Blood work

I realized just before Christmas that I have an endo appointment on January 4th and was supposed to get blood drawn in mid-December. Oops! So I went and got it done today, and the results showed up online tonight when I checked.

My A1c is 7.3% which is great! It hasn't gone down but also hasn't gone up. I'm going to talk to my endo about infusion sets because I think I have serious absorption problems sometimes. The night before last as my site was nearing the end of day 2 (I normally change them every 2 days) it got super itchy and my blood sugar and ketones shot up. Then again last night my blood sugar randomly shot up to 17 (300 mg/dl) with ketones and stayed there for hours, but came down literally just as I was about to change the day-old set (and today BG has been totally fine). It's so annoying! I think if I could somehow prevent having these totally random extreme highs (without having totally random extreme lows) I would be able to get my A1c down a bit and into a better range.

I also got my cholesterol tested which was 4.9 (191 in U.S. numbers) for the total cholesterol, 2.8 (109) for the LDL, and 1.7 (66) for the HDL, and 0.9 for triglycerides. I am sort of dreading telling my (new) endo that I didn't take the Crestor he prescribed. But from reading up on it and talking to people I am just really not comfortable taking it. Especially because I don't think my cholesterol is that bad (especially considering I have weight I could lose) and I don't have any history whatsoever of heart disease in my family, and I'm only 31 ... I think if I started to see my cholesterol go up or if I was older or showing signs of heart disease, maybe, but I've also had a bazillion heart tests over the past year that shows that there is not even a hint of any heart disease starting. So I don't know what else to tell him other than that I'm uncomfortable.

The one test that might be slightly concerning is my estimated kidney function test dropped from 120+ three months ago to 79. It's never been that low before. Usually it has always been 90-120+. So I'm not sure if that's concerning or not, but I suppose I will find out when I see my endo.

Maybe the pump isn't worth it with all the set problems. You write about that frequently. I don't have a pump, but if I did I'd have ditched it from persistent highs.

I've thought about that, but believe it or not my control on MDI was much worse than it's been on the pump even given the highs I sometimes have! At least with the pump I can maintain an A1c in the low 7s, and even hit the high 6s a handful of times, as opposed to getting high 7s and low 8s; and I can stay between 3-11 on many days as opposed to most days I'd range from 2-20 on MDI. As much as my control looks bad in comparison to many on this site, it's much better than I was ever able to achieve on MDI ... and that's even doing things like waking up every night at 3:00 AM to take fast-acting insulin and so on.

I'll probably ask my endocrinologist what he thinks about it, though, but I've tried taking a few pump vacations to see if it helps, and I always end up coming back to the pump in under a week because I can't take the utter chaos. I think my biggest problem is that I seem to really need a variable basal rate (and that is the #1 reason I went on the pump in the first place). Maybe something like the "untethered regimen" might be a good option, though.

I think a lot of my site problems are related to allergies, which have gotten worse in many other ways over the past few years. I might give Contact-Detach sets another try (tried them before and 50% just bled, so gave up). I also think I tend to wait too long to change a site with a string of highs, partly because I'm nervous of running out of infusion sets, so I want my doctor to know why I sometimes go through sets so fast so he can make sure the prescription corresponds to that.

What kind of sets are you using? I've been using the Silhouette sets, almost as long as I've pumped and I hardly *ever* [knocks on wood...] have problems with them, pull them or anything like that. I often see people, yourself included, but way more than that, reporting bad sets all frequently and that is not my experience at all. I've only done it a few times, less than 5 for sure, more like 2-3, in going on 5 years of pumping.

I like the Silhouettes as I can stick them in manually and sort of nudge them to make sure there in deeply and securely. Occasionally, a site will "brush up" against what I figure is scar tissue or something like that during insertion and I can wiggle it away from that or put it over a bit but I like the manual much more than the Quicksets. I think that I use the 13 mm ones to get them in as deeply as possible. I always liked the 12.7 mm (1/2") needles for shotss and want more needle w/ sets too. I dunno if doctors/ medical suppliers always recommend that but I wonder if that may help me too?

Great job on the A1C, BTW! I'm glad that your efforts have been rewarded! I was sort of in that ballpark, w/ 110 LDL in the summer of 2011. I added 4 servings of veggies in, pretty much all the time, including broccoli and spinach. Some of the veggies replace pretzels/ popcorn and other crap in my diet but my LDL went down 3 months later to 86 and last time was 74, less than my HDL. My docs don't talk about food that much but making a small effort to adjust my diet and be more rigorous about that has helped me improve those numbers w/ no meds, T2 cholesterol mess or whatever? The downside is that I'm becoming acutely aware that the spinach and broccoli around in the winter are not *nearly* as fresh/ tasty as what we get in the summer, it doesn't last as long in the fridge and I hope I don't get food poisoning.

I use Comforts which are the same as Silhouettes, and I do manual insertions. The frustrating part is that usually my "bad sites" don't LOOK bad. When I take them out they look fine, but as soon as I switch over to another set, my blood sugars that have been high for hours come right down and (if I had them) ketones disappear. A lot of times (but not always) my sites get really itchy or are red and irritated when I take them out, which is why I think I have allergy problems. I can rarely keep a set in beyond two days or it just dies on me. Sometimes it doesn't even last a day! I've tried Contact-D sets and they helped with the itching, but a lot of them bled for me for some reason, and I still seemed to get itchy from the adhesive (though I think most of my issues are with the cannula).

I made a few dietary changes for cholesterol three months ago, and this time around my HDL had gone up and LDL stayed pretty much the same, and my total went up. Overall my cholesterol is better than it was a year or two ago. Doctors have been talking about cholesterol medication for years which I find really frustrating. I think I'll try adding in more veggies (that's one area I really struggle with) and hopefully in three more months, or whenever my doctor wants to check cholesterol again, my levels will be even better. My endo wants my LDL to be under 2.0 (70 for U.S.) and said even lower than that like under 1.8 is better.

I am surprised your a1c didnt go down with all the swimming you do!

About half that swimming was accompanied by big spikes in BG afterward, so I doubt that helped! (Plus, I've been sooo lazy the past few weeks, have to get on track soon!) Maybe now that I've gotten the spikes figured out it'll help for my next A1c!

You spike after excersize???? wow and I thought my D was weird! LOL

I go down a lot and then spike 1-2 hours later if I don't take insulin. Seems to only happen with swimming, but swimming is also the only exercise (so far) I really push myself with.