Timing is Everything! Like You Didn't Know That

You've heard the phrase, "Timing is everything," right?  Sometimes it's used to to explain why something happens.  Sometimes it's used instead of a single word, "Luck."  But, timing is indeed important when it comes to taking medication.

In life correct timing can make all of the difference between success and failure.  And, treating diabetes is no different.  In fact, it's far more important than I ever imagined.

Dr. K will go into the best times to take meds sooner or later, because it does matter when you take them.  (Like how I volunteered you, K?)  Two things have happened recently, and I don't believe in coincidence most of the time, hence this blog entry.  You know, even in this, I guess timing is everything.  That just occurred to me.  Yes, I'm a bit thick sometimes.

The two things:

1. In my quest to lower my glucose readings and eventually my A1c, I started looking at the time I took my meds.  (Yes, I am a bit analytical.) For most of the last three years I took them in the earlier morning before 6:30, and then again late at night - say about 10:00.  It worked pretty well for me since for the last 18 months my A1c has been between 5.9 and 6.2.  But, about ten days ago I started taking the medication at night at about 7:00, or so.  Guess what?  My readings are a bit lower and more consistent, now.  I know, for most of you that's more like, "Well, duh!"  I'm just a slow learner sometimes.
2. The second thing that happened was a comment from a reader about higher readings in the morning two hours after eating than they thought they should have.  I forwarded the comment to Dr. K who explained to me that when the medication is taken is incredibly important because different meds get to maximum effectiveness at different times - some get effective faster than others.

So, in both cases, timing is everything.  You have to know when to take your meds in order to gain the most from them and to maintain a consistent glucose level in your body.  And, since Dr. K is the expert, I know she will address this pretty soon.

Are these two items coincidence?  I think not.  It was a matter of timing - the reader's comment and my changing the time I take my meds in search of a slightly lower number.

Indeed, Timing is everything!

As always, thank you for reading.

Made Meters

Do you know what the folks at Consumer Reports did in the current issue?  They evaluated blood glucose meters!  You can read about their testing procedures and what  qualities make a good meter here.  It's worth reading.

Their top five picks in alphabetical order are:

1. Accu-Chek Aviva
2. Accu-Chek Conpact Plus
3. Bayer Breeze 2
4. FreeStyle Freedom Lite
5. FreeStyle Freedom

I don't use their order because it's their work, and I respect it.  But, these are the top five out of twenty-one meters evaluated.

By the way, there is no implied endorsement of any meter; I just hope you test using a meter several times a day to manage, control and beat down diabetes!

As always, thank you for reading.

The Ultimate Diabetes Book

When I was first diagnosed with diabetes I tried to find one book that would tell me how to manage and control the disease.  In order for me to save you time, let me tell you, there isn't one.  Why not?

I really wanted to find that ultimate guide.  That one book I could refer to over and over and over that would guide me through the pitfalls and dangers of diabetes.  Oh, I looked.  At my local bookstore.  On Amazon.  Google Books.  Just about any where I could think of to look, I looked.  I reviewed a lot of books to find out none of them offered solid guaranteed-to-work steps.

Don't misunderstand me, there are some great books for understanding diabetes and they offer guidelines on what you can do.  And, in some future blog, I will list some of the ones I found helpful.  But, there is no one-size-fits-all book.

I even toyed with the idea of writing one, but did not know enough.  I mean how hard could it be?  You have diabetes?  This is what you do.  Wrong.  And, now, I know I can't write a guide for you.

I was wrong because we are all different.  Blame it on our body's chemistry.  What works for me may not work for you; or will be less effective.  There is no single diet - for which cookbook writers and publishers are thankful.  No single medication - do you think drug companies are happy about that?  Of course they are!

There can be strategies for victory.  There can be guides.  But no one way works for everyone.  It's just a fact of life.  And, why this blog is called Solutions for Type 2 Diabetes.

I have told you about my food diary.  In it I wrote down everything I ate or drank, exercise and glucose readings.  Not only do you become more aware of what you are putting in your body, you are charting your body's response.  Morning glucose reading goes up - not so good.  Morning reading goes down or is where it should be - good, keep doing what you are doing.

What you are really doing is creating The Ultimate Diabetes Book for yourself.   So, it seems as though I was wrong.  There is one Ultimate Diabetes Book and you create it for yourself.  It doesn't get any more custom that that!

I learned very quickly what I could eat and what I couldn't eat.  It's right there - in 'black and white.' How long does it take each day?  If you really stretch it out - five minutes, maybe.  Even now if I see a higher glucose reading than I think should exist, I re-start my food diary immediately.  Within a day, and sometimes sooner, I can see what the problem is and fix it.

Notice, this is my diary I complete - nobody else can complete it.  You have to take responsibility for your care and this is probably one of the single best things you can possibly do.

You are creating your own reference piece that will guide you, the owner and operator of your body, to control of diabetes!  You can do this.  You can keep a food diary and by doing that simple step, you will be working to manage and control your diabetes.

This is really, really important to do.  It will take less than five minutes a day - that's all.  Five minutes a day to create The Ultimate Diabetes Book for yourself.  In 30 or 60 days you will have your own book completed.

What do you list?

1. Your morning reading.
2. Your morning weight (I had to lose weight, so I listed it.)
3. Everything you eat or drink by meal or snack.
4. Exercise - length and what you did.
5. Evening reading.
6. Medication
7. Repeat for 30 or 60 days.

It really is easy and incredibly useful. 

You are going to win your battle with diabetes.  You will control and manage it.  Start by writing your own Ultimate Guide.

As always, thanks for reading!

A Test You Can't Fail - Part Three - How to Test

During the last few days I have been reading instructions on various sites about how to test using a glucose meter.  Most of them are pretty good and get the high points really well.  However, there are a few things they miss, which can make all of the difference in the world when testing.  So, here is the process I follow for testing.

When do I test? I test when I first get up in the morning before I eat or drink anything except water, and then at night before going to bed.

The steps I always follow are:

1. I wash my hands carefully using plain soap; soap without any fragrance.  I found scented soaps would effect my readings - make them higher.  The last thing I ever need is a fasle higher reading.
2. Dry your hands using either a clean hand towel or paper towels.  I use paper towels because I know they are not putting anything on my fingers.  If you paper towels are scented, do not use them.  (Heck, I don't even know if scented paper towels are made, but I thought I'd hammer the un-scented thing one more time.)
3. Give the hand you are going to test on a few shakes to get blood into the tips of your fingers.  This might be more important for you to do in the morning than the evening.
4. Get the lancet ready.  Do whatever you need to do like inserting it, or cocking the lancing device.  Just make sure it's ready to go.
5. Insert a test strip into the meter.  For me, the insertion of a strip turns the meter on, so I have never had to physically turn a meter on with an extra step.
6. Lance the side...the side of your finger.  It's less sensitive than your finger tip.  I have no clue why every picture I have ever seen of someone lancing their finger shows them using their finger tip.  It hurts far more than using the side of your finger.  In fact, I don't even feel the lance about 50% of the time on the side of my finger.  By the way, I have used one of two fingers on the same hand for the last few years - I don't vary it.  Do what's best for you, though.
7. Squeeze your finger a bit so a drop of blood appears.  It doesn't take much to test - far less than a drop.
8. Apply the testing strip to the drop of blood.  It will pick up the blood it needs through capillary action.  Be careful not to touch your skin with the strip - it could pick-up contaminants that will effect the reading.
9. Rinse the blood off of your finger as your meter gives you results.
10. Dispose of the lancet properly - in a medical sharps container.  DO NOT put it in the trash.
11. Dispose of the testing strip in the same manner.
12. Record your reading on your log.
13. Put your meter and supplies away.

I know supplies can be a bit pricey, but use lancets and strips only once.  That's important so I will repeat it - use lancets and strips once and then discard properly.

You have done it!  You have taken the test you cannot fail.  But, will fail in your battle on diabetes if you do not test!

There are so many meters on the market, that I won't get into any one brand right now.  If you do not know what your meter is capable of, or the information you can gain from it - learn.  Read the directions that came with the meter, or find them on the internet at the manufacturer's site.

As always, thank you for reading.  Fight the good fight and you will win your war with diabetes.

"Victory is always possible for the person who refuses to stop fighting." ~Napoleon Hill

"Be kind, for everyone you meet is fighting a hard battle." ~Philo

A Test You Can't Fail, Part One

The whole idea of having to test my blood twice everyday was a huge challenge to me...just the idea of lancing my finger to get a drop of blood kind of made me a bit scared.  Looking back on it, I don't know why it was like that, but it was.  I just did not want to prick my finger.  Why make yourself bleed?

Why indeed?  Well, first, I have to tell you that pricking my finger was no big deal.  Yes, there is a bit of pain, but if you read the directions on how to use your glucose meter (which I strongly suggest you do), you will learn where to use the lancet so it really isn't painful.  I won't kid you, there is just the tiniest bit of discomfort once in awhile.  But, if you prick the side of your finger - yes, the side, and not the tip, you may not feel a thing.

Wait, that's important enough to repeat - prick the side of your finger!  Somewhere between no pain and very, very, very little pain.  Got it?

And, while I am at it - you only need a little drop of blood.  The scientists have figured out how much you need to give up and it varies from meter to meter.  For me, it's just a bit bigger than the head of a pin.  I'm serious.

Meanwhile back at glucose testing - which is what you do at home with your meter - it's suggested that most Type 2 Diabetics test twice a day.  Once in the morning just after you get up and then once at night before bed.  That's it.  Twice a day.  Now, when I was just figuring things out in the beginning, I was fortunate because my doctor prescribed enough strips and lances so I could test three times a day.  The truth is sometimes I tested three times, other days two times and sometimes even four times a day as I was learning how to manage diabetes.  I got so much good information from doing this.

I tested in the morning, before lunch, two hours after lunch or dinner began, and at night.  I knew what my body was doing when; I knew about what my glucose reading would be within 10 points after a few months even as it was going down and stabilizing.

What did I do with this information?  I wrote it down in my food log.  Learning what I ate and seeing my reading gave me invaluable information and immediate feedback.  I very quickly learned what I could and could not eat.

For example, some folks can eat wild brown rice.  Not me.  Any rice no matter the color or type causes my readings to go up.  And, I loved rice!  But, I learned that if I wanted to control diabetes, rice did not love me and became a 'has been' in my diet.

then, again, I learned that a basic (stressing the word BASIC) hamburger really didn't hurt me.  You know the kind - a basic hamburger from In N' Out.  Not a lot of dressing and the bun is not huge.  Although, I found that any number of french fires - any number - were off my menu.

How did I learn this?  By frequent testing and comparing the results to what I ate.  Recording everything - food and test results in the food diary helped me so very, very much to begin to gain some sense of control.

The message here is clear, I hope.  Test.  Test often  Keep a food diary.  And, use the results to learn how to best manage diabetes.  That is the first step to gaining control.

Remember, to manage diabetes you have to give yourself a glucose test at least twice a day; more often during the first few months if possible.  It's a test you cannot fail, but you will fail to manage diabetes if you don't test.

Diabetes Week Two

I made it through the first week of diabetes.  My life changed in the same way you turn a light on - within a moment.  Was I still scared?  Oh, yeah.  In fact today, almost three years later I am still scared of diabetes if I was being completely honest.  I have a deep and abiding respect for what the disease can do if not managed and controlled.

The good news is that it can be controlled with a bit of effort which was my big "AHA!" during Week Two.

Anyway, back at Week Two.  I had begun to take my meds - Metformin twice a day 1.000 mg each time.  Pretty standard starting treatment.  And, it was just the Metformin.  I know many may have two pills to take, which for some proves to be very effective.  It's kind of like a one-two punch and when you are in a war with diabetes, you want to throw as many punches as possible to get your glucose, and subsequently your A1c, down somewhere in normal range.  If you need to see the a chart for A1c values and how they compare to your blood glucose readings, look here for a pretty easy to read chart.

Remember not to use one reading, but look at your average reading.  Even then, it depends on when you take it.  More on that at some point in the near future.

Again I got a bit side tracked.  Week Two - I had begun my walking.  Every evening for 30 minutes.  I know I have written here before I don't like exercise, but we were talking about my life here.  So, that walk became one of my best friends.  I didn't try to walk fast or go very far at first.  I used shoes that were about five or six years old and just walked.  One foot in front of another.  For 30 minutes - which seemed like forever the frist few days, but by the time Week Two started, the time seemed to go a little faster, but not much.

And, I was getting more ideas of what I could and could not eat.  Think about it, we get near immediate feedback with our glucose readings.  If it's not the right food, up it goes.  If it is the right food, it dips a little bit.  Take your readings twice a day, more often if your doctor will authorize it, so you will know what your blood sugar (glucose) is doing.  You should be on a steady downward trend.  And, keep a record of your readings as well as diet (everything you eat and when) in a food diary.  You will really learn what is working and will be able to spot trends faster.  If you spot the trend, you can make adjustments.

Me?  I just liked seeing the numbers go down.  I started with seeing glucose numbers of 300+.  It was an exciting morning when I hit 297.  During the second week I saw it get down to 275.  I was making progress!  Fear was gone because I was taking action.  I knew the meds would not make me go too low - fat chance when you are in the high 200's.  Things were beginning to work and I felt empowered; that I could get this disease under control. Hey, I even found I lost my first couple of pounds during Week Two,

What was I doing?

Meds.  Diet.  Walking.  Testing.  Recording.  If I was really bright, I'd come up with some sort of catchy acronym, but alas and alack, I am not that bright.  I am open to ideas, though.  You know what my meds were.  I was on a low carb diet.  I was walking 30 minutes a day, six days per week.  And, I kept records.  All of this really began to come together during the second week.

You can do this.  It's all about little steps that collectively make a journey.  You can take the small steps without fear - a lot of folks have gone before you.

It's Not a Sprint; It's Your Life

I have just finished watching Ernie Els win this year's British Open.  He did not do it through getting out in front and staying there.  He did it by grinding out golf shots and giving himself the opportunity to win.  He was behind when he finished, but when the tournament was over, he won.

What did it take?  Perseverance.  It took a disciplined approach over 72 holes.  It was not what he did on one hole or one day. It's what he did over four days - and he did the best he could with every shot.  Sometimes the holes went well; other times, not so much.

Controlling and managing diabetes takes perseverance.  It's not about one meal or snack, or one day.  It's about your life and how you choose to live it.  Do you live it as a victim of the disease and just give up?  Or, do  you face it and work to control it?  The choice is your's.  Just remember, it's your life we are talking about. 

It took about six for me to get a handle on controlling and managing diabetes.  I took my medication.  I started exercising.  I changed and adjusted my diet.  I was afraid of the disease and not willing to let it win.  But, it still took months.

Control and management could take you months, or longer.  But, you have to keep at it - you know you can do it.  Sure, my diet might not work for you, but it will get you moving in the right direction so you can make those little adjustments that will lead to victory.  You will be heading toward triumph and not giving in. You will be taking control of your diabetes

I have been asked why there isn't a 'handbook' for diabetics.  We;;, we are all different and our body chemistry is different.  Yes, there are established ranges and norms, but there is no one number that is right for everyone.  Why do you think the 'normal' fasting glucose range is from 80 to 120?  Because we are different!  A woman I know goes into a sugar low if her glucose level gets below 70.  I have had readings as low as 59 and 61 and still felt okay.  Why is that?  Because we are different.

Listen.  Learn.  Discover what works best for you.  It's not a race; it's your life.

Two thoughts from Winston Churchill:

"If you are going through hell, keep going."

"Never, never, never give in."

The First Day...I Do Remember

I know I have referred to the first day my doctor told me I had diabetes.  Fear.  Fear.  Fear.  I was afraid of everything from what could happen to me with diabetes (I have a vivid imagination) to the fear of changing my diet (and to what?) to the fear of medication (what if it took my sugar down too low...vivid imagination kicks in, once again).

At this point some folks just freeze and don't do anything hoping it will all go away.  News Flash - it's not going to go away.  Changes have to take place.

So, my biggest fear was the damage diabetes can do.  I won't go into it.  Chances are you already know, but in the event you don't, read about it here.

First things first.  Get the medication.  For me it was 1,000 mg of metformin twice a day.  I was also changing the way I ate - I have referred to that in a previous blog.  If you want more details, all you have to do is ask.  And, I started testing as soon as I could as much as I could.  It happened that I could test up to like 3 times a day.  In the beginning I tested four times a day.  I wanted to know exactly what was happening.  How fast was my glucose going down? Was it getting dangerously low?  Because I was testing so often, I knew exactly what was going on.  I began to gain some confidence in the process of diet, medication and exercise.  And, being a bit anal, I kept some records.

In case you don't know, your glucose meter keeps records, too.  It probably can go back at least 90 days to give you averages, and might be able to go back seven days for specific readings including date and time of day.

Remember, it's just your first day...things are going ot be changing - a lot will be changing!  Make the dietary changes, take your medication religiously (NEVER, EVER MISS A DOSE), make a few life style changes, and test, test, test the first few weeks if you have enough test strips to do so.  If you don't, ask your insurance company and doctor if you can get more.  You aren't going to need extras forever, just a few months as you learn you can control diabetes.

Because of all of my testing and record keeping I know within 10 to 20 points, or so, where my glucose is at any given time.  The last time I went in to see my doctor we got into a discussion about my current reading.  It was about 4:00 in the afternoon and I told him it would be about 80.  He said that wasn't possible.  It should be around 90 or 100.  I just said, "Test me."  He did and what was the reading?  78.  He lowered my medication, which caused me to change my diet a bit (he wanted me to lose about 7 pounds, anyway - but that's another story) and increase my exercise a bit to compensate for the lower medication.

You see, I like lower numbers.  It means that I probably won't have the side effects of diabetes. But, remember I have been testing and working through managing and controlling diabetes for about three years - knowing about where you are won't come over night.

So, you see, there is good news.  If you are a bit diligent you can control this disease.  I am here to assist you in anyway I can.

Thanks for reading.