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Saturday, January 7, 2012

Anatomy of Her GlucoCoaster (Along with the Apidra 6 Week Review.)

Apidra has been going well.

Really well.

You might remember that I had a moment of crazy, and randomly filled Sugar's insulin pump with Apidra on Thanksgiving night.  It was 2 days after her last endo appointment...which happened to fall right smack dab in the middle of a perplexing rut of blood sugar madness.

That's always fun.  There's nothing quite like showing up for your endo appointment with practically nothing except 400's to show for the previous week.

Anyway, it's been about 6 weeks now...which means we're about 6 weeks away from our next endo visit.  In this pic you can see that her averages began dropping between the 60 day and 30 day marks.  I'm crediting the improvement to Apidra since the 6 week point falls in there somewhere.

851 finger pricks divided by 90 days = 9.4 tests a day.
In the past 6 weeks, we've rarely seen a BG over 300.  Since changing insulins, her overall average has dropped nicely into her ideal target zone of 80 - 150.  I do believe we're seeing the proof in the pudding that Apidra is a more effective insulin for managing Sugar's diabetes. Obviously the true test will lie in how well her numbers do over the long haul, but I'm definitely encouraged.

So, with all that being said...

Diabetes can be a flipping SHREW sometimes.

I present Exhibits A, B, and C - Z:

That was 2 days ago.

Since I'm a "seize the moment" type of girl, I snapped a picture to help me break down the zones, and get to the nitty gritty of how the anatomy of these numbers look from my viewpoint.  

GREEN LINE -- The area just above this line tends to bring a little shakiness, along with hunger. The areas below this line, however, can cause combativeness, confusion, and loss of consciousnesses.  She becomes ravenous once she begins to recover, and often wants to take a nap.  If we cannot bring her blood sugars up quickly using fast acting sources of sugar, she's at risk for a seizure, and her life could be in immediate danger.  She may require an emergency glucagon injection.  Before starting the pump in 2007, Sugar used to pass out from low blood sugars pretty regularly.  It was horrible, horrible horrible.  Thanks to the ability to program an intermittent ZERO basal rate into her regular pattern, keeping close tabs on Insulin On Board, and administering micro doses via her insulin pump we were able to put a stop to these horrifying episodes.

WHITE LINES -- Coloring between these lines brings (me) euphoria.  I think she feels "normal" in this range...sadly, however, I'm not sure she really knows what "normal" feels like.  In this range, she's upbeat, positive, and smiles almost all the time.

YELLOW LINE -- Around the yellow line, she tends to feel a little lazy and distracted.  If she's doing something that interests her, she acts pretty normal - otherwise, she's easily bored.  She might drink a little more water, and tends to ask for repeated snacks, especially if she hangs out in this range for any period of time.  We don't particularly like to see numbers in the 200's, but they're not something that cause much frustration unless we can't seem to bring them down. We'll try up to 2 correction attempts and then a site change, unless she's continuing to climb - in which case, we'll change the site sooner.

ORANGE LINE -- Up in this range, she's definitely thirsty and needing to use the restroom more frequently.  She has a terrible time concentrating, and her handwriting becomes pretty sloppy. She's usually trying to eat anything she can put in her mouth, including a crumb or two from the countertop.  She gets emotional, and often starts crying for no apparent reason.  She's easily irritated and often complains of a headache.  Sometimes she says her tummy hurts as well.  We'll usually attempt a correction via the pump one time as long as no ketones are present.  If there hasn't been a significant improvement within 2 hours, we'll change the pump site using fresh insulin.

RED LINE -- At this point, she's downright cantankerous.  She wants to eat, drink, and stomp her feet.  She becomes incredibly emotional, and cries easily.  Her head hurts, her tummy hurts, her eyes hurt, her legs hurt.  She's dying of thirst, and can't seem to get enough ice cold water. She's downright miserable, and usually needs to lay down to rest for awhile.  If she continues climbing, or stays in this range for very long, she's at risk of DKA, which can progress to coma or death.  This area is managed with an immediate correction via injection, and a complete site/insulin change.

I don't know what it feels like to have a BG under green or up in red.  Since she doesn't wear Dexcom full time, I'm often wondering what direction her numbers are moving.  Assuredly, I would have changed her site on this day when she was 350ish and then climbed to 450ish. With those Dex arrows, though, I knew she was going to be okay.  

I see these sharp rises and falls, and stand in awe of how well she handles them.  You'd never know from looking at her that she was having a day like this.  After 6 years of witnessing how difficult some most of these ranges can be for her, I'm just amazed at how awesome she is.

More on our APIDRA experience...
The day we started.
The experience.
The trial end.
The 6 week review.
The verdict.
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  1. We've been pumping with Apidra since the get-go and I can't imagine life without it! We had to do two months on humalog and it was not as consistent. I'm so glad you are swing results with te Apidra! Keep up te good work!


  2. Those averages look awesome! I knew you'd love Apidra...just knew it! =)

    And very educational post, yourock!

  3. you had me at "I knew she was going to be okay". I know everything will be okay eventually

  4. I hear so many good things about Apidra. I'm very tempted to try it, but Novolog has worked so well for Matthew. Why change if life is good, right? Of course, puberty is right around the corner, so who knows!

  5. she is awesome. I am amazed at how incredible our children are at handling all of this. Thanks for sharing your apidra experience, we're still begging for coverage with it! Have a great week.


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While I'm happy to share our experiences with what works, and what doesn't work, for the management of Type 1 Diabetes and Celiac Disease in our house, please do not mistake anything you read here for medical advice. Decisions regarding your/your child's health care should be made only with the assistance of your medical care team. Use any information from this blog at your own risk.