Pump decisions

this sucks. i'm not sure how i want to deal with the situation yet. the situation is...... i need insulin. :-(
i have basically two options, well actually three. 1- multiple daily injections. 2-insulin pump. 3-no insulin and slowly starve to death. there are really no good options, but i guess the first two are not as bad as 3.

1- MDI
advantages
1.not attached to a machine
2. can wear whatever i want and not worry about the pump and tubing
3. will not get caught in door knobs
4. no issue with scaring
5. no worries about bad infusion sites.
6. less testing
7. harder to obsessively treat BG
disadvantages
1. not very precise dosing
2. multiple, sometimes painful injections
3. injections more likely to bruise
4. more math
5. harder to correct high BG
6. lantus injections sometimes burn going in
7. i need a lot more insulin- possible weight gain

2. PUMP
advantages
1. very precise dosing
2. flexible basal rate- can adjust throughout day
2b. possibly fewer hypos
3. theoretically better control, not sure if i buy it
4. less insulin
5. wizard help
6. keeps track of everything, including IOB
7. easier to bolus in public- no needles
8. easier to correct high BG
disadvantages
1. its ugly
2. i hate the tubing- it gets caught everywhere
3. hard to wear dresses
4. it makes me much more obsessive about my BG numbers
5. i hate it beeping at me all of the time
6. scar tissue
7. worry about infusion site problems

Not really sure how to decide. If I felt that the pump would in the long run give me better BG control for sure, then it would be an easier decision.... but I'm not convinced.

BD Ultra-Fine Nano pen needle review

I hate needles and getting poked in general. In the hospital, it was incredibly hard for me to make that first self-inflicted insulin injection. It took a few hours of convincing, and eventually threats by the nurses that I would never be let out of the hospital unless I can show them that I can do this. Finally, I did it and it wasn't as bad as I expected, but still not fun. Given my fear of needles, my doctor told me to use the insulin pens instead of a regular syringe, since needles are much smaller. She ordered the smallest pen needles the pharmacy had at the time, the NovoFine pen needle 32G 6mm.

About a month later I started seeing ads for the BD Ultra-Fine™ Nano Pen Needle (32G 4mm), which are the "Smallest Pen Needles Ever" I was very excited to try them. I figured that they are smaller then what I was using and so they would probably hurt less. Plus, BD is offering a full rebate on your first box, so it was definitely worth a try.

I was excited to get them, the needles look tiny and they were cute and green. Although nothing about diabetes is really ever green. Diabetes supplies are so wasteful. Anyway, I was disappointed when I finally tried them. Although the were shorter than the NovoFine needles, I thought that they hurt a little bit more. I think they are not as sharp as the NovoFine, which apparently is more important than length. So, for now, I'll stick with the NovoFine.

my search for a good low-carb chocolate

One of the things that makes me sad about having diabetes is having to limit the amount of sugar I eat. I love sugar, and so far, all of the sugar-free treats I've tried pretty much taste sugar-free and not very good. For the first two months after my diagnosis, I did not have a single drop of sugar. Recently, I decidee to try finding a good dark chocolates that are low in sugar to satisfy my cravings. I found a couple of different ones to try and decided to write a short review. I'm including carb counts per 10g pieces, which is about 2-3 squares, and the most I would eat in a day.

- Endangered Species, All-Natural Dark Chocolate with hazelnut toffee:
I found this one at Whole Foods. It was delicious, very smooth and no bitter after taste. Although I think the hazelnut toffee made it higher in sugar then the other chocolates I tried.
Score: 7, Net carbs per 10g: 4g

- The dark chocolate lover's chocolate bar:
This one I found at Trader Joe's, and although it was very low in carb, it was a little to dark and bitter for me.
Score: 5, Net carbs per 10g: 2g

- Chocolove: almonds & sea salt in dark chocolate
This one was my favorite of the week. I love the combination of sweet with a little salt. The chocolate was very smooth and delicious.
Score 9, Net carbs per 10g: 3g

- NewTree: dark chocolate with ginger
It was also very good. It's smooth with no bitter after taste, but it definitely tastes like a strong dark chocolate. I like the subtle spiciness from the ginger. Although it had the second highest carb count for the chocolates I tried this week.
Score 7, Net carbs per 10g: 3.5g

- Lindtt Excellence: extra dark
This one was impressively low in sugar. Only 1.25g per 10g serving. Although, for me, I think it was a little too dark and bitter.
Score 6, Net carbs per 10g: 1.25g

After trying these chocolates, I'm realizing that I seem to prefer the ones with slightly more sugar. Still, they are all relatively low in sugar. I decided to stay away from sugar-free chocolates, since they are mostly made with maltitol, which I hear is not good for you. I'd love to hear what other dark, low-sugar chocolates people like.

eating out

At the hospital, when I was diagnosed almost three months ago, the dietitian came to teach me about carb counting. This seems to be the cardinal skill necessary for any insulin dependent person. She gave me some guidelines and print outs and told me to buy the essential carb counting guide, Calorie King.

So, I went home, pulled out my scale food scale for the first time, and started measuring every single thing I ate. In the last few weeks, I'm finding that it is insanely difficult to count carbs..... you have to measure every single thing that you eat, know exactly what is in your food, and know the carb count for every ingredient in your plate; it’s more manageable when you are eating at home (although still exhausting), but when you eat out, it is nearly impossible. After the first couple of weeks, I just started guessing.....but honestly most of the time I have no idea.

Now, the thing that has been bothering me is that except for large chain restaurants, most restaurants don’t seem the least bit interested in providing any kind of nutritional guide for their food. This bothers me for several reasons: 1) most restaurants don’t change their menus that often, so it would be easy to figure out nutritional info for most of their dishes; 2) it’s really easy to figure out nutritional info, and there are many free websites, like http://recipes.sparkpeople.com/recipe-calculator.asp available for this purpose. All you need to do is enter the ingredients and portion sizes. It would not take very long. Even my mom figured this out and has already catalogued all of her signature dishes. 3) Finally, it would be tremendously helpful not only to people like me, who need to know exactly how many grams of carbs they eat in order to dose the right amount of insulin, but to anyone trying to make informed decisions about what to eat.

I really wish small, independent restaurants would start doing this…. even if it’s only for a few of their dishes.

meter inaccuracy

Last night before dinner I checked my blood sugar and it was 170. I was surprised because it was much higher than I expected, so I tested again using the same meter...... and it was 124. I was shocked.

This morning I checked my blood sugar with my regular Aviva meter and it was 103. Then, using the same drop of blood, I also checked using my one touch meter, and it was...... 128. What? I checked again using both meters and now it was 112 and 106. I am very surprised by how inconsistent these meters seem to be, even with the same meter and same drop of blood. Is this normal? How am I suposed to make decisions about insulin when I don't trust the meter? How do other people deal with this problem?

clinical trial

I just finished receiving treatment for a clinical trial. This trial is to test a potential new treatment for newly diagnosed type 1 diabetes. The study was blinded, meaning that I had a one out of three chances of receiving the placebo, and neither I, nor the study PI would know. Given that this drug is strong, and I experienced severe side effects, I'm not sure how it is possible to keep the treatment blinded. Unless, of course, they create a placebo that also gives you severe headaches. I'm not sure how this is supposed to work. Or maybe not everyone that receives the drug has such a severe reaction. Who knows...

So, for the last eight days, I've been waking up at 6AM to get infused with this ?? (i'm almost certain it was the drug). Not fun, I hate needles and blood. I'm definitely not a good candidate for diabetes... but nobody asked me.

The week was pretty miserable. On day three, I started feeling very sick, even taking tons of ibuprofen, I still had a fever, and the most terrible headache of my life. Although I was miserable, I'm also glad that I had such an intense reaction, because at least now I don't have to wonder whether or not I received the drug. I really hope it helps me get better. I know this is not a realistic expectation, but I'm holding out some hope that maybe I'll be off insulin for a little bit. I could really use a break. I wonder how long it will take before I feel the effect....if any.

newly diagnosed with T1D

I'm not much of a writer, but I think writing about everything that has happened in the last month might help me deal with it or maybe just understand it a little better. About a month ago, on May 6th, I was diagnosed with type 1. It was all pretty shocking. It still is.

I had all of the classic symptoms of diabetes, I was insanely thirsty all of time for the past couple of months. I would buy gallons of juice at costco and it would be gone within a day. Also, my vision got progressively worse.... I thought it was because I turned 30 and needed to update my prescription. I lost some weight...although it took a while for me to notice, since I rarely weigh myself. And finally I started having terrible leg cramps at night. One night when I couldn't sleep because of the leg cramps, I googled leg cramps, and found the long list of symptoms for diabetes, of which I had every single one of them. The next morning, I made an appointment to see a doctor. She ran some tests, and then called me the next day to tell me that I should rush to the emergency room or I could risk going into a comma (scary).

I spent the next three days at the ICU, recovering from something called ketoacidosis (dka), and learning much about diabetes. What? I have diabetes.... I honestly did not know much about it except for that there was no way that I had it. I've always been healthy, I didn't even have a primary care doctor, it is still pretty shocking, at least for me. For whatever reason, I associated diabetes with unhealthy older folks. Not me! Now I realize that type 1 is an entirely different disease then the ubiquitous type 2.

From what I was learning, a life with t1d seems absolutely miserable. I hate needles, I love sugar..... having to test my blood sugar 5+ times a day, and giving myself multiple insulin injections seemed like an absolute nightmare. I know, like everyone keeps telling me, I will get used to it, it will become second nature, blah blah blah.... but I don't want to get used to this. I don't want to have to carry tons of crap with me everywhere I go, and constantly think about what I'm going to eat, always worry about what my blood glucose is doing, and have to give myself insulin every time I want to eat something.

I wonder how other type 1s dealt with it when they were first diagnosed.