Diabetic Inconveniences and Insulin Shots

I’m back to measuring everything I eat.  My blood sugars have been completely out of control since starting chemotherapy in April 2010.  The initial chemo didn’t seem to have the impact that the 50 doses of arsenic, and then the year of tretinoin, methotrexate, and M6 mercaptopurine had.  Those really messed things up.  This morning my ‘fasting’ blood sugar was 161 mg/dl. That is beyond unacceptable, and I’ve been off of all chemo for roughly 11 months.

Before the leukemia my blood sugars were those of someone without diabetes- but that doesn’t mean I wasn’t diabetic.  My diabetes was just in control.  Diabetes doesn’t go away; it gets controlled.  For 12 years I didn’t take any medications at all. I went from an A1C of 10.2 at diagnosis (random blood sugar was 389 mg/dl) to an A1C of 4.7 and fasting blood sugars between 65-85mg/dl about %95 of the time; rarely over 100 in the morning.  Even when my A1Cs started to rise and I started on metformin my numbers were still doing OK- but I saw that they were starting to go up, and asked to do something before they got ‘bad’.  I didn’t want to wait until things were in a higher risk range.  Proactive, not reactive.

The metformin ate my stomach. I couldn’t keep taking it, so I was started on Lantus (long-acting) and NovoLog (rapid acting, for right before eating) insulins.  My numbers went back to where they had been almost immediately.  I could see my risk for blindness, amputations, and dialysis going away. That was my whole point for starting insulin.  Keep the risk for complications as close to nil as possible.  I already have an autonomic nervous system disorder, so didn’t want that getting worse.  And it has since my blood sugars have been out of control.  I don’t know for sure if there’s any correlation (it could ‘just’ be progressing), but I don’t want it to keep going in the wrong direction if there’s something I can do to avoid that.  I need to get my blood sugars back under control.

When I hear people talk about their resistance to starting insulin, I do understand that.  I’d given countless insulin shots (and IV doses) to patients over the years I worked as an RN before becoming disabled.  That helped a lot in knowing how and where to give the shots.  But I didn’t realize how little the needles had gotten. They are tiny !  They are so easy to get used to, and the vast majority of the time I don’t feel the injections at all.  Initially, the Lantus burned some but my numbers were so much better I didn’t care.  Now, the shots don’t hurt at all.  There may be a bit of discomfort for a second or two, but it’s no big deal. 🙂 I’ve had worse fingerstick soreness than I have had with insulin shots.

Anyway, while on chemo, it didn’t matter what I ate or how much insulin I took- nothing helped keep my blood sugars ‘OK’.  I wasn’t supposed to ‘diet’ during active cancer treatment.  I was gaining weight, taking more insulin (which stores fat), and had high blood sugars which makes ones appetite weird.  Hyperglycemia causes increased appetite. I didn’t need that.

Now I’m getting used to the ‘new’ normal.  I’m having to recalculate my insulin-to-carbohydrate ratios.  I had been at a steady 1 unit for every 4 gms of carbs pre-leukemia. Now it’s a crapshoot.  SO back to measuring, weighing, and doing before and after meal blood sugar checks.  It’s annoying, but I’m guessing dialysis, getting used to a leg prosthesis, and learning Braille would be much worse.  I’m also having to tweak my Lantus dose, and am doing a trial of twice daily Lantus.  I’ve got to DO something !

I’ve got a nice digital food scale (measures in grams and ounces), multiple sets of measuring cups, and various measuring spoons. It’s a pain in the butt to have to measure out everything that goes into my mouth.  But it’s necessary.  I’ve got to get things back in check.  Surprisingly, my A1C was under 7 during my annual physical and diabetic lab work in February of this year.  I want it under 6- where non-diabetics live.  The closer to normal I can keep my blood sugars, the greater chance I have at not developing the big complications.  So it’s all a pain in the butt for a very good reason. 

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