BetterCell (see updated Links) posted a question on how my blood sugars reacted after my surgery... So seeing that it's actually been a while since I have focused my blog on my Diabetes, I think his question gives me a good reason to not only address his question, but also discuss some other things going on in my current Diabetes management.

Honestly, my Diabetes control wasn't all that great after my surgery... At first, I really didn't notice too much of a change in how my blood sugar is usually. But then, as time went on, I started seeing more and more elevated numbers :o(, to my dismay.

I guess it's sort of understandable- I was off my usual routine, spending most of the day lounging, and got no kind of exercise or activity of any type. I contemplated increasing my basal rates... but, ultimately, opted not to. Instead, I thought I would ride it out. I knew that my week off would end & I would get back in the groove... and, with any luck, my readings would respond accordingly. And I have found this to pretty much be the case- so that is good :)

However, saying that my blood sugar is back to normal isn't saying that my blood sugar is great. Because, honestly, it is NOT. Unfortunately, I am still having some of my old issues. And there's one main issue that I am beginning to think will never go away... that being, my nighttime readings.

Sometimes I wonder if I have some kind of insulin resistance going on in the evening hours. I don't know if that's even possible... All I know is that I eat dinner and my post dinner readings are almost always in the 200 range, no matter what I eat :(. Not only does this leave me frustrated and upset too many times to count, but it's hurting my control.

To give you an example, yesterday, I ate a slice of turkey meatloaf with salad and my post-dinner reading was 243~ wtf! Yes, the dressing had carbs, some of the veggies in the salad may have had a low amount of carbs, and even the meatloaf may have had some carbs (due to the tomato sauce and bread that was listed as ingredients). But, I took about 5 units of Novolog, which I would think would be enough. Evidently not. :(.

So despite my Endo's opinions of perfecting my basal rates before introducing another variable into the mix, I started Symlin (actually started two Sundays ago). I came to a point where I felt like I wasn't getting anywhere with basal test after basal test, that I felt like I had to make an executive decision and take charge of my own disease.

However, saying that, I can't really say that I have seen much of a difference. In fact, I've seen very little difference at all. The first days I took it, I had the same familiar readings after dinner. .. In other words, highs, which, yes, are a little disappointing. So then I thought that maybe I should up the dose a little.

Instead of taking the initial 2.5 units they recommend starting on, I opted to take 5 units instead. Well, the first time I did this, I did see a difference... I think I had a reading of 113 (perfect!) but this also has not been consistent, nor have I been consistent taking it (last nite I forgot!) But, still, it seems like some days it works and sometimes not.

Then tonight I again used it at dinner... I had the meal of turkey meatloaf and salad again, took my 5 units of Symlin, bolused 2 units to correct a pre-dinner high (of 200), and bolused 2.4 units to cover my meal. Two hours later, I was sitting at 154... which is really good for me. But like I said, to take that much insulin for a meal so low in carbs kind of surprises me and makes me think there is another issue going on.

I know 2.4 units doesn't sound like a lot of insulin to cover a meal, but don't forget that when you are on Symlin, you take half of what you would regularly take for the meal w/o it. So that would mean that my meal would typically require about 5 units of insulin,in addition to the 2 I gave to correct... It seems like an awfully large amount of insulin to take when I don't believe that my meal was chock full of carbs to begin with.

The only other thing that might explain things is whether or not my Symlin is even working. I actually opened the bottle a couple of months ago... but my Endo wanted me to hold off on it (in effort to work on my basals), so I closed it up and left it in the fridge. I think it's possible that it's lost some of it's potency and may not be working to it's full potential.

That would sort of make sense to me, b/c that would mean, for instance, tonight my meal wouldn't really require 5 units of insulin, but instead that the 2.4 units was sufficient. It would also explain why I haven't had excellent post meal readings. Plus, it would also explain why I haven't had any negative side effects, such as the hypoglycemic reactions, nausea, or vomiting that some have described.

The only thing it doesn't explain is the weight loss I have seen recently. But now that I am thinking further about it, I think there could be other reasons for that. In the last few months, I have been able to cut down on the insulin I take w/o Symlin, as I have been eating lower carb. Also, I haven't been grazing as much. And, I haven't been having to treat a lot of lows. All of which the weight loss could be attributed to.

Well, whatever it is, I'm not complaining :)... But it would be awesome to see a little bit more and, if Symlin can help in that respect, I'd like to further pursue it (full potency this time!). So I am thinking of trying this vial a few times more and seeing how my blood sugar reacts and if I see more bouncing blood sugar, I will go ahead and get a new vial.

That basically sums up the state of things right now regarding my Diabetes... I did have one other piece of news to share, but I think I will save that for now (as this one has gone on forever already). However, I will try to post about that next time and I will, also, keep you posted with how my adventures with Symlin goes... With any luck, I'll be able to report good things next go around!