Another major life change

[carbonel]

My blood sugar and A1C had been in the prediabetic range for several years, but this June there was a spectacular increase. This happened just before I spent the weekend at Scintillation (a small SF convention in Montreal), so it was much on my mind at that time, but I wasn't ready to talk about it until things were better.

And then things did get better, but pddb recently pointed out that I'd totally forgotten to mention it here.

So yeah, I'm now a type 2 diabetic. Thankfully, my blood sugar (which I test daily) is being managed well with some changes in diet and a maximum dose of Metformin. Initially, it was high enough that my diabetes educator had thought I'd need to go on insulin, but for now it's mostly running between 90 and 125. That may not last forever, but with daily testing I'll have plenty of notice. (I did ask about Ozempic, and the educator pointed out that on Medicare it would run me about $1,000 per month out of pocket. So I'm passing on that for now.)

I'm trying to eat more vegetables -- mostly I've become good at making stir-fry with lots of veggies and a few ounces of meat -- and I've replaced sweets and ice cream with fruit. I'm a big fan of watermelon and will be sad when that's no longer in season. And I'm trying to limit carbohydrates in meals to 50 grams or under -- which is still a lot more than during the several years when I was doing much more stringent low-carbing.

I've lost around fifteen pounds (which doesn't show, best I can tell), which I mostly attribute to the fact that one of the side-effects of Metformin is decreased appetite.

Other than that, life goes on pretty much as usual. I'm still spinning a lot, and five of the six items I entered in the Minnesota State Fair won ribbons. Just one blue ribbon, but that one came with a $25 gift certificate to StevenBe, which is a nice bonus. And in January, I'll be taking my longest cruise yet, with friends, to Hawaii. Most of that will be travel time, but I'm looking forward to the entire thing.

Comments

[pameladean]

I'm actually pameladean, but pddb isn't taken and I'm wondering if I should snatch it up. Then again, I hardly use one Dreamwidth account effectively, so why would I want two?

I'm glad the metformin and your dietary alterations are working. When I hit the maximum metformin dose I was worried about insulin's being the next step, but in fact I ended up on Tradjenta as well as the metformin, and apparently there are a lot of other meds that address different aspects of the entire complex and wacky feedback system. I'm really hoping to avoid insulin. I don't feel capable of keeping track of things at that level of detail.

P.

P.

[ckd]

Does your insurance cover continuous glucose monitors with your diagnosis? Mine does, and I've found the feedback very helpful in managing my blood sugar. (This plus metformin got my A1c down from 6.4 in February to 5.3 in August.)

I joke that it's a new phone game where I try to keep the graph in the green area, with really weird controls....

[carbonel]

I believe Medicare -- even the good Medicare supplement plan that I have -- doesn't cover continuous glucose monitors unless one is also using insulin.

How does the feedback help in managing your blood sugar? What do you change in response?

[carbonel]

Apologies for going with my incorrect memory on your handle.

I'm also hoping to avoid insulin, though if I have to at some future point, I will go for all the automatic stuff that I can.

[pameladean]

Well, if I posted more often, you wouldn't have had such a dim memory to go on!

The automatic stuff is certainly a comfort when I fret about the future.

P.

[ckd]

It makes it really easy to see which foods spike it, which ones ramp it up slowly, and which ones don't affect it much at all. I've also found that exercise (a brink 10-15 minute walk, or more) can often flatten a spike or reverse a high reading, giving me room to treat myself a bit more and then keep an eye on the numbers as long as I have the time to go for a walk after a meal.

I also adjust what I have for meals based on the CGM reading, or walk a bit before lunch if breakfast seems to have kept my numbers high longer than expected. If it's been high for a bunch of the day (like the day where I took a sushi roll making class and therefore had a lot more carbs at lunch than I should have) I'll walk it off and have a very low carb dinner.

(It's also helped me be less of an unthinking snacker, which is a separate but very useful effect in and of itself.)

[graydon]

Hurrah for the positive aspects?

Glad you've got a decent prognosis.

[lcohen]

congratulations on all the ribbons and may managing your diabetes continue to work well!

[gwyn]

I just went to our state fair yesterday, and saw people spinning and working with fibers. So congrats! I know how nice it is to get those 🎀!

[lydamorehouse]

Good luck with the new dietary restrictions. By chance, I am also trying a new diet to help with GERDs and high cholesterol. We can be food struggle buddies.

[carbonel]

And good luck with yours!

I have issues with reflux, but I'm not sure they rise to the level of GERD. I miss the days when Zantac (ranitidine) was available; these days I mostly make do with Pepcid analogs.

[carbonel]

Thanks for this. I'll be meeting with my diabetic educator in October, and I'll bring up the possibility with her. (I'm pretty sure the answer will be that I can have it if I want to pay out of pocket for it.)

[carbonel]

Just as a follow-up on this -- I discussed CGMs with my diabetes educator and, as I expected, it turns out that my insurance won't cover it at all. She did give me a sample Dexcom 7 sensor that's good for ten days that I'm seven days into, and it's been interesting, but not as informative as I'd hoped about spikes. That's because most of the spikes I've seen haven't had any apparent cause that I could figure out.

I'm contemplating getting a set of the OTC Stelo sensors (made by Dexcom, but not called CGMs because they're not FDA-approved) for the cruise I'm going on next month because that will give me feedback for any indulgences. Those run $100/month, which is annoying but mostly affordable.