Tuesday, December 23, 2008

How Sensitive Are Basal Rates To Diet?

Since I've been home on break my basal rates have bounced around a bit. After a few days of experiencing lows I reduced my basal rates and then encountered some 200 plus days. Two weeks ago when I finally made it back to NY my basal total was 13.5 units of insulin per day. Today my daily total basal is 16.25 units per day, more than double my basal totals at the time of my Ironman.

My diet has not been as healthy or consistent as it was when I was down in Virginia. Staying at my parents house, seeing friends and spending time in Boston all has added to a bit higher carb, higher fat diet than normal. My workouts haven't been as consistent as I would like and my sleep patterns probably haven't been as regulated. However, a 3 unit jump in basal rates in just over a 2 week period seems high.

I suppose it is now time to buckle down, return to nothing but egg whites, turkey sandwiches and chicken sausage until I get this thing back under control. I'm going to try and get my weight back under 190 by the time I return to school to see if the 7 to 10 lbs I gained after the Ironman have increased my insulin requirements. I also really need to find my software for my quick link so I can load my blood sugar information to my computer for analysis - in other words I need to become a good diabetic again.

Monday, December 15, 2008

Is The Honeymoon Over?

My first semester at Darden is finally over so now I have a chance to focus on my internship search, marathon training and diabetes. Last week was hell with 5 consecutive days of 5 hour exams; not a good time by anyone's calculations but thankfully the stress didn't throw my blood sugars out of whack as they were kept pretty steady over those 5 days. However, in general I've been having a much harder time locking in my basal rates.

Over the past three months I've been playing with my basal rates on a near weekly basis; while getting my blood sugars to spike prior to a workout has been much easier. I'm pretty sure the honeymoon is over and the fight in my last islet cell has been won by diabetes. In a way that will make life easier in terms of knowing how my body will react to exercise, food and basal rates. But in another way that kind of sucks since there was a time period when I could eat pizza with just a moderate bolus.

I've been working out consistently for the past two and 1/2 weeks but have not had the reduction in basal rates that I expected. I have encountered more lows over that period than I had when exercise was less consistent due to class work but I still haven't had the blood sugar reactions I expected. Although it does seem like the overall trend in my basal rates is changing; at night I've had to increase my basal rate by a huge amount as I woke up a few nights it a row with blood sugars above 300 at 4 am; but then I would hit consistent lows around 11 am. To get all this corrected I'm going to have to keep detailed notes over the next few weeks to identify the trend and figure out exactly when my basal rate errors are occurring - consistency is the key and I just need to get back to that.

Tuesday, December 2, 2008

You Know You're An MBA Dork When....

You are sitting there in your second quarter operations class learning how to use six-sigma models and realize you have been using that methodology nearly everyday since you've been diagnosed with diabetes!

We were learning that under six sigma models you set an upper error limit and a lower error limit. The data points on the graph are filled in by point in time quality spot checks - quality outside this range is deemed in error. There are then a host of equations that spit out some graphs that indicate if your system is out of control and if a change needs to be made to prevent errors.

This is the exact way I manage my blood sugars. When I upload my blood sugar readings to my computer I have an upper limit of 140 and a lower limit of 75. Anything outside that band is considered in error. Overtime I determine if there is a trend for the blood sugars in error and make a change accordingly.

Just like a firm doesn't want to chase their tail to fix errors, we don't want to constantly chase blood sugars. Making a basal rate change too soon will cause the blood sugars to be in error more often. It's essential for us to keep our blood sugars "in control" - who knew I was just using six sigma to do it!

Can you tell I'm a week away from finals!?