Exercising With Your Insulin Pump

So, as I have noted in previous posts, I am trying to lose weight, a difficult task for sure.  With an insulin pump you will get quite a few differing suggestions on how to set your insulin basal rates.  The only common thread among the different regimes is that exercising with an insulin pump is certainly easier than traditional syringe therapy, once you get the hang of it. 

The first thing to know is that you should not simply remove your insulin pump when exercising, unless you are in sports that require it (you know, like sumo wrestling or deep sea diving!).  Even when playing contact sports, like football, you can keep your pump on, provided you have taken precautions, like having your cannula inserted somewhere unlikely to get pounded, and your tubing is safely tucked away.

Obviously important is to test your blood sugar before, during, and after vigorous activity, to ensure you are not experiencing low blood sugars.  With all the various diabetes educators I have had, I have rarely had anyone tell me to watch out for lows hours after activity.  I have found that not only will my blood sugar dip during and immediately after activity, but also up to 8 or 9 later (fun when you are asleep!).

Now, you will find many suggestions as to what basal rates you should change your insulin pump to during sports or exercise.  I have tried at least three different ideas on how to make things work, none of which have worked for me. This, like everything else that deals with a person's body, is highly individualized, and you will have to experiment for yourself.  As much as I would love to say "before going out for a 20 min. jog reduce your basal rate to 25% for 2 hours, and ensure your blood sugar is at least 6.5 before starting", I can't.  That is what works for me.  What works for you may be something close, but maybe your optimal basal rate is 50% or 0%. 

What I am truly trying to communicate, is that you have to try and experiment on your own.  Start conservatively and work your way towards what is best for you.  For instance, I started at 0% basal rate for three hours.  My sugars were too high an hour (and two and three) later, so I worked towards something that was optimal for me.  Make sure you do start conservatively, though.  You don't want to mix up the feelings of adrenaline with low blood sugars.

As a famous Canadian fitness team says, "Keep fit, and have fun!".

Diabetes Blog Week - Diabetes Hero

This Diabetes Blog Week has been fun.  I hope you have had fun reading the posts, not only by me, but by everyone involved in it.  I learned a few things!

The last topic for the week is about who my Diabetes Hero is.  My hero is you, me, and millions of others around the world who contribute donations to their local diabetes related organizations.  Without the help of all of us, many advancements and discoveries would not have happened, and many of us may not even be here today.  Fundraising and donations do not only occur in November (National Diabetes Month in many countries) but throughout the year, and in different forms. 

Whether it be through donating used clothes and household goods (through the ClothesLine program in Canada), volunteering your time, fundraising with the Diabetes Walk, or donating money, you should all stand up and take a bow.  While I am sure we far from a cure, we can certainly take solace in the fact that everything we do brings us one step closer.

Diabetes Blog Week - Something Good To Eat Wildcard

So today's Diabetes Blog Week post was supposed to be a picture blog, but I don't feel I have enough good pics to show about diabetes really affects my life, so I am going to grab one of the "wildcards" for the week - talking about something good to eat.

I have always loved a good weekend breakfast.  I will often indulge in an Eggs Benedict, however the normal serving that you prepare in the traditional sense can run you upwards of 590 calories and over 35g of fat.  This makes it quite the special treat.  What I do is a little different.  While I keep most of the ingredients the same (substituting a few better health choices, at least in my mind they are!), I make one big change.

I start with one English muffin, making it 100% whole wheat.  I add a couple slices of ham, and two large poached eggs.  This is pretty much the same, so far, as a regular Eggs Benedict serving.  The topping, instead of using hollandaise sauce is half a can of cream of mushroom soup. Personally I use Campbell's 98% Fat Free condensed soup (do not add water, just heat).  With these ingredients I come up with about 445 calories (or a quarter less) and about 20 g of fat (over 40% less).  For carb counting, that gives me 31 g of carbs to give myself insulin for (fibre count already removed).

I like it and it lets me feel a little less guilty about indulging.  :)

Diabetes Blog Week - What They Should Know

Today's Diabetes Blog Week topic surrounds what is something I, as a diabetic, want non-diabetics to know about the condition.  Seeing as how diabetes, if left improperly treated or undetected, can be such a dangerous condition, responsible for about a million amputations a year, 5% of blindness worldwide, and kills a person every 10 seconds, I want people without diabetes to know when they may have it.

I want non-diabetics to know what the warning signs are.  If you have some these symptoms, it could be a sign of diabetes and should be checked out by a doctor.  Many of these symptoms can seem harmless enough, and often are ignored.  My thought is don't ignore them, get it checked out.  Some symptoms of diabetes (type one or two) include:
- frequent urination
- sticky urine
- excessive thirst
- excessive hunger
- unexplained weight loss
- often fatigued
- blurry vision
- cuts or sores that take longer than usual to heal
- dry mouth

While recognizing that you have diabetes is not going to heal you, you can at least be treated by a professional and get the help you need to live a normal life.  That is my wish for non-diabetics to know about diabetes.

Diabetes Blog Week - Fantasy Diabetes Device

This Diabetes Blog Week thing is fun.  I am enjoying writing about these different topics, I hope you are enjoying them, too.  Today's topic is creating a fantasy diabetes device.  As much as I'd love to say a cure, or an artificial pancreas, I think those go against the spirit of the topic.

There are so many things to wish for from prickless blood glucose meters, to an insulin pump that can automatically detect what insulin you need without any user interface.  However, what I would love to see is an affordable adhesive CGM, that "talks" via Bluetooth to your insulin pump, or any other Bluetooth device. 

The first part of this device is the adhesive CGM.  Building on the the concept of a prickless blood glucose test, I'd like to see something like a band-aid that can be applied to any part of the skin that continually reads your blood sugar, ideally your actual blood sugar levels and not the interstitial fluid that CGMs currently test.

The second part is that this is a Bluetooth device, and make insulin pumps Bluetooth capable.  By having your insulin pump able to read your glucose levels you can see what your sugars are and you could adjust insulin levels appropriately.  The Bluetooth capability would also make it easier to transmit your data to your computer or mobile device so that you are able to track trends and see how you are managing your diabetes.

Above all else, though, and this is where the "fantasy" part comes in....make it affordable.  Current CGMs on the market are not affordable for anyone unless you have insurance coverage.  Most insurance (at least that I have seen) do not cover it CGM supplies, despite their obvious benefits. 

We can all dream, right?

Diabetes Blog Week - One Thing to Improve

So after yesterday's post exalting the virtues of my wife and how she helps me through my sugar lows, I now get to look at something I can improve, as part of Diabetes Blog Week.  If you read yesterday's post you will see a plethora of things that I can improve on.  That was actually the condensed list!  :)

The one thing that I know I have to improve on is something that I have just recently started to do.  That is losing weight.  Growing up, weight had never been a problem for me, but as I age, I guess my ability to metabolize all I was used to eating went away.  I have known it to be an issue for a long time, and even tried to fix it up through a weight loss program, and that was going well, or so I thought.  I was shedding the pounds, but my sugars were out of control.  Given some recent doctor visits and blood pressure readings, I know I have to lose at least 60 pounds.  Given the health problems that diabetics are prone to with elevated weight issues, I have to look after that part of my health, if not for my sake, then for my family's sake.

I have started by doing a few things to really bring my weight down.  The first is exercise.  I am forcing myself to go out for a run or walk everyday.  It sure did hurt the first week or so!  Secondly, I am recording everything I eat and checking my caloric intake.  Just simply the act of recording my food makes me realize how much I had been eating and that I had to bring that down.  So far things are working.  Now the task is to keep it up!

Diabetes Blog Week - One Great Thing

Today's post for Diabetes Blog Week is to talk about something that I (or my loved one) do well with respect to my diabetes.  As much as I would love to talk about the stuff that I think I do well, I wouldn't be there to do it if I didn't have my wife. 

I know I am a diabetic, I know that I am SUPPOSED to carry my blood glucose meter with me all the time, I know that I am SUPPOSED to test my blood sugar before driving, I know that I am SUPPOSED to carry some sort of candy or other quick sugar with me all the time.

With everything that I "know", you would think I would know better!  My wife has lived with me a lot less time than I have lived with diabetes, but she does know better.  She knows that I do not carry fast acting sugar on me at all times.  So whenever I am in need of a quick sugar fix, I know that I can turn to her and get what I need. There have been so many times when we are out for a walk, grocery shopping, or on a long drive, when I have had to turn to her and ask if she has any candy in her purse, knowing full well that she does.  In fact, she recently cleaned out some old purses from our closet and in each purse she found a baggie of candy!  Love you, honey!

Diabetes Blog Week - Find a Friend

So, the point of today's post (as part of Diabetes Blog Week) is to let people know about other sources of information, other bloggers who are out there and have something good to contribute.  Kim (of TextingMyPancreas) has been one of the "finds" that I have really enjoyed following.  She is a really active blogger and tweeter (@txtngmypancreas).  However, with almost two thousand followers on her twitter profile, she isn't exactly unknown.

Kim has been a type one diabetic for over 25 years, and really seems to have a great outlook on diabetes and how to handle it.  She uses a CGM and an insulin pump, and works with the DSMA Advisory Board, Diabetes Advocates, and JDRF, among other things.  Her posts are varied and entertaining. 

Head on over and search her posts by the posted labels on the right side of her page. 

Diabetes Blog Week

I've decided to do something a little different for next week.  Coming up that week is something that was created by a lady in New England, Diabetes Blog Week.  Running from May 14th to the 20th, she has set up a range of topics for diabetes bloggers to write about.  They range from feel good topics like "One Great Thing" to the imaginative "Fantasy Diabetes Device". 

I will try to get a post done for each day of the blog week in accordance with Karen's topic list.  I encourage you to go and check it out and see what topics you will want to read up on.  Here is a list of what blogs are to be posted each day:
Find A Friend - Monday
One Great Thing - Tuesday
One Thing to Improve - Wednesday
Fantasy Diabetes Device - Thursday
What They Should Know – Friday
Saturday Snapshots - Saturday
Diabetes Hero - Sunday
Something Good To Eat - An extra posting topic for any day of the week
Diabetes Creativity  - An extra posting topic for any day of the week

There are some really great topics there and I can't wait to go around reading some of the various blogs by different people.  I hope you find something helpful, too!

Can I accidentally bolus without knowing?

One of the concerns I had when I was getting my pump was how I might inadvertently give myself a bolus without knowing that I was.  My fear stemmed from the fact that you can quite easily give yourself a bolus with a few clicks on the pump.  I feared rolling over on the buttons in the middle of the night and the proper sequence of buttons getting pushed, or when the pump was in my pocket that the buttons might be pressed in that order, too.  Something else that probably contributed to my fear was the fact I had received a "butt-dial" from my sister-in-law earlier that week from her cell phone. 

Well, in much the way that cell phones today have screen locks, your insulin pump has the same sort of blocking functionality.  This was a function I knew that my Medtronic insulin pump came with, and before using the pump I learned the menu navigation to turn the function on and off.  Incidentally, I have only ever used this function once.

There are other precautions against accidentally bolusing in this manner, as well.  I cannot speak for other pumps, as I do not have a wealth of experience with them.   However, with my Medtronic pump, while the the buttons are open and exposed, they are designed in such a fashion that you have to apply a certain amount of pressure on the right part of the button.  I definitely can't apply pressure to the whole face of the pump and depress buttons at random (I tried a few different ways, with various body parts, as if I was asleep). 

Finally, while my Medtronic pump comes with an "easy bolus" function that allows me to receive insulin in unit increments with very few button presses, you are able to turn this function on or off.  A reason some people use this function is, for example, if they are in a meeting and know that for the food they are eating there they need an amount of insulin, but do not want to pull the pump out of their pocket or belt (or wherever it is).  You can simply hit the easy bolus button and get a bolus done without even looking at the screen on your pump.  This function, however, can be easily enabled or disabled.

In the end I felt really safe in the understanding that there was very little chance of me giving myself an unexpected bolus, and you should feel just as safe.