Monday, January 3, 2011

New Year, (Hopefully) New Me...

As we all know, 2010 came to a close a couple of days ago and 2011 is now here in full swing!  New Year's is usually just a blip on the radar for me, an homage to the whole "this year, I'll finally lose weight/exercise more/drink more water" thing we all do, but this year it has quite a bit of significance for me: 2011 is the first year I've started with diabetes.  I was diagnosed on August 23, 2010 (my seven month wedding "anniversary", no less), so I've dealt with the disease for just over four months now. 

The past four months have been a series of ups and downs, both emotionally and literally, as I've come to learn what it means to live with diabetes.  Many of you followed my journey through the American Diabetes Association's "Blog 30 Days of Diabetes in November - and Beyond!" and are familiar with some of the challenges and breakthroughs I've had over the past few months.  I've learned A LOT about the disease, dealt with its inevitable highs (and lows), and been through the emotional roller coaster of being diagnosed with a chronic illness.  Through it all, I can honestly say I've come to know myself better and am on the road to being the healthiest I've ever been thanks to the urgency and importance of healthy living to managing this disease.

For the first couple of months, I was able to use diet and exercise as my only means of diabetes management.  However, at the beginning of November, I started having some unexplained highs.  I would eat two carbs, and my blood glucose would go up over 100 mg/dl, and I was seeing numbers higher than I'd experienced thus far (in the upper 300's).  I called my endocrinologist, and he wrote me a prescription for Janumet, a combination of Januvia (sitagliptin) and metformin.  My BG quickly improved after that, and I was back within my target range most of the time.

That level of control only lasted about a month, though, because in the past few weeks I've been dealing with abnormally high postprandials (after meal BG) and higher-than-normal fasting readings again.  I forgot to mention that I was initially diagnosed as Type 2, but all of the professionals in the field that I've talked to (dietitians, CDEs, insulin pump representatives & nurses) have all been skeptical of that piece of information.  You see, I'm 22 years old, of normal weight, and relatively healthy otherwise...Not your typical Type 2 patient.  The first time I saw my CDE, she thought my mom (who was with me for the appointment) was the patient, and when we told her I was the one there to be seen, she had me pegged as Type 1 and was in disbelief when I told her otherwise.

I don't doubt my endocrinologist's expertise, and all of my labs have been consistent with a Type 2 diagnosis; however, as one book pointed out, sometimes you have to treat the patient and not the labs.  I've come to the conclusion that we may not know for sure which type I am (though I'm leaning towards Type 1 or LADA) until things go down(or up?)hill...i.e., I'm in the "honeymoon" phase at this point, and just caught it early on.  I'm going back to the endo for a three month checkup on Wednesday the 5th, and I'm anxious to see where I'm at A1C and lab-wise.  I'm also going to push for starting on insulin because I think it would give me tighter control over my BG and will put me on the right track to preparing for pregnancy.  My insurance switches to a new year on March 1st, so I'm wanting to get on the road towards getting an insulin pump as well.

I've been going over the materials I was given over the Medtronic and Animas pumps, so I'm in the midst of contemplating which one would be better suited to my needs.  I like the CGM (Continuous Glucose Monitor) feature on the Medtronic, but from what I've heard, don't know if the sensors that go with it would be reasonable cost-wise since I'm not certain my insurance would pay for them.  My sister has the Animas Ping and really likes it, and the feature I like the most is that it can be remotely controlled instead of having to bolus at the pump itself...which I can see being helpful when you don't want to expose yourself when you're in public--i.e., the majority of the time.

THEREFORE, I have a lot of things going on right now, and not only diabetes-related.  My husband just started a new job and is in the process of finding a work truck, and we're both trying to decide if we're ready to start a family anytime soon.  Right now, the verdict is that I'm going to do what I have to in order to get healthy and prepared for pregnancy, and we'll go from there! 

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