The fear of nighttime lows, including mine

2 yrs old heh heh hehMe at three years old

I serve as a communications advisor to Dex4, maker of glucose products, lending them my patient perspective and expertise. 

I’ve also done a number of writing/editing projects for their “situational lows:” web and print information on “managing weight and lows,” “exercise and hypoglycemia,” “safe driving and hypoglycemia,” and “school days and hypoglycemia.” They’re all under the Learning Center tab on their web site. Great information about correcting and preventing low blood sugar.

So how uncanny that just as I’m working on another situational about nighttime lows, the most dreaded of all, my mother just spent the last two days thinking I had suffered one. Luckily as of this morning she knows I’m not sprawled in my bed or on the floor unconscious.

This is what happened. Every time my mother called my landline she got a busy signal because the last time I used the phone I had used my earpiece and hadn’t properly hung it up. So she’s hearing the phone ringing and ringing when, for me, the phone isn’t ringing at all. 

Meanwhile my cell phone was in my coat pocket for two days because I had put it there when I walked my husband down to the car service to take him to the airport Tuesday night (just in case they didn’t show) and completely forgot to take it out of my pocket. So, even though my mother left three messages on my cell phone, my phone battery was dead. Only last night did I look for my cell phone, realize it needed to be charged and it spent the night on the charger.

When I pulled my cell phone off the charger this morning I saw I had three messages, two from my mother and one from a friend she had called in Florida to see if she knew where I was or if something had happened to me. 

I called my mother right away and her relief was palpable. I can only imagine her picturing that little girl up there in the photo in dire trouble. I’m not usually a ditz. Actually, never. But I have had a horrendous body (and obviously mind) numbing cold/flu where all I can do is walk myself from my bed to read and doze to the couch to watch some TV and doze to the kitchen to make some soup, to barely lifting my ipad to check my emails. Work has largely gone by the wayside so I didn’t even realize the phone hadn’t been ringing.

All to say, I’m really sorry mom and we really do have to teach you how to email! But I also want to use this as an opportunity to remind you that if you suffer from lows and are alone, it’s wise to have a plan so you can get help if you need it, and assure your loved ones if you don’t. 

My current plan is if my mother experiences the same again, she is to call my brother and have him email me. Yes, even in a stupor, I check email. If I really had had a devastating low, (which in 39 years I never have thankfully) I have glucose tablets several places in the house. I also know I should have a better plan. All I can say is I’m working on it.

 

The Ricordi Chamber stars on “Grey’s Anatomy”!

I thought it was way cool while zoning out last night in front of prime time’s soap, “Grey’s Anatomy” to hear the words the “Ricordi chamber.” 

There I was wondering would Meredith make Mr. Dreamy realize she’s not just his wife but a fine resident? Would Calli ever stop screaming about her pregnancy? Would Mark ever tell Lexie about the baby he’s fathering? Then while Dr. Bailey’s performing surgery that Lexie’s twittering about in the background – much to the consternation of the Chief – someone either in the operating room or via twitter says they need a “Ricordi chamber.” The Chief looks doubtful but a twitterer (I think, because now I’m leaping over to my computer to send a fast email about this) helps them realize the viability and that there’s one down the road at a nearby hospital.

The Ricordi chamber is the creation of Dr. Camillo Ricordi, Scientific Director at the cure-focused premiere Diabetes Research Institute. The Ricordi chamber extracts healthy beta (insulin-producing) cells from a damaged pancreas that can be used for islet infusion. 

I interviewed Dr. Ricordi a few months ago on the Huffington Post, where he spoke about the Ricordi chamber, and much to his dismay having it named after him.

Dr. Ricordi: One night they were discarding a pancreas at the university. I waited for everybody to leave the lab and did a secret experiment. I thought if it doesn’t work I won’t tell anyone. If it does I’ll tell my boss. It worked, and within a few weeks all the engineers at the lab switched to this new procedure I’d tried. It’s based on a chamber.

Riva: This is the Ricordi Chamber?

Dr. Ricordi: Yes, but it was not my idea to call it that. I had called it the Automated Method.

Riva: How did you come up with it?

Dr. Ricordi: Truly, I was inspired watching a log burning in a fireplace. I thought you could develop a process where the pancreas would sit inside a chamber and like the slow, continuous process of disassembling a log in a fireplace, we could disassemble a pancreas and liberate insulin-producing islet cells. At the time it was very tough to break down an organ and get the islets out. They used a very heavy mechanical device not unlike a kitchen grinder. So my idea was quite radical. People laughed, “Sure you want to put a whole organ into a chamber and have things coming out the other side!” But it worked.

My leap to my computer was to email Tom Karlya, Vice President at DRI, whom I’d recently lunched with, and Lori Weintraub, VP of Marketing and Communications. Tom emailed right back, “Cool, huh?” Lori wrote back, “Thanks Riva!”

Yes, it’s ever so cool seeing a conversation about our lives coming out of the mouths of Dr. Bailey and her team over at Seattle Grace Hospital.

We’ll get healthy when health is the easy choice

New Year’s resolutions be damned, we’ll get healthy when health is the easy choice.

Yet again this morning I heard on the CBS Morning Show a segment from medical correspondent, Dr. Jennier Ashton, listing how to stay younger. You know how, you’ve heard these rules a zillion times. Don’t smoke. Eat healthy foods in smaller portions. Exercise, both aerobic and weight training. Wear sunscreen. Get 7-9 hours sleep. Get 1,200 units of calcium for bone loss. 

OK, I listened to hear if anything was new. It wasn’t. Then I went to do my laundry and while shoving shirts in the washer thought, how am I supposed to follow these guidelines given my day? How are you supposed to follow these guidelines with your busy life? Is your boss making time for you to go to the gym? Is your cafeteria or ubiquitous corner deli, fast food place, family chain restaurant or airport kiosks offering more healthy choices than unhealthy ones? For the same price?

Can you enjoy peaceful slumber in these recessionary times? Can you sleep 8 hours if you’ve got little ones or a job you’re trying to hold onto? Can you even find 30 minutes to get outside to wear your sunscreen?

As I’m typing the same show is now doing a segment on “How to jumpstart your oops, missed it, either weight loss or exercise.” As if I had room in my tiny apartment for a treadmill. Or even the space to lie on the floor with dumbbells as they’re now showing. 

It amazes me, again and again, that we preach what we should be doing out of one side of our mouths and do nothing to create the infrastructure to support people doing it. Food manufacturers have powerful lobbies to keep making artificial food-like substances. The government continues to fund farmer’s over production of corn so high fructose corn syrup is in most things you eat, including the burger you can buy for a buck. No wonder people are chowing down at McDonalds and not on apples that also cost nearly a buck. So tell me, talking heads, what do you really expect people to do? 

Or is it because a big corporation owns the TV station, the newspaper, the magazines and profit rules what people say but not do.

Finland’s capital city, Helsinki, has a mysterious high population of type 1 diabetes – more people in Helsinki have type 1 than anywhere else – and they now have a growing epidemic of type 2s. What did Helsinki do? They redesigned the city to create more parks for free outdoor activity, they created more bike lanes and more walking paths. What are people doing? Playing outside (hopefully with their sunscreen on), biking and walking on a regular basis. 

Without the infrastructure to make it easy to make healthy choices, it takes enormous commitment and effort to stay healthy in America. It takes learning about the health quotient of different foods, being able to afford them and packing your own wherever you go. It takes waking up early or sacrificing time with your family to get those 30 minutes of exercise. 

I’m not saying it can’t be done. I do it. It’s important to me so I’ve worked it into my life as best I can. Don’t ask me how frustrated I am when I can’t find something healthy to eat at an airport. Thus the photos. I’m just saying when are we going to admit that we tell people what to do to stay healthy and do next to nothing to make it easy for us to do it. 

Oh wait, gotta go, NBC’s weight loss guru, Joy Bauer, is about to share her Slimdown program.

Happy New Year, Hurrrrrrrrrrrmmmmmmmmpppppppphhhhhhhhhh!!!!!!!!!!!!!

Type 1 vs type 2 diabetes debate continues

Which is worse t1 or t2? Keeping another myth alive.

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Wow, I am late to this discussion, but felt it worthwhile to join because it appears the debate continues…

Last month Diabetes Health published “What People with Type 1 Diabetes can Learn from Type 2s” by Clay Wirestone  It set off a firestorm of comments, mostly from type 1s, about how dare you tell us we can learn something from those lazy, fat type 2s!

David Spero, blogger over at Diabetes Self Management then wrote this post, “Type 1s Vs. Type 2s?” calling for type 1s and type 2s to come together for the sake of our health and that both sides are not fully aware of what the other side lives with. Interestingly, the comments posted on Spero’s site were almost unanimously empathetic.

It seems to me, Wirestone’s biggest goof was his argument (that t1s can learn from t2s) and his tone. If he’d approached the topic from the point of view that t1s and t2s share some commonalities and we can each learn something from each other, the war may have never ensued. But it is a fascinating study in how we all emotionally hold diabetes.

You should go read the stories and comments to both stories. In reading all the comments to Wirestone’s post, I found Allison Blass nailed it for me:

“The problem with this article isn’t so much that it’s saying people with type 1 can learn something from type 2, but assuming that people with type 1 aren’t already learning these lessons for themselves. Plenty of PWDs with type 1 exercise regularly, take their medication faithfully, and make small changes to get healthy. These aren’t genius concepts divined by the type 2 community. 



I will say that the amount of misinformation and misconceptions about type 2 diabetes in the comments are disgusting. Type 2 diabetes is not CAUSED by obesity – it’s a contributing factor. Type 2 is not cured through diet and exercise – it is managed, just like insulin. Type 2 diabetes does not have the same flexibility as type 1 – blood sugars have to be dropped through extra exercise or changes in diet, not just a simple bolus. People with type 2 diabetes can go years without being diagnosed, which means that many people with type 2 are diagnosed at the same time they find out they have complications. 



Type 2 diabetes is a bitch, same as type 1 diabetes. And yes, they are different. But we both have to do things that are different, we both have a health issues and learning tactics and strategies for handling certain situations could help. 



In any event, if you don’t like people spreading misconceptions about your disease, you should probably be damn sure you’re not spreading misinformation about someone else’s. It’s not nice.” 



-Allison Blass 
www.lemonade-life.com

And then, as I said, even tho I came late to the game, I felt compelled to add my own 2 cents worth and so I posted this today on Spero’s blog:

“As a type 1 for 38 years I understand the cry of type 1s that no one understands how hard and intense it is to live with this disease, and that we are grouped under the same umbrella of those lazy, fat type 2s who did it to themselves.

Yes, many type 2s engaged in poor health habits that may have led to their diagnosis, but not all. One in five are slim actually. For some the genetic component is so strong they would have gotten it regardless of their actions. And there must certainly be type 2s who are annoyed with the bad press their own brothers and sisters bring them.

But one diabetes being worse than the other? It’s all a matter of perspective. I wrote a book recently, “50 Diabetes Myths That Can Ruin Your Life and the 50 Diabetes Truths That Can Save It”  and the myth I always quote is, “Type 2 diabetes is not as serious as type 1.”

It is one of my favorites, because the emotion runs so high and because the answer seems so obvious, but is not. Both are extremely serious because they can both lead to the same devastating complications. While type 1s will never get off their insulin, and endure more intense management, type 2s are asked to undertake preventive behavior, which anyone can tell you, is a bitch.

Since most type 2s are diagnosed years after they have the illness, many already have complications by time they’re diagnosed. And while most type 1s will live with their illness longer than type 2s, many will also live more healthfully with it because they developed healthy habits earlier and they see more directly the positive result of healthy habits.

When “What People with Type 1 Diabetes Can Learn from Type 2s,” appeared on Diabetes Health what incensed most readers was the cavalier notion that type 1s aren’t doing good enough, so obviously we could learn a thing or two from type 2s. That reeks of presumption and offends.

We all have something of value to share from our experiences, and it’s up to us as individuals how we manage our diabetes. And, how we choose to see it – some see themselves as victims and only see hardship, others see diabetes as a welcome wake-up call and get healthier, and others see diabetes as a signal that life is precious and go about making the most of it.

Since no one can argue with your experience, it’s foolish to throw rocks at someone else’s. And while personally, I would vote to change the names of type 1 and type 2 diabetes to better reflect the differences and educate the general public about the differences, when it comes to helping each other out, let’s not overlook that living with any chronic disease we share many similarities.”

What’s your take on this?


Is diabetes worth all the work? Wait ’till you hurt your foot.

Oh, no, a fractured toe!

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If you’ve followed this blog for a while you know I’ve had a bunch of minor injuries over the last year or so. Ankle tendonitis, wrist tendonitis and recently a stupid fractured toe. 

Someone was handing me a bottle, I didn’t realize it, they let go of it and bam, it landed right on my toe. My foot took all the impact so when the bottle rolled off it and onto the wooden floor, it didn’t even break! 

My foot is now in this lovely surgical shoe. Truth be told, I could open a lending library of medical braces.

I’m not going to go into why all these injuries are happening. Or karma or any of that. Because frankly I don’t know. 

Some good news resulted from my injury: Days after my new footwear, I  flew to Amsterdam on a night flight and the Delta/KLM ticket agent took pity on me and upgraded me to World Business Class, KLM’s version of First Class. Yes, that was mighty nice compensation for my injury and a breath of human kindness in a world that often feels like it’s all gone. But giddy as I was playing with my reclining bed-like chair, I find something even more rewarding – that the constant care of this annoying condition (diabetes) paid off.

The afternoon I sustained my injury the pain was tolerable until going to sleep. Then it turned intolerable. I searched my medicine cabinet for a sleeping pill. But I didn’t have any. I ended up swallowing two Benadryl cold capsules hoping it would knock me out. It didn’t. The pain was that severe.

My painful sleepless night put every diabetes foot horror into my head. Will I get gangrene? Will they have to amputate my foot? How will I exercise without my foot? Maybe they’ll just take off my toe….C’mon, isn’t this in every diabetic’s head when something happens to your foot?

First thing the next morning I called my podiatrist and heard those blessed words, “Come anytime today.” My podiatrist reassured me, while I fractured a bone in my big toe, that nothing was displaced and that with an ace bandage and a special shoe it would likely knit together in eight weeks time and heal just fine.

So, I hobbled around, went to Europe, cut out my power-walks and have just come from my three-week check up. The X-rays confirm just what he said. The joint at my big toe is unharmed, the little crack or whatever it is in my toe is healing just fine. My toe’s still a little tender, which he said is normal, I’m still sporting a dull purple bruise where the greatest impact hit, and that area of skin remains a dull purple, but everything’s OK.

When I got the upgrade flying to Holland on the 10 PM flight, this sleepless soul on a night flight, was flying high before we even took off. But as great as that gift was, knowing my blood sugar is well-enough controlled that a foot injury causes me no special trouble or damage, that’s the best gift I could have.

It reminds me that when all the work of managing diabetes feels so thankless, you may just find a time when the every day slog of managing your blood sugar really is worth it – especially when the shit hits your foot. 

Now I just have to ask my psychic-witchy Aunt, who predicted when I was in my twenties that in my fifties I’d have a series of troublesome but not dire health problems, if we’re done. 

Smaller size vial of Humalog for hospitals and possibly patients

Asante-Snap-Insulin-Pump-4-Humalog-Humalog rapid-acting insulin

In January Eli Lilly, maker of Humalog rapid-acting insulin, began supplying hospitals with a smaller size vial– 3 ml instead of 5 ml

I got a flier about it because I’m a member of the Association of Diabetes Educators. My curiosity was peaked to know if there’s now a smaller size available for patients?

In truth, I don’t use Humalog anymore. I switched to Apidra about a year ago. I find Apidra works a little faster for me and this means I can also use a little less. Of course, since I eat a low-carb diet, I don’t use much mealtime insulin anyway. I use about three units to cover my morning oatmeal (my big carb meal) and then about 1 unit for lunch and 1 for dinner. My carbs in those meals being vegetables and beans.

This means at the end of every month, when I have to start a new bottle of rapid-acting insulin, I have to throw the one I’ve been using away – and it’s still 4/5 full. 

So I called Lilly and asked if a patient could buy the smaller size vial. I was told a patient could ask their pharmacist to check with his or her supplier whether they could get it. 

Not a wholly satisfying answer, but if you, like me, use very little mealtime insulin, and you use Humalog, you may want to check if you can get less.

Diagnosing diabetes with the A1C may mean you’re cured!

A fellow type 1 friend of mine was trying to get a CGM to better control her blood sugar. 

She’s had diabetes for more than two decades. Her blood sugar bounces from high to low often enough that her doctor felt a CGM would be extremely helpful, even though her A1C is just below the American Diabetes Association recommended 7%. 

Of course the A1C is an average of your last two to three month’s worth of blood sugars. That means you can have lots of blood sugars around 250 mg/dl and lots around 50 mg/dl, and average out at 150 mg/dl – just below an A1C of 7%. 

While this averaging game is nothing new to me, what was new to me is that her insurance company would not cover a CGM because the liaison between the insurance company and the CGM company said my friend’s diabetes was cured. Why? Her A1C is under 7%. 

My friend’s doctor told her he’s seen this coming ever since companies decided to diagnose type 2 diabetes with the A1C test. The American Diabetes Association has recently recommended this along with an international committee from several other diabetes organizations including the International Diabetes Federation and the European Association for the Study of Diabetes.

One main advantage they cite for using the A1C test to diagnose diabetes is that it can be taken any time of day, and without fasting. 

Yet, at what cost does this come? If an A1C of 7% or above will mean you have diabetes then will insurance companies say a well-controlled diabetic, who has an A1C under 7%, does not have diabetes? If that’s the case then I’ve been cured for years and didn’t know it. Funny, though I still experience hypos and highs no non-diabetic gets.

Will patients lose having tools that could help them better manage their diabetes with this diagnosing criteria? I know one who already has. 

Dr. Oz, won’t you please set the record straight?

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If you missed it, Oprah did a show on diabetes ten days ago where Dr. Oz confused and scared a lot of people about diabetes with misinformation. As one diabetes educator said to me, “Dr Oz is a SURGEON.!!!  Diabetes is NOT in his area of expertise!!!!!!” Read my post on the Huffington Post.

Now I ask you to join me in letting Dr. Oz know that we are worthy of accurate information to help us manage our diabetes, not myths and fear, and that if he truly wants to help patients he should correct the misinformation he’s put out there. 

Spread the word, tweet, twitter, leave a comment on the HuffPost and let’s send the message that the diabetes community deserves the respect it’s so often denied. 

 

New approach to type 2 diabetes management

UnknownGet your heart checked

A few weeks ago I attended a seminar given by Amylin Pharmaceutical, manufacturer of Byetta and Symlin, in of all places Carnegie Hall. I have no complaints, it included lunch and a tour – and an important education. 

Amylin’s seminar, “New Approach to type 2 Diabetes Management” had five prestigious presenters at the helm: Dr. Louis Aronne, Clinical Professor of Medicine, Weill Cornell Medical College and obesity expert; Dr. Robert Chilton, Cardiovascular surgeon, University of Texas Health Science Center; Dr. Donna Ryan, Obesity expert, Pennington Biomedical Research Center; MEd Molly Gee, Dietician, Baylor College of Medicine; Dr. Matthew Wintle, UK, Director of R&D, Amylin.

The new approach proposes that the same attention on glucose control for type 2s must be given to cardiovascular risks. We heard from the presenters that type 2 diabetes is a cardiovascular disease. As Dr. Chilton warned, people with type 2 diabetes have a two-to-four-fold increase in risk of stroke and coronary heart disease and a two-to-five-fold increase in risk of heart failure, and will likely die due to cardiovascular disease. Cardiovascular risks: obesity, blood pressure, cholesterol, triglycerides and inflammation, (also known as metabolic syndrome) typically accompany type 2 diabetes. If we don’t control these health ailments, cardiovascular events will occur in greater numbers as the tide of type 2 diabetes rises.

In all disclosure, Amylin is working on a drug that will help control cardiovascular disease risks as well as glucose, and not produce weight gain. The catch-22 of course is that weight gain contributes to cardiovascular risk and some diabetes medications cause weight gain.  

I came away from the Amylin seminar thinking unmanaged type 2 diabetes is a time bomb, and for the first time I understood why the American Diabetes Association has long advocated a low fat/high carb diet; obesity prompts the hormonal imbalances that create metabolic syndrome. I won’t get into healthy fats vs. unhealthy fats or that unused carbs also turn into fat. Suffice to say, if you have type 2 diabetes, get your vitals checked and ask about your heart health.

As February is American Heart Month it’s a good time to learn more about your heart health and risk for heart disease. Cardiovascular disease is America’s number 1 killer – every 25 seconds someone experiences a cardiovascular event and every minute someone dies. It is time, I agree, to think ‘heart’ as well as ‘sugar’ if you have type 2 diabetes. 

I’ve long heard that people with type 2 diabetes have as much chance of having a heart attack as people who’ve already had one. Somehow it doesn’t sink in unless you’ve had a heart attack or until you see, as I did, the stunning pictures of what clogged arteries look like. 

To show support for heart month, this Friday you’re encouraged to wear red. I’d also ask you to show support for your heart: Take a walk and make that doctor’s appointment to check out your heart-health. Then you can toast your heart-healthy actions with a glass of heart-healthy red wine. 

My CGM sensor report

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The CGM iPro sensor I wore for five days (see post below) came off Monday morning in a hurricane. Not exactly what you think, but I like the drama. My walk from the subway station to the hospital to see my CDE was in a rainstorm at high gale winds we rarely see here in New York – umbrellas discarded on the streets, puddles knee-high. Were it not for the fact that my iPro site was itching like mad for two nights from the sticky tape over it I’m not sure I would have braved the storm at all.

By the time I arrived at the hospital the entire front of my jeans was soaked so that I was wringing water out of the cuffs. I was eternally grateful that not only did I brave the storm, but that my CDE did as well. Moments later the CGM came off, a lot more easily than it went in thank goodness, and we downloaded the results. Luckily the battery lasted for as long as I wore it, just over five days. That’s not always the case, but it was here. Hallelujah!

Then we stared at pages of graphs, charts and numbers of my blood sugar numbers as picked up by the sensor every five minutes and I got to see my patterns throughout the day, and night. 

Since I was doing finger sticks at least four times a day along with wearing the sensor, my daytime numbers were not surprising, and, my daytime numbers are typically understandable to me. When I’m a little high it’s usually because I didn’t calculate the carbs in a meal or snack correctly. When I’m a little low it’s usually for the same reason, or my powerwalk lowered me slightly more than I expected. Being insulin-sensitive, as many type 1s are, a half unit of my rapid-acting insulin has an impact. 

During this five day period I also went high after a birthday lunch for my mom who turned 80 – a poor calculation on the calamari and spring rolls! But mom, you’re worth it. And I discovered just as routine is my savior, so is my experience. Since I was logging my numbers, I used the carb counts on packages more than usual and that led me more astray than the educated guesses I typically make based on years of testing. Perhaps it’s because food manufacturers are allowed a 20% margin on the carb counts listed on their packages, so beware.

But what I really wanted to know from this experiment is what my numbers do overnight, and that was the reveal. Around midnight they start sliding downward hour after hour. Around 5 AM they are at their lowest, in the high 50’s/low 60’s, and then they begin to gradually come up between 5:30 and 6:30 AM and then rise more swiftly. If I wake up and test my blood sugar around 6:30 AM the number’s usually around 75 or 80, a half hour later they’re 90 or 100. A half hour after that they’re climbing over 100. This is without doing anything or eating anything.

“This is perfectly normal,” said my CDE and nothing to worry about. In the morning your liver is pumping out glucose-raising hormones to get you ready for the day (dawn phenomenon). Even if you’re a little over 100 before you take your injection, it’s fine.” O.K., I’m relieved about that since my boundaries are admittedly narrow. 

“Can I prevent the overnight slide or morning rise?,” I asked. “Not really, this is your body and you’re doing fine. The only thing that might reduce the overnight low is cutting back on your Lantus one unit, but I don’t think you need to do that. You don’t go that low at 5 AM and then you come back up. “Would a pump level this out?,” I asked. “Yes, and that’s when most of my patients change to a pump, when multiple injections just can’t do more for them.”

So what I know is I’m working the MDI (multiple daily injections) system as best I can. I keep my blood sugar between 120 and 140 before I go to sleep, on the higher end of that range if I’ve had wine with dinner since that creates a slightly greater drop overnight. Then I blunt the morning rise with one unit of my rapid-acting insulin as soon as I wake up and take the rest of my breakfast dose just before or during my morning meal.

My concern that I drop so low overnight, like to 30 or 40 mg/dl, that my liver shoots out glucagon to save me from dying turned out to be false. That is a relief. Also, while I don’t log my numbers ordinarily, I’m already obsessive enough, if you log your numbers – and for most people this is an invaluable exercise – make sure you also note what you eat and any exercise. Most log books don’t give you space for this. So log your numbers on a simple sheet of paper. A bunch of numbers without these references is an incomplete picture.

I highly recommend if you have access to wearing a trial CGM for a few days to see your pattern that you do so. This kind of information can lead to an important change or modification in your treatment plan. I know I’ll be sleeping better from now on.

Note: Our bodies are different. Don’t base any of your own treatment decisions on my results. Check with your health care provider to be safe.