Diabetes.Blog.com

Maybe I'm just in a bad mood, but I gotta vent about an absolutely terrible article in the December 2005 Diabetes Forecast (a newsmagazine from the American Diabetes Association). Splashed across the cover of the magazine was a huge blurb for a story about "The Best Diabetes Information On The Web." The title was misleading -- the story was not about where good information could be found (other than tooting their own horn, and mentioning a few of the top-notch US government websites). And the story never mentioned other diabetes organizations, whether their "competitors" (such as the JDRF) or those in other countries, including the UK, Canada, Australia, among others, as well as the IDF.

The article clearly was aimed at newbies, but neglected to tell them about the HONcode (sponsored by the Health On the Net Foundation) as a reliable indicator of which health-related websites voluntarily pledge to honor the 8 principles of the HON Code of Conduct (HONcode). BTW, the ADA site doesn't display the HONcode logo.

Also, the article never mentions search engines...

Bill the diabetesdoc
wwq@diabetesmonitor.com

Diabetes.Blog.Com is a blogcompanion to our main website, the Diabetes Monitor, which you can find at www.DiabetesMonitor.com

It's now two-and-a-half weeks since I was diagnosed as having the Big D. My BGs now stay mostly in the low-to-mid 100's and frequently down into the 80's; still (amazingly) only one insulin reaction (see Day 7). Rarely bounce into the low 200's. I continue to check about 8 or more BGs/day and giving myself shots about 5-7 times/day.

One of the more common questions I get from my friends who are doctors and nurses is, "why didn't you start with diabetes pills, instead of jumping right in with insulin?".

Well, there are several reasons:

• First, the side effect profile of insulin is very simple: hypoglycemia if you overdose, and weight gain if you overeat.
• Second, why futz around with pills, where changing doses takes days (or weeks) to clarify what change in effect may (or may not) have occurred, compared to insulin, where I can adjust doses hourly if I want to (e.g., popping 2 more units if I misjudged the mealtime bolus).
• Third, no matter whether the pills work or don't when initially tried, sooner or later, the big D will progress and as the pancreas gradually poops out, insulin will be needed sooner-or-later.

So my decision was to start insulin sooner.

Bill the diabetesdoc
wwq@diabetesmonitor.com

Diabetes.Blog.Com is a blogcompanion to our main website, the Diabetes Monitor, which you can find at www.DiabetesMonitor.com

It's been over 2 weeks since my wife Steph (who's a CDE) and I diagnosed me as having the Big D. My BGs are now mostly in the low 100's and frequently down to the 80's; still (amazingly) only one insulin reaction (see Day 7). Occasionally bounce into the low 200's. I continue to check about 8 or more BGs/day and giving myself shots about 5-7 times/day.

A reader recently commented that I should consider using an insulin pump. That's something that Steph and I have been discussing back and forth, and I am seriously considering. I've got no objection to being tethered to a mechanical monster 24/7 (heck, I've got a cell phone, a PDA, and go nuts if I can't check my e-mails every few hours, so I live with electronic miracles all the time). But on the other hand, I've no objection to carrying an insulin pen and using it at any time (such as at meals in restaurants, in meetings, etc.): it's small enough to be almost totally unnoticeable by others nearby.

What's your opinion about whether I should be on a pump, and why or why not?

As always, many thanks to everyone for the words of sympathy and support.

Bill the diabetesdoc
wwq@diabetesmonitor.com

Diabetes.Blog.Com is a blogcompanion to our main website, the Diabetes Monitor, which you can find at www.DiabetesMonitor.com

It's been almost 2 weeks since Steph and I diagnosed me as having the Big D. My BGs are now mostly in the low 100's; it's irritating (emotionally) when I don't guess right on insulin dose, and end up in the 200's. I continue to check about 8 BGs/day and giving myself shots about 5-7 times/day.

I'm giving more shots, as I've become more comfortable with small touch-up doses if I'm high after guessing wrong on a mealtime bolus. Warning: Don't try this unless you're checking before & after meals, and before driving, and carrying sugar, and wearing MedicAlert ID.

I've learned to jab my belly for injections right through my shirt -- it's a snap, and that way I don't have to worry about tucking my shirttails back in...

By the way, I don't bother with the alcohol swabbing stuff. I always thought that all the alcohol did was irritate the skin germs, and stir them up (sort of like batting on a hornet's nest?). Anyway, as anticipated, it's a lot easier, and no skin irritation or infection.

And as always, many thanks to everyone for the words of sympathy and support.

Bill the diabetesdoc
wwq@diabetesmonitor.com

Diabetes.Blog.Com is a blogcompanion to our main website, the Diabetes Monitor, which you can find at www.DiabetesMonitor.com

Taking insulin (by insulin pen) at mealtimes, usually afterwards so I can count up how many units to balance the carbs, occasional "touch-up" doses (sometimes called correction doses) when it stays a bit too high 2 hr after eating, and a single dose of long-lasting
insulin every evening.

Actually it's becoming quite routine. Bit scary to say that, as one of these days (sooner or later) I expect I'll have one of those rip-roaring insulin reactions where you not only "crash" but "crater".

Again, many thanks to everyone for the words of sympathy and support.

Bill the diabetesdoc
wwq@diabetesmonitor.com

Diabetes.Blog.Com is a blogcompanion to our main website, the Diabetes Monitor, which you can find at www.DiabetesMonitor.com

This Symlin forum was activated to allow comments on October 15 and deactivated on November 14 to prevent more posts to this forum. However, you can still read the earlier comments, and search for information throughout any forum, by using your webbrowser's FIND or SEARCH feature while at the earlier forums, or by searching at the advanced search feature that is at the Diabetes Monitor.

Bill the diabetesdoc
wwq@diabetesmonitor.com

Diabetes.Blog.Com is a blogcompanion to our main website, the Diabetes Monitor, which you can find at www.DiabetesMonitor.com

Back in the good old days, when I had a solo endocrinology practice, every time I demonstrated BG testing to patients, I always wondered "is this the time it'll be high?" Of course, thereafter, I didn't have the need to demo to patients, nor for that matter the means (as all the strips slowly outdated) so haven't tested for a few yrs.

So, now I also have the Big D, self-diagnosed a week ago. I've been on insulin several days now, and BGs are bouncing between 70's (with shaking and grouchies and MEGAhunger) & 200's. Checking about 8 BGs/day and shooting up about 5 times/day.

Many thanks to everyone for the words of sympathy and support.

Wonder when I will stop counting the days since diagnosis?

Bill the diabetesdoc
wwq@diabetesmonitor.com

Diabetes.Blog.Com is a blogcompanion to our main website, the Diabetes Monitor, which you can find at www.DiabetesMonitor.com

As I've mentioned on this blog previously, I now also have the Big D, self-diagnosed this past Friday. I've started insulin (on a basal/bolus program), and am checking zillions of BGs (before & after meals, bedtime, before driving, and anytime my wife nags me). BGs now regularly in the 100's. No hypos (yet).

Called an endo, and believe it or not, got an introductory visit with him the same day (hmmm, did my background as a specialist in diabetes/endocrinology make any difference?). He too believes in aggressive insulin use, basal-bolus, pumps, all that sort of stuff. Didn't seem at all surprised that I had already begun multiple daily insulin doses, or that I brought in an Excel spreadsheet graphing the BGs vs the insulin doses (though I think he only looked at the printout of the data, not the graphs I labored to create).

I've updated my MedicAlert info to include diabetes & the insulins I'm on (it can be done on-line!).

I had alerted folks at work and now they are watching me closely and asking "are you low?" and other solicitous questions like "are you okay?". (Sure. I'm okay, just a touch sweeter than I should be...)

Bill the diabetesdoc
wwq@diabetesmonitor.com

Diabetes.Blog.Com is a blogcompanion to our main website, the Diabetes Monitor, which you can find at www.DiabetesMonitor.com

As I mentioned on this blog yesterday, I too now have the Big D. I started insulin (on a basal/bolus program), and am carrying my pen and BG test stuff in the cute little black plastic case everywhere. I'm comfortable perforating my fingers, though maybe I'll try AST sometime sooner or later. (BTW, I won't mention brands of insulins or meters, so don't ask.) BGs continue mostly in the upper 100's & 200's although I got all the way down to 96 (once). And to date, nothing in the 300's. No hypos (yet).

My wife, Steph (who's a diabetes nurse educator) is having a blast, second-guessing my portion sizes, insulin doses, insulin-carb ratios, etc.

Decided that I'm probably LADA, and planning on looking at antibody and C-peptide levels to confirm/refute.

Still don't have an appointment set up to see an endo... sorting out reputations, locations, insurance, then trying to set an appointment. Oh, and gotta notify MedicAlert to update the info I've got on file with them. Already let folks at work know that if I act more flaky than usual, to feed my face...

And thanks to everyone for the feedback to date.

Bill the diabetesdoc
wwq@diabetesmonitor.com

Diabetes.Blog.Com is a blogcompanion to our main website, the Diabetes Monitor, which you can find at www.DiabetesMonitor.com