Wednesday, February 07, 2007

Nobody's Perfect, Diabetically Speaking

I'm not perfect.

No, really. I'm not.

I have, in fact, proclaimed my ability to fairly accurately predict the general range of my blood glucose levels as a diabetic, often within about 50 mg/dL. Scott has even gone so far to call this ability my "Spidey-sense". Very flattering, though undeserved.

Why am I coming out, now, with my lack of perfection in this area? Well, because just as I try to be helpful in teaching others how to hone their own Spidey-sense, the truth is no one will ever be perfect at it. In fact, there will be times you are widely off.

Take last night as a fine example. I came home from the store with some cookie dough all ready to eat several delicious chocolate chip cookies. So, after sticking the cookies in the oven, I figured I'd better test. I mean, I knew I wasn't high. Maybe 150, though.


302! D'oh! So, I bolused and waited for my BGL to drop...and then ate my delicious chocolate chip cookies. (Turns out I over-estimated carbs, and ended up low enough to eat an extra chocolate chip cookie about an hour later.)

So, see there? Even Spidey can be wrong.

But this whole experience got me to thinking about something only slightly related. As I was testing, I was thinking about how much each strip costs, and how expensive that can be for those without insurance. I'm sure plenty of folks forego testing as often as they should in order to save money.

So, let me give you a tip that I sometimes do if I don't have the ability to test, but suspect I might be high. Let's presume I had been perfect yesterday, and I had known I was around 300...but couldn't tell for sure. Let's also presume I was out of strips (which happens from time to time). What to do?

Well, I could give a correction for that 300. But if I'm wrong, I risk a serious low. I could do nothing, but that wouldn't be healthy if I was right. The answer is to compromise.

In such a scenario, I will bolus enough to bring down a high slightly, but not enough that should I dip into low territory, it would be dangerous. Start with a unit or two in my case. Then I wait. I wait maybe two hours...enough time for that bolus to do most of its job. (Sure, there is residual insulin, but very little with a two-unit bolus.) If I didn't go low, then I'll give myself an additional bolus of a unit or so. Then wait again.

Rinse and repeat.

Then, once you start to feel yourself going low, you stop bolusing and eat a snack enough to counteract any additional insulin you bolused.

I'll add a caveat that this is only a good idea for those who are sensitive to their lows. Not a good idea for those who experience hypo-unawareness.

Anyhow, that's my technique for today. Sure, not a medical-doctor approved method, but we live in a real world with real medical costs and real situations where you might not have test strips available. It works for me, and that's all I'm saying!


Scott said...

This really stinks for those of us with Type A personalities ... LOL!

George said...

I am meterless today so I am gonna use your method and see how i do.

This sucks!