First A1c!


For those of you who follow me on twitter you know that I recently went to the doctors to get my first a1c since my diagnosis. For those of you who don’t follow me on twitter, you should @typeonefun. When I was diagnosed with diabetes my a1c was 9.8. So you can imagine I was quite nervous/anxious leading up to this test and waiting for my results. However the results are in and my new a1c is a 5.2! I am very happy with this number but I was nervous about some of the blood cells still left over from my diagnosis affecting the outcome of this a1c. That apparently was not the case.

My doctor said that the 5.2 is too low and that I have been too aggressive with managing my diabetes. I however to do not agree with him. While I might be aggressive with management, I am happy with the results and am happy with the management routine I am doing. If I were constantly having low blood sugars or if my management was interfering with my life I would agree with the doctor. But that is not the case at all. I quite satisfied with my diet and the foods I eat. And I am happy with my exercise routine.

The exercise I do has been very helpful with managing my diabetes. Before I started working out and bike riding regularly I was using around 25 units of insulin a day including my basal rate. Now, due to the exercise, I take around 14 units of insulin daily. And some of this is due to my pump because I can now take fractions of a unit unlike using the pens where I can only take whole units.

I also believe that my low carb diet is helpful in managing my diabetes. I try to eat less then 80 grams of carb per day and usually average less than 50. Going out to eat throws this off sometimes but oh well you have to splurge once in a while. My theory is that the less carbs I intake the less chance there is for my blood sugar to get high.

Now one could argue that is easier for me to manage my diabetes because I am still in the “honeymoon” period. Which is definitely true. I am for sure still honeymooning and therefore my blood sugars are easier to manage. However another theory of mine is that if I keep tight control over my blood sugar and keep the load off my pancreas, I can prolong my honeymoon phase and preserve my remaining beta cells for a while.

But all in all I am very please with the outcome of my first a1c. I hope I can keep a good grip on my diabetes and can continue to have low a1c’s.

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July DSMA Blog Carnival


Blood glucose.  It’s front and center when it comes to diabetes.  It is how we get diagnosed and it is what we are trying to manage.  An important tool we use to manage our blood glucose is our meter and its strips.  But what happens if our meters aren’t giving reliable information?  Let’s explore that this month as we discuss a topic from the June 26th chat Fill in the Blank.  Weigh in on the following statement:

Test strip accuracy is important to me because______.

…because if they are not accurate then we are screwed!

Testing my blood sugars gives me a window into my health. It gives me an empirical/numerical value in which I can judge, and over time the blood sugar values can ultimately tell me how healthy I have been. Now certainly a high blood sugar every once in a while is nothing to stress about but it is still something I take note of and try to figure out what I did to make it high so I can log it into my mental diabetes database. I essentially like to keep track of a rough A1C day to day (CGM is wonderful for this). So of course having accurate testing devices is super important for me to have an accurate picture of my health.

One of the main things that frightens me is the knowledge that at some point in my life I could go blind or lose some fingers/toes or, hell, even lose a limb all because of diabetes. This really scares me. And because of this fear I try to always have complete control of my blood sugars. Its actually weird that high blood sugars upset me more then low blood sugars which are immediately dangerous. So having accurate test strips and glucose meters are crucial for me to know that I won’t have serious health complications due to diabetes or can at least prolong the diabetic health complications until I am way old and have health problems any way.

Since my diagnosis I have been using diabetes as a tool to live a more healthy life. Its my way of “looking on the bright side” of having diabetes. Pre-diagmonsis: I was very unhealthy. Never working out, eating too much crap, smoking cigarettes, and drinking too much too often; pretty much just being a stereotypical college guy. Post-diagnosis: I work out every other day, I heavily limit my sugar/carb intake, I don’t smoke, I rarely drink (and even more rarely over indulge); basically a complete 360 from where I was. And because I believe that my blood sugar testing equipment is accurate (or as accurate as possible) I know that the effort into being more healthy and controlling my blood sugars is not in vain.

So a simple answer to the original question: Test strip accuracy is important to me because I want to stay healthy.

“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/

Tandem T:Slim Review


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Recently I have acquired an insulin pump (Tandem T:slim) and it has made managing my diabetes so much easier. I essentially have insulin-on-demand now and no longer have to carry so many “diabetic supplies” such as my insulin pens (Humalog and Lantus) and extra pen needles. You no longer need to have two different types of insulin with a pump (fast acting and long acting) because you use fast acting insulin to compensate for the long acting insulin. It really has given me more control over my diabetes, therefore giving me more control over my life. I highly recommend any one who does not use an insulin pump to seriously consider getting one. Granted, they are not for every one but all I ask is you do not automatically rule it out.

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About a week ago my new t:slim pump arrived and I am absolutely loving it. Like I said it has really changed how I manage my diabetes. The t:slim has so many great features that really make it stand out and truly makes it a great pump.

Micro-Delivery System

First off Tandem has truly revolutionized the actual pumping technology of the insulin pump. They have developed a micro-delivery system to disperse the insulin in bursts rather than in one steady stream. Other pumps use a system that is essentially an electronic syringe whereas the t:slim uses an electronic syringe system with an addition of a device that separates the insulin into smaller doses. It was developed as a safety feature so you cannot not receive one big dose of insulin but rather several small ones. As an example say you need a bolus of 8 units, instead of getting all 8 at once the t:slim would give you 2u-2u-2u-2u over the course of a second. This video will display the micro-delivery system technology better:

Color Touch Screen

Another great feature of the t:slim is the color touch screen. The color screen makes the pump much more pleasant to look at while the touch screen makes it very user friendly. “But what if you accidentally hit the screen and administer a bolus to kill all other boluses?” Good question! The pump has a lock screen which you have to tap buttons in a sequential order to unlock, so it is nearly impossible that you will pocket bolus. On the screen itself, it displays graphics in the corners to let you know exactly how much battery life you have and how much insulin is left in the reservoir. Along the bottom of the screen, the pump shows you the Insulin on Board (IOB: the insulin still in your system) and well as the time remaining until the insulin is no longer in your system. This really gives you a good idea how much insulin to take and keeps you from “stacking” your insulin which can often lead to a low blood sugar disaster.

Bolus and Basal Insulin

The pump also has some unique features when it comes managing and using your insulin. You can set your basal rate down to the third decimal place. Mine right now (I am still fiddling with the numbers a little bit) is .487, which means that every hour I receive .487 units for a total of 11.7 units over 24 hours. The three decimal places really gives you a lot of control over your basal rates and provides greater accuracy when setting your rates. You can also setup temporary basal rates for times when you are sick/stressed, have low/high blood sugars, disconnecting for a couple hours, or anything that requires an altered basal rate.

In the course of making a profile (which stores all your info) you will input values for your insulin to carb ratio, a correction factor, and your ideal blood sugar level. The insulin to carb ratio means 1 unit of insulin counteracts X grams of carbs. The correction factor is a ratio that represents 1 unit of insulin lowers your blood sugar X mg/dL. When administering a bolus, the pump takes into account your current blood sugar level, the amount of carbs you are about to eat, the IOB, the correction factor, and the carb ratio to give you a projection/recommendation for a bolus amount to keep you at your target blood sugar level. Of course you can manually change the recommendation if you feel it is too much/not enough insulin. The pump also has a quick bolus feature which allows you set a desired insulin amount and can administer it with the touch of a button. You can also extend a bolus meaning you can administer X% of a bolus now and X% at a later time which is good for long periods of snacking or maybe even pizza.

Other Nice Features

  1. Water tight up to 3 ft for 30 minutes
  2. 300 unit insulin reservoir
  3. USB conectivity
  4. T:connect application to keep track of insulin usage and other diabetes data
  5. Alerts and reminders (re-test blood sugar after low/high, low insulin the reservoir, low battery, bolus not delivered, etc.)

This is just a brief overview of the Tandem t:slim’s more unique features. If you want to find out more about this pump you can check YouTube for more videos and you can also check out there website here. As I mentioned before the pump has been life changing and seriously recommend people to check out the t:slim and insulin pumps in general.

June DSMA Blog Carnival


This post is my June 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/june-dsma-blog-carnival-3/.  I participated in the May blog carnival so this will be my second attempt/second go at a DSMA Blog Carnival and hopefully you will enjoy this one as much as you liked my last one.

The prompt for June is:

Regardless of which type of diabetes you have – T1 T2 or T3 – you probably use one or more diabetes devices on a daily basis.   For this post, when we refer to devices we mean blood glucose meters, insulin pens or pumps, and all other diabetes medications.  This month we’re going to revisit the May 15th chat on Diabetes Devices and really think about what we use.  We’d like to know:

How do you select the diabetes devices you use?  To others looking into new or replacement devices, what would be your best advice to someone shopping around?

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I use the OneTouch Ultra 2 blood glucose meter and a OneTouch lancing device. They were the devices my doctor prescribed to me when I was first diagnosed, so I have not/did not shop around for any other glucose meters. I am unaware if there are other “better” ones out there, or if the one I have is top of the line, or if  there is even a big difference between glucose meters. That being said, I have zero complaints with the meter. It is very accurate (from what I can tell) and you do not need much blood for the test strips which is definitely a plus.The supplies might be a little pricey but I figure most all diabetes supplies are expensive.

Two other essential devices are my insulin pens. I have a pen of Humalog and a pen of Lantus and obviously as a type 1 diabetic, my insulin “devices” are very important to me. For those who don’t know, the Humalog is the insulin I use before meals to counteract the food I eat, and the Lantus I take once every day and it is my long acting (basal) insulin that keeps my blood sugar in check for 24 hour periods. Although within the next couple of days/weeks I will be getting the t:slim insulin pump so I will no longer be needing my pens except for emergencies if the pump breaks down or something. Now, I did shop around for other pumps (looked at brochures and watched videos) but the t:slim really stood out as the pump for me. The sales lady made it a point to address how the t:slim was designed by diabetics where as other pumps were designed by engineers with diabetics in mind. I think using a product that is for diabetics by diabetics speaks volumes about that product and how people with diabetes can benefit from it. I look forward to beginning my life as a pump user.

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Another device that I use and think very highly of is my Dexcom G4 CGM. For anyone who does not know, CGM stand for Continuous Glucose Monitoring. I wear a sensor in my abdomen which transmits my blood sugar levels every 5 min to the device shown above which plots it on a graph. It also tells me if my blood sugar is rising or falling too rapidly so I can react to it faster. I find this device almost invaluable and urge every person with diabetes to look into getting a CGM. The CGM has made me very much aware of my blood sugar trend and just how much food/insulin affects my blood sugar. And more importantly it made me aware that I was dipping low during the night and have since adjusted my basal insulin dose accordingly. I did a little research on other CGM’s but I felt Dexcom has the best system out and will have the best system in the years to come. Some of the brands of CGM take blood sugar readings every 20 minutes and have a start up time of 10 hours, while the g4 checks every 5 minutes and has a start up period of 2 hours. Those were big selling points for me. Although a potential negative I have found with wearing a CGM is that I feel naked and vulnerable if I have to go a long period of time with out it (which is not very often thank god).

Pump Update


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As you know from a previous post of mine, I have been shopping around for an insulin pump to purchase. Everyone’s comments on said post were very helpful and I thank you all very much for your advice. A lot of your comments had to do with insurance coverage and until recently I had no idea what kind, if any, coverage my insurance provides for insulin pumps. I did some research and contacted my health insurance provider to discuss potential pump possibilities (see what I did there? 🙂 ). And to my pleasant surprise, they cover 80% of the cost of any insulin pump! Sure there is better coverage available but my insurance is not very good (cheap) so 80% is good enough in my opinion. In fact, I still have to call them twice a week to make sure they are working on getting the Dexcom system covered, which they barely are. They are so slow!

So all that being said, I have made the decision to get the Tandem t:slim pump. Tandem was accommodating enough to send a sales representative to my house to allow me to play around with the pump and ultimately hook myself up to it with a saline cartridge. And I must say I thoroughly enjoyed all aspects of the pump: the features, the size, the weight, the look; just about everything. The sale rep unfortunately was not able to give me a loaner pump to wear for a couple days, but I was able to wear the infusion set for a few days just make sure it was comfortable. And it is quite comfortable… or not uncomfortable, rather.

The infusion set I have been wearing is the Cleo 90 and it seems like a good set. I am not too sure of the differences in the infusion sets other then ones a steel needle opposed to a plastic/rubbery insertion. And one is at a 45 degree angle opposed to the 90 degree insertion that the Cleo is.

I have been in close contact with Tandem recently and so far they have superb customer service. They have a very nice and knowledge staff that is eager to help make people with diabetes lives easier/better.In fact a good few of the employees I have spoken to are diabetics or spouses of diabetics, so they know quite a bit about the D-lifestyle.

So, a few days ago I faxed them the required paper work and contacted my insurance provider to get the ball rolling so I can hopefully acquire the pump soon-ish.

May DSMA Blog Carnival


Better late then never!

The prompt for the May DSMA Blog Carnival:

What do you consider to be your Diabetes Strengths?  What do you think are your Diabetes Weaknesses?

Well I will begin with my weaknesses. Obviously the first thing that comes to mind is that I have zero weaknesses and am the perfect diabetic/person/diabetic person. Ha! Hardly! I think at this stage in my life with diabetes, one of my biggest weaknesses is the lack of knowledge I have. And maybe I don’t actually have a severe lack of knowledge pertaining to diabetes, but I FEEL like I do and that makes me just as ‘weak’ as actually lacking in knowledge. I think in actuality I probably know about the same as your average diabetic but I just have this huge feeling that I am missing out on some important piece of information vital to life with diabetes. Though I am probably not.

This early on into diabetes, I am still very much overwhelmed with everything (insulin shots, finger sticks, dieting etc.) which is also a weakness of mine. I am definitely starting feel in control and probably portray control/seem fairly underwhelmed to my family and friends, but that is not the case. It getting there but not yet. And maybe the portrayal of control/acting is more of a weakness then the actual feeling of being overwhelmed. Either way both should pass in due time.

On the other hand, one of my biggest strengths would be how seriously I am taking my new life with diabetes. I have been dropped into a new world full of change and I have tried hard to be as responsible as possible to become a healthy diabetic (via taking insulin, watching what I eat, checking blood sugars, getting into the D-tech, etc.). I have heard many stories about people with diabetes (both type 1 and 2) who go into denial or do not take the disease seriously and end up either dying or becoming super unhealthy/having lots of medical problems. Those stories scare me and inspire me to be a ‘good diabetic’ and not be like them. And my hope for the future is that I can continue to take this seriously and maintain my health.