Author: Chris Tall

Prior to 09 Nov 2008 I wrote it all down in a paper log book. This was the start of my spreadsheet.

The “dark times”

I was diagnosed with Type 1 Diabetes in the summer of 1991, when I was 17.5 years old. I can’t remember exactly when but I moved onto Insulin Pen Therapy at some point which was much better than using syringes and vials. I could grab a pen and take it with me without having to think about the additional nausea of carrying all the paraphernalia round with me. Just dial up the dose, screw on a needle and inject. Easy. I also can’t remember exactly when I stopped doing proper testing but I know I did. I seemed to slip into an easy rhythm of doing the same injections at the same time each day without really thinking what I was doing or eating, and not really testing my blood glucose at all. Looking back now I see this as a “dark time” in my diabetes control, when I was going through the motions without actually properly monitoring how I was doing.

When I would visit the consultant I would just make up some numbers for my blood sugar and put them in an excel spreadsheet. I don’t remember what my HbA1c was like during this period but I do remember not being worried about my visits to the consultant or being “told off” during them. I just sailed through without any problems it seems. I didn’t have any serious hypos, or hypers nor did I develop any other complications. My vision remains fine and I still have feeling in my feet, but I did have these checked each year by the hospital.

The one thing that does surprise me is the amount of exercise that I was doing at the time did not cause me any serious hypos. I would cycle 10 ~ 16 miles a couple of times a week, sometimes when it was really hot and sunny, and I had no problems. I used to take water and a Granaola bar which I often didn’t eat but never my blood meter or Lucozade. I find this scary to think about now, especially as I am far more aware of how my body reacts to exercise and what my blood sugars will do. I am amazed that something serious didn’t happen to me in the quiet lanes of north Cardiff to be honest.

When I moved to Bristol and transferred to a new hospital I had a chat with my new Diabetes Specialist Nurse (DSN) who asked me why I wasn’t testing and I explained that I had just got out of the habit really. We talked through the benefits of checking my blood sugar, she gave me a shiny new meter and being a sucker for technology I agreed to start checking my blood sugar. I have now tested since August 2008 and moved onto carbohydrate counting and a pump but I have benefitted enormously from the testing I have done since that discussion.

While sometimes it can be a chore to test my blood it is an essential part of my daily life and not doing it would be very difficult for me to do. I have good days, bad days, hypos and hypers, but checking my blood sugar allows to me figure out where I need to make corrections and more importantly it allows me to eat what I want. Which is awesome.

Remember kids, not checking you blood is not big or clever!

My Diabetes Statistics

I record everything related to my diabetes. Everything. I have a spreadsheet that I record it all in which I update every night. My records go right back to 2008 when I started properly testing again after a period of darkness. I was on MDI back then but I have graduated through carb counting to pump therapy today.

Recently I have been updating my spreadsheet to pull out some facts and figures over the last year. I need to use this information to improve my control but it has shown me some surprising numbers from last year. The two that I find most fascinating are that I did 2,683 blood glucose tests and, slightly disturbing, I ate 124,669g of carbs! That’s 125kg. Of Carbs! Wow. To put this into some context I am 2 metres tall and I weigh about approx 94kg. Although when I write this it doesn’t make it seem any better.

I class a hyper as a blood glucose of 12 or over and a hypo as a blood glucose of less than 4. Of the 2,683 bg tests I did 474 were hypers and 114 where hypos. I am pleased with the number of hypos as although this is still high I have improved this since November and I have only had 15 from 01 Nov until today. My hypers are something that I am going to have to work on though.

By posting this I can already see that I need to gather some more stats from my spreadsheet (no of corrections, no of tests in range, standard deviation, a nice pie chart, total insulin dose & total basal & total bolus) but, more importantly, I can also see where I need to focus my efforts to improve my control.

For me this level of data collection works, despite the effort, and I would love to hear how you collect your data and what you do with it.

 

PS. My biggest month was September 2014 when I ate 546g of carbs in one day!

Bruce, my inseparable buddy.

Bruce is my inseparable buddy and we have been together for just over two and a half years. Bruce is my insulin pump which I received after I changed from Multiple Daily Injections (MDI) to pump therapy in August 2012. I had been struggling with MDI for several years to the point that I was on 5 injections a day but still having problems with unexplained hypos and hypers. My Health Care Professional (HCP) had mentioned an insulin pump to me and I had immediately dismissed the idea because I didn’t want to be attached to something all the time.

But we reached the end of the line with what we could do on MDI and my HCP said to me the only course of action was to stick with my current MDI regime and wait for a new insulin to be developed that might help. She said there was something on the horizon but it was at least a year away, so I asked for some more info about an insulin pump.

The decision

I had not quickly changed my mind and decided to try to get a pump but I wanted to see if and how it could help me improve my control. I was given some brochures for Animas, Medtronic and Accu-Chek to take away with me. I studied them intently during my holiday, talked it through with my wife as it would impact on her too, and decided to take the plunge. I would like to say that I weighed up the pros and cons and listed them out, considered the long-term benefits and improvements it could deliver in my blood sugar control, thought about the effort I would need to put in to get that improvement in my control, discussed it at length with my wife to ensure we both understood the implications of a pump on our relationship, but I didn’t.

I did discuss it with my wife and thought about the pros and cons but I didn’t spend a long time deliberating over it. I think partly because there was nothing else to do on MDI and also I think I was wowed by the technology factor, as I am a geek. Ultimately I chose the Accu-Chek Combo, partly because I was already using an Accu-Chek Expert meter but mainly because I would be able to control the pump entirely from the meter. I wouldn’t have to use the meter then separately use the pump to administer the insulin. I would be able to leave it entirely under my clothes and not touch it all day long. This was the biggest selling point for me as I really dislike the idea of having to access the pump after using the meter to give myself my bolus.

So I had decided, I was going to get an insulin pump.

I will blog about moving onto my pump in my next post but I would be really interested in hearing your pump decision stories.

The Type 1 Astronomer.