Life in LADA land

Living Philippians 1:6 with type 1.5 diabetes

Moderation – in all things?

on October 7, 2013

This is the post I was going to write before the really terrible, horrible, very bad Sunday a couple of weeks ago.  I am learning about moderation in diabetes, and in life maybe too.

The first lesson came after realizing that I was having to change out infusion sets* in between pump refills more times than I would like. For those of you out there who aren’t wearing insulin pumps, my Animas Ping holds about 200 units of insulin, which lasts me about 4-5 days. The other piece of information you should have is that the infusion sets are only supposed to last 2-3 days, so I stretch that beyond the limit most of the time. Unfortunately some of the time, the site where the infusion set is  attached to me doesn’t always work that long (something happens so that insulin no longer gets through, either the cannula is kinked, or blocked or some mysterious force just makes it stop working), so I have to put in a new one for a day or so until I change out the whole system.  The problem is that none of this stuff is cheap, so I really dislike having to use up more infusion sets than pump cartridges.  Also, there’s a symmetry issue that bugs me, having more boxes of infusion sets than cartridges but that’s my problem……  My always-wiser-than-me CDE  suggested that the way around this is to just put less insulin in my pump than the pump actually holds, say, 3 days worth instead of 4-5 days worth.  Huh. Why didn’t I think of that? It’s really better for me to do that, since leaving the infusion sets in longer than recommended isn’t really good for my skin. But it is hard for me to psych myself up to do this – not filling up the pump to full capacity feels like some kind of weird failure.  I know it’s the right thing to do and will save on insulin and supplies in the long run, but something in me just wants to FILL that cartridge up to the top.

Then there’s swimming.  I have been struggling for months with unpredictable blood glucose levels after swimming, despite having the same breakfast, dosing the same way with insulin and trying hard to do the same level of intensity as I swim. Some days I would drop really low, others I would soar into the 200s and stick there for a while.  In August and September, between travel and knee surgery, I had to miss quite a bit of swimming so when I started back up in mid-September, I had to gradually increase the length of time I swam back to where I had been. Funny thing happened. My blood glucose behaved better when i wasn’t swimming so long.  I have settled out at 30 minutes (instead of 35-40) and it seems to be helping make things more predictable after swimming. But again, it’s less than I COULD do.  I COULD swim for another 5 minutes, but doing so seems to take a toll on me that is inconvenient, to say the least.  By settling for less than my maximum capacity, my mornings improve greatly. You would think that would be a no-brainer to do, but I have to fight myself almost every morning to stop swimming at 30 minutes.

To be honest, I’m not sure what the lesson is for the rest of my life. I’m waiting for it to catch up to me, as I know it will.  I’m sure I have something to learn about moderation in areas other than managing diabetes. Stay tuned for updates and insights.

*An infusion set is the place where the pump meets my body – there’s a quarter-sized sticky patch with a plastic connection where the tubing from the pump attaches. Under the patch there is a very short plastic cannula that goes just under my skin and that’s how the insulin is delivered.  Pictures of an infusion set for the strangely curious are here.

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