Diabetic in Calgary

Diabetes is my Leprechaun

2008-07-13T13:43:00.004-06:00

Dealing with Leprechauns is deceptively simple, in all the stories: you stare at them and they can't get away, and you end up getting their pot of gold.

For me, keeping good diabetes habits is the same way. I focus on them, integrate them into my life, keeping my eye on the diabetes pot of gold - a future without complications.

Then it seems like I blink and it's all scurrying away. My habits turn into mirror images - snacking on carbs instead of avoiding them, and I wonder if those gold coins are slipping through my fingers.

This is less a frustration rant, and more an acceptance that it's time to reel myself in again, and reach for a plate of cheese instead of a granola bar. Maybe I should cut my cheddar into little circles to remind me why it's so important...

Bad Days

2008-07-11T09:40:00.003-06:00

Not anything diabetes related, but my stress level the past couple of the days is just through the roof. I've been doing a lot of internal rants in my mind, and a lot of teeth griding over what other people are doing.

This has been the kind of week that really brings home how little control you can have about what goes on in your life. I'll be taking some steps to try and make sure that it doesn't get quite this upsetting again, and hopefully it'll help.

What frustrates me the most is the feeling that I should have been able to do something different, had more foresight, different priorities, I could have avoided it. Logically I know this is an illusion, but sometimes it's easier to blame myself for not having planned well enough than accept that there will be obstacles in my life I can never avoid.

Diabetic Moments at the Stampede

2008-07-06T21:26:00.003-06:00

We went to the Calgary Stampede today - if you've never been or heard of it, it's sort of a combination rodeo/agricultural exhibit/carnival/state fair thing that is a huge deal every summer in Calgary. We all wear jeans and cowboy hats to work for a week, all the store windows are painted with cowboy designs and pancake breakfasts are scattered throughout the city.

If you'd asked me as a child I would probably have said it was my favorite 'holiday' after christmas! It was a lot of fun, though we just didn't have the energy to stay for the free mini concert at the end of the night - Hedley was playing, darn it!

Of course, I had a few diabetes moments. It's "Marathon Sunday" in Calgary today too. On our way to the stampede grounds, we passed the finish line for one of the marathons. I saw a couple of ladies with 'Team Diabetes' t-shirts who had completed the race, which was cool.

At the marketplace, admist the knife displays, three kinds of blenders, this amazingly weird water massage booth, and various sellers of cowboy hats, I found these cooling neckbands filled with some kind of polymer that soaks up water and keeps cool for (apparently) days. I bought one, and wondered if it's the same stuff that's in a Frio Wallet. Not that I have any insulin to keep cold, but it was my first thought.

Finally, after avoiding the fresh squeezed lemonade all day - I love lemonade but it's way too much sugar - we finally noticed a tiny line noting they had 'diabetic lemonade'. This turned out to be water, a fresh squeezed lemon and a packet of splenda. I enjoyed it - but I drink lemon water pretty frequently. It wasn't 'lemonde' to me, because it wasn't sweet (perhaps a couple more packets of splenda..), but I really appreciated that someone was making an effort to provide alternatives for those who can't have sugary drinks. And it was a very tasty lemon water.

Of course, it was an 'off plan' day in part - I don't think i found a single veggie in the grounds, though I'll admit to not looking that hard.. but normally I'll at least try to get veggies and dips if I can find them. I did have some okay beignets for breakfast, and half a really tasty smashed potatoe for lunch/supper. The smashed potatoe place is there every year - it's a regular baked potatoe, but they flatten it with a large wooden mallet before you get your toppings!

I'm soo tired now, so it's time for an early bed.

Another use for Lancets

2008-07-01T21:08:00.002-06:00

My family is very big into board games. My younger brother collects them - he has over a hundred - , so on game days, we'll alternate between old favorites and something new. I'm not sure how we'd manage to pass an evening without board games, it's such a habit!

One game we played needed counters to keep track of part of the score. We pulled out the old coin bin to sort out pennies, nickels and dimes but needed more. So I went to the closet and pulled out a box of lancets.

Plenty of counters, and it just made me smile to see them in play.

Farmers Market, yay!

2008-06-28T20:58:00.003-06:00

The farmer's market is quite different in summer. They've re-arranged it now that there is fresh produce. Fresh local produce!

I felt like a kid in a candy shop, or transported back to summers working at my aunt's fruit stand. Piles of fresh fruit, fresh veggies. No blemishes or bruises or waxy coating. We got corn, and tomatoes and pale yellow carrots and dark blue carrots. And raspberries, and strawberries. I barely resisted the cherries and the blackberries.

I forget, going to the grocery store, what a difference freshness and a lack of industrial handling makes. There's no picking through for that one apple without an obvious bruise or a tomato that isn't somehow off, or that box of strawberries that hasn't started to get soft or moldy.

Nope, just reach in, pick something up, and enjoy the goodness.

I've only eaten the raspberries so far- most of the rest is for a family dinner tomorrow - but oh my goodness, SO GOOD! Sweet, tart, and seemingly right off the vine. The grocery store ones have lost some vital essence, but these were a reminder of summertime at my grandmothers house. We'd be given ice cream buckets and sent to pick raspberries from the bushes that lined the garage wall.

I think even as a child, if you'd offered me a choice between raspberries and candy, the raspberries would have one. Raspberries would beat chocolate, sometimes!

If there's a farmer's market in your area - check it out some weekend. It'll be worth it!

When to say something

2008-06-26T21:41:00.002-06:00

I try not to talk about other people too much on this blog. Even if I don't use names I don't like to discuss people where they aren't aware of it. But I had a conversation the other day that I do want to bring up.

Someone I know commented to me that their doctor was very surprised they didn't have diabetes, given their weight gain over the past couple of years. I nodded along - after all, not everyone gains weight because of diabetes.

I asked what test they'd been given, ready for complaints about that awful orange drink they give you on a glucose tolerance test. And then I hear they were just given a fasting glucose test.

I stared blankly for a moment, then commented "I don't like your doctor". Who diagnoses diabetes based on fasting levels! I tried explaining that the 2 hour test was supposed to be the standard. And that often, by the time the fasting levels are elevated, you've already got a damaged pancreas.

Unfortunatly I don't think they were interested in listening. I'm going to try and lend out my copy of Blood Sugar 101 - perhaps that will make a difference.

It's not my body, it's not my health. But I have to try and pass on some kind of information here!

Salad Day

2008-06-25T23:11:00.003-06:00

Wednesday is now 'Salad Day' at work. Instead of ordering in burgers or pizza or sushi or other food, we make salad for lunch.

I love ordering in lunch. I don't have to worry about having leftovers or making a lunch in the mornings. We save money on groceries because work buys it. And I get to eat a variety of things.

Most of those things aren't very good for me. If everyone's eating pizza and I'm eating carrot sticks, I feel deprived. It's really hard to make good choices day after day, and I've completely fallen off the 'lots of veggies' lunch wagon.

Instead, since I know I'm eating something carby, I try to reduce my portions, or order something that is easily adjusted to be lower-carb. Only part of my burger bun, only a few bites of noodles, only 3/4 of my pizza. It's becoming habit, and I think it's a reasonable way to handle things - unless I get a nasty A1C.

Even though I'm being more consistent with dealing with high-carb lunches, I'm happy we have salad day too. If everyone is eating salad and veggies and cold cuts for lunch, I don't feel deprived. And I know that at least one day a week I'm eating like I should!

Updating My Google Alerts

2008-06-24T20:42:00.003-06:00

I've got several diabetes related 'google' alerts set up. Every day, they email me new links that match my search terms. While sites like Diabetes Daily are great for feeding me news and updates from inside the Diabetes Online Community, the google reports tend to give me more news and 'outsider' updates.

It also gives me daily links to articles about how exercise can reduce your risk of diabetes. I swear that's the most common topic I get. I really should do a comparison at some point of stories about 'stuff we know already' and 'new stuff'.

During weeks (months) like this one where my life slips into high gear, I get a little backlogged. I have over 100 diabetes related google alerts just sitting in my gmail waiting for me to filter them to find the 'good ones'.

So I've switched to weekly mode. I just can't seem to keep up with the daily ones. I think it'll also help as I continue to add more terms to find more unusual and interesting links. I havn't found a way to roll up the searches so I just get one big email instead of a bunch of little ones for each variation. Generic searches like 'diabetes' don't return much that interest me right now, but 'glucose meter' occasionally returns something new and interesting.

But it's an interesting tool, and quick to set up - just head over to www.google.com/alerts to try it.

CGMS

2008-06-23T20:32:00.003-06:00

I received my semi-annual update from Bayer Ascencia today. Every few months they send out these informative pamphlets. This time, there was a large section about how great CGMSs (Continuous Glucose Monitoring System)s are, and a big ad for their Guardian System.

I won't be buying, of course. If I had that kind of money to spare, there are other things I consider more essential - new glasses, some dentist time (you do not want to know how long it's been) on the medical front, some car repairs, some books.. An actual vacation that's more than a three hour car ride away..

I make a good living - and once my husband finally gets his residence card and can work we'll make an even better one - but I just can't see putting out the money for a CGMS. To me that's a win-the-lottery type expense.

Of course, for me it's more a 'I wish I knew what my blood sugar was doing at all times' sort of thing, rather than a 'I NEED to know what my blood sugar is doing at all times' thing. I think what surprises me about seeing those types of ads is that they are needed. To me, anyone who could use a CGMS should already know about them and want one! Anyone who doesn't... this is a medical device you attach to your body, not a impulse buy.

Of course, a lot of people aren't as obsessed as I with reading up and and learning about the technology, so for a lot of people that ad is probably the first they've heard of this thing.

Maybe one day, I'll be able to indulge. Hopefully those who really need this device will be able to get access to it sooner and with less insurance struggles as there is more awareness of the benefits.

Sobey's Whole Wheat Croissont

2008-06-19T22:09:00.002-06:00

This is my new alternate breakfast. I've never seen whole wheat croissants before! I was really pleased to see these ones! The label reads 'Whole Wheat and Honey Croissants', and they have that touch of sweetness I associate with croissants. Taste wise, these really stand up to the white version. With some products, I find the whole wheat version good, but the white better. These I like just as well as the white, and they feel like far less of an indulgence.

They come in a pack of eight, and are 190 calories and 22 carbs each. I've been eating them plain, but I'm sure a touch of butter and honey would make them extra special. I'd even use them for some sandwiches - the sweetness isn't pronounced enough to interfere.

So now I've found whole wheat cheese buns and whole wheat croissants. What's next? Here's hoping it's whole wheat garlic bread!

Blackberry Metformin

2008-06-18T21:22:00.003-06:00

Every so often the pharmacy refills my metformin in it's original bottle, and I am once again reminded that the stuff is, apparently, blackberry flavor. It strikes me as odd every time.

Blackberry is one of my favorite flavors - a splenda blackberry Yogen Fruz is a favorite dessert. So adding a little more blackberry into my life should be a good thing.

Every time, I take out a pill a lick it, just to see. And it doesn't taste like anything. Neutral.

Today, in the interests of science, curiosity and more blackberry-ness, I've undertaken an experiment. I figured it was flavored for people who have to take the pill crushed. All that tasty, tasty blackberry must be on the inside!

So, I had my husband split me a pill, and I prepared to lick the inside....

Please, don't try this at home. There is no blackberry!

It's just bitter, bitter medicine. Bleeck! Luckily the flavor was easily washed away with milk but I don't think I'll try that experiment again!

Has anyone else run into 'blackberry' metformin? And actually tasted the blackberry?

Burger Inn Bison Burger

2008-06-17T20:52:00.002-06:00

I'm back! Recovered from my cold and finally feeling like I have some energy again. Here's hoping I get back on a regular posting schedule again.

I had a ferocious day today, so we ate out as a treat. I had a buffalo burger at Burger Inn. It's a local Calgary chain that specializes in a variety of burgers. They've got beef, but why eat than when you can have bison, elk, wild boar, salmon, pork, ostrich, lamb or turkey?

They offer the burgers on white, wholewheat, or bunless, along with the standard toppings. You can also add ham, mushrooms, pineapple, friend onions, cheddar swiss or bacon. Yum!

They also have excellent poutine - fries with gravy and cheese curds, which I also had tonight. Definitely a treat item - I don't even want to think about the carb count! But it was the perfect indulgence for me today.

One day I'm going to try their milkshakes - they've got great flavors, including root beer, which is one of my favorite milkshake flavors. They've also got raspberry, blackberry, banana, peach and mango in addition to the standard vanilla, chocolate, strawberry.

I don't eat burgers often - but when I'm in the mood for one, I'll pick Burger Inn! Same price as any fast food place with far better quality.

Bah! Sick!

2008-06-08T20:14:00.003-06:00

I came down with the nastiest cold on Thursday. It came on like a train wreck - usually colds creep up on me with plenty of warning, but this one had me healthy to miserable in a day.

Ended up taking off most of Friday from work. It is progressing - I think - so while I'm still miserable I'm miserable with different symptoms and hopefully the darn thing will just go away soon.

I want my appetite and energy back, thank you!

Blogging will resume when the darn thing is vanquished by time, rest and cold meds.

A Few years earlier

2008-06-05T20:20:00.002-06:00

I wonder what would have happened if I'd been diagnosed earlier sometimes. I figure the insulin resistance really kicked in when I was in university, in the late 90's. That's when the PCOS symptoms really began to show up - though I didn't realize it, of course.

It was masked during my marriage as I was on the pill. When I got off the pill after my marriage broke up and found I was still irregular, I didn't worry about it. Then I moved and didn't see a doctor for a good year or more. Then I go from 'I really should get a checkup' to 'Diabetic-but-not' in a few short months.

I remember reading a billboard about diabetes, back in the day on the way to class. One of those checklist ones. Sedentary lifestyle? Yes. Overweight. Yes. But I didn't have any history of diabetes in my family (I know differently now), I was young - far under 40, and I'm Caucasian. So I had two out of five, and those two were really just being out of shape. I never seriously considered I might have diabetes! And I certainly wasn't going to ask my doctor about it - I'm no hypochondriac!

Of course, I'd never heard of PCOS, or it's connection to diabetes. I figured at worst my irregular cycle meant I might have some fertility problems - and as I've always planned on adopting if I have kids, that wasn't a concern. I had one doctor mention that if it continued, I should get it checked out because it could mean 'something serious', but I assumed that was a reproductive 'serious' not a overall health one.

Hindsight is always clearer of course. And I enjoyed a lot of fine carbs in those undiagnosed years. If I'd taken my first trip to Georgia and not been able to enjoy the fabulous biscuits and creamed potatoes... And I had a lot going on in those years too - having to adjust my diet and test my blood sugar would have been an emotional and financial blow.

Instead, I was diagnosed at a time when I was in a good position to change my diet, I could afford to pay out of pocket for meter supplies, and I wasn't in any big emotional upheavals. I doubt I could have picked a better time to get diagnosed if I'd tried. And as I'm still at a pre-diabetic stage with good numbers, not too much damage was done in those years of minute rice and pizza pops.

I guess, looking back, things worked themselves out pretty well after all.

No Time for Diabetes

2008-06-04T21:39:00.003-06:00

Sometimes, the diabetes just gets swept off by the wayside. This is a luxury, I suppose - I'm able to ignore it when I need to. But I don't like realizing I've unconsciously shoved it aside.

I only have so much time and energy, and so can only handle so many things at a time. Heavy deadlines at work, lots of social stuff, taxes, illness, dealing with the government. Any of these pile up, and I just lose the time to test my blood sugar, do my research, worry about the disease.

I am getting better at not tossing my diet aside at these times, but I don't think I tested at all today. It's been a busy few weeks. Crazy at work, a touch of food poisoning or flu on the weekend, three family events in the last couple of weeks, and my husband's immigration was finalized last week as well. I haven't really settled down and relaxed, and I wake up each morning feeling like I've hit the ground running.

I really struggle in these times to let my diabetes management fall by the wayside. It's the easiest thing to drop (well, after exercise), when life gets too busy, too complicated. But there's no guarantee I'm always going to be able to ignore it, so I'm trying to think of a way to balance it.

I'm not sure how to do it yet, but I think I'll try to work on forming better habits, like always testing before and after I eat lunch, so that I always get at least one pair of tests a day.

Breakfast makes a difference

2008-06-03T21:21:00.004-06:00

Work has once again gob smacked me, so I'm feeling very behind on my email and blogging and reading. I keep thinking it'll settle down, but somehow it flares back up again. But at least I'm feeling competent and useful and skilled, which all make me feel good.

The continuing appearance of numbers in the high 4 range (85-90) isn't hurting either. I need to get some more iTest strips and run some comparisons - I lost the 4's when I switched to the iTest, but I'm pretty sure the freestyle I'm using now is just as accurate.

So I'm pretty sure these results are not due to meter changes, hormones, or a decrease in caffeine. I think it's breakfast.

I've always been a solid breakfast eater. I don't feel awake until I've put food in my mouth, and I've always been wary of compromising on breakfast. It's the most important meal of the day, right? It's also been my most carb heavy: oatmeal and oatbran have been my staples the last few years. 1/4 cup of that plus some milk gets me about 40 carbs for breakfast.

Over the last few weeks, partially due to the fact that I am REALLY tired of oatmeal, I switched to a single slice of whole wheat toast, slathered (and I mean slathered!) with cream cheese and a tiny smear of jam. I find I end up wanting my mid-morning snack a bit earlier, but it keeps me going pretty well.

And, at the end of the day, say 3-6 pm.. I'm getting lower numbers. I don't notice lower ones in the morning, which boggles me. But I'm definitely seeing a trend to lower numbers in the afternoon that appears to have nothing to do with what I'm having for lunch or afternoon nibble.

I don't understand it, but I like it. Looks like we'll be buying lots of cream cheese in the future.

No Suffering

2008-05-31T21:27:00.000-06:00

I ran across the phrase 'suffers from diabetes' the other day, and disliked it intensely.

I don't suffer from diabetes. I'm annoyed by it, stressed by it, occasionally pained by it or maid sick by it.

Suffering brings to mind children in war torn countries to me, or slow painful death or torture. Suffering is not having to watch my carbs, poke my finger, worry for my future. Worry and fear don't mean I am suffering.

Worry is part of life, in my opinion. I can't escape it, in any case. If I wasn't worrying about diabetes, I'd be worrying about other things.

I'm not suffering. I've got a good life, and far more positives in it than negatives. I'm never going to accuse anyone else of suffering this disease either.

We aren't suffering it, or defined by it, or submerged beneath it.

We're all just living it.

Diabetic Fingerprints and Rainbows

2008-05-30T21:38:00.002-06:00

"Are you bleeding?"

My husband shouted this down the hall at me today. I guess I kept bleeding after my last test, and left a few diabetic fingerprints on the fridge door. It's not the first time I've left a smear behind, but usually I notice! I'm glad it wasn't the work fridge - that might have been embarrassing.

I also saw a fabulous rainbow today! We get rain rarely enough that it's more of a treat than anything. But the rainbow was an extra treat. I haven't seen a two side rainbow before - we usually just get a half arch. This one was beautifully complete, amazingly bright, and had a shadow rainbow on one side. Just amazing!

Off Plan Day

2008-05-29T22:10:00.000-06:00

Today was fairly momentous. My husband is now officially a Permanent Resident of Canada. We've been married since August of '06 and filed for his residency in April '07. So it's been a long road to get today. Now he can work, get health insurance, and we don't have to renew his visa every six months. I think it's still sinking in.

I was going to not blog about it initially, because talking about today would mean talking about what I ate today. I have no idea how many carbs I've had today, but it's been more than I "should". I don't like admitting when I've blown my diet completely out of the water.

But I'm going to. Consider the rest of this post my 'carb confessional'. I'm not perfect. Today I was far from it. But I'm trying hard to not say I 'cheated'. Instead, today is just a little bit 'off plan', as Jenny of Blood Sugar 101 says. I'm going to enjoy this day, with as little guilt as possible.

On with the confession: feel free to skip these carb ramblings.

I had not one but two Chinese custard buns for lunch. White bread, sugar, custard and some mysterious crumbled topping. And I had TWO, double my usual dosage.

I did skip out on snacks the rest of the afternoon - I think. It kind of went by in a blur, with the sleepless night catching up with me. But I stuck with green tea. I was 7.6 (137) two or so hours after the second bun.

Then we went out to celebrate. I had every intention of having the baked potato and apple crisp for dessert. We went to Montana's, who have really excellent huge baked potatoes. I found out for the first time that they'll put cheese on your baked potato! Yum, yum yum. I surprised myself here - I had only a quarter of the baked potato - usually I scarf down half of one. I had wine instead of a fruity drink. I only stole a few bites of my husband's corn bread. And I skipped dessert - at the restaurant.

I thought that'd be the end of it, but we ended up going out for an emergency monitor replacement. In our house, a broken monitor is a crisis to match a broken car - or perhaps worse! So out we went. I bought some dark mint chocolate to try later, stocked up on my secret indulgence of sweettarts candies. If I have them in the house, it's (usually) easier to not go overboard on them.

Then we went to Tim Hortons, and I had a cheese croissant. Another favorite food that I don't eat often. It vanished very quickly. I had tested before we left at least, so I knew I was around 5.6 (101).

Finally, at my husbands urging I had a small scoop of carmilk ice cream. Very very tasty.

I suppose all in all, that's not that bad. I could have done far worse. I did pull back a little bit. And I feel pretty good. I can live with not being perfect - and there's always tomorrow to get back 'on plan'.

Jugo Juice: I am not a carb hater / carb crazy!

2008-05-28T20:26:00.003-06:00

We ordered from Jugo Juice for lunch today. I knew it would be a bit tricky because they're not exactly carb-lite. They do have a low-carb smoothie, but all whey protien and no yogurt is not my kind of smoothie.

So I check out the "grilled fare" section and pick out a club sandwich - 64 grams of carbs on some kind of (I think) white bread. I ate half, a reasonable amount of carbs. The description on the page irked me though. It started out with a line like

Don't let those carb-haters fool you!

or similar. I didn't write down the exact wording so I'll have to post an update with it from work tomorrow.

I'm not a carb hater. I don't tell non-diabetics not to eat carbs. I tell diabetics not to eat carbs that raise their blood sugars out of range.

But I love carbs. I didn't skip the 80 carb smoothies my coworkers were enjoying because I am a carb-hater, I skipped them because I didn't want to have a nasty carb overload reaction.

I did check out their website looking for the same content, but there's no mention of carb-haters there. Perhaps I got an old menu? On the website they simply talk about how their food is full of "healthy carbohydrate" on a page much more politically labeled "carb conscious".

They have a diabetes page that offers the following advice

People with diabetes are often very active in regulating their eating habits and medication – they are free to enjoy Jugo Juice smoothies, beverages and wraps.

Perhaps for some, but for me, 'regulating my eating habits' means not enjoying the smoothies and beverages.

Update!: The actual page reads as follows:

Don't let those carb crazies* steer you away from balanced meals. We've chosen our bread products carefully, with just the right amount of cabohydrates and fiber. Moderate amounts of breads and grains are an important part of a well -balanced diet (and frankly, so satisfying!).

*carb crazies: folks that consider all carbohydrates evil.

I'm still not very impressed. Yes, going no-carb is unhealthly, but there's a lot of debate on what counts as a healthy level.

Plus the wholes thing seems silly - 40-60 carbs for a fast food sandwich isn't so bad, relatively speaking. So why make such a big deal over the fact they are offering no reduced carb offerings? There is no one-size-fits-all 'just the right amount' of carb. I don't like opening a page, looking for something that fits my diet, and seeing 'carb crazies' in the first sentence, no matter how they qualify it.

Ah well, life is full of these annoyances.

iTest / Keynote Meter Followup

2008-05-27T19:15:00.001-06:00

Back in April I posted my first-impression review of the iTest or Keynote Meter. I meant to follow up at the end of the month, but work exploded and it got put on the back burner.

But have no fear! My follow-up review is here. I've actually been using a Freestyle Lite for the past few weeks, but I'm going to save most of my commentary on that for another post.

Accuracy
On my first review, I was fairly concerned with the accuracy level of the iTest due to what I considered 'random high numbers'. After a month's use, this really amounted to about 5 tests in a hundred. 4 of these were in the first couple of weeks of using the meter, so I'm inclined to blame some kind of user error for these. As well, several of these were the second test on the same drop of blood. I found a mention somewhere - curse me for not bookmarking - that testing the same drop twice can sometimes lead to wonky results, so this may be another cause here.

I did run into several bad -low- results. About three or four times, I didn't get enough blood on the strip (the little fill window was not full) and the meter processed it but showed a low number, like 4.5 (81). A retest on a new blood drop would give me a more expected value like 6.5 (117). So I think there may be issues with under filled strips not being properly recognized. These were the only times I saw numbers in the 4's on this meter, so I sure noticed when this happened!

Overall though, I'm pretty confident personally in the accuracy. There's one big reason on this - the Freestyle Lite, which I'm testing now, was rated as the most accurate meter in a recent study of meters. They tested the Freestyle Flash, but as far as I know the Freestyle Lite is the same meter or the Canadian edition. In any case, my iTest results are nearly identical to my Freestyle results. They agree within 0.3 (5) points. That's pretty amazing consistency across brands.

All in all, I did end up re-testing a few times, but it got pretty predictable when I needed to - usually when I didn't get quite enough blood.

Lancets
I was really impressed with the lancets when I first started using the iTest. However in the long run, I won't keep using their device. Painless? Yes. But my skin is just a bit too calloused to work well with it. Typing all day long must really toughen up my fingers. Even on my easy to bleed pinky fingers, I need to massage it to get enough blood with those tiny tiny pinpricks. This leads to more bruising - an ultimately sorer fingers.

I did dial up the lancet device - and accidentally hit a nerve! I think that's what I did anyway - my entire finger stung for a day and I was anxious not to repeat the experience. While it's still leaps and bounds over the Contour's lancing device, it's not a personal pick for me.

However, as far as lancing devices go, I'd recommend trying this. This would be my 2nd best lancing device - and one I'll keep around for backup for sure. I have a feeling that even though it's not perfect for me, it'll be a huge improvement for other people.

Software
One big reason I had for trying out the iTest / Keynote Wave was to try out their shiny shiny Zero Click software. However, it turned out this was not to be.

If you go to the http://www.itestglucose.com/ website, and click on "Discover iTest" you'll see a screen that extols the features of the meter.

It lists the "Dynamic Electrochemistry" feature, the "Extreme Accuracy" feature, the "Screen Settings" feature, and the "Zero-Click Data Management" feature. Click on Zero-Click, and you get:

"World's only Zero-Click System now available in Canada!" and "Just plug the meter in, and Zero-Click does the rest!". I guess I was being a little too optimistic when I interpreted this to mean the software was installed on the meter, and came with it.

So I found a USB cable with the right ends - we have a ton lying around, and plugged it in. No go. As far as my computer was concerned, the meter wasn't even attached. I decided to do some more research. I re-read the page, looking for a download link. Nothing - just a pdf brochure. No mention of the software on the list of products on the left side either (the meter, the lancets, the strips).

I went to the US site - often US companies will have a considerably different site for US customers. WaveSense /AgaMatrix is no different. The Zero-Click software is at least listed as a 'product' there. I knew I had to buy it, but didn't know how much. If I could recommend a single update to the AgaMatrix websites, it would be a 'SOLD SEPARATELY' notice on the Zero-Click pages.

Checked the website of the pharmacy chain (London Drugs) where I bought the meter, but couldn't find it listed. This is undoubtedly the responsibility of London Drugs and not AgaMatrix, but it was another annoyance. After more googling I found it listed at the DLife Store. $40 US, Regularly $45. And that was the end of that story. I'm doing this new-meter-every-month thing because it costs me nothing. I'm going to be shelling out $75 for strips no matter which meter I choose, so I might as well make use of the free meter offers that abound in Canada.

But I'm not paying $40 for results software ON TOP of that. Not when there are amazing free software apps like Sugar Stats that will manage my results. Even Ascensia / Bayer didn't make me pay for their (pretty sucky) software - it's a free download on their website. Bayer did sell me a 'cable & software kit' for $20-30 ( $24.99 on their website right now), that turned out to be a generic USB cable I could have bought for a lot less at my local electronics store, which annoyed me to no end.

I think a lot of us feel we're being bilked by these companies - 75cents per strips works out to a considerable profit margin I am sure. And anecdotally I've heard that while meter prices have decreased, strip prices have gone up - I haven't been testing long enough to see price changes yet, nor can I find a chart online to prove this, so perhaps I'm wrong. But in any case, we're spending a LOT of money on these things and it can hurt to pay even more for extras.

So, long rant and story short, I'm just not willing to pay for the software. I don't analyze my results enough now to pay $40 on the chance that it'll be useful enough to pay for itself. If you're a user that does depend a lot on stats, this software could be useful for you.

For more details on what the software can do - the product description pages are pretty scanty - I suggest you download the user manual here. I tend to always check out the support forums and user manuals of software before I buy - I learn more about what it actually does from those than any brochure. From a quick skim, the software uses a special USB cable - so you won't be getting a generic cable for an upgraded price at the very least.

You'll be able to adjust all your meter settings, break your day into 8 chunks to represent meal times, set your target numbers, and view, print and email 6 reports such as log book and trends. There is also a 'backup database' feature, but no details on what format the backup takes, so I have no idea if it will allow you to export the results in a format that would allow you to bring them into other software. The import feature appears to only read backup files made by Zero Click, so I'm not sure how you get your backlog of data into the software either. You also cannot delete bad results (from testing someone else or having something on your hands). There is no way to enter medications, exercise or notes on any of your readings.

I have not actually used the software, so this is all from the user manual. I'd suggest reading the manual yourself, talking to someone who has actually used it or checking with AgaMatrix before making a decision to buy or not to buy.

Meter Charts
Another feature I was really interested in on the iTest / Keynote was the built in charts. In addition to 30,60,90 averages, they have little built in graphs to show you trends over the same time periods. These turned out pretty useless for me. My blood sugars stay in such as small range (5-8 or 90-144) usually that they don't even make a bump in the chart. I just get a straight line on all three. This tight range is not the usual for diabetics - but I'm pre-diabetic so it's something I can maintain. I'm not sure at what point the chart starts showing something other than a straight line, but I would assume that the average PWD would see something different.

Company
I've been impressed with AgaMatrix as a company in the last month and a half. They are the only meter company that I am aware that actually spends time on diabetes sites. They've commented on a discussion about meters at Tudiabetes.com, posted on my blog, and they have an employee who blogs about diabetes, even though he isn't diabetic. That kind of online presence is really important to me. It makes me feel a lot more connected and valued as a consumer than any other company has.

Final Impression
This is a good, solid, accurate meter. Once I'm finished testing various meters, this will definitely be on my short list for a meter to stay with. While there is room for improvement, as with all meters (check out my initial review for my wishlist) they do very well in other places. And for any meter, accuracy is KEY. Actually, precision is even more important, but accuracy is a huge deal. Seeing how it's results compare closely to known-to-be-accurate the Freestyle Flash really elevates my confidence in the meter.

I recommend the iTest / Keynote, especially over the Ascensia Contour or Breeze.

Trying to eat slower

2008-05-25T22:04:00.005-06:00

Ran across an article today that pointed me to an insulin resistance study in Japan. Okay, first I found a blog that reprinted the entire article as if they'd written it themselves - I have nothing but disgust for thieves of this sort - and found the original one (I assume) that actually linked sources.

In any case, the study I found was a strange one. Eating Fast Leads to Obesity: Findings Based on Self-administered Questionnaires among Middle-aged Japanese Men and Women. I would think that WHAT you eat would matter far more than how fast, but apparently it's not quite as simple.

The basis of the study was a questionnaire that asked several thousand people how fast they ate, among other things. They had to rate themselves on a scale of 'very slow', 'relatively slow', 'medium','relatively fast', and 'very fast'. It's a very open ended question. In any case, long story short - those who ate faster were found to have gained more weight, and had a higher BMI (Body Mass Index).

There's a lot of other reasons to eat slowly to - like enjoying your food more, and turning a meal into a time to relax.

This is good in theory for me, but not practice. I tend to eat because I'm hungry or having a mood swing - It's amazing how fast a granola bar can snap me out of an ill mood. I tend to be multitasking during meals - either I'm reading a book or thinking about work or watching TV. It's often something to get done quickly so I can get back to something more important. I know I eat fast - I tend to be done before everyone else around me.

It's hard to slow down. I'm so used to not paying attention once I've put the food on my plate. It's only on very special meals - or when I'm eating something that's an absolute favorite - that I stop and enjoy. I'm not sure how to change the habit day to day.

If I'm in "the groove" at work, I don't want to interrupt that thought flow at all. If I'm eating by myself, I'd rather read a book to occupy my thoughts. I guess I'll have to experiment and find something that works.

Type 2 Diabetes in Remission?

2008-05-24T21:00:00.002-06:00

Reading through some diabetes news updates this morning, I ran across a few articles talking about a new study. Some newly diagnosed diabetics in China had been given insulin, and a year later they were still 'in remission'. I've never heard that term applied to diabetes, and I was a bit confused. How much insulin were they taking? How often? And what did they mean by 'Remission'? Diabetes doesn't just go away for a while, as far as I know.

The entire article isn't available online - unless I shell out $30 bucks - but I gleaned what I could from the abstract on The Lancet's Website. Here's what they did:

They found 382 newly diagnosed diabetics who were not yet on medication. They had fasting levels between 7.0-16.7 mmol/L (126-301). They split them into three groups and gave one group oral meds (they don't specify which in the abstract), another group multiple daily injections, and a third "continuous subcutaneous insulin infusion" which I assume means some kind of pump.

They tracked how long it took patient to achieve "normoglycemia" - non diabetic responses to some tests, possibly the glucose tolerance tests, insulin, and proinsulin levels. Not surprisingly, insulin - especially the continuous infusion - brought glucose levels back to normal the fastest.

Once someone had maintained this for two weeks, they took them off the treatment they were on. All patients were switch to a diet-and-exercise management routine. There are no details on what diet they were on, but I would assume it as similar for all patients.

A year later, they went back and retested the patients. If a patient still showed normal responses on their tests, they said they were 'in remission'. 50% of those on the insulin treatments were 'in remission' as well as 27% of those on oral meds.

The tests they run showed that the beta cell function was "improved significantly after intensive interventions". However, the improvement declined in the patients who were treated with oral meds.

The bottom line here seems to be that for half of the patients, receiving insulin treatments restored some of their beta cell function for at least a year. That's pretty amazing to me, and it opens a lot of questions. Why did it work for some but not others? Was their any affect on their A1C? This is definitely a finding that needs more research.

I've linked the abstract above, but there's an article by someone who's read the whole article and not just the abstract available at Medical News Today.

Thank You Jeff

2008-05-23T21:20:00.003-06:00

Every day when I log into my blog, I check for comments. I'm always happy to see that there is a new one - and more often than not, it's from Jeff over at Go Do A Test. Not only does he write an interesting and amusing blog, he takes the time to say a few words from time to time.

It means a lot. I know someone's reading. If I wanted to journal just for myself, I wouldn't do it online.

Thank you very much Jeff, and every one else who's taken the time to post.

I'm trying to return the favor and post on other peoples blogs too.

Spontaneous Great Number

2008-05-22T19:14:00.004-06:00

I hit 4.7 (84.6) today for the first time in months. I was really surprised to see the number - I haven't been able to get past 5.5 (99) since March. I love seeing this number because it's in the non-diabetic range. It's a really, really, normal number.

I'd love to be able to see this number pre-meals all the time. If this was sustainable, repeatable, then I'd feel like I was actually reducing my insulin resistance.

Of course, I've spent some time trying to see if I can figure out what the magic combination was today. No caffeine? Different breakfasts this week? Lack of sleep? I really have no idea.

I'm going to enjoy it for today.

Japanese UG-201 Meter - No Blood Required

2008-05-21T20:11:00.003-06:00

Well I've been saying how much I want a non-invasive blood sugar meter. And I've finally found one coming on the market. The UG-201 doesn't require any finger pricking. It uses innovative pee on a stick technology.

Ick!

On the one hand, this meter has a lot of really good ideas. The sensors can be reused 200 times (ick!) and will cost about ¥6,000 or $56 Canadian Dollars. That's about a quarter a test - I pay seventy five cents now. Yay for cheapness. Huzzah for the environmentally friendliness of a re-usable sensor. They've got to be able to come up with this for blood.

They're working on a separate USB memory system that the results are transmitted to via infrared. This idea I love. Meter testing should be separated from meter results. Work together closely, yes. But I want whatever is holding my results to plug in to any computer and give me instant access to the data. No downloading software, no installing. I want something that I can take with me on vacation, use at work, or kill time with when I'm on a plane. There's no mention of any software like this in the article, but it seems like a good first step to me.

So two really good things. Then there is the downside.

Personally, I'd rather live with a tiny pinprick than have to run off to the bathroom every time I need to test. There's a three minute wait between tests as well. That's a long, uncomfortable time hanging around a bathroom if you need to re-check the numbers. Plus the fact that you don't always have to go to the bathroom, and that bathrooms are not always immediately available.

A huge issue is also accuracy. If testing on your arm is 10-15 minutes delayed from your finger pricks, how out of date is your blood sugar number going to be when it has time to affect your urine? The system also needs to be re-calibrated weekly which adds to the inconvenience.

And did I mention the whole Ick factor? The idea of carrying around a sensor, using it, rinsing it off, and tucking it into my purse seems so unhygienic. Somehow a tiny drop of dried blood on a test strip doesn't bother me at all.

Still, this will probably be a popular product. They've been selling a non-portable version since 2004, and this announcement is for the release of a portable model. I wonder what other diabetes technology is being developed in Japan?

Words to live by

2008-05-20T19:54:00.002-06:00

A post today over at Diabetes Mine inspired my topic today. She wrote about mantras and best advice. It made me think about the phrases that bring inspiration to me.

A big one has always been This too shall pass. No matter what situation I'm in, no matter how scary or sad or painful, I can hold to that one. Sooner or later, whatever it is is going to get easier. It'll resolve itself, I'll learn to deal with it, I'll heal, or a new opportunity will appear. I've yet to be proven wrong with this one.

For diabetes, this means I remember on the days that I am frustrated and tired that there will be days where it breezes by. I hold hope for new treatments and devices to make life easier, and an eventual cure.

The second thing is less a phrase than a concept - that of a 'big picture' or 'fate'. It's hard to see the silver lining when you're in a bad patch. I try and remember that. I know it's going through a bad first marriage that makes me aware and committed to my second one. Getting diagnosed with and treated for pre diabetes helped me drop the weight I couldn't lose. Early detection is going to save me from a lot of potential complications.

I don't believe that life is meant to be free of challenges and low spots. It's what you learn and grow from. Of course, I'm not turning down any sunny days that come my way either.

Lunch is a Bowl of Cherries

2008-05-19T21:26:00.003-06:00

You have to love cherry season. Today was the first time I've noticed them in the stores. Over winter I forget how many is a serving, but 15 seems about right. These were a great lunch. Not too sweet, a little tart, just ripe.

I don't eat cherry jam, cherry pie, or cherry anything else. But the fresh ones always remind me of summers visiting my aunt's fruit farm in BC. We'd bring home tons of fruit - most of which I wouldn't touch, but cherries are always fabulous.

I worked there two or three summers, and having that fresh produce was great! I didn't realize how good I had it, until I came back home, took a look at the grocery store offerings and was agast at how old all the stuff looked. I still have trouble buying apples - they seem so waxed and bruised.

Diabetes Meme

2008-05-18T21:51:00.000-06:00

With all the meme's going around, I wondered why Diabetics don't have our own. So I thought I'd create one. Of course, I have to fill in my own answers.

1.) What type of diabetes do you have?
Pre Diabetic / Type 2.

2.) When were you diagnosed?
Dec 2005

3.) Do you have a favorite finger / area to test with?
I poke my pinky's most often because they bleed the best and don't bruise a lot.

4.) What is your favorite meter?
I like the iTest / Keynote best so far of all the ones I've tested.

5.) What medications/supplements do you take for diabetes?
Metformin & Vitamin D - both on Doctor's instructions.

6.) What surprises you most about Diabetes?
How different it is among people. Different messages, Different treatments, Different Results.

7.) What is the hardest/worst part of having Diabetes?
Forgetting how it was to not have it, or at least to stop missing that old lifestyle.

8.) What is the easiest/best part of having Diabetes?
Losing 40 pounds and gaining a lot of self esteem and improved self image.

9.) Do you have any diabetes Heros?
I find the entire diabetes OC amazing, but I am always particularly astounded by what insulin dependant diabetics go through, often with great cheer.

10.) What's the first thing you'll do when there's a cure?
Give thanks, then binge on carbs. :D

I feel like it should be longer, but can't think of any other really good questions. I suppose ten questions about diabetes isn't bad, but the ten things meme I did yesterday was more fun!

Meme Tagged!

2008-05-17T21:23:00.007-06:00

There's a meme going around the blogosphere, and Jeff over at Go Do A Test! has tagged me.

Once you've been tagged, you write a post with 10 weird, random facts, habits or goals about yourself. At the end, choose 6 new victims to be tagged, list their names, and why you tagged them. Don't forget to leave them a comment saying ('You're It!') and to go read your blog. You cannot tag the person that tagged you, so, let me know when you are done so that I can go read your blog answers. Here are my ten:

1.) I hate both onions and oranges. It's rare to find anyone who hates onions, and I have yet to find anyone who doesn't like oranges, so I'm pretty sure this is weird. I do like those sweet little Christmas mandarins. There are a lot of other foods I don't like, but none of them are as alliterative.

2.) I am a completest book collector. If there is an author I like, I have to own EVERY book they have ever written. I may not even like all their books but I will still try to collect them all just to have them. I also sometimes buy entire series before reading them to see if I actually like it. This is an expensive habit, so I've been trying to break it.

3.) I like Anime and Manga. This is normal to me, but watching subtitled Japanese cartoons and reading translated Japanese comics is seen as weird by many people I know. I also have several series of manga (comics) in the original Japanese, which I cannot read but this is an offshoot of weirdness #2.

4.) I eat my food in order. Almost always I will clear my plate of one item before moving on to the next. First the meat, then the starch, then the veggies. I've apparently done this since I was very young and never grown out of it.

5.) I walk with a cane. I have had a bad knee since I was eight and as I've grown older I find it more difficult to walk or stand for long periods. The weird thing about it is that unlike diabetes, I have no resentment for the knee or the cane or the pain. It's so deeply ingrained into my self image, I can't imagine being without it, or clearly remember being able to run and jump.

6.) I'm short. 5 feet even. Tall shelves are my bane.

7.) I have a very poor sense of spatial perception. For this reason I do not drive. I cannot estimate distances, volumes or acceleration.

8.) I spent most of high school calculus in the back of the room doing cross stitching while the teacher lectured. I somehow still got an A in the course - an a surprise mention of the cross stiching it in the yearbook.

9.) I am a geek. Girl geeks are rare but definitely present. I am a self taught, female programmer. I have yet to meet, in the flesh, another. Weird but good. I also LOVE programming which most non programmers seem to find weird, and I played World of Warcraft (an online game) on my honeymoon.

10.) I want to have a Cornish Rex Cat at some point. My mother used to breed them - I grew up in Cat Show Circles - and I absolutely adore them. They are utterly strange looking at first glance, but have amazing personalities, able to switch from lap cat to maniac kitten in the blink of an eye. My parents have one right now that likes to hang out on shoulders.

Most of the people I would have tagged have already been hit with this meme, so I'll stick to just tagging one - Lora at The Diabetes & Stuff.

Fruit Bouquet

2008-05-16T18:10:00.005-06:00

This incredibly luscious fruit bouquet was delivered to our offices today! We've be having a lot of upheaval this week and it was a pick-me up from a company we work with. The strawberries were absolutely huge and very delicious. I had one chocolate covered one - very sweet chocolate so one was more than enough. The rest of the team was happy to go for chocolate covered ones while I nibbled the plain ones. I also had some of the grapes and melon balls.

And to top it all off, we kicked off early today to enjoy the long weekend - it's Victoria Day on Monday here in Canada. I can sure use a break and this was a fabulous way to close out 12 straight days of work.

Testing At Work

2008-05-15T20:42:00.004-06:00

I decided to start being a little less discrete about testing at work. I'm not making a big statement about it, but I'm not leaving the room to do it. If I'm in the middle of a test and someone comes up, I don't stop. We've got a new part-time staff member sitting right beside me, and he's watched me test a couple times now. I usually do it in my lap but it's pretty obvious to the people on either side of me.

I've gotten a few surprised looks, but no one has said anything. I'll admit that one complaint and I might have gone back to trying to be incredibly discreet about it, but it doesn' t look like it's going to be a problem.

I'm more surprised that I haven't gotten any questions. I think most people in the office know I have diabetes or prediabetes. Some of them hear more about it from me than others, but I'm always willing to talk about it. I think in the long run, being more open will make it easier to manage, because I can just pull out my meter and test when I need to without disrupting my work flow a lot.

Living with a Carbavore

2008-05-14T22:28:00.003-06:00

My husband is adopted so we don't know his medical history. We're pretty sure there isn't any diabetes in though - he eats a ton of carb and never has elevated sugars. He's from the south - Georgia, and was raised always having a couple of starches with his meals. Supper is usually not complete without some kind of bread - in addition to potatoes and rice.

It means we have a lot of carbs around the house. Potato chips, bread and buns, ice cream and crackers. Sometimes it is a lot of temptation, but we work it out. We share a lot, so that I can have a little bit of something, and he'll finish it off. That works great for cinnamon buns. Or he'll buy things in flavors I just won't go near, like smoky bbq chips. It's pretty automatic to him now to not give me carbs or to give me a small portion when he's putting together our plates. He knows how many mini potatoes (4), how much rice (1/4 cup) and how much bread (1 slice) to give me on the nights I'm having some.

I'm still in charge of what and how much I eat of course, and we've got a good rhythmn of checking in with each other on that. There are days I wish I could just pass it all on to him of course, but I need to be responsible for my own health.

All in all it works pretty well.

I've got it pretty good

2008-05-13T21:28:00.004-06:00

There's an excellent review of Bloodless testing and other treatment advances over at Diabetes Mine. I've got to hope that with all the advances in planning and design, at least one will make it to the market. It'll help with a lot of the little annoyances of life.

I'll admit though, as a pre-diabetic I have it pretty easy. I can -and do- coast along with minor testing. As long as I keep a pretty close eye on my carb intake and remember to take my metformin, I do okay. I don't test enough to get permanent scars and marks on my finger tips. I don't have serious highs or lows.

Somehow these past few days it's been -wonderfully- easy for me. I've not been stressing on choices, being more aware of what I'm eating, and in the mood to do a little exercise.

Don't know how long this mood will last, but I'm enjoying it.

Back on Track

2008-05-12T20:40:00.003-06:00

Was much better with food today - didn't do post meal checks, but I was always in the 5's on my pre-meal so I couldn't have been doing bad. Nixed a ton of snacks as well.

Also went walking for the first time in over a week, so I'm back on the exercise wagon. I unfortunately overdid though, so I'm exhaustedly headed for an early bed.

Now I just need to figure out how to get more veggies and I'm really rocking.

I feel good. A few days of not the best control isn't the end of the world. Getting back in saddle is waht matters.

Busy Days and Bad Numbers

2008-05-10T20:55:00.006-06:00

We've an imminent deadline at work, and it's been 12 hour days trying to make it. As the week has gone on, I've been eating more and more meals at work. It's great that work orders in lunch and buys groceries for us, but the convenience food that's often at hand is not good for my sugars.

Pizza, granola bars, toast, waffles - all right there and easy to eat one handed without stopping work. Plus I've been tending to reward myself when we hit a big milestone - a cookie here, a cupcake there, dark chocolate now and then.

I didn't realize how mindlessly I've been eating the last couple of days until I hit a blood sugar of 8.5 today - 153. For me, that's really high - I'm usually never over 7 (126) at the most - and I've been seeing that number more than I've wanted to in the last week too. I have a feeling I've been higher than that too - I haven't exactly been testing at an hour and a half after a meal. Sometimes I've been hard pressed to even remember when I last ate.

It's so easy to get into bad habits and ignore what you're eating when you're distracted and busy. Tomorrow I'm going to be trying to pay more attention and get back into a normal eating cycle. Those high numbers are not going to be sticking around.

New Prediabetes Reseach

2008-05-08T21:08:00.003-06:00

Found a new study on Prediabetes today. It compared insulin sensitivity and insulin response in people with different types of Pre-diabetes. You can get diagnosed with Pre-diabetes if you have Impaired Fasting Glucose (IFG) - high blood sugar in the mornings before you eat, if you have Impared Glucose Tolerance (IGT) - high blood sugars after you eat, or both. I have impaired glucose tolerance but my fasting levels are still good.

The study looked at obese adolescents, comparing 40 who had normal glucose response with 41 with impaired glucose responses.

They found that insulin sensitivity and first phase insulin was reduced for all groups - it was more severe for those with impaired glucose tolerance than with impaired fasting levels. For those with both impaired glucose tolerance and impaired fasting, the second phase insulin response was also impaired.

This follows the model of how blood sugar control deteriorates that is laid out over at BloodSugar101.com.

You start out producing enough insulin to handle the food you eat. As your insulin resistance goes up, you start losing the ability to produce insulin - high blood sugar kills beta cells.

So you have less stored insulin to release when you eat (first phase response), and eventually, you stop being able to produce enough backup insulin (second phase response) to cover what the first phase didn't get rid of.

As this goes on, you start showing elevated levels all the time because your system can't ever catch up without diet changes or medication or both.

Once you start showing both impaired fasting glucose and impaired glucose tolerance, you can be pretty sure you've lost a fair amount of beta cells. Getting diagnosed with only one or the other is a good sign, because it's being caught in the earlier stages.

Caffeine Weirdness

2008-05-07T20:55:00.003-06:00

I love my coffee in the mornings. I drink it black for a few weeks, then switch to cream and splenda, then drift back to black. We've got a pod coffee machine at work, so fresh and tasty coffee is always available. I love pod coffee machines - I have one at home as well - because even I cannot screw up coffee when using them.

Since I've been fighting this cold - almost gone, thank goodness - I've had to swear off caffeine. For some reason one cup of coffee makes me jittery for hours right now! I'm used to being the kind of person who can drink a cup of coffee and go to bed an hour later, so this sudden overreaction to caffeine is really annoying.

Hopefully as the cold departs, the caffeine reaction will too. I'll stick to decaf until then.

This has to be the weirdest side affect for a cold I have ever had.

Zeer - Food Reviews

2008-05-06T20:41:00.003-06:00

I ran across Zeer.com recently. It's a food review site currently in Beta. It looks like a combination of food review site / social network. You can add friends, post reviews, rate products and join communities.

It caught my eye because one of the communities they have is 'diabetes'. The idea of reading reviews of products by diabetics appeals to me - it's one reason I like blogs like Glucoholic. Anyone in the diabetes group can classify their review as belonging to the group, so they aren't forcing any constraints on what products are 'diabetic', which I like.

It's a beta site, so obviously it's in early stages. I think it needs to grow a bit to become really useful - there are only three reviews in the diabetes section as of today, including one on a persimmon has no nutritional information and reads, in it's entirety 'no sugar'. If the community grows and more useful reviews are posted, I can see it being a strong resource.

The biggest problem I have on the site right now is finding products. They have a huge database of items, and a number of ways to search them. It's really easy to find a product if you know the brand and product name. I found a few specific products really easily, as well as finding they don't have my local brand of Omega 3 milk.

However for non specific searches you can get thousands of results. For example, a search for all products that have less than 5% of the daily recommended allowance for carbs returns over 4000 pages of results! I could add additional search terms, but I'd rather browse through the list.

I'd love to see 'drill down' links on search results that allow you to refine your searches quickly without having to remember the name and brand of various products. I'd also love to be able to limit by location - there are a ton of brands available in the States that aren't in Canada, and vice versa.

I think they'll need to provide a little more information for consumers as well. From a programmers standpoint I can see why searches for carbohydrates and other nutrients are done in Recommended Daily Amounts, but I have no idea what the rda for carbohydrate is, so the carb search isn't that useful for me. A link to a table of data would really improve this feature. I did try searching for items with 100% of my daily rda for carbs - but this gave me Kibbles 'n Bits with an carb count of 0. I'm not ready to go no-carb!

I'd also love to search on an ingredient level - so I could load up all products sweetened with splenda, or avoid all the ones using asparatame. They have an ingredients search box in their advanced search, but I couldn't make it work.

For a beta, I think it's a pretty good site with a lot of potential. I'll keep checking back to see if the diabetic section is growing, or if they add more tools for finding products. It's still early days so there is a ton of room for them to expand and improve.

Diabetes & Aspirin

2008-05-05T20:26:00.005-06:00

I saw a few reports on Aspirin and Diabetes and Obesity recently. Asprin's pretty well known for decreasing the risk of heart disease, and I know it's recommended for some diabetics to take a baby aspirin daily. There's some heart disease in my family so I suppose I should be taking it. Something to discuss with my doctor, though asking if I should be on [yet another] pill always makes me feel like a hypochondriac.

In any case I thought I'd do some reasearch on it. The most annoying headline I ran across was 'Are you Obese and Fear Diabetes? Take Aspirin!', which misrepresented some of the information I've come across. Of course, inflammatory and inaccurate health headlines are not rare.

I did find a couple of stories that were a bit more clear on what's been found.

In non diabetic obsese people, an asprin-like compound called triflusal caused the pancreas to release higher levels of insulin. It didn't affect insulin sensitivity. The full study won't be out until July, in the Journal of Clinical Endocrinology and Metabolism. I'm not sure if I have a lot of faith in this study leading to useful treatments. Without knowing what the subject's A1Cs were, it's hard to know if they were predisposed to diabetes. If they weren't, then who's to say that it would be preventative?

I'm also skeptical of any medication that increases insulin production - does it do it safely and sustainably, or will it lead to beta cell burnout from over work? As far as I know there hasn't been a study of insulin-stimulating drugs that confirms or denies burnout as a side affect.

The next study I found looked at another aspirin relative, Salsalate. It found that the drug reduced both fasting and glucose tolerance numbers. It was a tiny study, and looks like it lead to a bunch of other studies being funding, including a three-year trial for diabetics. They perscribed it in huge dosages - 4gms! The pills are sold in 750gm pills, so that's more than four pills a day. Salsalate has been in use for 40 years, so it's a known safe drug. In the article, they postulate that it's the anti-inflammatory action that is giving the effect. Reading the abstract for the study, it states that insulin levels did not rise, so insulin sensitivity improved. A long tested drug that increases insulin sensitivity? I hope this research goes somewhere, FAST!

Finally I found a mouse study using actual aspirin. Apparently asprin-like compounds have been noted for improving blood glucose levels since 1900. They found that high doses of aspirin block an enzyme, leading to more insulin sensitivity. And I mean dangerously high levels - the human equivalent would be more than 10 regular aspirin, which leads to a lot of nasty complications. There are some interesting quotes in this article - "We strongly recommend against anybody considering treating their diabetes with aspirin" - which I would assume means high, dangerous doses and not the baby aspirin recommendation I mentioned above.

Second is one that is painfully true:

"There is a lot of stuff that looks promising in mice that just doesn't pan out over time. It is a long way to the clinic and mice are not humans."

Ain't it the truth.

Swedish Nutrional Labels

2008-05-04T18:51:00.007-06:00

I'm pretty used to reading Canadian/American nutritional labels. Reading ones from other countries throws me now and then. I ran across these 'My Smoothie' juice boxes from Sweden and did a quick skim of the label - 12.7 carbs! Huzzah! Juice I could enjoy!

I really should have considered how they managed to put in all that fruit with so few carbs, but I wasn't going to look a gift horse in the mouth. When I went to drink it, I did a second check of the label. And noticed a tiny little detail I'd missed on the first round. The label reads "Nutrition per" in three languages, then adds "100 ml". The box was 250 ml, so a serving was less than half a box.

I'm extra careful with liquids because they cause such dramatic spikes. So I dutifully measured out 100 ml, as shown below. The juice isn't bad - it'd be better mixed with some yogurt for a proper (in my eyes) smoothie taste. But I really need to remember to check foreign labels a little more carefully in future. It's small packages that cause me the most trouble - I can't help assuming that entire container is a serving.

Belmont Diner French Toast

2008-05-03T21:16:00.004-06:00

We went out to lunch at the Belmont Diner today. Neither of us wanted to cook, and the place had an excellent review in our local restaurant critic, John Gilchrist's new book My Favorite Cheap Eats. We've tried a few places from the book so far, and they've all be good.

There was a line out the front door so we had to wait for 20-30 minutes for a table. We'd been warned about the line from the book, so it wasn't a surprize. When we left the line had grown to a dozen people. I think the restaurant only seats a couple dozen, it was a tiny place.

I'm a sucker for diner breakfasts, especially hash browns, pancakes, french toast and waffles. They have a tiny little notice on the menu that smaller portions were available, so I downgraded my order to a single slice of french toast. It arrived perfectly cooked with a mess of crispy bacon and a serving of their bottomless hash browns.

I was very pleasantly surprised to find it wasn't made with white bread. In fact, I didn't see a single slice of white bread in the place - even the toast was made with some kind of brown bread. The waitress thought it was whole wheat, but I couldn't tell for sure. It was very flavorful bread - I'm sure they're either making it themselves or buying it from a good bakery. In any case, it was really nice - not soggy, plenty of egg, and I topped it with butter and the real maple syrup they stock at each table. I don't mind fake syrup, but the real stuff was very tasty, and I didn't need much with the cinnamon sprinkled on the toast.

I'd been smelling the bacon while we waited and it did not disappoint. I think I had five or six rashers on my plate - too much for me so I passed a couple on to my husband.

I finished off with soft fluffy hash browns. Next time we go back I think I'll order eggs just so I can nibble more than a couple of bites of the hashbrowns. I love hashbrowns in all their incarnations, but these were really excellent, with a great flavor. I have no idea what they spiced them with, but it was great to enjoy hashbrowns that don't rely on salt for taste.

In any case, it's great to know there's a place to go and get a whole wheat grilled cheese or really tasty hashbrowns the next time we're having a treat for brunch.

Bret Michaels wins $100K for JDRF

2008-05-02T16:43:00.003-06:00

Did anyone else watch Bret Michaels (Poison/Rock of Love) last night on Don't Forget the Lyrics? They're doing a series of charity episodes where celebrities compete to win money for their favorite charities.

Michaels got to the $200K level in the game, and split his winnings between the Juvenile Diabetes Research Fund and St. Jude's Children's hospital.

Of course, the bulk of the show was about the music, but he did give a quick explanation that he has Juvenile Diabetes (I don't remember him saying Type 1) and was on insulin shots. There's some more information about him and diabetes over at DiabetesHealth.com

True Lemon Hot Lemonade

2008-05-01T20:21:00.004-06:00

I'm fighting a nasty cold right now. I hate being sick - don't we all? The fatigue, the sneezing, the runny nose and watery eyes. But the worst has been the sore throat. It's been waking me up at night. Every few hours I'm awake and trying not to swallow.

I broke down on my aspartame avoidance and bought some sugar free lozenges. I've been gargling salt water - not nearly as bad as I thought, though it only helps for a little while. I've been spraying my throat with Chloraseptic when it gets really bad.

And I've been drinking lots, and lots, and lots of Hot Lemonade. It what we were always given as kids when we were sick. My mom would mix up mugs of powered lemonade with hot water instead of cold. Lemon scented steam always makes me feel better. I avoid all those powdered lemonade mixes now - way too much sugar. I've been using True Lemon to get through this cold.

I heard about True Lemon last year as a drink flavoring substitute. Each packet is the equivalent of 2 squeezes of lemon or lime. It's made with crystallized juice - no calories, no carbs. I usually carry a few packets in my purse so I can flavor water when I go out - tap water can be pretty unappetizing at times. I'll also dump it in Perrier or Club Soda if I want some 'pop'.

And when I'm sick, it dump it in hot water and drink it down. It dissolves far more easily in hot water than cold, and I enjoy it without needing to add any sweetner - the lemon flavor is enough on it's own. Plus it's so soothing for my throat.

I'll be so glad when this cold is over with. But the Hot Lemonade is making it easier to get through.

And This Bowl is Just Right

2008-04-30T21:05:00.005-06:00

One way I keep my portion sizes under control is to have different sized bowls for different foods. Finishing an entire bowl of anything is satisfying, even if it's a small bowl, and it's easier to resist going back for seconds. It also makes it easy if my husband is putting together a snack - he knows if I ask for a 'bowlfull' to go for the small bowl. We've gotten most of our small bowls in Chinatown - the stores often have a selection of small rice and condiment bowls for reasonable prices. I find them a good size for cereal and servings of fruit, as they hold about a cup. I'll fill them to the brim with berries, and half full for cereal.

The tiny 'ice cream' bowls are actually teacups, and hold single small scoop of ice cream or pudding. Having a tiny cup makes me eat it slower and reminds me to savor the flavor. It was a bit of an adjustment - and every so often I'll upgrade to a larger size - but it really does help re-enforce moderation in sweets and carb heavy foods.

The big bowls are regular salad/soup bowls, and I try to make sure I'm not using them for anything but veggies.

I do this with glasses as well. The only time I use a large glass is if I'm drinking water, crystal light or some other sugar free beverage.

Anything carb heavy like milk or juice gets a small glass, usually only half filled. We found the small glasses in a six pack at the dollar store, so they were really inexpensive.

I find it really tedious to pull out the scale or the measuring cups every time we eat, so having our serving dishes in the appropriate sizes really helps.

The only thing I don't use smaller things for is plates: For those I just try to make sure half the plate is covered with veggies, though I'm not always successful.

Australian Meter/Game System: Glucoboy

2008-04-29T08:30:00.005-06:00

Found another new meter, unfortunately only available in Australia right now. The Glucoboy is made Guidance Interactive (I can't find any other meter products by them) in partnership with Nintendo, and is targeted at children. Apparently this became available in November or December 2007 after several years of development. I'm not aware of any other meters specifically designed for juvenile diabetics, and I think it's a great idea.

Aside from the standard meter functions, the Glucoboy has a bunch of built in games that offer reward points though 'GRiP', a guidance reward platform. This includes an online community to help encourage good diabetes management. It sounds like testing regularly earns you more points, which are then spent inside the games or on the website.

The Glucoboy requires you own a Nintendo DS or or a Gameboy Advance to play the games - You plug it in as if it were a Gameboy cartridge to play. The device itself is designed in white and bright orange, and looks very kid friendly. It retails for $299.00 AUD, so it is quite expensive for a meter or a game (Though I don't know how other meters compare in Australia - in Canada meters run about $50 CAD, though you never have to pay for them). The strips are bright orange, and retail for around $31.30AUD for 50. They're planning a lot of accessories to go along with this meter as well.

I'm not Type one, so I have no experience with being a child with diabetes, but I'd like to think this device is a good idea. It seems like a way of making all the unfamiliar changes that come with a diagnosis a little easier to learn by putting it in the familiar context of video games. I would think one of these would be 'cooler' to take to school.

Of course, any child is going to get tired of a game after a while (or at least I always do), but it might be a good way to form the habit of regular testing. Of course, it would be great if Nintendo continued to put out games, or found a way to link the incentive points with their regular offerings.

Any Type 1's or Type 1 Parents out there care to give an opinion in this? I'm really interested in hearing a thought from the inside.

A Pretty Concept Meter - Ninos

2008-04-28T18:40:00.005-06:00

Concept art for diabetes products seems to be a new trend. On the one hand, it'll be great if any of this stuff actually hits the market. On the other hand, these concepts always seem to be promotional pieces for designers with little chance of actually getting picked up by an equipment manufacturer.

The one that caught my eye today was a dual concept study called the Ninos As & Ninos GL. They are very stylish, very pretty in modern black and silver.

Reading the story though, I wondered how much research had been done. The Ninos As is an insulin inhaler concept. As sleek and streamlined as it is, I'm not sure how valuable a concept it is when Inhaled Insulin has been linked to Lung Cancer.

The blood meter concept (the Ninos GL) looks a lot like a cellphone. It has a shiny touchscreen and all the charts and graphs you need built in. I love this concept.

However, the concept meter uses a "bloodless glucose measurement system". Apparently you're just supposed to press your finger against a notch in the top. Again wonderful, if the technology existed. As far as I know, it doesn't. The first meter that doesn't use test strips is going to have millions of people flocking to it.

I haven't been able to find much about these concepts - most of my searches online have returned reprints of the same article, often written as if these were actual, available devices. I think they may be German, from squinting at the photos provided. I don't know if there part of some contest or just a designers portfolio.

Love the prettiness of these, but I do wonder about the science behind them.

Whole Wheat Biscuits

2008-04-27T16:33:00.004-06:00

I took a stab at converting our favorite 'Touch of Grace' biscuits to whole wheat this weekend. My mother loves these, so we have an excuse to make them a couple times a month. Now that they're becoming a regular part of our diet, I thought it was time to make them slightly more diabetic friendly.

I've never tried to convert a recipe before, and I wasn't quite sure what the rules were for changing things up. We ended up just winging it. The recipe calls for 1 1/2 cups of white flour, and we substituted 1 cup whole wheat and 1/2 cup white instead. We've made this recipe enough that we know what the dough should look like, and that made it a lot easier. I had to add a half cup of extra milk to get it to look right. Now I know that whole wheat flour absorbs a lot more liquid.

They turned out great. Still had plenty of 'biscuit' flavor, nice and fluffy, and in no way did I feel deprived of my regular white biscuits. I'm going to try all whole wheat flour next time - and use buttermilk (we were out this weekend) because I did miss the buttermilk taste. But overall, a great experiment.

Whole Wheat "Touch of Grace" Biscuits
adapted from The South The Beautiful Cookbook

1 cup whole wheat flour
1/2 cup white flour
1 1/2 tsp baking powder
1/8 tsp baking soda
1/2 tsp salt
1 tbsp Splenda or sweetener of choice
3 tbsp vegetable shortening
1 1/4 - 2 cups Milk or Buttermilk
1/2 cup additional flour (any kind)
2 tbsp melted butter

Preheat oven to 500 F/ 260 C. Lightly coat an 8" pan with cooking spray.

In a medium bowl, mix the first six ingredients. Work the shortening in, forming pea sized lumps with a pastry blender or your fingers. Gently stir in milk or buttermilk until just mixed. You want add enough milk that all the flour is moist. We find we need less milk than buttermilk, but you will need at least 1 1/4 cups for the whole wheat version. This is a thick, wet, drop biscuit dough, sort of like thick muffin dough.

Let the dough stand 2-3 minutes. The dough is so wet that you cannot shape it in the usual manner. Pour the last 1/2 cup of flour into a plate and flour your hands. Spoon a biscuit sized lump of dough into the flour, and sprinkle with flour to coat it lightly. Shape the biscuit into a soft round, shaking off any excess flour. Place into the pan. Continue with the rest of the biscuits until the pan is full, or you run out of dough, pressing each biscuit as close to the others and the pan edge as possible.

Brush the biscuits with melted butter and bake 15-20 minutes until brown. Let cool for five minutes, then serve and enjoy.

Offline Diabetes

2008-04-26T23:20:00.001-06:00

Sometimes I wish everyone diabetic wore a button. I know there are many diabetics around me, but I rarely meet them offline. Those I have met with diabetes, including my stepmother, aren't really interested in talking about it. It's a closed door. I tend to share it, though I don't (I hope) ram it down people's throats.

Meter comparisons, concerns about doctors, venting about daily stress, any acknowledgment of the day to day frustrations and successes.. these only exist for me online. I read a lot of blogs, soaking up those other experiences.

When I go out, now and then, I watch the people around me. Perhaps someone will pull out a meter or I'll see a pump. I don't know that I'd do anything if I did. I'm far to shy to approach a stranger, and diabetes can be very personal. I think perhaps a great number of people don't want to discuss it. Sharing a disease doesn't make you friends or acquaintances. Given the variability of diabetes, their experience could be far removed from now.

But it would be nice to not be the only diabetic in the room all the time. To have a face to face conversation about it. I'll get there, sooner or later.

Blood Sugar 101

2008-04-25T18:08:00.007-06:00

After much anticipation, my copy of Blood Sugar 101 by Jenny Ruhl arrived this week. It did not disappoint. The book is full of the best tips, techniques and information from Jenny's site, BloodSugar101.com. I've loved Jenny's site since I first encountered it, so buying her book was an absolute must.

Despite the somewhat alarmist subtitle - "What they don't tell you about Diabetes!", the book is very straightforward and to the point. I think this should be a standard 'Textbook' for diabetics. It's got so much useful information on diabetes itself - all backed up by actual medical studies - combined with information on insulin, oral meds, supplements, plus useful techniques for lowering your sugar levels and A1C. I would have never realized chest pain is a Metformin side effect without her detailed analysis.

She asks and answers a lot of very critical questions: Does Diabetes have to progress? (No), At what blood sugar level does organ damage start? (140-160 [7.8-8.9] post meal levels), What should you eat to reduce your blood sugars? (Fewer Carbs).

She explains how to use your meter to find out what foods you react to - no one size fits all diet plans here - as well as coping techniques to stay on your diet. One of these I really like is the idea of 'off plan' eating instead of cheating. How you think of things, the words you use, have a huge effect on how you feel about them. "Cheating" brings a lot of guilt and shame, but "Off Plan" eating brings the focus back on the fact that it's your choice.

It can be a very scary book at times - Jenny is very straightforward about how the disease progresses and the risks of various complication. But it's enormously hopeful too, because it gives practical techniques for avoiding them by keeping your blood sugars low. There's a very simple progression of techniques - Adjust your diet, adjust/add meds, adjust/add insulin - to help you find the right balance of techniques to meet your own goals. She really promotes the least expensive and invasive techniques (diet) before medication and insulin, without pretending that a diet solution is going to work for everyone.

If you have questions about the different types of diabetes, how insulin and glucose are managed by the body, what causes diabetes, how effective different drugs are and what side affects they have, what supplements actually work, and what your doctor should be doing to help you manage your disease, you'll find answers both in the book and at Jenny's website.

I'd recommend this book for anyone with diabetes, and anyone who knows a diabetic. It's available from Amazon or through Jenny's site. But don't just stop at the book. Be sure to visit BloodSugar101.com for even more incredibly useful information, plus Jenny's blog critiquing the latest published studies.

Blimpies 3 Inch Sub

2008-04-24T21:27:00.003-06:00

One of my husband's favorite fast food meals is a Blimpie's Sub. My father owned a sub shop (not a Blimpies) for five years so it's a bit of a nostalgia meal for me too. I made a lot of subs in high school.

I like the freshly sliced meats, the extra tasty mayo and the provolone cheese at Blimpies.

Of course, the problem with any sub place for me is the enormous sub bun. A 6" wheat is about 40 carbs according to a few nutritional sites. I'm not eating all that.

Instead, I ask them to cut it in half, then dump all the filling into one half and munch my double thick three inch sub.

Yum!

Parents - Leftover Disposal

2008-04-23T21:49:00.004-06:00

Since we moved to the same city as my folks, we have them over for dinner a couple times a month. It's something I really enjoy. For one, I like feeding my folks - it's a great reversal of all the meals they've fed me, and I know they appreciate having someone else doing the cooking. We usually play a couple of board games as well which is great fun, and difficult for two people.

Every time they come, they leave loaded with leftovers. I end each evening looking around and going 'what else don't I want'. Tonight they not only took the supper remains (chicken, cauliflower, biscuits), but dessert - 3/4 of a boston cream pie, and a half a bag of cookies I was trying to avoid eating. It was great to have the boston cream pie - we never buy it because it's too big to finish, and I can't be tempted by extra biscuits or cookies if they're gone.

It's nice to give away extra food - and especially extra carbs - instead of letting them go to waste.

Jelly Straws

2008-04-22T21:14:00.002-06:00

The import foods aisle at the Real Canadian Superstore is always filled with strange and interesting things. Most of it eye with astonishment and skepticism. Dried Squid? Corned Mutton? Wasabi Peas? Grass Jelly (Jello)? No thank you.

I do run across something I like now and then though. Jelly straws are now a staple snack in our house. It's a pretty simple product - assorted flavors of Gelatin in a tube. We don't have Jello in our house much, as it seems impossible to find sugar and aspartame free varieties, at least up here in Canada. These are a great alternative.

Each straw is only 4 carbs, so they're a great quick sweet snack. I find the flavoring fairly subtle - each pack has a mix of grape, pineapple, lychee, apple and strawberry. I wouldn't recommend them for lunches because I've never been able to get a tube open without scissors.

Gelatin has always been a treat for me - I never had it much growing up, so I appreciate being able to have it anytime I want.

Stuttering

2008-04-21T20:50:00.001-06:00

Apparently when I was very young, four or five, I used to stutter. I don't remember doing it at all, but in the last year or so it's come back.

When I'm tired, or stressed, or need to eat I start to feel this chattery teeth sensation. Then I'm forcing myself to slow down to get words out. It's really disconcerting, because I can be one of those mile-a-minute talkers. Not being able to get words out, or not being able to get past repeating a single word or syllable is another is scary scary.

Of course the big part of the fear is that I'm once again out of control. So far I haven't been unable to get words out at work, but today I wasn't feeling well and I had to slow my speaking down to keep talking.

I've tried looking up any tie between diabetes and stuttering, and come up empty. I'm guessing that it's just co-incidence that it's come back so soon after my diagnosis and medication. It's definitely one of the strangest and scariest changes I've had in the last couple of years.

Insulin Envy .. and Admiration

2008-04-18T20:38:00.004-06:00

I'll admit to feeling a twinge sometimes, when I hear an insulin dependent type comment on eating something especially sweet or having bread and potatoes AND dessert for dinner, or otherwise exceeding the 20 carbs at a time limit I try to stick to. 100 or 150 carbs in a single meal? I just can't do that. I wish I had the ability to 'cover it' with insulin, and have that freedom of diet, or simply having a way to make those numbers go down instead of "don't eat it" and "wait it out" techniques I have access to.

Of course, insulin is not that easy. Sure, you can take insulin to cover what you eat, but it's not like you have a choice in it. And it's not like it's always predictable, or figuring out how much and when is straightforward. No insulin, and you're in bad territory. Too much insulin, same deal. I can't image waking up with the shakes of a low or struggling to get numbers down when you're dealing with a bad batch of insulin, or having to insert pump needles every few days.

I don't think I'd be willing to trade that uncertainty for the ability to counteract the effects of a big chunk of cheesecake. It's reading all those blog entries about the realities of being insulin dependent that keep me motivated to avoid progressing to that stage. My image of the insulin dependent lifestyle has changed from a simple 'lots of shots' idea to a complex, challenging system of checks and balances you can't take a break from.

It's amazing and admirable to me to know of all the people who make it work, and find the strength to deal with it every day.

Brownies & Bad Moods

2008-04-17T21:04:00.002-06:00

Alright, brownies are on the 'eat less of' list, but it's been a while, and they looked delicious.

I was careful. I only ate half my multigrain burger bun at lunch. I waited a couple hours to let it digest.

Then I had a small brownie. Not tiny, but within what I can usually handle for a brownie. I was quick to regret it. It was small, but sweet, and very lacking in that chocolate fudge flavor that was the entire point of eating it.

Then I started feeling that sugar rush. The fatigue, the swirling stomach, the fuzzy head and lack of focus. It always makes me just want to curl up somewhere until it passes - not really possible at work. I have no idea how much sugar that baker used but it has to be considerably more than the average brownie to get that reaction.

For some reason, the sugar rush never seems quite reflected in my sugar levels - I tested at 7.7 (139), which is high for me - I try to stay under 6.5 (117), but it's not hugely over.

Fries, I will note, can easily raise me to 9 (162) with no adverse reaction. It takes sugar to screw me up.

Usually I figure once the sugar rush is past, the worst is over. But I'm very slowly starting to clue in to a secondary reaction: the sudden bad mood, five or six hours later. There's such a huge time frame between the sugar rush and the bad mood it's taken me a long time to connect that they're related.

Especially since, once again, it's not reflected by my blood sugars. I'm holding at a stubborn 6.0 (108), even though aside from some roast beef I've barely eaten in 5 hours. Not a bad number, but it means I have to be careful what I eat if I don't want to get past 6.5 again today.

I still haven't figured out how accurately judge what's going to give me a sugar rush. I'm glad I've figured out that sugar rush means an oncoming bad mood later - and my husband will certainly appreciate the warning - but I feel foolish for taking so long to clue in. I need to remember that even if my meter isn't showing crazy numbers, what I eat can be affecting me in a lot of other ways.

Explaining Insulin with Pizza

2008-04-16T21:18:00.003-06:00

I've been trying to come up with a good metaphor for describing some of the ins and outs of diabetes. One I've come up with for insulin is a Pizza Delivery Comparison, as illustrated below:

I like this one for a couple of reasons: Pizza's a pretty understood concept. I don't think many people in the western world haven't had pizza delivered at least once. Sugar's easy enough to equate to other food too. Insulin triggers the opening of cell doors to let in food, so that's a pretty straightforward comparison too.

It makes explaining insulin resistance really easy too. If you've got insulin resistance, as Type 2 Diabetics, Pre Diabetics and some Type 1 diabetics do, then some of your 'doorbells' are broken. So you're wondering if that 30 minutes or it's free delivery deal is still good, and outside the pizza guy is wondering if anyone is home.

I'm not sure how to create a good image with this metaphor to describe a lot of other aspects of diabetes - lack of insulin production (Type 1, Insulin Dependant Type 2) is easy enough to talk about, but an image of a pizza guy with no hands doesn't work for me. Beta cells and insulin factories don't really work with hands either.

Still, it's a start.

Diabetics on TV

2008-04-15T19:05:00.000-06:00

The TV world we watch rarely seems to include diabetes. I can't remember ever watching a show with a diabetic on it. Part of me objects to this - there's a huge number of diabetics in the world, and you'd think we'd be mainstream enough to include. The other part is a little glad, because diabetes could so easily get sensationalized for dramatic effect. I wouldn't want to see a diabetic on TV if it was all seizures and comas and the like.

But I do wish there would come a show that'd show it in an intelligent way. After all, the day to days of diabetes, the blood testing, the shots/pills/pump, the carb counting, the rest of it, is pretty boring. A character that was all about diabetes would be really boring and one dimensional.

But one that was diabetic as just a character trait, not a character focus, would be worth watching.

I wouldn't object to the occasional diabetes-specific shows. Say one for an upcoming A1C, or having a meter break, or a bad batch of insulin. Things that are handled in a realistic fashion, not an 'OMG DIABETES EMERGENCY' one.

But the gold would be in the tiny details. I can picture little vignettes.

A bunch of teenagers sit down to eat, and one of them pulls out a meter and tests.

A college student accidentally hands in a term paper with a test strip attached.

A young woman hurries to make an appointment on time after having to reset her pump insertion.

Someone gets snarky in a conversation, and is asked if they've checked their blood sugar.

At a restaurant, one person at the table cuts their potato in half and sets it aside, or removes the third slice of bread from their whole wheat club sandwich.

How awesome would it be to see these little slices of diabetes life in the "mainstream"?

Diabetes History

2008-04-14T20:40:00.003-06:00

Today's all about awareness in the Diabetes Online Community. We've all got our own personal histories with the disease, and it's amazing how far we've come in some ways, and how much we have left to travel in others.

I thought I'd link to a diabetes timeline. It's got some interesting tidbits.

There have been some interesting miss-steps - apparently in the late 1850s, patients were prescribed sugar. Between 1900-1915, they were trying carb heavy diets based on milk, rice, oats and potatoes. Elliot P. Joslin, a leading diabetes researcher in the early 1900s proclaimed diabetes as one of the best of the chronic diseases, for being, among other things, 'seldom unsightly'.

Of course, there are some important advances too. Insulin, oral drugs, blood meters, awareness and education campaigns. We're in the middle of so many potential advances. Hopefully in the next few decades, we'll see the disease itself become history.

Diabetic "Sucess"?

2008-04-13T18:50:00.000-06:00

I know what I consider being successful at this disease. Reaching say, 80 or 90 without getting any of those nasty complications will definitely be a success. That's my ultimate goal.

The problem with this goal is that the only signs of success are the lack of signs of failure. I know my A1C's have been good, so I assume that I'm on the right track. So far I'm able to keep my sugars in control with the combination of diet and exercise and medication I'm on now. I don't have any diabetic complications.

But I wish I could go in to the doctors and find out that I've sustained the same amount of beta cells, or that my nerves are free of damage or see my level of insulin resistance go down. I'd like some way to guarantee that I'm holding my own.

I come out of each A1C feeling like I've gotten a report card: really good at measuring past performance, but still no guarantee of the future. Just because I have an A this term doesn't mean I'm not going to flunk out next year.

I wonder if I'm going to go to the doctors one day, and they'll do some tests on my eyes or nerves and give me bad news. Even if I feel like I'm more or less doing everything right, there's always that push to try and do better, just in case some silent damage going on in the background. Something that I won't know about until it's too late to reverse it.

I know there are no guarantees of the future, but that blindfolded feeling is one of the things that scares me the most.

Glamorgan Bakery - Whole Wheat Cheese Buns

2008-04-12T19:10:00.006-06:00

This is a whole wheat cheese bun. I've finally found one! I love any kind of cheese + bread combination but try to avoid all the white bread.

This one was discovered at the Glamorgan Bakery. We'd been told they had good sausage rolls and cheese buns and decided to check them out this weekend. The cheese buns did look good, and exceptionally cheesy. I didn't spot the brown ones on display, but they had a sign up so I knew to ask.

For me, about half of one of these is enough. They're really packed with cheese, both inside the bun and on top, so it tears apart in cheesy layers. I did find them a little salty for my taste, but still something I'll buy again. I don't eat a lot of salt so I find I don't have much tolerance for it.

I'll be having cheese bun for breakfast all week!

Weight Loss.

2008-04-11T15:01:00.001-06:00

After years of steadily putting on weight, I'm very proud of myself for losing 40+ pounds. I'm about 5 pounds away from the top range of a 'normal' BMI for my super-short height. I want to lose another 10-15, so that even if I mysteriously gain 5 or 10 pounds overnight I'm still in a good spot, BMI wise. Of course, I haven't been that weight since Grade 9.

Strangely, I don't feel I've done much to lose the most of the weight. It started just FALLING off me at a rate of 3-4 pounds a month when I went on Metformin. I know I've gradually started to eat less now that I pay attention to portion sizes, but there was never a quick change. I've always felt it was the Metformin that made the real weight difference. Unfortunately, that quick and easy weight loss did not last.

Losing the first 30 was easy. It's the last 10 pounds I've had to struggle with. That bit of fat just likes to pop back constantly. It's really hideous the way weight comes back.

Trying to lose any more has, as of yet, been impossible. I'm even resorting to regular, low impact, EXERCISE. Hopefully it'll do the trick.

In any case, losing the weight has made me feel so much better about myself. I've watched inches come off my measurements, and sizes come off my clothes. I have new, fitted shirts to replace my old baggy ones. I almost enjoy clothes shopping. I'm willing to take a few more risks in what I wear. I got half my hair cut off, which I'd been putting off for years.

And I'm proud of myself every time I get rid of that stubborn 10 pounds. Again.

Food Blogs

2008-04-10T21:13:00.003-06:00

I love reading food blogs. Tastespotting is my go-to place for finding great food ideas. All the stuff I'd love to eat, would never eat, can't believe people eat. A thousand funky new veggies and ways to serve them, as if I ever would.

I don't -cook- you see. Well, on very rare occasions. But I've really got no intention (time, desire, willpower) to actually find ingredients and follow instructions and figure out what it is I'm doing wrong. After all, what I make never looks like it does in those luscious food photos.

Still, I like to browse, check the newest postings as if it's a huge menu I place imaginary orders from. I'll take the flan please, and those cookies are great, and those meat skewers from Malaysia... The salads and veggies and soups and whole wheat/oatmeal/seed bread never make it onto my ideal plate. Except when I see blt salads in bacon cups. Those, I'd make an exception for!

When I read these blogs, I tell myself that one day I'll find that one recipe that makes eggplant appealing, or a way to eat zucchini that doesn't involve disguising it in chocolate cake. I know I need to add a LOT more veggies to my diet. The five or six I eat get very boring.

Salad. Carrots. Broccoli. Cauliflower. Asparagus. Corn. Tomatoes. Cucumber. When I try to convince myself that olives should count too, or that mushrooms have a lot of nutritional value, then I know I'm just lying to myself.

I have been trying. I have decided that even deep frying cannot make a yam palatable for me - though yam fries are everywhere I go these days in Calgary. I went out for Ethiopian - and that was too much shock for my westernized taste buds. I'll eat bok choy at a Chinese place - but it's only a few shades removed from broccoli.

But really, I'm struggling. I'm tired of the veggies I do eat, the rest either I don't like or I'm unwilling to believe I would like. I love the voyeurism in reading these blogs. I get to imagine being at a dinner where they're serving espresso panna cotta, or ordering an extra large poutine or munching fresh baked cookies.

At the same time, I look at the healthy stuff and think, "Hey, someone out there obviously enjoys Brussel sprouts. And beans. And squash. So maybe, if I keep reading, that perfect recipe will come along and somehow I'll enjoy these things too."

Counting the Cost

2008-04-09T19:24:00.001-06:00

Will at Life After Dx posted a vision today:

A dollar bill with a test strip taped to it. A dollar bill with a test strip taped to it and a sticky note that says "I pay one dollar per strip. I need six strips a day to stay healthy and in control of my diabetes. Can you spare me two grand?"

I pictured hundreds, thousands, tens of thousands of envelopes piling up on someone’s desk. But whose desk? Who can help us?

I think this sort of thing could be hugely powerful in showing the financial costs of diabetes, though I'm not sure who's desk it should end up on. As a general awareness campain, something directed at a politician, to insurance agents? I can see this on billboards or posters, but I don't know if that's going to reach the right people.

I'm going to be watching this discussion and see where it goes, but I hope that he can find a way to use this idea and pass on the message.

We don't use dollar bills up here in Canada, but here's my version, to show my support:

I hope others will head over to Life After Dx and join the discussion.

Hungry Days

2008-04-09T12:09:00.001-06:00

I am having one of my hungry days. They usually happen on weekends, so I've been blaming them on the lack of my usual breakfast. I count on those weekend breaks to avoid being too bored with my repetitive breakfast.

However, I ate my breakfast today, and I'm still hippo hungry. I had breakfast. I had a snack. And another. And another. Let's all pretend they were low-carb snacks. I feel like I could go out and eat a cow. (Medium rare, with baked potato.)

Lunch just arrived and my stomach is growling.

I hate these days because I've never figured out how to turn it off. I eat carbs. No luck. I eat protein. No go. I eat fatty foods. Nope.

I'm not doing anything unusual today. No extra exercise, no extra stress. No changes in schedule, no trouble sleeping. Just rampaging, insatiable hunger.

I'm going with my backup plan after lunch: lots of water and gum. There's sure no need for me to eat anything more.

Another new blogger - The Diabetes & Stuff

2008-04-08T19:14:00.003-06:00

Okay, so I'm really new at this blogging thing. But I'm not the only one. I realized today there's another new diabetes blogger on the block - The Diabetes & Stuff.

I really enjoy seeing new blogs. There's always a new perspective, a new voice, a new concept that gets me thinking.

I like what I've seen at Lora's blog so far - there's a no-nonsense, honest and straightforward tone to it that really appeals. I'm trying to keep this blog as honest as I can, and it's great to see someone else doing the same, and doing it well. She's also very organized, with a nice little glossary up as her second post.

Great work Lora, and keep it up - I'll be reading.

Diabetes Made Visible

2008-04-08T00:47:00.000-06:00

Diabetes Made Visible is a really fabulous project. Hosted on flickr, it's a repository of photos showing how diabetes affects daily life. The photos are a mix of portraits, graphs and charts, artwork, food and technology shots. It's incredibly evocative to see these images and to read the commentary that accompanies them.

Seeing a tiny hand with blood testing pinpricks, or a bag full of supplies that someone can't leave the house without really enforces the effects this disease has on every day life. Or simply someone sharing a new food they've found they can eat, or those horrible/great numbers.

I feel a great connection to these images too. That person uses the same meter as me! She knows what it's like to prick your finger too! I'm not the only one who misses cookies or distrusts sugar alcohol.

It's also reassuring. Hey. This person has a smile while they test. That person has transformed a wasteland of needles or lancets into beautiful art. Despite it all, Life is good.

My favorite is this piece. What's yours?

The iTest (Keynote) vs The Contour

2008-04-06T10:29:00.004-06:00

As a reward for my shiny A1C, I bought a new toy - the iTest meter, aka the Keynote Wave in the States. I was almost out of strips anyway, and since I have to buy some more, might as well get a new free meter to try.

This is the third meter I've tried. The first was a Breeze 1, which I didn't care for. The Breeze 2 is undoubtedly better than the 1 (smaller size, faster), but I just didn't like the packet of test strips concept.

My usual meter is an Ascencia Contour. It's a good meter, with a small sample size and nice speed. The iTest is supposed to use a different, more accurate calculation for blood sugar, which is one reason I chose it.

The Case:
My first thought when I saw it was 'wow, that's smaller'. The I Test carrying case is in standard black, and smaller than my Contour case. It looks less bulky as the fabric is a bit thicker. I'm not sure this photo shows off the difference well, but it's thinner and not as wide.

Unfortunately, the case doesn't have a belt loop, which is a small detail that I appreciated on the Contour case. If I'm not carrying a purse, it's nice to have the option of attaching it to a fanny pack or belt. However, the smaller size will make it far nicer to tuck into my purse.

The Lancing Device
The lancing device on the iTest is pen shaped, and I already like it better than the Contour lancet. It's far more natural to hold and push the button. The needle is definitely thinner, and it has depth settings going from 1-8, while the contour has 5. It makes a far smaller pinprick. I find on my fingers these means a lot more stretching/massaging to get enough blood to test. My fingers have lots of familiar smudges. If I prick closer to the nail it flows better, and this technique is helping me avoid bruising. I think as I continue to practice, it'll get even better. I haven't picked up my Contour lancing device once since I tried the iTest version.

The Lancets
The lancets are visually very different, and you get 100 with the iTest. Both are equally easy to handle and load.

I prefer the lancet cap on the Contour meter. The cap lays straight before I take it off, and sideways when I push the needle into it after use. I can instantly look at a lancet and know if I've used it or not, even if I've jumbled them together or dropped my case and sent some flying. I keep my sharps container at home, so it's not unusual to have a mix of lancets in the case.

On the iTest, the lancet cap goes on exactly the same way after you've used the lancet, so there's no way to really see that it's already been used. I tried pushing the cap on backwards, but it falls off pretty easily. The tiny needle just isn't strong enough. I've been mashing the lancets against the nearest hard surface to bend the needle. Once it's smushed, I'll never confuse a used one with an unused one.

The Strips
The iTest strips are smaller and seem more flimsy than my Contour Ascenscia strips. I accidentally bent the first one I picked up, so now I handle them more carefully. They slide into place without a lot of feedback. On my Contour, there's an audible beep when you insert a strip. On the iTest, you have to watch the screen, or bent strip! I'm sure once I get used to the new meter, it'll become a habit, but for now I'm really having to watch what I'm doing. At my pharmacy both strips are the same price.

The iTest also requires coding, which the Contour didn't. This hasn't made any difference to me. The number that automatically pops up has always matched the number on the vial.

I've also run across 1 dud strip so far (Error 1, "Wet, Used or Damaged Strip" on the meter), which has never happened with Contour strips. Maybe I dented it without realizing, or maybe it was just a bad strip.

Testing
The iTest uses 0.5µL and the Contour 0.6 µL. Somehow it feels like the iTest uses a considerably smaller amount. I think it's the smaller strips and smaller display window.

I also like the countdown better on the iTest. It's actually a second faster - 4 seconds instead of 5, but instead of a simple number countdown, it fills part of the screen with lines. Because there's always something moving on the machine, it feels faster. A second can seem really long when you're waiting for a number to flip. I really like that animation.

The Results
I expected the iTest to read higher than the Contour meter. Nearly every mention of this meter I've found online has talked about higher numbers. My meter is no different.

Here's a sampling of the differences I'm seeing:

iTest	Contour	Difference
6.0 (108)	5.5 (99)	0.5 (9)
5.6 (101)	5.3 (95)	0.3 (6)
8.7 (157)	7.5 (135)	1.2 (22)
7.9 (142)	6.0 (108)	1.9 (34)
5.4 (97)*	5.0 (90)*	0.4 (7)
5.9 (106)*	4.4 (79)*	1.5 (27)
5.7 (102)	5.4 (97)	0.3 (5)
*These four were taken at the same time.

Almost half the time, the iTest was more than a point higher than the Contour. Without a lab to verify, it's impossible to say which readings are correct. Certainly the much higher iTest readings aren't what I'm used to seeing, and my low A1C would support lower readings as well. And hey, we all want to believe lower numbers over higher ones, right? I'm out of Contour strips now, so there won't be any further comparisons, but I'd love to see this meter in a mixed meter clinical trial to see how it really lines up compared to other meters.

Another feature I am missing on the iTest is the 'bad reading' indicator. If I'm testing someone else (which happens occasionally), or I know a reading is crazy off, I can immediately mark it as invalid on my Contour, so it doesn't affect my average. The iTest does not have this feature.

Other Features
The iTest does have a bunch of features I haven't tried out yet, namely charts and graphs. It automatically organizes your results into breakfast, lunch, dinner and bedtime, and provides an average of each. I'm not sure if I like this or not. My fasting readings are being marked as breakfast, and I'm wondering if my two-hour post breakfast readings will show up as breakfast or lunch. The Contour has a simple post/pre meal flag, which I never used.

The iTest does come with six alarms you can set for any time of day. The Contour has a single alarm that you can set to go off 2.5 hrs after a test once you've marked the reading as 'pre meal'. I didn't use the Contour alarm, though I would have if I could have adjusted the default time frame to 2 hrs. I don't have a predictable schedule for most of my meals, so I'm not planning on using the iTest alarms either. I'm sure there are others who would use these alarms.

The iTest also calculates 14, 30 and 90 day averages, which I'm interested in seeing. The Contour has a 14 day average only. You can flip into graph mode on the iTest to see a simple chart showing your ups and downs, which also looks interesting.

Both meters have high/low summaries, but being a pre-diabetic, I never hit those ranges so I can't give an opinion. They also both count the number of tests you've done.

Finally, the iTest comes with a "Zero-Click" software package via USB cable. I haven't hooked it up yet, but from the screen shots on the website, it looks more updated and shinier than what I downloaded from Ascencia. Once I've got a few more readings in the meter, I'll take it for a spin.

Conclusions

So, my first impression is fairly neutral. There are a few things they've really done well, and a few important details I feel they've missed. I like the smaller meter, smaller case, smaller blood samples and pen style lancing device. I miss the auditory feedback, belt loop and 'bad reading' settings my Contour has. I'm really liking the "waiting for results" animation, but fairly concerned by the higher readings. I don't care for the iTest lancet cap, but that's something I can get used to. Once I've got enough data to graph, I can start evaluating the software.

Once I get close to the end of my strips, I'll post again to give a second opinion.

Sobey's Mini Desserts

2008-04-05T12:57:00.004-06:00

We went to our local Sobeys (Grocery Store Chain) today, trying to find something to sooth my sweet tooth without skyrocketing my sugars. We usually go on weekday evenings when the bakery section is a little bare, but it was fully stocked today.

They have an entire section they call 'Assorted Pastries', which is filled with twenty or thirty itty bitty desserts. Chocolate things, mini tarts, cakes.. I was too busy trying to pick out a couple to really register what the complete selection was.

At 50 cents each, I was able to pick up a miniature butter tart (always a favorite), and a mini roll cake, shown here with a quarter for size comparision. The pastry on the butter tart was a bit bland for me, but the filling with one or two raisens was great.

The roll cake is the sort of thing I never buy, because even one slice is way too much and who's going to eat the rest of the cake for me? This one was very sweet, with tons of icing and took about four bites to eat. It was just perfect in size. I wouldn't have wanted any more, and it definitely satisfied the sweet tooth.

We'll have to go back on weekends now, so I can continue to sample selections now and then. For me, this is a much better option than a chocolate bar, or a cake that I'd have to slowly eat over a week before throwing out the remainder.

Major Yays for appropriately sized sweets!

Eating Your Meter

2008-04-04T19:42:00.005-06:00

I have to admit, every time I read about 'eating your meter', I have this image in my head.

Eating your meter refers to checking your meter after each meal you eat, and removing or reducing the quantities of the foods that run your sugars too high.

It's a good technique for keeping sugars in range - I know from this that a personal size, multigrain crust pizza doesn't do much damage to my sugars, but a serving of fries does.

More on the Non-Invasive Front - Breath Testing?

2008-04-02T22:26:00.011-06:00

Ran across an article today on a new new theory in blood glucose testing.

The gist of it is this: Dr. Pietro Galassetti at the University of California is the guy in charge of the study. They've found that the concentration of a certain gas (Methylnitrate) in the air you breath out is related to blood sugar levels. When the kids they studied had high blood sugars, that had more methylnitrate too.

There's also an interview with Dr. Galassetti, that goes into more detail. I love what he says about finger pricking:

"The prick is not very painful, but doing it five times a day all your life becomes very obnoxious."

It's clear this a very preliminary concept. Dr Galassetti talks about '5 or 10 years down the road' and needing to develop a profile of gases related to blood sugar. But it's nice to see research being done on alternate methods.

Edit: Jeff @ Go Do A Test! pointed to me to an older article on the study, with more specifics on the experiment.

A1C's Should Make Sense

2008-04-02T12:05:00.003-06:00

At the end of last year, I was in the zone. I ate my meter. I stuck to 150 gms of carbs a day. I exercised semi-regularly. I did all the stuff I was supposed to do. And my A1C went UP. From 5 the year before to a 6.

This freaked me out. My meter averages had me expecting an A1C in the low fives. After that, I pretty much stopped testing. Between the holidays, finding a new job, moving, my diet was out the window.

We made dozens of cookies for Christmas. With sugar, not splenda. I ate bread, muffins, and, on the many long car trips, potato chips. We ate out every night for weeks. And of course I started putting on the weight, which is always a danger sign.

I was worried about getting my A1C back after those months of reckless eating. What number do I get today? 5.5!

I have no idea if it's the reduced stress or if my meter is less than precise, or what. I was expecting to leave the doc's today with some plans for getting my A1C under 7. Instead, I'm trying to remember what I was doing back then. I sure wasn't food logging. I'm still not testing, but in the last month or so, I've been back to a reduced carb diet.

But I guess I can relax a bit with the carbs. I'm still going to try and lose those holiday pounds, but I'm really not sure what else to do to keep this level steady. And for now, bask in that pretty number.

So, so weird.

Joe's Goals

2008-04-01T12:19:00.007-06:00

I'm trying something new right now: tracking my goals with JoesGoals.com. It's a nifty little website. You create an account, set up a few postive and negative goals, and then track by clicking on each day. It's really nice visual feedback to see all the little checks and xes over a week. There's a live demo on the site (see image below) that lets you test it out without creating an account, which also sucked me in.

I know I forget my lunchtime metformin a lot, and I'm not getting close to exercising daily. This seems a really good way to track that sort of thing, without going to a lot of effort. I get really tired of detailed logging, and this one-click-and-you're-done style will hopefully be more effective.

I'm not sure I'd ever use it for blood sugar logging - I like charts and graphs that break it down by time of day and give me monthly averages. In theory I'll start cross referencing food with blood sugar and actually stick with it in the future. For that, I'll want to use diabetic specific software.

But for simple goals like increasing exercise, cutting down coffee, and remembering pills, I think this will work wonderfully.

Sating the Cravings

2008-03-31T12:06:00.003-06:00

A post at Ride to Remedy got me thinking today.

Someone very helpfully brought in a bunch of lindt easter bunnies at work. They were on sale after easter and I ate way more than I should have. I've been wondering what happened to all my willpower, and I think he really hit the nail on the head here.

I used to pack a few pieces of chocolate in my lunch every day. Just a few Dark Chocolate Pastilles - a tiny amount of carbs, but I had the taste of chocolate whenever I wanted. I'd go weeks without eating any, but as soon as that craving came back, I could nip it in the bud.

Since I started my new job in January, I've stopped having chocolate on hand. Now, when I do get chocolate, it is so much harder to resist. I think it's time to start a chocolate stash at work again.

It's amazing how easy it is to forget a lesson once you've learned it. Having small amounts of stuff -often- works for me. If I know I can have a couple bites of chocolate every day, then I don't even look at the chocolate bar rack. If I can steal a few fries from my coworkers every few days, then I can walk by New York Fries without a blink.

Today we got cheese bread (one of my personal irresistibles) in the work grocery delivery. I had a slice. Soooooo tasty! But I was able to resist the second. I'll have it tomorrow. It's so much easier to put something off than to deny it altogether. After all, it's not saying "NEVER" it's just saying "Patience".

I must remember this rule!

Giving It Up: Smoking vs Carbs

2008-03-29T16:23:00.002-06:00

One of my coworkers gave up smoking a few months back. He's been really happy with it, really proud of the accomplishment. In the past few days though, he's started to fall off the wagon. I've been ragging him for it - after all, doesn't he know how bad that is! Which is silly, of course he does, but I can't help feel like I should do something to 'help'.

It took a while, but it finally clicked today. There's another coworker who, now and then, tries to gently point out that maybe I shouldn't eat something. I tend to get a bit annoyed but try not to show it. I'm making my own choices.

It took a while for me to see it was the same thing. After all, that next smoke isn't going to be the one to start cancer growing any more than that next helping of fries is going to put my pancreas out of commission. It'd be lovely to have a readout somewhere, letting me know that I've got so many hours of high blood sugar before I do irreparable damage. But it's impossible to know how much damage is being done - especially if you can't (or don't) test after every meal.

It's so easy to say, okay, this splurge can't do that much harm. Just like I'm sure my coworker figures just one smoke won't hurt him. I don' t know so much what to do about it. I'm still trying to sort out my own balance.

But I guess I'll try to bug my coworker a little less about his choices.

Guilt, Guilt, Guilt

2008-03-28T10:55:00.000-06:00

Am I a bad diabetic? Probably. I've tested once in the past few weeks. I've eaten carbs til I felt sick (admittedly, that doesn't take too much). I haven't checked my weight in a few weeks, so I have no idea if I've been doing any damage to those holiday pounds. I'm thinking about my diabetes, but not deeply. I'm not stressing it, I'm not logging it, I'm not always listening to the little voice saying 'I should' or 'I should not'.

Quite honestly, I put the whole darn thing on the back burner for large amounts of time. I do the basics. I eat something fiber-filled for breakfast (oatmeal/oat bran). I don't drink sugary drinks (including juice!). I do my once a week workout (usually). I try to not binge on the carbs and ask work to stock some low carb snacks.

But I cheat. And I don't test to make sure I'm really making the best choices. And I ignore the nagging little voice that tells me I should be paying more attention and doing a better job. After all, it's my body, my health, my future.

I feel like I'm the only one struggling sometimes. As if there's this great ocean of people who do what I do because they don't know any better. But because I do read up, and I do consider myself educated, I should be able to 'fix' all these bad habits and cravings and avoidances. I can read uncounted blogs about people who handle it just fine, thank you every single day. If they can do it and more, why can't I? Am I just lazy? Stupid? Self Destructive? It's been two and a half years now. I should have the hang of this, shouldn't I?

Guilt. Guilt. Guilt.

The Holy Grail

2008-03-26T10:54:00.000-06:00

Okay, right, a cure is the real holy grail. But a cure is going to take time, and money, and skill, and probably a zillion more mice. They're getting really good at curing mice these days.

But for my day to day life? The holy grail is blood sugar testing without blood. No pricks. No way to skip out of tests because I 'forgot' my meter or I'm nearly out of strips. No stopping what I'm doing to go to the washroom to test - in case someone in the office doesn't like seeing blood. Fingers than don't get sore. Of course, I'd like some consistency and predictability, and an A1C that always matches what my meter's telling me too.

But I'll settle (for now) for losing the blood. There's a new non-invasive blood measuring device I just read about, the Echo meter. Early tests are positive. It's the sort of thing I take with a grain of salt. Early tests new stuff always seems positive, or it would never make the news. And then there's the whole "We need millions more dollar to develop this" gotcha.

If I ever win the lottery, I'm donating to this kind of research. Devices and technology that improve our day to day. Yes, we need a cure. But we also need quality of life.

Diabetes Alert Day

2008-03-25T12:22:00.005-06:00

Today is Diabetes Alert Day. I didn't know this until I saw it someone's blog, but then I'm generally unaware of diabetes-related awareness events.

I'm really not sure what you're supposed to do on them. I'm fairly open about my diabetes at work. More in a 'I really shouldn't be eating this chocolate bunny you brought in, but I have no willpower' sort of way, but I'm not in the closet over it. I'll answer questions if they come up, or include diabetes related stuff in my daily ramblings and rantings.

But to me it seems the height of rudeness to say to someone 'Hey, have you been tested?'. I mean, to me ones medical issues (or lack thereof) are a personal topic. If you wish to share, fine, but I'm not one for seeking them out.

At the same time, I do understand the need for testing. I wish I'd gotten my diagnosis ten years ago. I remember reading one of those 'these symptoms could mean diabetes' billboards years before I'd gotten tested. I never asked for a couple of reasons - I didn't know at that point that there was a history of diabetes in my family. I was overweight and sendtary, but I was young and didn't smoke, so I felt I wasn't really at risk. Also, I didn't want to seem like a hypochondriac asking my doctor if I maybe had a disease when I felt healthy for the most part, and did have some real medical issues.

It's very uncomfortable to me to go to a doctor and start suggesting what could be wrong. Especially if there are no "symptoms". I notice now that post-carb icky feeling, but I had to learn to pay attention to it, and to associate it with food.

So, in the interest of promoting awareness, here's my advice. If there is a history of diabetes in your family, make sure everyone knows. Your siblings, your kids, nieces, nephews, grandkids, aunts.. everyone.

Second, talk to your doctor, especially if you're in Canada and there isn't a barrier to getting tests done if you do have some risk factors. There's value in knowing you DON'T have it, and if you do, the sooner you know, the better.

Luxury Bread

2008-03-19T20:31:00.000-06:00

I don't think about food all the time. Or diabetes either. But I don't eat without thinking about it. I can't put a bite into my mouth without running through the checklist of "How bad is this for me". That doesn't stop me from eating white bread or dessert or juice or hot dogs or anything else - but it does tend to moderate my intake.

It also really, really, really, makes me wish for some decent, lower guilt options. Especially when it comes to bread. I've been eating mostly whole wheat for 3 or 4 years now. I have white for two reasons: First, I miss it, especially if it's really good crusty white. Second, no whole wheat alternative is available.

I have never seen whole wheat raisin bread. Whole wheat cheese bread. Whole wheat garlic toast. Whole wheat cinnamon buns. Whole wheat biscuits.

I've never found a bakery or restaurant willing to make any of this either. And I miss it! Sure, I can get whole wheat bread, tortillas, bagels, pitas.. but only in the plain variety. Where's the whole wheat blueberry bagel? Where's the spinach and whole wheat wrap? Where's the whole wheat Cinnabon? (Okay, Cinnzeo is never going to be healthy, but a whole wheat alternative would ease my diabetic conscience.)

It's annoying to have to give up all the other flavors to avoid/reduce white flour. You want to break down my resistance? Give me a slice of garlic bread. White is the only way I can get it, so I eat it on white.

There are a few exceptions to these: crackers and pancakes mostly. And once in a very long while, I'll find a place that makes french toast with rye or flax or wheat. But it's really an exception.

If you own a bakery or restaurant, please please, consider offering these alternate treats!

Conquering Fear

2008-03-18T20:06:00.000-06:00

Sometimes I think it's better to not do something at all instead of doing it badly. Sometimes I realize that that kind of thinking is going to prevent me from doing a lot of things I want to do. So, we'll give this a try. The worst that can happen is no one reads it. I can live with that.

I can't eat for the rest of the night - A1C and Cholesterol tests tomorrow. I'm kind of nervous about it as I was not eating by my diet in any way shape or form over Dec and January. I had a lot of excuses - It's the holidays, we're moving and don't have a kitchen, but that wasn't the real reason.

The real reason was: I ate what my blood meter said didn't raise my sugars much (ei, I tried to keep it within 2 point range ( 160 in US units). I was expecting an A1C in the 5's. But it was a 6 - which is higher than I had the year before, when I wasn't trying the whole low carb and whole grain thing. It was incredibly frustrating - not only did I lose faith in what my meter was telling me, but I felt I'd really hit the limit of what carbs I could cut from my diet. It felt like all the work I'd been doing - we're talking adding exercise, changing my diet, and losing 40 pounds accomplished nothing.

Now I have a new doctor who should be more pro-active. Which I need, because I'm really not sure where to go from here. I'm on the max dose of metformin. And a 6.0 isn't a bad number. Many people would kill for those numbers. But I don't want to see them higher. I have no idea what my diagnosis number was - I've only got 2006 (5.0) and 2007 (6.0). This is a very bad trend. I don't know at what point I become officially 'type 2' instead of 'insulin resistant', but I'd really rather not cross that line, as arbitrary as it seems to me.

So, tomorrow, I get some blood drawn, schedule a follow up, and try to tackle this whole thing again.