25 and losing it...

[PinCushion]

ok, so being diabetic sucks, right...it was so much easier when my mom helped with everything. Maybe I should get her involved again haha. So, here's the skinny...I recently got married (August of 06) and I want to have kids....soon. As a result I have been going nutso on my diabetes. Im talkin checking my sugar 15+ times a day (no, I don't have CGMS) and eating healthy etc. The downfall...I have made myself nuts to the point of anxiety and stress, which only makes the blood sugars worse. As soon as I inject my insulin I instantly have an anxiety attack. IRRITATING. So, I decided to go on the pump (again, I had one 9 years ago....got rid of it because I was a stubborn teenager..) however I can't seem to get my insurance to cover ANY of it. Minimed says that it will cost me nearly four grand to get the **** thing, my insurance will cover the supplies, and there is NO coverage for ANY part of the CGMS. I'd like to switch to a tester by one touch (I think it's the ultra or the smart...something like tht) so that I can plug in my insulin doses etc right there on the machine. However, my insurance only covers accu check. At this point I just want to scream! You'd think that there'd be better coverage and more options out there for people who suffer from a disease that kills millions every **** year!!! So, kids probably won't happen soon. I'm trying to calm myself, relieve some of the stree and anxiety of it all....it's hard. So, I have decided to make it into steps. I joined this forum (today) and am hoping to get some helpful information regarding everything I am experiencing. I'm meeting with my mom tomorrow, I'm going to throw some fits and get this **** pump and hopefully the CGMS as well. Please, share any advice you may have. :) And I look forward to getting involved in more discussions as time goes on. :)

[ant hill]

ok, so being diabetic sucks, right...

Yes it do suck!!! and after 36 years of diabetes you do get to lern many things PinCushion and as much as we like to emulate a heathy pancreas unfoutuantly we cannot be allways be a perfect control and so buy lerning the foods that we eat have an effect on our control but not allways the case.
So don't get too upset over not getting a perfect 100md/gl or 6mmol/l but to have the knowlage to correct our findings with our meter. Take some thought on exersize as appart of you control too as that can get those high levels to a premium.
Experiment and explore and you will lern. :)

[bryan42]

Welcome Pincushion....You are in need of prayers, and I will get them to you!

[xMenace]

Welcome.

Your not alone in your boat.

You can do an excellent job with MDI, and if that's what you have to do, then do it. The 15 times a day are high, but I've beaten that a few times. The advice I give on testing is 7 times a day for maintenenace or confirmation that your plan is working. Go crazy when setting that plan: basal and meal profiling.

There's some excellent MDIers on here. Hopefully you can hook up with them and make that dream of kids come true. :cool:

[owlyn]

First, welcome.

Okay, next... There's not much point in testing 15+ times per day unless you want to either drive your self insane (not the likely choice), or do something with the results. Your BG will be high for the first 2-3 hours after eating. That's just the way it is. The real benefit of testing for Type 1's is that it allows you (for the most part) to determine what your carb to insulin ratio is, and take the appropriate action (insulin/exercise) so that after 2 or 3 hours, your BG is normal, if all goes well, which it often does not, and there is no point freaking out about it when it doesn't. If you don't know what your ratio is, post back and we'll explain how to determine it, as well as suggest that you get another doctor, as it should have been explained to you 9 years ago.

[grace girl]

Hi, and welcome! If you're going to stay on MDI, get a copy of Using Insulin by John Walsh. He details exactly how to do basal testing, as well as getting your carb ratios and corrections set exactly right. I believe it's possible to have excellent control on MDI, but it takes just as much testing to get things set right as it does with the pump.
You will learn a great deal here, too!

[LancetChick]

There's not much point in testing 15+ times per day unless you want to either drive your self insane (not the likely choice), or do something with the results. Your BG will be high for the first 2-3 hours after eating. That's just the way it is. The real benefit of testing for Type 1's is that it allows you (for the most part) to determine what your carb to insulin ratio is, and take the appropriate action (insulin/exercise) so that after 2 or 3 hours, your BG is normal, if all goes well, which it often does not, and there is no point freaking out about it when it doesn't. If you don't know what your ratio is, post back and we'll explain how to determine it, as well as suggest that you get another doctor, as it should have been explained to you 9 years ago.

Wow, it's comments like this that drive me insane, not testing 15x a day, which adds up, incidentally, to about 15 minutes a day. If you can't afford 15 minutes a day, then perhaps it would be too much to ask. Do you think a normal pancreas tests "every once in a while"? No, it tests continuously, and the result is normal blood sugar. I test 15x a day, and don't always achieve normal blood sugar, but my A1c's are in the non-diabetic range (last was 5.2), and I've managed to reverse two complications. I assure you, I find a lot more from testing often than what my I:C ratio is.

I agree with grace girl about getting a copy of Using Insulin. It explains everything in detail, and is very, very useful. In addition, I find that testing often is nowhere near as effective as testing often and logging the results along with foods eaten and insulin given. Logging is something of a pain, but that's how you learn to recognize how foods, hormones, exercise, alcohol and everything else react with insulin, as well as patterns. In my view, the thing most likely to drive a person insane is the feeling of being out of control, and that does not have to be the case. And logging, of course, does not have to become a permanent habit.

[lgvincent]

The AccuChek Complete meter has entries for things like insulin injections, exercise, and carbohydrate intake. I don't think it is made any longer but you might be able to find one on ebay. I could try to find a copy of the operating instructions to send you to see if it might interest you. They come with the cable and computer program and I could send you that stuff if you should find the meter and not have the extras that come with it. I don't know if the program will work with Windows XP or Vista but it worked with Windows 98 which was on my old computer that died last month.

[owlyn]

Wow, it's comments like this that drive me insane, not testing 15x a day, which adds up, incidentally, to about 15 minutes a day. If you can't afford 15 minutes a day, then perhaps it would be too much to ask. Do you think a normal pancreas tests "every once in a while"? No, it tests continuously, and the result is normal blood sugar. I test 15x a day, and don't always achieve normal blood sugar, but my A1c's are in the non-diabetic range (last was 5.2), and I've managed to reverse two complications. I assure you, I find a lot more from testing often than what my I:C ratio is.


1. I never said it was a matter of taking too much time. I never even mentioned inconvenience or time. I said that it does no good if you don't do anything with the information. You may apologize at any time for your remark.

2. Your pancreas tests and adjusts continuously. We can't do that, at least not yet. So, what's the point of just testing? Are you suggesting that she spend her whole day testing? You never mention what to do with the information. At least I gave her some tips to get started. More is not always better. Sometimes more is just more, and sometimes it can be confusing, which makes matters worse. 15x per day is more than once every two hours. She is already freaking out about it, and you tell her to keep on going. How does that help? You can draw all kinds of wrong conclusions if you don't know why a reading is what it is. If it works for you, great, I'm very happy for you, but don't force your opinion down my throat. Why is your experience and opinion more valid than mine?

"Get this book" is also great, but how about what to do in the meantime?

IMO, testing on waking and before and after meals is a great way to get started. It's manageable (not overburdening), and it doesn't make you feel like diabetes is controlling your life. Once you know what you're doing, if you want to fine tune things like you do, that's great. And I don't wave my A1C in anyone's face to prove my point. As it happens, may A1C is not great and it's not terrible (in 16 years has always been in the same range), but after 16 years, I still have no complications. So is my way better? I don't know, but so far, it works for me, just as yours works for you. Your way is no more correct for someone else than my way is, but you make it sound like your way is THE right way, and that's not fair to others.

[poodlebone]

The original poster didn't say that she tests 15 times a day and then ignores the results. I'm sure that if she's testing that many times, she's using the information to fine tune her control. I test a minimum of 10 times a day, 12 is about average, 14-16 when I need to check things or have unexplained highs/lows or am very active.

I am very rarely high at 3 hours post-meal. Humalog lasts about 3 1/2 hours for me and if I'm high at 3 hours, I correct. At 2 hours it will depend on my reading and what I had eaten before I decide to correct, if at all. Many times I can be in the 140-150 range at 2 hours and not go low by hour 3 or 4.

It used to drive me crazy to see any number over 120 at 2 hours pp, but I've learned to live with it. That's why I check 2 hours after eating (or sooner if I've been active), 3 hours and often once more. Since I don't eat the same thing in the same amount at the same time every day, frequent testing lets me see how different foods and different amounts effect me.

[poodlebone]

Welcome, Amy!

Is there a way to appeal to your insurance to get the Lifescan strips covered? I know some people have been able to do that successfully. If your doctor writes a letter saying that the Lifescan meter & strips would be a benefit, it might help.

I seems odd that your insurance would be willing to cover pump supplies but not the actual pump. Do you have anything from the insurance stating what they cover, and how much, under DME? Did Mimimed contact your insurance for you? My pump is 2 years old and was covered by insurance. I would love to get the CGMS but can't afford it and I'm hoping that in another 2 years, when my warranty is up, insurance is more open to covering it.

I used to be insane about getting perfect numbers. My CDE still tells me that I will never have perfect numbers, it's impossible to be at target all the time, and that since my A1c is good I should stop being so "obsessive". Over the past 2 years I have calmed down a lot. I realize that carbs raise my BG, I like eating carbs, and my BG will not be 85 every time I test.

However, I'm not looking to have children. My CDE has told me that I can be as obsessive as I want if I wanted to get pregnant, but since I don't want to I shouldn't drive myself crazy over it. It IS important to have tight control throughout a pregnancy. The thing is, you're already anxious and that would probably increase if you got pregnant now. I think you're going in the right direction looking to get back on a pump and testing frequently. MDI never worked well for me and my pump has been a lifesaver. I hope that you can work something out with your insurance to get the meter you want and get the pump covered, at least partially.

[ClaireZk]

I'm meeting with my mom tomorrow, I'm going to throw some fits and get this **** pump and hopefully the CGMS as well.

Ok, I so don't want to admit to doing this, but if your mom is like mine, this might work. I still get lots of stuff paid for by my guilty mother :o

I don't really have any advice for you, but I just want to say I hear ya on everything you said. I was always either apathetic or totally zenlike about my Diabetes. Then as soon as I turned 25 I went totally wacko. I think it just hit me "wow I am a REAL adult now and this is a REAL problem and it is MY problem." I handled it pretty much the same way: micromanaging, testing a million times a day, switched to pumping. But I am starting to realize again that my control doesn't have to be perfect; it just has to be good enough, if that makes sense.

If you can make things work on MDI, I think you should give it a fair chance. If not, a lot of pump companies have financing programs. I personally don't think the meter is a big deal. I have an UltraSmart and I was sooo excited to use all of those cool features. I have NEVER used a single feature besides memory.

Just try not to panic. Things will get better. See if you can get your hubby to go to the endo with you and talk about all these concerns and try to work something out. Easier said than done, but don't let Diabetes drive you crazy!!! :)

[PinCushion]

Wow, thanks to EVERYONE for all the responses! To answer a few questions...I do record my results, my insulin intake, and my food intake. Its the anxiety attacks that are causing me to test when its not necesarry (like every five minutes when I know my sugar is on the decline....) and while I know it's not necessary it's the only thing that stops the anxiety attacks. So, that being said. I tend to check about na hour after taking my humalog. I usually take my injections immediately after I eat. How long after eating do you folks usually check your sugars? I always wonder if I'm checking too soon and stacking my injections too close together. I guess it's just been too **** long since my diagnosis so I don't remember all the basics too great. On top of that I went through the stubborn teenage years where I didn't even carry my monitor (I can't leave a room without the **** thing now, I don't know how I managed...). My A1C is currently 9%, the highest it's been in years. I guess it's just extra frustrating because I feel like I am trying harder now than I ever have and I just can't seem to get control. Oh, and I don't care how often I have to prick my finger or stick a syringe in myself...I'm kind of use to it. My only complaint is the expense of the strips! haha. And I must say, since my switch from Lantis to Levomir my sugars have been noticeably "better". I feel like I might be making progess. I am going to check out that book a couple of you mentioned. :)

[June91]

Basal testing is definitely what I would do as a first step. If your basal is spot on, your bg will not fluctuate as much too fast, which will help with the anxiety. Also, don't worry about not getting a pump, it's not the end of the world, although it helps enormously. I had my baby on mdi - not easy, but I am sure you will get all the advice you need right here. Now first let's get you to relax a little and flatline those basals! :)

[Gangrel]

Honestly, I look at Diabetes in 4 hour chunks. Why? Because that's how long Humalog lasts me.

For example, if I eat at 5pm, and my pre-meal reading is a 9.8, I will bolus for whatever i'm eating, and take probably 1 unit to correct (maybe 2).

Then, if i'm in the mood, i'll check again 2 hours after eating, which is when the carbs have theoritically maxed out (in a perfect world, don't start with GI and fat, etc, i'm keeping this simple!)

If my BG is between 7-10, I know i'm exactly where I should be.
If my BG is 10-13, I won't do a thing. Why not? Because I am still going to come down before my next meal more then likely, and while yes, i will be higher then i should be, i avoid injecting MORE Humalog during the 4 hour action of the previous Humalog, and keeps things clean and simple.

I find if i inject more Humalog during the previuos shot's duration, I can't figure out exactly how much to give usually, because now you have 2 different doses in action. Yes, I know and I have seen charts that can show me how much strength is left for Humalog and figure out a dose to give, but I don't want the stress of running to Microsoft Excel every 4 hours to figure out how to run my life.

That being said, if i'm higher the 13, I WILL take more Humalog, just because i hate being uncomfortable, and 13+ is higher then you should be.

Anyway, this is my "KISS" theory... (keep it simple stupid).

Makes my life a lot less stressful and involves a lot less thinking and finger pokes.

[andypoo]

Pincushion, In my opinion,Gangrel,has always been very right on in what he tells you. He's more down to earth and very relaxed and calming,at least this is what I've always observed. Listen to what he says,relax about the big 'D",freaking out is not healthy for you. Thanks again,Gangrel for posting to this poor girl,I was worried for her. I remember when I went through that anxiety,it's a killer. When I read your post to her,I even felt a sense of relief for her. Pincushion,every one here wants to help each other,you'll find your middle ground and your comfort zone here from opinions expressed here.It's been a lifesaver for me,as well. I am so greatful to everyone on this forum,I consider them all my friends.

[poodlebone]

Wow, thanks to EVERYONE for all the responses! To answer a few questions...I do record my results, my insulin intake, and my food intake. Its the anxiety attacks that are causing me to test when its not necesarry (like every five minutes when I know my sugar is on the decline....) and while I know it's not necessary it's the only thing that stops the anxiety attacks. So, that being said. I tend to check about na hour after taking my humalog. I usually take my injections immediately after I eat. How long after eating do you folks usually check your sugars? I always wonder if I'm checking too soon and stacking my injections too close together. I guess it's just been too **** long since my diagnosis so I don't remember all the basics too great. On top of that I went through the stubborn teenage years where I didn't even carry my monitor (I can't leave a room without the **** thing now, I don't know how I managed...). My A1C is currently 9%, the highest it's been in years. I guess it's just extra frustrating because I feel like I am trying harder now than I ever have and I just can't seem to get control. Oh, and I don't care how often I have to prick my finger or stick a syringe in myself...I'm kind of use to it. My only complaint is the expense of the strips! haha. And I must say, since my switch from Lantis to Levomir my sugars have been noticeably "better". I feel like I might be making progess. I am going to check out that book a couple of you mentioned. :)

Why are you injecting after you eat? Do you often not finish all of the food you thought you would eat for that meal? I always calculate my carbs, check my BG, bolus and eat. If my BG is high I'll delay eating for a bit. If I really don't want to wait I'll go out for a brisk 15 minute walk, which helps to bring my BG down quickly (after I've corrected). But I never bolus after I eat.

Humalog takes about 15 minutes before it begins to work. If you eat first, your BG is going to start rising as soon as the food enters your mouth. Say it takes you 15 minutes to eat. If after 15 minutes you inject, it takes another 15 minutes for the Humalog to start working. Your BG has a half hour to spike really high from the food before the insulin starts to work on bringing it down. You're almost guaranteed to be high if you check an hour after injecting. And if you correct that high, you'll most likely go low later on. When I was on injections my CDE told me not to bolus within 4 hours of a previous injection unless my BG was over a certain number. I don't remeber what that number was, though. And she told me to never correct before 2 hours. I used to have a big problem with stacking boluses and I'd have serious lows because of it.

I usually check 2 hours after a meal but since I go for a walk every day after lunch, I check 80-90 minutes after eating. I often have an extra carb boost while walking because no matter how much I cut my bolus, set a temp basal or set the bolus as a square wave, I seem to go low. I will check again at the 2 hour mark.

My advice is to inject before you eat, unless you have gastroparesis or you have a history of not eating the food you've prepared. Wait two hours to check your BG unless you feel like you might be low. Not just in your mind - pay attention to how you feel physically too. Don't stack your boluses or correct too soon.

[PinCushion]

you're all so awesome. So now my questions is....on MDI how in the world do I basal check????

[June91]

Basal testing is exactly the same process on or off the pump. You can see how here: HOWTO profile your Basal Rates. (http://www.insulin-pumpers.org/howto/baslr.html)
It is how you can then fine tune the basal according to the info you collect that is different with mdi.

[Chris Graham]

Hi ya! Welcome to the forum. I am 32 weeks pregnant on MDI. Aside from a few higher-than-they-should-be fasting numbers in the past few weeks, I have had really great control. I have, of course, seen a few highs and had a few lows...that is always going to happen. Our baby is doing great! It is possible to have a healthy pregnancy...don't let the big D stop you!