and one thing I heard a couple of times was “I recommend you get off the gliclazide and to start bolusing”.

The more I think about it, the more I feel like this is something I want to try. Gliclazide is a good drug that helps my pancreas produce more insulin. Taking it with carb heavy meals does help to keep tighter control. It also results in hypo sensitivity during exercise because there is no ‘dosage button’ for my organs. I can’t predict what it will do. On low activity days the gliclazide is not always enough.

I am eating to cover my insulin on exercise heavy days and other LADAs have reported that their control is better off the gliclazide and on bolus. Eating to cover insulin is not what a diabetic should do, and it’s a path that’s keeping my obesity going and growing. Injecting less insulin will remove the hypos during high activity days.

At least that’s what I’m hoping. Two more weeks until my doctor is back from her vacation and we can discuss it.

When we slip

Oh boy. I’ll start out with the good news: my friend sent me his used smartphone so that I can replace my dying one (and also play Pokemon GO!, we’re both first generation players who never stopped playing 🙂 ). He included cards of some of my favorite Pokemon with it! The US won’t allow batteries being sent out through the mail in phones, so he had to send it without. I ordered a new battery which should be here first thing tomorrow.

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The bad news: my blood glucose control has been total and utter shit today. Cravings and random hunger pangs, a bag of chips (or crisps for the non-American folks out there), a bag of Dolly Mix and fast food elevated my values all day above 10. Boo Sanne. Booo!! Right now I’m miraculously low at 6.4 which I don’t understand, except maybe it’s thanks to the extra dose of gliclazide after dinner, and having a both carb rich and greasy dinner. I might spike during sleep again. I have a killer headache and foggy brain right now though. Not sure if it’s from riding the highs all day, or because I’m super tired (maybe from riding the damn highs?).

As I’m a type LADA with a 50/50 treatment plan (oral meds + basal insulin – bolus) a lot of the fancy diabetes tracking apps and sheets are either much too detailed for my regime, or don’t allow me to enter my basal units and meds as they’re too simplistic. I have an app on my phone installed that lets me be a bit more flexible about it, although the features I really want (like pretty PDF and XLS reports for a nive, detailed overview) are locked into a premium version that costs €28 a year or so. Money which I unfortunately don’t have. Boo….

I slipped up today, no use in crying over that. I was weak, I fell, tomorrow I get the fuck back up and eat properly as much as my supplies allow until I get next week’s grocery money on Monday. No dolly mix or chips, I’ll go for a nice bike ride if the weather isn’t going to roast me and I’ll focus on chores. I have peaches for those between meals snacks and a cucumber and I will eat them before they go bad. I have 6g carb crackers that pair well with a slice of Gouda and some salted cucumber slices. I have oatmeal and milk for a nice warm bowl of cinnamon oats. Plenty of options to have filling meals!

I will be meticulous about logging my meals at the very least even if I don’t test my values. I want to preserve my supplies for as much as possible until halfway through October.

Riding highs and lows (but mostly lows)

Early this afternoon, I decided to pay my parents a visit. I needed to do some repairs and maintenance on my bike and I didn’t have the tools for the repairs, but my dad does! Before I left I checked my mailbox, and what do I find?

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The medical bracelet that I ordered arrived! As I am on my bike every time I have to go somewhere, and I can’t detect hypos well while I’m biking, this was something that I really felt I needed. To my understanding, medical personnel is trained to look for medical bracelets and jewelry in emergency situations. There are medications that insulin does not go together with (even if it’s unlikely I’ll ever need those meds, you never know) and if I am passed out from low blood sugar or get into an accident, a bracelet like this would give the EMTs a heads up to give me the proper treatment. I don’t fit the usual profile of a T1D to most people, so this helps a ton.

I wore it on my bike ride to my parents’ and felt really safe. They really liked the way it looked and the quality of the bracelet too. 🙂 It’s comfortable to wear, not rough, and I forgot I was wearing it half the time.

Some well deserved plugging: this bracelet and many others are sold by Cobra Band on Etsy. (I can’t leave a review until next week, so my blog post will have to do until then. 😉 ) The bracelet is handmade from woven paracord, and the metal plate is custom stamped with whatever text you want within their set limits. The quality is very high and the bracelet feels very sturdy. It’s secured with a strap buckle on the bottom and won’t come off until you want it to. Even with sweaty skin during bike rides, the cord doesn’t irritate my skin!

They have more than an excellent customer service, as they are quick to answer any inquiries and reassured me that they add about an inch of give to make the bracelet feel comfortable even on snug measurements. I’m not disappointed! They estimated production to 1-2 weeks, and my bracelet was shipped out on the 2 week mark. It arrived within 5 business days as promised! All in all, a very transparent process with friendly communication and a high quality product.

The best part is that the price is very affordable. I think I paid €12 or €13 for the bracelet plus shipping to the Netherlands (from the UK). Should I ever need a replacement they will be the first shop I’ll hit up!

If you’re diabetic, allergic, have epilepsy or any other conditions where a bracelet like this will be beneficial, I highly recommend you consider this shop and their bracelets. They make ICE (in case of emergency) bracelets for young children too!

With that addressed, I am proud of myself and mildly frustrated by my body today. My parents live 9km away from where I live, and there are many hills between us. Biking is no joke. I don’t mind, except for the last part where I am basically forced up a very steep hill and then have to ride it all the way back down, THEN BACK UP AGAIN because that’s how things just are around here in the Southern parts of the Netherlands. I don’t relate to my country as ‘flat’, that’s for sure! Those fellows up North and West have it easy with their flat roads.

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This added up to about 18km to and from my parents’ (which my phone didn’t track properly, god I wish I could afford a Fitbit) and took me about 1 hour and 45 minutes total. (The purple in the circle is some walking, the red is biking outdoors.) It wasn’t too hard, the hot sun was really the one thing that made it more difficult than it had to be, but overall I was handling it well.

I did have ridiculous low glucose levels throughout the afternoon though. I left my place at about 9.0, and when I got to my parents’ I was down to 5.9. Not too bad, but my levels consistently continue to drop after that kind of exercise, so I was snacking all afternoon to maintain that level. I didn’t manage to get up past 6.0 anymore despite the whole wheat crackers and biscuits with dried fruit, which was frustrating. My mom and I went on a brief grocery shopping trip and I bought more fruit biscuits and gummy candies mix (we call them Tum Tums, but as I understand it these are antacids in other parts of the world – I’m talking about straight up candy!). I shoveled a small handful down my gullet before I left to go back home, biked my ass off and managed not to drop below 5.2 as I walked into the door.

This is a good example of my low carb and I don’t mix. My body doesn’t want to listen! I had a lot of whole foods during the day, moderately low carb (40-60 grams for breakfast, about 30 for lunch) and the results are too many almost lows that I have to hastily fix with sugar bombs and more complex carbs just so I can stay on top of it. Slow (fiber heavy) carbs are included but they don’t prevent the lows, I’ve noticed.

That said, I did end up burning 800 calories on my bike rides today AND I avoided hypos throughout it all. Can I get a HELL YEAH? I may had to pull some dirty shots with the candy to stay on top, but I did it! 🙂 I’m waiting for my timer to go off to test my post meal values for my day curve, but I don’t expect anything terrible.

Low carb and me

I don’t do low carb. I try to on most days, but it’s not a lifestyle diet I can maintain right now.

I’ve connected with a lot of diabetics around the globe and one ‘helpful piece of advice’ that gets thrown at me all the time is “go low carb!”. Every time I have to politely tell them “That’s not an option for me right now, sorry” and hope that they won’t pester (bully) me into accepting this choice of diet.

Let me break it down in a few simple points.

  1. I am bound to a very tight budget. I have €30-40 a week to buy all the groceries I need, which is more than just food. Cat litter and cat food, toiletries, household items like cleaning supplies and anything else you can imagine that are needed on a weekly basis. It doesn’t get you a whole lot when everything is added up, and there are choices to make. Sometimes the carb rich junk food is cheaper than the fresh plants and proteins that are the better options. Meat isn’t cheap. I don’t eat pork so I’m down to chicken and beef – both expensive meats if you can’t get them on sale. I buy according to whatever is discounted most of the time, and the fresh, healthy alternatives are very often not included (or items that I can’t stomach). Healthy food is expensive where I live. (To illustrate, I can get two cheese or chicken burger that you reheat in the microwave, buns and cheese included, for just a little over €1 a pair. That €1 combo counts as two whole meals to me. Do the math when two pieces of chicken breast cost almost €4.)
  2. My diabetes doesn’t play nice. I caught my type LADA early, and my pancreas throws random insulin parties and I have to bring all the carby snacks because nobody else will. I can’t do without my basal insulin which my values and day curves are testimony to, along with my general sense of feeling healthier, and I can’t do without 40-60 grams of carbs in a meal when my glucose level decides to drop to 3.0 because of my body’s own insulin production. Low carbing is something I strive for on days that my glucose runs high, but as long as I am still riding my (very long) honeymoon wave, it’s not something I can faithfully and consistently pull off. And that should be okay. 

I understand the many benefits of the diet, but we’re all different. Everyone has unique needs and I’m so frustrated that, within a community where ‘individual needs’ are at the front of all treatment and diet methods, this is so easily disregarded when it comes to giving advice about low carbing.

When you have been T1D for 15+ years and your insulin production is zero, then low carbing means lower/less insulin injections are necessary to meet your body’s needs. That just doesn’t work for me. It will one day, but not right now. I am frustrated that my weight problems and dietary choices are somehow turned into a blame game of me not doing something right, when I’m doing the best I possibly can. I can’t inject less insulin and exercise without eating heaps of crackers because of the way my body works. If you’re the kind of person who advocates low carb, that’s alright, but please be considerate of who you advocate to. Understand that my issues happen to others as well.

Be less judgmental and less eager to preach, and take some more time to listen and consider in silence.

It’s hypo season!

Goodness body, what are you doing?

I was one hour late with dinner yesterday. Just one lousy hour. I made some oven fries with a Dutch snack because that’s what I do on Thursdays. Small portions, nothing crazy. Fifteen minutes after I eat and want to grab a glass of water, my heart started beating fast, I started to feel warm and got sweaty, and generally felt unwell. “It can’t be!” I thought to myself, whipping out my glucometer and going stabby stabby on my fingertip. But it was so. 3.6mmol/L and the knowledge that my dinner, despite being oven cooked, was greasy and would need about 2-3 hours to really have any effect, I shoved a ‘hagelslag’ sandwich down my gullet. (It’s a special kind of chocolate sprinkle for bread, made by the Dutch.)

It took a long time before my symptoms settled down, but knowing I had more than enough carbs in my system to even this out it was a matter of time, not panic. I checked myself regularly and didn’t peak past 9.0, which was a little weird to me as I expected it to be higher.

This morning rolled around, I had a peanutbutter sandwich, got a call from my doctor. She noted down my day curves which were excellent except for some of the post meal peaks. I’m going to increase my gliclazide dosage around dinner time for moments where I test too high or start with a high value to help increase my body’s own insulin production, and we’ll see how that works out in the next 3 weeks. If it helps, great! If not, we’ll start boluses.

Then I went to group and had lunch there. I felt unusually ravenous and had 3-4 crackers with cheese, a slice of whole wheat toast with gouda and salami, and another hageslag sandwich. I tested 2 hours after and was perfectly okay at 9.6. Just a smidgen high, but not high enough to fuss about. I still had to bike home after all.

That’s what I did, stopping by at the grocery store on my way home. I’m having Turkish pizza wraps today, which are about half the carbs of a normal pizza and five times more raw, fresh veggies (or as much as you can force onto it without everything falling out). Yummy! Biked home, stored my bike in my basement storage unit, walked up to the 3rd floor to my apartment, then repeated this journey as I forgot one of my bags in the basement, and I sat down at my desk… with another bloody hypo.

I didn’t even notice I had dropped to 3.1. This is why I’m so worried about biking sometimes. I can’t tell when it’s happening until it’s almost too late and I get dizzy and lose control over my body. I shoved a whole KitKat and a cheese bun down my gullet, and barely got high enough to notice a difference. Almost an hour later it was only up to 4.8, which was 30 minutes ago, so I had another bun. I’m desperate here!

While this will probably be good for my A1C results in October…. I’d rather not go this low all the time. I don’t know what’s causing this. I’m eating well, my exercise is unchanged from the past 3 weeks, so what gives body? What’s this mucking about and screwing with my values, making me eat foods I’ve been working hard on cutting down on?

I’m going to have another late dinner tonight at 8pm because of how much food I’ve had just to fix this damn low, which hardly counts as a nutritious dinner. These are the kind of days that can make you desperate and frustrated with this illness, but you know what? I’m in control, even if that is limited to fixing a drop. I’m managing this. I’m doing fantastic. Thumbs up to me!