LifeAfterDx--Diabetes Uncensored

A internet journal from one of the first T1 Diabetics to use continuous glucose monitoring. Copyright 2005, 2006, 2007, 2008, 2009, 2010, 2011, 2012, 2013, 2014, 2015, 2016

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Location: New Mexico, United States

Hi! I’m William “Lee” Dubois (called either Wil or Lee, depending what part of the internet you’re on). I’m a diabetes columnist and the author of four books about diabetes that have collectively won 16 national and international book awards. (Hey, if you can’t brag about yourself on your own blog, where can you??) I have the great good fortune to pen the edgy Dear Abby-style advice column every Saturday at Diabetes Mine; write the Diabetes Simplified column for dLife; and am one of the ShareCare diabetes experts. My work also appears in Diabetic Living and Diabetes Self-Management magazines. In addition to writing, I’ve spent the last half-dozen years running the diabetes education program for a rural non-profit clinic in the mountains of New Mexico. Don’t worry, I’ll get some rest after the cure. LifeAfterDx is my personal home base, where I get to say what and how I feel about diabetes and… you know… life, free from the red pens of editors (all of whom I adore, of course!).

Tuesday, October 16, 2007


Yeah, yeah, yeah. I know, I know. I’m really, really, really bad about moderating comments. I actually went on my very own blog to try to leave a counter-comment the other day but it’s been so long the site doesn’t remember my logins and neither do I. How embarrassing. That said, there were a few things so powerful or wonderful or in need of an answer that I decided the best way was to post directly.

By the way, just because I’m lazy about this doesn’t mean I don’t like getting comments. I love getting comments. I know from the hit counters I got lots of readers. Just not many commenters. Probably ‘cause I lazy about cultivating it. Comment away, I do like to know what you all are thinking.

Rich, who has asked twice: a cherry slice is a candy made by Sathers. They are like the more common orange slices (wedge-shaped gum drop type things covered with large white sugar crystals) but in cherry flavor. Sort of hard to come by. Believe it or not, I get mine at a hardware store! Portable, tasty, and brings my BGL up without an excursion. Also, I love your description of my blog as “high end reality internet!” So cool! Thanks. I’m going to get a T-shirt that says LifeAfterDx: it’s high end reality internet. And one other thing that Rich wrote has stayed with me. Eight words more powerful than poetry. “Diabetes will be like polio without a vaccine.” Wow. Chills down my spine.

Bernard who wants photos. I’ve had some real DSL troubles that makes loading images near impossible; plus it involves more time, which I’m chronically short of. On top of that, I’m not feeling much need too. I like to paint with words, and there are no shortage of images of this gear at MedT’s website. But I’ll try harder to include some. It’s not like I don’t know how to use a camera, after all.

Itesseract: thanks! I loved the image of me being “some famous doctor writing revolutionary books about diabetes treatment” rather than some poor slob with multiple jobs awash in overdue bills!

Actually, that said, I’ve been asked to author a couple of diabetes books. So that’s my project for winter. One will be on CGM, of course. The other is a guide for “Born Again Diabetics,” basically a refresher course of all the stuff you use to know, but have forgotten.

As to all the flak I created in musing about T-2’s on oral meds using glucometers; I’ve come around. I think more people benefit from them than not. Also, the cold fact is that if you live with diabetes long enough you WILL be taking insulin. Might as well get good habits from the get-go.

I updated already on the cat situation, so that should cover all of that feedback.

Sorry, Marina, I still disagree with you. Health care is a basic human right. Most people with chronic illnesses have done nothing to bring it upon themselves. It is unfair to make them carry a greater burden money-wise just because of their genes. In a fair and just society we collectively share the costs of civilization: that includes education for all, common defense from all perils (police, fire, disaster, and military), quality transportation networks, well ordered airspace for safe flight and, healthcare. I’m sorry you have no interest in your neighbor. Even if he “can’t be bothered to exercise and eat right.” Let’s assume that is true. You are only interested in your pocketbook, right? I’ll cost you less to get him free health care now; ‘cause you’ll end up paying for his dialysis later. Fact is, where I work, money is short. People will buy beer before they’ll spend a dime on their own health care. It would be nice if we could fix that, but changing culture takes decades. Let’s do the right thing for our neighbors. Let’s make them healthy and then create a culture of health. The fact that we can save money in the long run by spending now is just icing on the cake. I’m truly glad you can cover your own health costs while being self-employed. But wouldn’t you have rather spent that money on your family?

But to answer you question on a later post: I chose the CGM over the PUMP as a choice of LIFE over DEATH. I do no feel lows and I’m “brittle.” I did feel one low a while back, but 99.9% of them ambush me. Last week I had a 37 that was a real bitch to turn around. Deb’s writing a post about that rather scary night. When she gets it done I’ll post it (writing comes harder to my wife, so it may take a while). A pump is just a delivery device. You can get control with any delivery device. Granted, a pump makes life waaaaaaaay easier; but in my case the CGM was necessary for daily safety, the pump was not. Also, I can (in theory) get better control with the continuous CGM info and the shots than I can with a pump and random fingersicks.

I’m more like Scott so far: a happy ex-pumper. My control still isn’t as good, but I’m making progress; and my life is easier without something plugged into me. You do have to stay more on the ball with shots than a pump, but that may not be a bad thing. As to your musing on the long term fate of NPH, given what we know about the politics and profits of big pharma; you already know that answer. The clock is ticking on NPH.

Thanks for all the remember-the-damn-basal tips. I got it down now (knock on wood).

I dunno Allison, I’ll bet everything you do is beautiful. ;-) Injections too. Actually, no one but diabetics notice injections. I was freaked out when I went back to shots, but in fact, with many, many, many public injections under my belt…well above my belt actually… no one has even given me a second look. I was actually a little bummed. The fact is, most folks just don’t really pay that much attention to what’s happening around them.

Scott, I too shoot through clothes, sometimes. But I find that it dulls the needle too quickly and I really like to stretch them as far as possible. As far as fear of needles, most folks I’ve put on insulin marvel at the fact it ends up being no big deal. The most common comment: “The fingersicks hurt more!” That said, if big pharma had the sense to develop inhaled basal first, it would be a good seller. The current inhaled insulin is fast acting. We almost always start T-2’s with basal. By the time they need fast-acting shots are no big deal. I wouldn’t personally invest even 2 cents in inhaled rapid. (But it dose work just fine!)

Jenny: yeah, portion size at fast food can vary, but at least you’ve got a starting point with the carb data. But don’t worry about Taco Bell, I only eat that crap about twice per year. But when you live as part of a family…..

Eric (commenting on the LARGE square marking a fingerstick in MedT graphs, and pointing out that the oversized squares could be a way of showing the inherent 20% error range of a fingerstick)…hmmmm, I had not thought of that. But I still think they are trying to be sneaky.

Frayed Edges….sorry I made you cry. But you are not all alone. You’ve got lots of “brothers and sisters” out there. Way more than you can ever guess. We’re all here for you.

Chrissie in Belgium: of course we are related! We’re all the same tribe, us D-folk!

Jen. Antecubital. Thanks! How could I have forgotten that???

Re: forearm testing. Should be banned. It’s not safe. The forearm lags waaaaaaaaaaay to much, especially for hypos. I’ve only let two patients test on forearm. One was a potter and the other had such horrible neuropathy in his hands that fingesticks were literally torture. In both cases it was forearm or they wouldn’t test at all.

And now we return to our regularly scheduled program…


Blogger Christine said...

I have several pictures of my CGMS on my blog.

I'm kinda surprised to see someone like you use the term "brittle."

May I ask what you have your low target set at? My trainer wants mine set at 80, but I'm not sure I like it that high.

Have you found that you've regained any of your hypo awareness with the Guardian and treating lows higher? I'm already feeling like I am.

9:37 AM  
Blogger meanderings said...

You always give me so much to think about. Thanks!

4:14 PM  
Blogger RichW said...

Wil, it's great hearing back. Thank you for the info about the cherry slices. I'll have to look for them.

Post your picture in the T-shirt when you get it.

I love your blog.

10:59 AM  
Blogger Jen said...

I think the big squares to cover the 20% error of fingersticks is bogus. If that is the case, shouldn't the line of the graph be thicker to account for that margin of error?
I couldn't post on my blog over the weekend because I didn't have my laptop, and I couldn't remember my login information either. It happens. There are only so many usernames and passwords I can retain.

1:28 PM  
Anonymous Anonymous said...

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10:03 PM  

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