Friday, October 26, 2012

Health Data from October Blood Panel

I didn't receive any info from the lab before I saw my doctor, so I went in eager to see my numbers, just like the "good old days".

The measurement that was unresolved last time was my thyroid levels. I had a TSH of 5.5. My doctor wanted to let it ride and see what it would do over time. This time it was 5.62, which is a tad higher. This time we also tested my free T4, which is the actual thyroid hormone produced by the thyroid gland, and it showed to be 1.1, which is in the normal range. So does that mean that everything is normal? I don't know. Reverse T3 is sometimes the real problem indicator for type 1 diabetics, but that wasn't tested. My doctor is satisfied with the results. Since I haven't had any complaints about my energy levels for the past few months, I guess I'm satisfied too.

Thyroid & Lipids
I brought up the connection between lipids and thyroid and he said that it is more of a story if the thyroid is really out of whack. He said since I don't have any signs of CHD, he's not going to try to figure out my borderline lipids via thyroid tweaks. I agree with that. The markers are fuzzy, and it's made even more murky because of the medical establishment's tendency to get everyone on a pharmaceutical when lifestyle solutions might be safer.

So, yes... lipids.
Total cholesterol: 250
HDL: 72
Triglycerides: 56
LDL: 167
CHOL/HDLC ratio: 3.5
NON-HDL Cholesterol: 178

The non-HDL Cholesterol was one I hadn't seen before. The target range is listed as 30 mg/dL higher than the LDL cholesterol target. Perhaps this measurement takes into account the fact that LDL isn't actually measured, but rather calculated... and it's, sometimes incorrectly, assumed that you have a certain number of lipoproteins, regardless of size. I'll have to find out more about this measurement and target.

Glucose Control
My A1c was 6.4, which goes along with what my average sensor numbers have indicated. Right now I'm hanging out in the 6.1-6.4 "higher risk of diabetes" range. I'd love to get into the "decreased risk of diabetes" range at <5.7, but based on my efforts I don't know if that's ever going to happen. Plus, I am positive that I already have diabetes.

My blood glucose at the time of test was 79 mg/dL. I tested on my meter before and after my blood draw and got readings of 79 and then 85, and my sensor was reading 80. I guess everything was pretty accurate at that point in time. Good to know...

To be honest, I think i have settled into a routine with glucose control and it hasn't been too variable over the last 6 months. I wish I had more to report, but things are getting pretty quiet and I'm not really experimenting too much. Sometimes it's hard to know what to blog about because most days are pretty simliar. 

I've been geeking out on looking at data across time lately, and I think I'll make some graphs that show trends throughout the past year.

Vitamin D
I made an effort to get daily doses of sun this summer, and I'm currently supplementing with liquid D3. I asked to have my levels checked and make sure I was on the right track. My levels were measured at 74 ng/mL. So, I'm in the top third of that range. My doctor said he's never seen anyone measure over the 100 ng/mL upper limit.

More Doctors...
I was planning to ask my doctor (an internist) for a referral to an endocrinologist. I thought maybe I'd get more aggressive treatment and relevant testing. I've started to realize that m doctor will probably go along with any additional tests that I feel are necessary, and he's always advocated for any devices that my insurance will cover. My long term relationship with him is good and we have mutual respect for each other. I feel pretty lucky to have him as my doctor. I decided to ask for a referral to a podiatrist for my plantar fasciitis, but held off on the endo request.

Thursday, October 25, 2012

Great post for T1 peeps, finally.

MarksDailyApple is one of my favorite blogs for diet and health topics, but I don't know if I remember Type 1 Diabetes ever being discussed as a main topic. Here it is.

I'm practicing many of the things that are mentioned as helpful for T1Ds. I think sleep is a factor that I didn't think mattered too much, but when I started sleeping the right amount, my insulin resistance really fell off.

Friday, October 19, 2012

Blood draw today!

I've been thinking I had a few things to write about, but, nothing earth shattering.

Immediately, I'm getting blood drawn today for my 6 month panel. My doctor is open to my suggestions and this time around I asked him for a more comprehensive tests for my thyroid levels. I've also asked for a Vitamin D metric so I will know if supplementation has been helpful. With the way things usually go, I'll have some results delivered to my phone by about Tuesday. In the meantime, I'm drinking black coffee, and it's kind of sad.

I have stopped doing at-home A1C tests every month because they went up in price ($26 test), I ran out of flexible spending funds, and my sensor data does tell me average blood glucose pretty accurately. That being said, when I stumbled across a great deal ($12 test) at a different drug store, I bought another kit. So, at the beginning of the month I ran the test and it was 6.7. I was coming off about two weeks of illness and some erratic glucose levels, so it was pretty much what I was expecting.

I've been learning a bit about how thyroid levels effect lipids, and for some people just treating the thyroid effectively brings the lipoprotein levels back to optimal. I'm not really concerned about my lipids, exactly, but they have been progressively going up, even while lifestyle has remained the same. The ratios are healthy, but the overal numbers are rising.  It has happened in parallel with my suspicions that something is awry with thyroid function. I'd be curious whether my TSH levels are still clinically high, or whether the lipid levels have continued to change. When I mentioned this connection to my doctor he didn't seem to think it was a factor to worry too much about.

I recently heard Chris Masterjohn talk about cholesterol and he was mostly talking about the false perceptions about what were good signs and bad signs of cholesterol in the body. It was interesting that he recommended thyroid correction (even minute amounts) to fix most non-genetic problems with lipids.

I'll report back with more data. I'll be seeing my doctor about my blood work next week.

Monday, October 15, 2012

Yeah, I'm doing this...

I post pure text too often, so here's a personal photo. It's me.
 I'm taking a lead from Michael Aviad, who is answering the GLU questions on his blog over at I think it's pretty interesting to learn how others live with diabetes.

I've been a member of the GLU online community for a few months. It is specifically set up for Type 1 diabetics. I'm mostly active because I enjoy answering the polls they post each day. I use the iOS app and just open it up and answer the questions every day or two. It is pretty quick, but since I don't like typing much on my phone, I hardly ever add comments to the answers. However, I think it's pretty amazing to see 200+ people weigh-in on a topic. I'm going to comment further here. 

Oct. 9th: Would you donate a blood sample for Type 1 diabetes research? 
I have never been part of a clinical trial, but I have gone through the arduous and worthwhile process of having my kids tested for auto-antibodies (they were negative!) through Diabetes TrialNet.

Oct. 10th: Do you celebrate your day of diagnosis? 
I do not. 
Through my blog, I celebrate the fact that diabetes has had a profound impact on my character, and my approach to health and life. But, it's not a dia-versary or anything like that. I don't actually know the day that I was diagnosed. I know it was roughly 27 years ago in the late-summer of 1985.

Oct. 11th: Do you ever check the blood sugar of your friends and family? 
My kids sometimes ask me to test their blood sugar, and I sometimes do it.
Several months ago I tested everyone in my family's blood sugar at the same time. It was really interesting to see how much variation there is in the non-diabetic experience (85-142 mg/dl). Some really solid days I might even have tighter control than non-diabetics I know.

Oct. 12th: Have you ever had to deliver or receive a Glucagon injection? 
I am happy about this. I have owned about 2 kits in my lifetime, and I currently have a non-expired one in my diabetic supplies cabinet. I'm not sure if anyone in my family or co-workers would be able to administer it. In my immediate family I have 3 diabetics, and I do not think any of us have ever needed injected glucagon. I have discussed this question myself...

Oct. 13th: What makes it challenging to be consistent when checking your BG or taking insulin? 
Since I use a pump and a CGM I have had much better focus on my blood sugar control. My CGM alerts me when I go up abruptly, and when I hit 150. Usually, this means that I don't get much above that. I eat low-carb, so the spikes are smaller and slower. It's easy to head off a rise before it gets too high.  Before I was using a CGM it was easy for me to get busy teaching, during my work, day and forget to check blood sugar and bolus for meals. I think the CGM has made monitoring and correcting my glucose levels a natural part of my day.

Oct. 14th: If you wake up low in the middle of the night, do you ever wake somebody up so that they know?
My wife is a light sleeper and she is usually aware when I get up or leave the room. She doesn't always know why I wake up. Usually, a low will trip an alarm on my CGM. My wife is like the "princess and the pea" when it comes to CGM alerts. I wish they would wake me up, but in the end, she's the one that gets alerted. She often doesn't know what type of alert it is, she just wants some un-interrupted sleep!

Friday, October 5, 2012

Why did I never try this before?

I've been getting 6-7 days out of my Medtronic sensors, which are labeled to last three. When they time-out I just restart them and they keep working until the battery runs out, which is usually about the 7th day. By that time, I'm usually pretty grateful for the extra time and take it out and start a new one.

This week I had a particularly good one. It was comfortable, accurate, and I didn't want to see it go. When the battery ran out I disconnected the battery pack and recharged it. I started it up again and the sensor has continued to be accurate for another week, and I'm still using it on day 12. So, yes, with a battery recharge, the enzymes in the sensor have been able to keep working 4X longer than the stated life.

In my last blog post I was talking about the fact the box of expired sensors I was using were showing themselves to be inaccurate. Well, this new box of sensors are showing to be accurate and, so far, long lasting.

Since I've been following an anti-inflammatory diet I've noticed that my infusion sites and sensor sites don't get irritated, and I don't have to remove them at 3 days, or even 6. I have been leaving them in until I begin to notice a loss of function. If my blood sugars run higher than usual it will often prompt an infusion site change and if the sensors become inaccurate I change them as well. However, I've been getting more time than I used to.

I was encouraged to try to see how long a sensor could work by the reports around the diabetes online community that people are getting more time out of their Dexcom or Medtronic sensors. I know it might be a fluke, but, I'm happy to win the min-lottery once in a while.  Inserting a CGM sensor is still one of my least favorite activities in my diabetic life. Looking forward to the Enlite, Dexcom G4, and a non-invasive sensor  someday.