Favorites and Motivations

Not feeling to great this weekend so I am a day late on yesterday’s post. The topic is (was?):


If you have been blogging for a while, what is your favorite sentence or blogpost that you have ever written? Is it diabetes related or just life related? If you are a new blogger and don’t have a favorite yet, tell us what motivated you to start sharing your story by writing a blog? (Thank you Laddie of Test Guess and Go for suggesting this topic.)

I was debating between two posts of which one to pick and I decided to go with Managing Blood Sugar with Gastroparesis. I picked that one because I still get people sending me messages about it. It is very sad but most doctors tend to write you off when you have a problem and don’t try to help you figure things out.

Salad gifA lot of people don’t really understand that some foods are worse than others to digest and no one has ever talked to them about that. Broccoli and oranges are the two hardest foods to digest and I once talked to someone that was eating broccoli every day with gastroparesis. No one ever bothered to ask her what she was eating.  I miss having my veggies every day but being sick in my stomach every day is not worth it.

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Gastroparesis and Apidra

Levemir and ApidraI first started using Apidra in the spring of 2008. I saw people talking about it on a message board and wanted to try it. I had some concerns that it would be too fast for me with gastroparesis and my PCP had those same concerns. He didn’t have any patients using it, but one of the nurses in his practice was diabetic and used it. He said that she really liked it. Fortunately for me, even though he had concerns, he was willing to let me try it. He gave me one of the “OptiStick” pens but did not give me a script to get refills. When I asked to try Levemir, he had given me the pen plus a script to get more. I am guessing he didn’t think the Apidra would work!

I love Apidra – I believe that it is currently the best insulin on the market to manage gastroparesis with.

As far as Apidra being super fast, that is not my experience with it. This chart on WebMD comparing insulin has the onset for Apidra at 20-30 minutes. It has the onset for Humalog at 15-30 minutes and Novolog at 10-20 minutes. According to that chart, Apidra is actually the slowest of the three fast acting insulins. For me, it takes about 20 minutes to kick in. In talking to other people, 20 minutes seems to be a common kick-in time.

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Gastroparesis: Is it Really?

StomachI have talked to a few people online that thought they had gastroparesis, but their doctor’s didn’t think that it was necessary to do the testing to confirm that. Diabetes in Control had an article about a study done by the Mayo Clinic that showed only 5% of Type 1s actually get gastroparesis and only 1% of Type 2s. They felt that anytime a diabetic has a stomach issue, gastroparesis is the diagnosis. You can read the full article here.

I know that I have seen much larger percentages. I just did a quick Google search while writing this and saw numbers as high as 55% of diabetics having gastroparesis. The article doesn’t state anything about the population of the people they studied. My feeling about most complications is that those of us that have been diagnosed longer have a greater chance of getting complications because the things we know and do today did not exist back then. If this study has only followed fairly newly diagnosed people (the study did last 10 years) that mostly only ever used the newer insulins and knew to test after meals, then that could explain the lower rate.

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Gastroparesis and Other Health Diets

Sometimes when you have multiple health problems with conflicting diets, you start to wonder what you can eat. Add in some food allergies and things get even more confusing. I hate the word “diet,” but I am not sure what else to call it.

SaladGastroparesis can make things challenging in the food department. Things that normally would be healthy for you to eat cause a lot of problems. If undigested food remains in your stomach for too long, it creates something called bezoars. A bezoar is a hard mass of food that may need to be surgically removed. Vegetables are very hard to digest so you now have an excuse not to eat your vegetables. Fruit is also very hard to digest. The two food groups that we are told are healthy and we should eat are now dangerous with gastroparesis.

If you have other health problems, you may have other restrictions on what you can eat. If you have kidney problems, you have restrictions on how much protein you can eat. If you have heart problems, they want you to watch fat. Fat causes problems for gastroparesis, so that won’t be a conflict, but if you look at the diet on the AHA website, they recommend 4.5 cups of fruit and vegetables a day. That would cause a different set of issues with gastroparesis.

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Total Available Glucose (TAG)

Total Available Glucose. or TAG – I first read about TAG on TuDiabetes.  Danny on TuDiabetes started a group for TAGgers, that you can check out at the link below and read more about it there.

http://www.tudiabetes.org/group/tagers

The idea behind TAG is that besides bolusing for your carbs, you also bolus a percentage for the fat and protein that you consume and then spread that bolus out using the dual wave or extended bolus (or combo on Animas pumps) feature on your pump.  There are some people doing MDI that belong to the group so don’t think that you can’t use this system if you don’t have a pump.  Whether you use MDI or a pump, you definitely need a calculator if you want to use this system!

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My Pump Start: The Good, The Bad, The Ugly

I had my training for my Animas Ping on Monday, June 28th.  I survived my first ten days on the pump!

The training went pretty fast.  For me, it was more of a matter of just getting hooked up.  I wasn’t looking for a lot of help from them.  I had talked to the trainer before going in and she told me what she had my targets set at – 110 during the day and 120 at night.  I have my high alarms on the Dexcom set at 120 so did not like her targets.  When we went to set stuff up at the training (I already had stuff set but she wanted to change it to her settings), she asked me to humor her so I did.  But as soon as I left, I changed it to 85.  I wasn’t going to shoot for a higher target just because I am on a pump now.

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