Wednesday, November 16, 2005

The Joy of Being High

I've never touched any form of mood-altering drug, illegal or otherwise. I don't even drink alcohol. (Well, there was that one time when I was about fifteen. I was at a wedding and my blood sugar was low, so I went up to the bar for a glass of orange juice. Took one sip and nearly spit it all over the table. Turns out I had picked up orange juice all right...mixed with Vodka. Blech!)

Anyhow, the kind of "high" I'm talking about is high blood glucose level. So, if you were hoping to share in the joys of marijuana use, you've come to the wrong place. The closest I've come to the stuff was when I was trying to sell oranges as a band fundraiser, going door-to-door, and at one of the houses, this truly stoned man came to the door in his underwear wreaking of the stuff. (He bought some oranges, though!)

Typically, highs trigger panic in a diabetic. The end of the world, and all. But in reality, those unexpected highs are an opportunity. If you've read any of my other entries about diabetes, you'll notice I'm big on the analysis thing. So, how can you best utilize your high BGL?

One thing is to verify your currently correction bolus factor. Let's say you test, and you are at 300. Also presume you haven't eaten anything for a couple hours. Your current correction factor is, say, 1 unit for every 50 mg/dL over your target (100 mg/dL for this exercise). That means you need to give 4 units.

Next. Test. Test every thirty minutes for the next 3-4 hours. If your BGL doesn't start to fall, or if it actually starts to go UP, then you know there is something in your system still feeding into your high. Perhaps there is undigested food still sitting in your belly. (You'll feel full, if this is the case.) Or, perhaps you had eaten a high-protein meal a couple hours earlier. If that's the case, then your experiment on your correction bolus is over because you need to not only bring your BGL down, but also give more insulin for the undigested food or protein.

But let's say your BGL starts dropping shortly after your bolus. At the end of the four hours, you find your BGL dropped to 140 rather than 100, as you had expected. Time to fix your correction bolus! Do the math: 300 - 140 = 160. You lowered your BGL by 160 mg/dL with 4 units. Divide the 160 by the number of units you gave (4) and you get 40 instead of 50. So, your correction bolus should have been 1 unit for every 40 mg/dL instead of 50.

Of course, one time isn't enough to know for certain. You should try it again the next opportunity you get. Often, what I do is split the difference. Instead of jumping to the 40 mg/dL next time, I'll change to 45 mg/dL instead. Then, the next high I have, I'll try it out again. If I'm still off, I split the difference again. This builds in a bit of protection against a fluke.

Being high (uh, talking BGL here remember) doesn't have to be a bad thing. If you see it as an opportunity to tweak your boluses, not only will you feel more at ease...but you'll be improving your long-term care. You can actually calculate a much more accurate correction factor when your BGL is very high versus just a little high.

Good luck...and may all your highs be joyful!

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