JDRF Annual Meeting

Yesterday my husband and I attended the JDRF San Diego Chapter Research Update and Annual Meeting. What a great night!

I was sent an invitation because we participated in the walk last year, but we haven't been that involved in the chapter other than that event. I felt a little awkward, like we were barging in on an established group, but my husband marched right to the front for a good seat! I was really touched that he took such an active interest in the meeting.

We sat down to claim our seats before getting some appetizers, when the Executive Director of the chapter, Linda Riley came by to introduce herself. The entire staff was very welcoming, and even my husband, who worried he wasn't supposed to be there because he wasn't diabetic himself, felt right at home.

The highlight of the evening for us was the keynote address by Dr. Steven Edelman, the founder of TCOYD. What a great opportunity to get to hear Dr. Edelman's presentation on "The Latest and Greatest in Diabetes Management" in such a small group (about 75 people), especially in a JDRF sponsored event, so that the focus was squarely on type 1 needs.

I am proud to say that there weren't any advancements or new technology mentioned that I wasn't already somewhat familiar with. I have to thank the OC for that. I don't spend much time researching new products myself, but with the help of Amy and others, I've been introduced to the most important research being done for diabetes.

One interesting tidbit that Dr. Edelman mentioned was the supreme importance of continuous glucose monitoring. He is wearing the Dexcom, and has been for five years! He said that he'd trade all of the other advancements: symlin, analog insulins, the pump, everything for the continuous glucose monitoring technology. He considers it the most substantial piece of technology for good blood sugar control. I can't wait to get one!!

Periodicaly, during the presentation, Dr. Edelman would check the monitor and announce his reading. It was 178 mg/dl at first, and then the alarm buzzed to tell him he'd gone over 180 mg/dl. These were his post-dinner readings, he explained. I told my husband proudly, "My numbers were better than the doctor's during that meeting!" I was 77 mg/dl before the appetizers (and a little red wine) and 121 mg/dl after the meeting!! :)

We also discussed Symlin pretty extensively (not surprising since the event was held at Amylin Pharmaceuticals). Dr. Edelman has also been using this drug for years. Personally, when I asked my doctor about it, he told me I did not need to loose weight (I beg to differ!) Also, my post-meal blood glucose readings are fine, so I suppose it's not imperative, but it does seem interesting. Dr. Edelman made the prediction that Symlin would soon be used by obese patients, even those who don't have diabetes. A weight loss drug... amazing!

All in all it was a very informative and fun night. Perhaps this is just me, since I'm sort of new to the diabetes advocacy world, but I felt a sense of pride last night. Seeing all these people (many who have kids with diabetes) working so hard to find a cure for diabetes, for me and all of you, was very humbling. Having our struggle validated by this organization made me feel cared for, comforted, and respected.

Anniversary Meme!

I liked this meme that Kassie posted so much, I thought I'd fill it out a month early! My 13th Diabetes Anniversary is next month... so here are 13 Great Things I've Done Since July 27, 1993.

1. Transferred to Saint Bernard's High School and had a graduating class of 44 students! Got to experience great people and a wonderful sense of family at our school.

2. Went to the National Youth Leadership Conference in Washington DC for 2 weeks! Fell in love with DC (again) and felt so grown up flying across the country with one of my closest friends, Beth Morrison.

3. Went on an extensive college search, looking for just the right school. My dad and I had the best time visiting Notre Dame and dreaming of my future.

4. Chose Saint Mary's College of California after learning about the Intergral Program. Spent 4 years reading the Great Books of Western Thought with 14 wonderful friends. Completely changed the way I think and see the world.

5. Traveled to Okinawa, Japan to visit my "first love"- had my heart broken and survived!

6. Went to Martinique for a month with 9 other women (and our male teacher!) to study the colonization of the Caribbean... amazing!

7. Graduated from SMC with a degree and a wonderful friendship with my college roommate Michelle My Belle!

8. Moved to San Diego, got my first real job at a law firm downtown.

9. Supported my parents and siblings while our family underwent some major changes (parent's divorce, family home sold, family dog passed away...rough year!)

10. Met my husband at work and enjoyed our wonderful year of dating.

11. Started grad school at San Diego State University in History and studied like I've never studied before.

12. Had the wedding of my dreams on November 6, 2004.

13. Became a "born-again" diabetic and quickly lowered my A1C to my goal number using injections! Getting my body ready for a baby :)

I can't wait to see what the next 13 years have in store for me!!

Rebound!!

We've all heard about rebounding blood sugars, most commonly in the form of dawn phenomenon. I knew that severe hypoglycemia can lead to rebounding highs, however I'd never thought too much about it in my personal management. This week I had a really obvious experience with this effect.

On Tuesday I did a strenuous Tae-bo workout after work. My blood sugar was 118 mg/dl before my workout, 97 mg/dl half-way through and after a few ounces of OJ, it was 144 mg/dl about an hour post-workout. I had a normal dinner and gave myself 3 units of humalog. At bedtime I was at 82 mg/dl. Since I am on lantus (administered at 10 p.m.), I tend to get low during the night, especially after a workout. So, I had my favorite snack: 1 brown rice cake with a little PB and chocolate chips, plus 6 oz nonfat milk. At 4 a.m. by blood sugar was 50 mg/dl! I had some OJ and went back to sleep. Upon waking at 6:30 a.m. it was 50 mg/dl again!

In contrast, here was my experience Wednesday:

I was in the low range all morning. After lunch, I made a bad decision and had a slice of reduced fat banana coffee cake from Starbucks. I gave myself some insulin for it, but since I'd been low for a day, I gave myself less humalog than I'd usually need. At 6 p.m., as my husband and I were preparing to run, my blood sugar was 227 mg/dl. Darn! I was angry at the high, so I gave myself 2 units of insulin.

We ran 3.5 miles (which was hard, I'm so out of shape right now!) We came back, and for some reason, I wasn't thinking and didn't test my blood. I could feel the low coming on in the shower. I just quickly finished, and started to heat up dinner. I was hoping not to have to have OJ to bring up my blood sugar and just hurry to eat dinner. But I was really sweaty and shaky. So I tested, 42 mg/dl. Now, I am low quite often, but it's typically at night, or after not eating for awhile. I don't have many lows that feel very intense. This one did! I had some OJ, ate dinner (the same dinner as last night) and felt better pretty quickly.

At 10 p.m. my blood sugar rang in at 80 mg/dl. I was just where I was the night before at bedtime. Since I had gotten low during the night after my workout Tuesday, I figured I'd have my same rice cake, PB, chocolate and milk snack, but just have a little extra milk and chocolate! Instead of getting low, my blood sugar was 248 mg/dl this morning!! WHAT?!

Suddenly it occurred to me... that low before dinner was pretty extreme, hmmm. Was this a rebound effect? I gave myself 4 units of humalog and had a bowl of Vanilla Almond Special K cereal (yum!) Typically this recipe would equal a 70 or 60 mg/dl by 9 a.m. Instead, I tested at 9:30 a.m. and was 324 mg/dl. Again... WHAT?!

3 more units of humalog and 2 hours later I'm 110 mg/dl. Finally.

I think this is a really clear example of rebounding blood sugars. Doing the exact same things two days in a row, only one with a low, demonstrated the effect of a rebound. Thinking back, I've often had those totally out of the blue (or so I thought) numbers that didn't make any sense. I'm sure when I flip back through my logs, I'll find that they followed extreme lows.

I think the connection took me awhile to make because I have "lows" fairly often. But, like I said they're typically brought on my lantus or just occur more gradually, thus the rebound response either doesn't occur, or is just less extreme.

Wow, I'm glad to pin-point this. However, it feels like one more thing I have to factor into my management system. I suppose the real lesson is not to let yourself get real low in the first place, huh?!

My Sister Helps with a Scary Low

This story isn't about me... in fact, I've never met the subject of this tale.

My younger sister Sarah called me the other day, left a voicemail saying, "Kelsey, I have a story I have to tell you." She did not sound happy, rather a bit weary. I called her back right away.

Sarah is a graduate student in agriculture at Cal Poly SLO. The other day, one of her classes took a field trip to San Jose, CA. On the drive she began chatting with a classmate, I'll call him B. B has type 1 diabetes. Sarah and B spent an hour talking about diabetes. Sarah found this really exciting since she hasn't had many conversations with other people who have type 1. (My family is quite interested in diabetes and all I have to deal with... I've only recently starting sharing more of my experiences with them.)

A few days later... Sarah, B and the rest of their class are in lab. Some of their lab equipment isn't working, so they take an hour break until it's fixed. Sarah comes back to see B laying on one of the lab tables. She gently tries to wake him, because it's time to start their experiment. He doesn't respond.

"Uh, guys? How long has B been sleeping?"

"He's been out a half hour or so."

Sarah notices that B is drenched in sweat even though the lab is freezing. She's not sure what this means. She wonders whether he is high or low. Again, Sarah shakes B, harder this time. He turns to face her and has the scariest look on his face. She's really disturbed by his expression.

"Hey, did B say anything before he fell asleep?" Sarah asks her classmates.

"Uh... he said he hadn't eaten in awhile. I think he might just be hung over, he went out last night."

It clicks.

"Okay, he's low. We need to get something sugary in him."

The professor enters and says he has some juice bottles. Class members run to get the juice while the professor calls an ambulance. They struggle to make sure B is aware that they're trying to give him juice. When Sarah provides the bottle, B grabs it. He knows that he needs it. Two bottles are gulped down with some assistance.

The ambulance arrives within 5 minutes (must be on campus). They squirt glycogen in his mouth and test his blood. 36 mg/dl. The students are asked to leave so B can recover in peace.

Sarah told me this story practically all in one breath. We agreed that it was good she was there, otherwise no one may have questioned B's sudden nap. This event made me think... family and friends of type 1 diabetics are a great resource to all of the other type 1s out there. As alert as Sarah was, I realized there were things I could educate my family about, so they could be even more helpful in an emergency. We all know that sweatiness means a low, but do our family and friends? Alcohol the night before was another clue... one that non-diabetics wouldn't know.

It would be wise to clearly explain the symptoms of hypoglycemia to our family and friends, so they can help us in an emergency, or another diabetic they come across in their everyday life.

I was so proud of my sister for helping another diabetic in need! Great job Sarsies :)

My weekend of dehydration

We had our first HOT weekend in San Diego... what do my husband and I decided to do? Go to the beach like the thousands of other folks in our city? Escape the heat in an air-conditioned movie theater? Hit the pool? Nope, we play 90 minutes of tennis in the mid-morning heat without being properly hydrated. Sounds like much more fun-huh?!

I spent the rest of Saturday feeling "off." I figured I was just tired from the exercise. Sunday morning the vomiting started. I barely ate all day, gave myself TONS of insulin and sipped down 1 liter of Pedialyte. Good times.

I took Monday off to relax and make sure my blood sugars did not go extremely high.

Two and a half straight days of lying on the couch watching TV sure makes you want to be a productive member of society again!