The numbers explained:

pbpk weight should be above 180
Fasting & pre-meal blood glucose 80-120
Post-meal blood glucose 120-180
A1C below 7%

Monday, February 13, 2012

Learning about Prandin

Day two on the pill. After finally allowing myself to sleep I lay down and only woke a few times during the night because of sweating (it wasn't that warm) and stuffy nose (argh!). Without a doubt I'm fighting a little cold of some sort but I won't let it get me down.

Despite feeling congested I found the resolve to go outside and workout. I ran about 3 miles total and did a bunch of stairs and other exercises with Seth. If any diabetics (or anybody else for that matter) want to know exactly what I do for workouts message me at the bottom. If I get enough requests I'll make a post about it.

After working out I called my endocrinologist Dr. Susan Thys-Jones. I told her about the previous morning and afternoon. Naturally she got quite excited. After all I had several tests in the 70s pre-meal and all under 200 after meal... until the night. I then explained how my sugar level then went absolutely CRAZY!!! She agreed with me that those were crazy numbers. I told her my hypotheses: the carbs at dinner were too simple, I was feeling sick, I had the pill with dinner. She countered with a few ideas of her own.

Dr. Thys-Jones' advice for my new Prandin therapy:

1. Start counting carbs again. Your first two meals were about 120c and your last meal was closer to 190. Based on this information she'd like me to try to take one pill for that 120c range, and another pill if I'm in that higher range. She didn't give specific numbers, but I'm going to start experimenting and see how it goes.

2. Try to change your circadian rhythm to more closely align with the sun. In other words I go eat too late and go to bed too late and then wake up too late. Your hormones are most active in the early morning and least active late at night. She thinks I may be able to improve my late night numbers by eating earlier when my own hormones are more active. This will be a hard problem to solve, but perhaps I can modify my habits a little. I could try making my meals ahead of time, but I'd still be eating around or past midnight. The other option would be to decrease my night time carb:Prandin ratio. Maybe try 90:1 or 70:1 instead of the successful morning ratio of 110:1.

3. Take basal insulin at the same time every day, ideally between 11 and 12 at night.

So, her advice plus my observations and hopefully I'll start to learn the rules of this new game. And I was just starting to get the hang of bolus insulin injections. Oh well, gotta keep it exciting.

The Dailies:

11:53 -> 114 Wow, so after my crazy out of control high night, I woke up with a sweet number...sweeeet! Cereal 110c. Three mile run w/stair training and circuits w/Seth. 1/2 Larabar 13c.
4:41 -> 127 Good! At 5:16 I took Prandin, then at 5:30 I had Dinner: salad 18c + brussels sprouts 18c + yams 50c + shrimp 4c + orange 20c + chips with tahini 10c = 120c.
7:40 -> 114 A little more than two hours later and I'm at a sweet number again. Awesome!
10:33 -> 121 Rising a little, probably the previous day's Lantus has worn off. Took 2 Prandin at 10:35 with Dinner: rice 70c + salsa 21c + mung beans 41c + miso 2c + kale 5c + asparagus 14c + chips 30c = 183c. Ate at 10:49. Took 5 units Lantus at 12:20.
1:01 -> 218 Bad news is that I'm HIGH again. The good news is that compared to the same situation yesterday (2:20 after dinner last night I was at 380) I'm 160 points lower.

So what will I do differently tomorrow? For starters I'm not planning a crazy workout, just something light (yoga? finally?) so I'll probably aim for a lower ratio in the morning, or for that matter, maybe I'll try using lower ratios all day.

Day 55

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