Tag Archives: insulin injections

The Same Yet Different

I just read a post from a woman who lives in the UK. She is also a diabetic as are many of the people I follow on twitter. Facebook is great for friends and such but twitter lets me find people who are like minded as far as my disease. Well I don’t go looking for them, Twitter finds them for me. I have some here in the States (one is on TWO of the new Dexcom G6 commercials) but quite a few are in the UK as well. I have learned as much from them as fellow diabetics here in the USDA.

The post I read was from a woman who yesterday ran a half marathon (10k) and finished it. Way to go!! Now some not familiar with diabetes may think so what. It’s only a half marathon and she didn’t finish first. Oh my good people, to me it is great that she even tried let alone did finish no matter what place it was.

Why? A diabetic knows the answer to that already, someone not so in touch with the problems of this disease may not. Let’s start with the basics. Diabetes is a disease where your body does not produce insulin to control your sugar levels in the blood. So a diabetic must double as their own pancreas since the one they were born with no longer works like it should. Normal people don’t get this as their body regulates it’s own insulin level. A diabetic has to do this the entire 24 hours of each day. It is a true 24 hour 7 day a week jobs and there are no vacation from this job. Now here is the first in lessons some don’t know. There are actually 2 types of diabetes and although they are both called diabetes they are very different creatures. Type 1 is insulin dependent and type 2 can still make it although not enough or sometimes the wrong chemical makeup, it doesn’t work right. There about 22 million diabetics here in the USA alone and out of those only a 10% section are type 1. That means I am one of about 2.2 million people here in the USA who depend on insulin to live. We do not make it on our own and so must take it several times each day. It is not a pill and though there has been some headway to make it easier, the only way to get it is to inject it through the skin.

“I’ve read that you can also inhale insulin.” There is only one and I do not know what complications it can cause or how effective it is. Most people, I do not know of any on this inhalable insulin, use injection. You can use pumps instead of needles but as some of my former coworkers can attest to, it is not a perfect solution. It also still goes through the skin. I was told years ago (decades really, I’m polishing my cane later) being a hormone insulin would not survive the human digestive tract hence it must be injected. As far as inhaling, I’d be more scared of an infection from that kind of delivery than an injection. In the 40+ plus years the only infection from insulin I’ve had is with a pump cannulas but it was on its 6th day instead of the 3 days recommended by the maker. I had to, sweated the first one off early so to make up I had to reuse the next one or I would have run out.

OK back to task, Type 2 diabetics are people whose body still makes insulin but it either makes not enough or the chemical makeup is not right and it does work as needed. Insulin does not actually control blood sugar but it unlocks the walls of cells so the sugar can get in and let the cell use it for energy. Think of it as a key for the lock on your cell wall door. If there is no key you don’t get in, if you don’t get in there is no power to run the cell and it will die. Type 2 can be controlled by pills or diet or both without needing insulin. Sadly, it can regress to the point where insulin may be needed anyway. My mom and both aunts where like after years with type 2.

Emma uses a pump and just to make things easier I will just say that if you have a hard time programming your universal remote a pump is not any easier and your remote won’t kill you if you screw it up. I don’t know her that well but I can guess from her post she does not run marathons on a daily basis. Here is another issue with diabetes, changing your routine is scary. I am far from a perfect diabetic but I try to eat at the same times and even the same foods on a rotating basis so I know how I react to each food and how many carbs are in each meal. Carbs are how diabetics count and calculate how much insulin they need for the food they eat. Each food has a certain amount of carbs that enter your body at different speeds and as a diabetic you need to be able to know how many are in each food and add them together and then calculate how many units of insulin you need. A pump can do this on its own but you still need to tell it how many carbs you are eating.

Since she was running a marathon her activity level was going to be so much higher than normal for her so she had to try and compensate for this. With a pump you can lower the background insulin you get on a temporary basis so she made the changes.

This where I noticed the biggest difference. She dropped her rate 2 units. Wow! My basal rate (background insulin) was at times only 0.250 units per hour! That equals 1 unit every 4 hours. There was no way I could have dropped it 2 units. Even as low as it was set, it still crashed my sugar level without extra work (running a marathon being as low as it can get on that list) and although it would shut off automatically,  I still needed to eat to bring it back up as it was low for hours after going low.

The other issue I noticed was when she described making corrections for a highs the morning of the race. Every diabetic has a rate to add extra units to prevent a high once it is started. Mine is 1 unit for every 50 points over 200. It used to be 2 unit back then when I was on the pump. She was correcting a 1/2 unit for less than 200. Amazing!

Reading about how she ran her diabetes compared to my treatment brought to mind what I frequently tell other diabetics. Everyone is different and has a different treatment routine. I have been telling people that for years now but I never had actually applied it to myself until reading that post. I had always thought I must have done or been doing something wrong to create this difference. I am me. I am not Molly, I am not Emma, I am not Amy, I am not any of the other diabetics I know.

I am not doing anything wrong I am merely doing things the way that works for me. MY correction rate works for me. My basal rates, well now doses, works for me. My diet works for me. It will not work for anyone else nor should it. I can try a technique I hear from someone but I will also need to test it to see if it will really work for me.

I can stop thinking “Why does this not work for me like others?” We, the other 2.2 million type 1 diabetics, have the same disease and share common problems and issues. Our solutions though are not and should be the same. They are unique to that person. Everyone is different and should follow their won path to control.

Wow! Already?

I read a post a little while ago from another fellow type 1 diabetic on accepting her “broken” body. I have to agree with her, our bodies are broken. Our immune system attacked and killed the beta cells in our pancreas that made insulin. Yes I said made because they are gone and have been for decades. We make no insulin on our own like type 2 diabetic so to live we must inject it everyday several times a day. To me although they are both considered diabetes type 1 an type 2 are separate diseases, different causes and different treatments.

Reading the post brought back memories of my life years ago when I was resolved to live with the knowledge that I was going to die much sooner than most if not all my friends. I would have to make sacrifices each day just to stay alive. The last few years of high school and the years shortly after I had given myself an expected life span of 40 years. Why you ask? I had been hearing for the last 10 to 20 years that I was more likely to have a heart attack, stroke, loose a kidney or an eye, loose a foot or leg, or one of many other possible bad things that are more likely for diabetics.

Well I am happy to report that my supposed end date was wrong. I have turned 49 so I’ve gone past my expiration date by 9 years already. I’ve had issues such as bad infections that apparently, according to my family doctor, was not expected to survive it was so bad. I also have had retinopathy in one eye but it is controlled and no further problems have been found. Just had them checked last week.

Now to the nitty gritty of why I’m writing this post. As much as diabetes has impacted my life, it has molded me into who I am today, a driven, resourceful, proud person. Some who know me might question that last description.

Proud? Yes, very proud. I don’t ask for help unless I’ve already proved I can’t do it alone. I don’t rely on others others to do things for me as I am completely capable of doing them myself. Maybe at times more headstrong than smart as I tend to push things to the limit to find where it is.

When I first became a diabetic, age 8 (1977), I had tried to hide it from others around me. I was different now. I had to pee in a cup to check for sugar in my urine. I had to get shots twice a day to stay alive. I had to get blood drawn once or twice a week to make sure the dosages were right. I had to watch what I ate at meals and in between. That was the worst as I had to get up in the middle of class to get a snack out of my launch box with everyone in the class watching. How was I supposed to hide that?

Diabetes is invisible. I don’t have a missing arm or massive scar on my face to mark me as a diabetic. Its why we all are expected to carry something like a med-alert bracelet/necklace. Even EMTs can not tell unless they are told. Makes it easy to hide.

I no longer hide the fact that I am a diabetic.  I do not go around spouting out to everyone I pass about it but readily will anyone who asks or inform coworkers to make them aware. One of the reasons is the growth in diabetic awareness. Not to mention the fact back then there were estimated to be 6 million of us. There are now 22 million of us with only 10% of them are type 1 like me.

As much as it has changed my life and made it harder, diabetes has also made me who I am today. I am driven to manage more than defeat this problem. I watch what I eat and try to control my sugar level but also live like a normal person. I don’t avoid sugar. I also don’t hide from work. I’m not going to call myself a workaholic but it would be close. My job is a material handler at a factory. Yes I do drive a fork truck but most of what I do is by hand. I can honestly say that depending on the night I lift and move maybe 1 to 2 tons of steel. 2,000 to 4,000 pounds of steel. I use an air grinder to remove burs and slag off parts. Try it for at least 4 hours before you call it easy, you do flip the parts you are grinding and some of them weigh close to if not over 100 pounds. Its hard work and I love it. My problem at work it I do so many different jobs that I don’t know from one moment to the next what I will be doing. Friday I started out unlading a torch table then moved to grinding parts and then sat on a fork truck for 4 hours. Even then I couldn’t take it. I kept the radio with me but jumped off to finish grinding the parts I had started earlier. I also jumped back off at the end of the night to help load the plasma table to get it done faster. I’m such a pain in the buttocks.

I guess it has given me a chip on my shoulder. Because I have diabetes I feel the need to proof myself more than others. I need to prove I can work with the big dogs instead hide under the porch. I have never and will never use my diabetes as a crutch. I can do anything normal people can with some special conditions. Foremost among them is being able to eat when my sugar level drops too low.

I guess to wrap this up, I’m done hiding (have been for years). I don’t broadcast being a diabetic but I don’t hide in bathrooms to do my shots or check blood sugars anymore. You can’t stand the sight of blood or needles? I’m sorry, turn your head then. I’m not going to apologize for being a diabetic. I didn’t go looking for this and am sure as he11 (don’t want to sware here but………..) not going to feel less than human for having it. I guess my feeling anymore has gone to the point of if I have to live with this then you are just going to have to cope with the ways I have to use to deal with it. You don’t have to do anything other than leave me to deal with the shots, sugar tests, and food intake. Its all I ask of you

Back in the Old Days

I read a tweet about a girl who gave herself an insulin shot in a classroom setting and managed to disrupt someone’s world. I’m being sarcastic. My response would not have been so polite, at least if she had made a second comment.

It brought to mind how I do things differently in modern times compared to back in the day when Fred Flintstone and I rode around together, feels like that at times. Back then if we went out to eat, my mom or dad went to the bathroom with me and drew up and injected right there in one of the dirtiest rooms possible. Why? Stigmatism. In those days if you saw someone with a syringe in a bathroom it was, what drugs are you using? That was on my mind each and every time we did that. It made me self conscious that I was making someone else feel uncomfortable.

I spent years trying to not offend or irritate people I didn’t know or really care about. My dad was really bad about this. “Let’s go in here to stay out of the way.” Seemed more like a “lets stay hidden so they don’t know we have issues” kind of move.

Now, I don’t care if someone sees me shooting up. I even call it that. Shooting up is usually a term used by druggies getting high, not diabetics saving their own lives. I never go into a bathroom to inject anymore. If someone flushes a toilet you just got sprayed with fecal bacteria. Does not matter much that you used alcohol or other disinfectant because once it dries it no longer works. That bacteria could hang in the air for several minutes before landing on the counter or faucet. Sorry to ruin people’s meals but this is reality.

I’ve had people come up and ask if I was diabetic, while I was injecting. There are so many of us now it is not as odd to see someone injecting in  a restaurant or store as it once was. 22 million of us in the USA alone and about 10% of them are type 1, insulin dependent for those not versed in the language. I make no apologies as I have come to terms with the fact that I die without it and refuse to say sorry for that.

My first response to someone who says they are not comfortable with me injecting is to take into consideration their timing. If they say something while I’m drawing the insulin from the bottle I will politely excuse myself to another area to jab and go.  Some people are sacred of needles and I get that. If they have waited, watching me draw it up and then say something while I have the needle stuck in my skin, well, they just out of luck. I am going to continue. A person who waits until it is too late will most likely be the person who pitches the biggest tantrum as well.

That is when my inner ass comes out. He is not nice nor is he well behaved. He will tell you most likely what you do not want to hear. I try to leave him at home but there are people in this world who seem to just be hunting for him. If you wish to be rude do not expect that to be a one way conversation. The worst mistake you can make is to think that because I am an “inferior” diabetic that I can’t defend myself. lol Game on.

First step first

I started a new job this weeks and to say that I was not nervous about it would be a bold faced lie. After my initial experience with my new pump and the adjustment I went through, I was highly nervous about how bad things could get that first week. I’ve been doing research on body fat and its affect on insulin. The reason for this sudden interest is simple. My doctor told me when I first talked to her that they have a negative effect on insulin. Being over weight like I have gotten over the last few years is bad. I’m trying to remember her exact words but its basically was that fat acts like an insulator for insulin. The more of it you have the more insulin you need because of its effects on your absorption of insulin. With this new job I plan to start losing all this extra weight I packed on since I last had a real job that I could work hard at. After leaving the factories to try my hand in human services, read that taking care of developmentally disabled individuals, and then moved into security I found myself slowly getting fat. Yes I should have cut down on my food intake but I had always planned to start exercising more to make up for it. OK well anyway………. Long story short I gained about 20+ lbs. over maybe 2 years. Enough that all my older jeans no long fit. I now am empathetic toward pregnant women who deal with this during the 9 months. OK back to topic now, this excess fat will end up costing me more in insulin. I will keep taking more insulin to do the same work as long as I stay fat. Loose this extra fat and the amount of insulin I need also will drop. Not to mention the fact I will not have to drag around this extra and that extra weight according to the height and weight chart I found on line, I should weigh about 180 lbs. max. Well at 261 lbs. currently I am 81 lbs. overweight, I take issue with the that ideal weight since have been a weight lifter and will be again. Muscle weighs more than fat so I feel that ideal weight should be a reference rather than a rock solid goal. So I have an extra 81 lbs. of fat wrapped around in my body that needs to go. Imagine all the damage it has been doing already. I found an article from Jade Teta who is an integrative physician and author on this subject from the http://www.metaboliceffect.com/science-insulin/ web page. Insulin causes many different effects on the human body and resistance to the insulin he says is not an all or nothing concept. The liver will react one way and the muscle another and to different degrees. Sorry if some of this is hard to understand. I get the basics of this all and am trying to relate it here without complicating the message. From what I read of the article, please read it yourself to get the whole message, when the liver looses its ability to sense and respond to glucose it is the party to create most of the metabolism issues. The resistance is brought on by the massive amounts of insulin given in injections and the bolus amounts although not as much. The pump gives the insulin over a longer time. An inject for me took as little as 3 or 4 second from start of plunger push to end. The pump will deliver he same insulin in a way longer time, in some cases over 1 minute. That big dump of insulin is not given in one shot but over an extended time frame, much better. Score one for the pump! I was told by my doctor that I had over the 36 years of being a diabetic, developed a lack of being able to sense lows and I now wonder if this has anything to do with that issue. In other words I fought long and hard to not get a pump and now that I was kind of led into that decision, I feel that my clod feet syndrome was a bad idea. There is no Dr. or M.D. with his name so I am just calling him Mr. Teta, says that the war between insulin and cortisol, adrenaline, and non adrenaline is what creates biggest problems for metabolic issues. Mr. Teta calls it the key to insulin resistance and also “the most insidious metabolic disturbance of the modern day”. Wow. As I said before the article has a lot of technical terms in it about triglycerides and other chemical names and processes but the under the tab of insulin and fat storage it makes me cringe. Insulin can push your body into storing more sugar as fat than it should. It make sense to me. I said earlier I was into to weight lifting more as a power building than body building but I got bigger regardless. Big arms and legs but one area I always had issues with was first the backs of my arms and then my stomach being fatter than the other parts of me. The reasoning I came to was that these were the areas I was injecting the insulin. In fact once I started in my stomach it quickly became quite visible. Quickly being maybe a year as my arms had been used for better than 20 years to give shots. If I can lower the amount of insulin maybe I can work at getting this fat off also. I just found the key to fixing all this resistance of insulin. Exercise. Plain and simple exercise. Mr. Teta says that muscle contraction is an independent method of moving glucose into the cells and also increases the number of glucose receptor on the surface of the cells. Well Mr. Teta didn’t say that but he referred to a 2010 study from the American Journal of Physiology, Endocrinology and Metabolism that discusses it. It goes on to talk about using resistance training to decrease insulin resistance and increase the body’s ability to store glucose. The growth of faster twitch muscle fibers have the best benefit for insulin and blood sugar control. I am shedding a tear now as I realize the heavy lifting I love to do but had to give up when money was tight was the one things I had been doing that was helping me with my blood sugar control. I can remember at times when I would stop lifting for either medical reasons or just to jump over a stalled workout routine and after just a few days, 4 maybe 5 that my blood sugars would start getting out of whack again. Once I started back up again they would drop right back into place and I felt better quickly again. I’m in almost full tear mode here since I love lifting heavy. It began back in high school and I kept with it  for many years after as well. I have not seen the inside of the weight  room since the beginning of last year, 2012 and can see the effects. I am fatter, weaker and my blood sugars are all over the place. I’m going to end this blog now and go eat breakfast and then this afternoon I will start a workout routine to begin getting back into shape. Seeing where I have been, where I am, and where I want to be it just makes good sense to go back to what I love.