The State of the Pancreas

I saw my endocrinologist last week. That wouldn’t be such big news, except for the fact that I hadn’t been to his office is almost 3 years. Between life changes, insurance switchings and everything that comes with it, I was always seeing my PCP because it worked well for me. But with the recent turn of events, my pancreas being so cranky and all, I decided it was time to go back to Dr. B and I’m so freaking glad I did.

I’ve always liked Dr. B. He’s personable, he cares about his patients’ mental well being above everything else, and he never gives me the talk about how things are so horrible, I better watch out. He may get frustrated—oh, so frustrated… but he never shows it. After all, it’s not his job to make me better… he’s just there to guide  and advise, but the biggest tasks are mine. So after almost 3 years, he was glad I went back, but not so glad that my diabetes is giving me a hard time.

The most important questions I had when I saw Dr. B were:

  • “Did my pancreas check out?”
    To which he replied that no, my pancreas is probably just overwhelmed and being stubborn.
  • “When do I start with rapid acting insulin?”
    To which he replied that it’s better to let the Lantus do its work and see if my pancreas responds.

So that’s what I’ve been doing, giving Lantus a chance. I’m up to 20 units a day, and my numbers—at least my fasting numbers—are getting better every day. I’m guessing I’ll find the “magic” number of units this week. However, my post-meal numbers are never under 200, and I hope they start behaving soon… (I’m low-carbing, dang it!). Based on my log, in two weeks Dr. B will decide if I need rapid acting insulin or add another medication to my metformin since Victoza didn’t quite agree with my stomach.

Whatever Dr. B says, this thing is no joke… it’s no joke when your blood sugar is 466 and you realize all hell got loose, and you want a quick fix. There is not a quick fix, not in the general sense (I don’t bolus). And it requires work, and tears, and a few swear words… and it never, ever ends.

Diabetes Alert Day

Did you know more than 25 percent of Americans who have type 2 diabetes don’t even know they have it? Are you one of them? Today people from around the country will take a simple test that can change their lives. We’re calling on you to Take It. Share It. Step Out.

There has never been a more urgent time to know your risk. An estimated 79 million, or one in three American adults, have prediabetes.

The Diabetes Risk Test asks you to answer a few quick questions about weight, age, family history and other potential risk factors for prediabetes or type 2 diabetes.

It takes only 60 seconds and it could save your life!

We can’t waste any time. Take the Diabetes Risk Test today and share it with everyone you care about. Chances are someone you love is at risk, and early detection can prevent or delay type 2 diabetes and its devastating complications.

 

Pinch, Poke, Go!

It took me 1 month to stop worrying about the side effects warnings, but I finally started my Victoza. My body didn’t have a lot of fun adjusting to the new medication, but I survived the first week with the 0.6 mg dose. There was some nausea, a lot of dizziness, and the feeling that a Mack truck ran me over. At some point it got so annoying I actually asked for half a day off from work while I crossed my fingers so the crappiness would go away. It subsided eventually, but then I was worried about increasing the dose to 1.2 mg. No issues there!

I have been on Victoza for 3 weeks now. I can’t say I feel wonderful, but all the initial side effects are gone, my blood glucose levels are in range, and I feel like I have a controlled, normal appetite; in fact, some days I just make myself eat something healthy even if I’m not hungry, with the sole purpose of taking my metformin pills at dinner time. I take my Victoza before I go to bed; the needle is a joke, I barely feel it. I am so excited about the pen I even got a special sharps container. I’m silly like that, but maybe it’s a good thing that I’m excited about the new medication because that will help me with compliance which has been my main problem.

And this thing is working! I hadn’t waken up with a BG of less than 150 in a long time, I hadn’t seen anything below 200 after I ate either. Now I’m seeing a bunch of 90’s when fasting, and my post-meal levels don’t go over 160. The only fear I had was the pancreatitis and pancreatic cancer risk, but last week I welcomed the news that the FDA eased the concerns for GLP-1 medicines. So far, so good. Let’s hope my next visit to the doctor shows an improved A1C.

 

Meet my New Best Friend

In a previous post I mentioned that I’ve been struggling with my diabetes management. Back in October my A1C was 8.3, and I thought going back to my regular care routine and making better choices was going to fix that. It didn’t… My latest A1C is a whooping 9.5, a number I have never seen. I felt like a complete loser, and my doctor was nice about it, but she reminded me that diabetes isn’t something to play with. Basically, she said, mine is progressing and we better do something about it.

When I asked if it was too early to start insulin therapy, she said we should try something else first. So she prescribed Victoza, I got my prescription and I’m going to see the nurse tomorrow to learn how to inject myself. Some people think I’m afraid of the needle… Are you serious? Are there any people with diabetes who are afraid of needles? If so, I would like to meet them! So no, I am not afraid of needles. I am, however, not looking forward to the nausea side effect I’ve heard about. Other than that, I’m ready.

I’m trying my best to not look at this as a defeat. Metformin has worked for me for the last 12-13 years, but it’s just not enough anymore. I’m hoping that with a better diet and exercise my glucose levels will improve, and maybe I won’t have to depend on the medication so much.

It is maddening, though… Sometimes it doesn’t matter if you eat well, especially when you’re sick. Last week I had a stomach bug, and every time I checked my blood glucose it was on the 200s, It’s slowly getting better; although I haven’t seen anything under 150 while fasting. So anyone who thinks type 2 diabetes isn’t frustrating, has surely not walked in my shoes.

I don’t know how many people are reading,  but I would like to know about experiences with Victoza. I’ve heard it has really made a difference for quite a few people with type 2 diabetes, and I hope it will make a difference for me.

Bring on that fancy pen!

 

Feeling Totally Derailed

Originally posted on Diabetes Daily.

As I sit to relax after eating a healthy lunch (green peppers stuffed with a mix of brown rice, chicken and veggies) I’m thinking why don’t I eat like this more often. In fact, I’m here thinking what happened in the past few months to make me completely derail from everything a person with type 2 diabetes should do in order to be healthy.

2013 has been hectic. For almost a year I was working two jobs so I could afford health insurance (see the irony?). My schedule was so crappy, I ate whatever was available, which means there were a lot of late night shifts that ended at the BK drive-thru. Decent sleep hours became a joke, so don’t ask me about exercise (which I previously posted about). My routine got completely screwed up, and I won’t get the award for taking my medications on time. Now my jeans feel tighter, you do the math. I feel tired which means my thyroid is angry. So it hasn’t been a good year for my diabetes management.

About a month ago my life changed for the better when I was offered a wonderful position at the college where I work. Now I have a regular week day, first shift, full time job. That certainly gives me time to plan things and take care of myself, but it’s taking me a while to get back on track.

The first thing I did was reassess my health and realize I haven’t seen my doctor since the beginning of May. My last A1C dates from March. I don’t remember when was the last time I tested my blood glucose levels because I ran out of strips, and the doctor will want to see me. But for a month I’ve been afraid to call and make that appointment… I am almost 100% sure my numbers will make her eyes cross.

Because taking my metformin has been rather an irregular thing, now that I’m taking it every day, as many times as required, my stomach is all messed up and I find myself cursing the diabetes demons. And while trying to decide how to soothe my poor stomach, I was thinking if I need a medication change, if it would be better to manage my blood glucose levels with insulin or if there will soon be a magic cure. Truth is, all I need to do is get out of denial and do what has always worked for me.

This is the story of my life. The story of the life of a person with type 2 diabetes. Especially one who doesn’t live on insulin. It’s homework every single day. Every decision affects our numbers. And the guilt paralyzes us.

I made my appointment with the doctor. I know it won’t be pretty, but I ran out of excuses.

Do you Strip Safely?

Imagine your life depends on knowing a number. Imagine you have the tool to find what the number is, and based on this number you have to follow the rules or you may end up in big trouble—and by trouble I mean death. I’m not joking… this is what people with millions of people with diabetes are dealing with now.

It is sad and scary to learn that there is no proper regulation for the manufacturing of certain types of glucose testing strips, which leads to inaccurate numbers… very inaccurate. If you have diabetes, and you’re on insulin, you may either over-treat or under-treat a rather complicated condition; and don’t forget insulin is a very dangerous drug. Too much, too little… NEVER a good thing.

Imagine you’re the parent of a child with diabetes and you need those numbers to be accurate so you know what is the right thing to do. Imagine you give your child more insulin than what they really need. Or less. Inaccurate readings are every person with diabetes’ nightmare, and that is one of the things we keep hollering about. One would think that after all the hollering we would be heard. But that isn’t the case

According to Strip Safely:

At a recent public meeting the FDA acknowledged that there are some 510(k) cleared blood glucose (BG) meters and strips that do not meet the accuracy standards for which they were approved. There is currently no clear course of action to insure people with diabetes are using blood glucose strips that meet regulatory requirements.

Then you have a person like me, who is not on insulin, and whose doctor recommended to test 2-3 times A WEEK (that’s a story for another day). If I already have a hard time getting an idea of how my diabetes behaves, you can do the math when it comes to a meter that isn’t giving me accurate numbers. The problem is, which one do I trust?

Last month, David Edelman posted a Blood Glucose Meter Accuracy Comparison chart. It isn’t the only one I’ve seen lately. Well known brands of glucose meters are barely making it, and they are well regulated by the FDA. What about those who aren’t? The “cheap” ones that will make you spend more money on complications at the end of the day?

And you must be thinking what you can do about the accuracy issue and ask for stricter regulations from the FDA when it comes to something as vital as adequate blood glucose level readings. Well, YOU GO TELL THEM!

Contact your congress person and make a DEMAND for stricter regulations from the FDA. Diabetes isn’t a joke. Glucose meters aren’t a toy. And we aren’t puppets.

Taking the High Road

Wouldn’t you know it… there are instructions for this: Take a deep breath. In for five, out for five. Close your eyes to get the full effect. Repeat if necessary until you feel like you’re back into control. Then smile. Look the person directly in the eye and give them a knowing smile. Usually, people find this disarming and want to smile back. Sometimes, this is all it takes.

When it comes to health conditions and each individual’s experience, there will always be someone who doesn’t agree with me. And lately I’ve found myself trying hard not to say something, especially about people with type 2 diabetes. Somehow we’ve been deemed the fat and lazy who deserved to get diabetes; the media doesn’t help and opinion are so divided, I really don’t know right from wrong anymore. I know my personal history, I know I probably could’ve delayed the onset of my diabetes, but the magic cocktail was there for me to develop it. Whether I deserve it or not… that’s another story.

One of the things I struggle the most as diabetes advocate is trying to make other people in the community understand that because I have type 2 it doesn’t mean I have no awareness about other types of diabetes. The constant bashing of type 2s makes me really sad sometimes, and I wish other people wouldn’t be so quick to judge and condemn. Things have gotten to the point that it’s bad that we’re all called diabetics. But that’s a rant for another day. What I’m trying to say is, that in the middle of this struggle, I decide to take the high road and keep on doing what I’m doing: caring, helping, educating.

Sometimes it’s better to smile and keep silent.

Go Test Yourself!

A couple of weeks ago I posted something on my Facebook timeline about testing my blood sugar (Shocking! I never talk about diabetes! :P). One of the comments came from a friend who’s afraid of getting tested, even though she was told she had pre-diabetes and she has a family history. She says she’s terrified they’re going to tell her she has diabetes because her father had too many complications and she can’t deal with that. My words to her: GO TEST YOURSELF!

As scary as the thought of having diabetes is the sooner you learn you have it, the better. Sure, when you’re diagnosed with type 2 diabetes, it isn’t fun to hear you have to change your life style, prick your fingers often, stop eating anything you want, exercise and all those fun things people with diabetes have to do. Most probably your doctor will put you on a medication that can and will upset your stomach and you will wish you never took it… but test yourself! If you’re afraid of developing complications, learn the most you can as soon as you can and take control of your diabetes if you have it.

People who are afraid of getting diagnosed or who are newly diagnosed see the condition as an overwhelming burden. IT IS! However, they also believe they won’t be able to make it, they won’t be able to manage it and they will sooner or later die of horrible complications. My words to my friend were “commitment and discipline” and her response was “the two things I lack of.” —Well, she’s not the only one. I think that’s what we struggle the most with, and I think that’s the first thing we have to work on instead of making ourselves crazy with a lot of information about the condition itself. Learn how to cope, learn what is good, learn that there is support, learn that you’re not alone.

It pains me to hear a friend telling me she/he has diabetes, but they won’t tell anyone… hence they’re not taking care of it. I don’t know if it’s denial, fear or a combination of the two… but please! If your doctor tells you that you have diabetes, don’t put it on the back burner. There is a way to live a happy, healthy life with a chronic condition. You just need to be aware of it.

D-Blog Week, Day 1: Find a Friend

It seems the most popular thing about Diabetes Blog Week is that it helps us find blogs we weren’t reading yet and connect with some new blog friends. With that in mind, let’s kick off Diabetes Blog Week by making some new connections. Think about the d-blogs you read that you think we may not know about and introduce us to one that you love!! Let’s all find a new friend today!

Yes! D-Blog Week is here, thanks to the most wonderful Karen. The first post of the weeks is about finding new friends in the Diabetes Online Community. We all read all kinds of blogs, we all have some we like more than others; there are also people who are more well known than others. So it’s fun to discover new posts to read.

I’m really bad at keeping up with my blog roll, but I do try to check my RSS feed reader at least a few times a week. But it makes me very happy when I find a new type 2 blog because I can related more closely to the person. So I’m going to present My Fall From Grace, a blog I started reading recently written by a woman with type 2 diabetes. We all seem to struggle with the same things, and we all try our best.

Check my blogroll for more goodies. And if you have a blog to recommend, please leave a comment!

His Thoughts About Type 2

I asked my husband to write something about diabetes from his perspective. This is what he had to say about living with a person who has type 2 diabetes.

Diabetes sucks, no way around that fact. It is a disease that affects people in a big way no matter what type they have. The hardest thing for me to understand was that a metabolic disease affects a the person in a lot of levels. So my tale begins.

I still don’t understand as much about diabetes as I should, but I try to keep myself somewhat informed. The truth of diabetes is that while it affects all facets of your life when you have it, it is not the only culprit. Sure, sometimes a “low” can cause impatience, hunger, thirst, but the person can also be simply hungry, thirsty or in an impatient mood. Living with someone with diabetes makes you learn to keep track of that and also learn how to prevent it.

That is probably the most frustrating part of diabetes with your significant other. The problem is metabolism, but a lot of it comes from how your body reacts to nutrition, especially for people with type 2. It is not only about, “hey, don’t eat sugar.” You would think that the hardest part would be to tell someone, “hey, you should not eat that…” Actually the hard part is to get them to eat when they don’t want to.

A lot of people link obesity with diabetes, especially type 2. The reality is that the frustrating thing of the disease is that even when you do eat healthy, your body might not process the good food as well either. That and that it is all about constant good nutrition, not just good nutrition when the “bad” cop is around.

That is the part I hate about diabetes, being the “bad” cop. Having to tell your loved one that ice cream might not be the right thing to eat when you know they want to eat it. I am in an even worse situation because I don’t care for sugar at all. I can go months or years without ice cream, cookies or cakes. If your significant other is someone that loves those things, it feels horrible because they don’t tell you not to eat bacon even though you have a history of heart disease in your family. It is a constant struggle between being loving, understanding and also supportive.

Then again, I struggle with making sure that my wife eats properly when I am not around. She is not very good about snacking and ends up not eating anything all morning and being really low by lunch time. While the highs are sometimes considered the dangerous ones when dealing with diabetes, the lows also happen quite often.

Besides nutrition the other factor that diabetes affects is energy. You cannot process the fuel, so your energy level is probably lower as well right?

Even though I have been very sedentary for years working in the computer field, I do have energy to do stuff. It can get frustrating when that energy does not match your significant others energy. Everyone loves to talk about exercise, but how about when there is no energy to do that because your body is not processing things to give you that energy in an efficient and constant manner?

Enough about the lows though. Life with a diabetic is no different than life with anyone else. Everyone, as they get older, has aches and pains. Diabetics get to learn to deal with those and adjust a lot earlier in life. It is also awesome when you see that their careful care of their disease yields good A1C numbers… whatever A1C is 🙂

You can visit my hubby’s blog and read more of what he has to say about everything. I married a smart one!