The cool thing was I got a new insulin pen (a Lilly Luxura HD) and it uses cartridges instead of single-use mechanisms. It can also do half-units of insulin, so I can more closely control my injections and use that half-dose when my carb count doesn’t work out exactly right.

We changed this because my correction doses were sending me on tremendous lows, and my sliding scale is more like 1 unit per 80 mg /dL over 120 instead of 40. I’m seriously sensitive to insulin, it seems.

Doc also prescribed me in 3 month increments so my co-pays will drop by half. That was nice of her. Maybe I’ll have her do the same when my Lantus supply is out.

I asked my Endocrinologist about the glucose tolerance test, and she said they rarely perform them anymore. A) they are time intensive, and healthcare has very little of that available, B) fasting glucose tests of greater than 140 mg/dL sieve for diabetes in general, and C) Glycosyated hemoglobin tests (the A1C tests) are also a reliable indicator of a long term glucose problem.

The tolerance test is being phased out like most natural insulins, urine ketone strips, and other non-electronic methods of testing.

After taking the original 6 units with meal I was at 231, so i took 3 more units and waited another two hours. 341. So I had to adjust with 5 more units, and I’m starting to feel ‘normalish’ instead of ‘head asplode from high glucose’.

I end up ‘hypo’ in the 89-100 range at times, and I always have something handy to eat to bring that back up, but most of my measurements of plasma glucose are around 90-110, with the occasional post-meal 120 or so. I’m keeping it in a pretty narrow target, and I’m beginning to wonder if I’ll need something like a CGMS or Insulin pump to maintain comfortably the fluctuations throughout the day.

I’m eating less carbohydrates, and luckily there’s a lot of great natural low-carb food out there. I use meat substitutes for protein and fat content, and I generally have some fresh vegetables on-hand at home for quick steaming. In order to avoid periphery nervous and vascular complications, I’m trying to reduce my use of things like cheeses and other polysaturated fats.

I’m taking a trip this weekend that I know will interrupt my schedule greatly, but I’m going to try and stick with my plan and eat roughly the same stuff where I can. I have all of my gear ready to go and will be able to maintain clinical discipline during the trip.