Tuesday, August 14, 2012

July Health Summary

My July was variable. I had a higher average glucose than I usually do. I'm okay with it. I had a great month with camp, varied activities, varied sleep and food, experiments with donating blood. All worthy pursuits, I guess...

Okay, on with the July numbers.
My average sensor BG  was 136 mg/dl.
Standard Deviation was 50.
Average TDD for insulin was 24 units. 

Blood Donation Experiment:
I donated blood in early July. I thought that perhaps my BG would be more stable. Studies have shown a connection between iron levels and insulin resistance. I thought that perhaps donating blood would improve my insulin sensitivity and lower my insulin needs. Not this time...

I didn't find that to be true. If anything, I found that it made my glucose levels more variable and unpredictable. I felt that I was more sensitive to carbohydrates. (a caveat: as always, if you have your dosage and correction factors up-ended by a physiological change, it can certainly make your glucose levels less predictable) For me it seemed like it was more than a factor that rocked the boat, it seemed like it actually made my levels less stable all around. I wouldn't discourage anyone from donating blood, but I would say that your results may vary. I plan to do it again, but not to gain any advantages in BG control, just to donate.

Travel  & Food Variables:
I went to camp with my kids and ate camp food, left my supplements at home, and battled it out with my glucose meter. I think the absence of my supplements (insulin mimetics) made a difference for a day or two. Once my body got used to the absence I was able to control my BG again. For the first couple days at camp I was averaging about 150 mg/dl. Even with eating less than usual, sometimes skipping meals I was running high-ish. By day three I saw a return to normalcy and felt that I was back on track. I think I can adjust to life without those supplements. I had wondered if my basal and correction factors were dependent on those supplements being in the mix.

At the end of the month I took a quick trip to the Pacific North West. The stress and excitement of travel rattled my nerves enough to show an upward fluctuation in my sugar levels. The whole time I traveled it was a bit off, but there were no significant lows or highs. I guess I'm really a creature of habit and depend on my sleep, daily walks and activity to keep things in check.

Things to keep an eye on:
I have had a few days during the last month in which I felt very tired and fatigued. My motivation was very low and I felt socially and physically spent. Sometimes it lasted up to 2 days, and it seemed more common when I didn't do my AM walk due to schedule.
For two weeks in the middle of the month I have had very itchy skin, all over. The skin is not inflamed and does not show a rash. It just itches like the dickens. At first I thought it was from flea bites or something, but there is no focal point of the itching, no welts, and no redness.

The two things above can be related to thyroid function, so it's still on my radar for possible issues. I've been feeling well otherwise. Although these symptoms have passed, I'm recording it because I want to make sure I keep track of them accurately up till I see my doctor in October. He is taking a conservative stance on thyroid interventions.

I saw my cardiologist toward the end of the month. He didn't have much to tell me, but he's a good listener. He said there was another drug for atrial fibrillation that I might like more than beta-blockers. He said it's like the ideal medication because the side-effects are almost nil and it works well. I don't seem to have any trouble with beta-blockers (well, except maybe the item mentioned in the next paragraph), but it might be interesting to try it and see if my energy is better. My primary doctor has mentioned that the beta blocker might be what is making me feel lethargic periodically.

Additionally, we discussed orthostatic hypotension. In the past several months I have noticed that when I stand up suddenly I get light-headed for about 2 seconds and have to wait for it to pass. I think it is has to do with the beta blocker lowering my blood pressure, which was already on the lower side. He seemed to think it was pretty normal, and didn't think I should worry about. Admittedly I've gotten used to it, and I've never blacked out.

I asked him if he thought I should see an endocrinologist since I have thyroid, diabetic and cardio issues to look after. He said he didn't think it was necessary. My primary care doctor seems to be doing all the things that are needed. At least, I asked. So far, I've gone for 12 years without seeing a legit endo. My primary care doctor (an internist) has been willing to work with me and go in the direction that I'm interested in. It seems to work well for me because he trusts my knowledge and interest in getting good glucose control.


  1. How high was your TSH anyways? Are we talking 4.7 or 14.7?
    I feel like being conservative to treat is a good thing, and so is being conservative to do invasive tests... but being conservative to treat is really really risky when you're not doing even the most basic of tests... and I'd include thyroid antibodies in there.

    I like having an endo who "trusts my knowledge and interest in getting good glucose control." Some people want an endo who will manage their blood sugar for them... and I can't imagine that working for me. I do sometimes have him look at numbers, or mention a specific issue I'm having.
    But I also need my doctors to trust my ability to make decisions that I'll want to live with, about everything.

    My endocrinologist has told me that when he has patients with subclinical hypothyroidism, he leaves the decision to treat or not with them, to be based on their symptoms and their sense of how significant those symptoms are.

    One more value in having an endo, beyond having somebody who knows what he's talking about when he's talking about diabetes, is that you have someone who knows what issues type 1 diabetics specifically are prone to- someone who, hopefully, doesn't get stuck thinking about type 2 diabetes.
    My endo checks my feet. He tests microalbumin. He reminds me to get my eyes checked. He has checked my vitamin D and has checked me for celiac, and of course, he diagnosed the thyroiditis.

    1. Hi Jonah,
      My TSH was 5.4.
      Yeah, I'd feel better about the whole thing if I'd had more tests done and had the whole picture of what's going on.

      Hmmm... those things you mentioned that your endo checked... I'd like that kind of specific attention at least once a year. Thanks for making the point on what and endo might do for me. I don't even know if the cardiologist or primary care physician know how the endo might operate differently. In October I'll see my primary doctor again, and I think I'll ask for a referral to an endo.