Tuesday, July 30, 2013

Cereal: The Devil's Food

“Hi. My name is Cara and I’m a cereal addict.”

I feel like I should be in some sort of a recovery program. Ever since I started monitoring my blood sugar super closely and got on an insulin pump, it became apparent that cereal was a TERRIBLE thing for me. Non-sugar cereals make my blood sugar crazy. The less sugar and more whole grains, the less crazy. But still crazy.

Sugar cereals make me so crazy that it’s scary. My blood sugars will rise quickly, sometimes as much at 150 points in half an hour, and stay up for HOURS, no matter how much insulin I take.

Because of the major issues I have with controlling my blood sugars when I eat cereal, I tend to stay away from it. I will indulge occasionally, but I just don’t do it because of all the horribleness that comes along with it. It’s just not worth it. Most of the time.

Sometimes I’ll get a box of rice crispies or cheerios and eat them. I LOVE them. I have to limit myself, but I do it. Recently I bought a box of rice crispies. When they were gone, I bought another box. When those were gone, I bought some corn flakes. (Are you seeing a pattern here yet?)

And then, on Friday, it happened: I found the small boxes ($1) of Cap N’ Crunch cereal on sale at the store. I refuse to buy a big box, but a small box… okay. I bought five boxes.

Saturday morning I had a bowl (translate: two large bowls) and bloused (I did a S.W.A.G. bolus; don’t know what that is? Click here where you can download a PDF of awesome d terms.), and went about my day. I knew I was going to spike. But I had plans to clean my house and figured it would help. But within a couple of hours I felt like crap. My CGMS said I was above 400 (it doesn’t give specific readings above 400, just an “above 400”). I checked and got this:

After having a mini-melt down, and suddenly understanding why I felt like throwing up (naseuea comes with high blood sugars sometimes), I gave an injection correction (I feel like that sounds lie something from School House Rocks!) and waited. Over the day I waited and bloused and waited and bloused. And tested and tested and tested. At one point I was somewhere between small and moderate ketones, but it didn’t last long (thankfully).

And it was nearly 12 hours later before I came down. And crashed at somewhere around 50. The blood sugar roller coaster is no fun, but in my earlier mentioned melt-down, I also did this:

Yes, you see that right. That’s a garbage bag. With every box of cereal in my house in it. In full disclosure, I still have the bag, but only cause I’ve not been to take off my trash yet. Oh, and pay no attention to my bare feet in the picture. :)

Honestly, I have a feeling I went from being sort of on the “no cereal” bandwagon, to falling off completely. And in order to get back on, I’m giving up cereal, cold-turkey. My problem is that I LOVE cereal. I can’t stop with one bowl. And I want to eat it ALL the time.

So much like a person addicted, I’m quitting. Cold-turkey. I won’t lie, I kind of want to go get that cereal bag. But I’m not going to do it. Until I can break myself of this horrible cereal eating habit, and learn to eat small amounts only occasionally, I’m done with the evil thing.

I think that a lot of times, we people with diabetes like to indulge. And it’s OKAY. It’s not that I can’t have cereal. It’s that I don’t particularly want to deal with the fall-out that comes with it. And I understand that I don’t have enough self-control to make myself stop with one SMALL bowl of cereal. But sometimes, even though we know better, we do it anyway. Perhaps it’s diabetes burn-out, in a way. Perhaps it’s just a “normalcy” thing that we want. I don’t know.

But for now, I’m on the “no cereal” band wagon again. My name is Cara and I’m a cereal addict. It’s been four days since my last bowl.

*I did NOT write this to make light of those suffering from actual addiction issues. As a person who knows and loves several different people who are recovering (or still) addicts, I encourage anyone dealing with these issues to seek help.*

Saturday, July 27, 2013

Strip Safely

Test strip accuracy is important to me because as a person with diabetes, I test my blood sugar. As a type 1 diabetic, I test my blood sugar sometimes as many as 12-15 times a day. True, with my constant glucose monitor (itself with accuracy issues) I sometimes test less. But no decision I make during the day (or night) is made without regards to what my blood sugar is.

The recommended range for blood sugar for a person with diabetes is 80-120. Some people say 70-130. Either way, these are ranges we should be shooting for our blood sugars to be a majority of the time. Anytime you deal with insulin (and food/stress/illness/other medications/the weather/the house that venus is currently in) blood sugar levels of a T1 diabetic is going to be outside of those ranges at times. But most of us strive to keep as tight of control as possible for our health.

Blood sugar levels that are out of control can cause major problems. In the immediate it can cause death, and in the long term it can cause complications which lead to death. And most of us don’t have a death wish. We want to live a healthy and as long as possible.

I’ve had T1 diabetes since February 5, 1986. It was a few months before my 5th birthday. I was practically a baby. And I was struck with this disease because my body decided to attack the insulin producing cells in my pancreas. Because of that my parents had to give me insulin injections, monitor what I ate, and test my blood sugar many times a day.

As time progressed I grew up. I learned to drive. I moved away to college. I’ve gotten a job. I’ve purchased a house. I’ve traveled the country with friends (and even sometimes alone). These are all things that a person without diabetes could do and no one would think twice about it. People living with diabetes do these things regularly and while some people may think nothing about it, our friends and family know the truth. Living alone, traveling, driving a vehicle, getting married, having children, and many other activities that are “normal” for most, take way more energy thought and planning for those of us living with diabetes.

Where is all of this going? Nearly every decision I make involves a number. My blood sugar number. Insulin keeps me alive. But it has the ability to kill me as well. Too much, or too little, insulin can lead to serious sickness and even death. This means I have to know how much insulin to take. How much insulin I take is determined by a lot of scientific math….and my blood sugar number.

Let’s just say my blood sugar is 120. This is good…right? It could be. But it could also depend on if I have “insulin on board” (this is insulin still working actively in my system), if I’ve just eaten, if I just completed exercise, if I’m getting ready to do exercise…among other things.

That’s a lot of variables, isn’t it? Think that’s bad enough? Try this:

Back to the beginning. My blood sugar reading says I’m 120. I’m getting ready to go on a road trip. It’s going to be several hours of driving for me. I am going to eat, right now. Forty-five grams of carbs. This means I’m going to give (hypothetically) 6.4 units of insulin for the food. And according to my goal blood sugar of 100, it also means an extra 0.5 units for the 20 points my blood sugar is over 100. So… 6.9 units of insulin, food, and driving.

Hypothetically this would work perfectly. But what if my meter reading was wrong. What if my blood sugar was actually 80, instead of 120? With the food and the insulin I took, a low blood sugar might not happen right away, but when my insulin peaks and my food is gone, that extra 0.5 units of insulin I took for that 20 points I was over 100….could drop me as much at 30-50 points. Which means an 80 could eventually be a 30 or a 20.

If I wasn’t passed out with a blood sugar of 20 or 30, I could be. If I didn’t catch the low blood sugar, it could be disastrous. To me, to other drivers, to people in the vehicle with me.

And 80 instead of a 120? That’s a 40 point variance. It could be enough to kill someone. Yet current FDA guidelines have a 20% ± variance. That means my 100 could be 120 or 80. And even worse than that? The FDA enforces these guidelines before the strips can hit the market…but they do NO enforcement after they are being manufactured. Which means even though a company may be able to meet the guidelines the FDA requires (even though they aren’t really strict enough) before they hit the market, they don’t have to meet them after they being manufacturing. There’s no monitoring to ensure that they are sticking to the guidelines at all.

This is a serious problem. I believe that there are lives that are hanging in the balance. I believe there are people who could very well die from this. If a medication was hitting the market and causing a huge risk of death to the people taking it, the FDA would step in and put a stop to it. Lawyers would have infomercials on at midnight telling you to call them if you took it so that they could help you sue the company.

Why isn’t anything like this happening with diabetes testing strips? What is it that keeps the FDA from monitoring the post production requirements of meter strips? What is it that keeps the FDA from making the guidelines even tighter for strip accuracy? Why isn’t anything being done?

I’m not sure what the reasoning is. It seems quite ludicrous to me. But it’s happening. And we need to do something about it. If we stand up and say something. If we show examples of the danger and the immediate risk. If we raise our voices, perhaps someone will listen.

My fellow D-OC members are raising their voices. They’re writing letters on their blogs and to their elected officials and to the FDA. They’re putting things out there. And now it’s my turn. This is my first letter, to anyone who might stumble across it. I’m setting myself a personal goal to send emails to all of my elected officials and to the FDA with my concerns for test strip safety.

I don’t want to go to sleep one night, thinking my blood sugar is fine, and not wake up the next morning. I don’t want to do that to my friends or my family. I don’t want to break their hearts in that way. I don’t want the hearts of other friends, family, and loved ones to break if they lose someone to diabetes if there’s any way it could have been avoided. I’m standing up and raising my voice for myself and for others living with diabetes. We DESERVE accuracy. There are enough variances in diabetes without worrying if our test strips are giving us accurate results as well.

For more information on Strip Safely, an inititive to improve strip safety and accuracy, go to their website. They also help tell you how YOU can make your voice heard. This post is my July entry in the DSMA Blog Carnival.  If you’d like to participate too, you can get all of the information at http://diabetessocmed.com/2013/july-dsma-blog-carnival-3/.