Tuesday, May 28, 2013

Scar Tissue and Insulin Absorption


When I was diagnosed in 1945, 67 years ago, I do not think my doctor knew that I should rotate sites when injecting insulin. My parents were so good about listening to my doctor, and we followed his advice without fail. We injected into the muscle on my upper legs for many years, and there were always very high blood sugar reports from the doctor's lab every six months. I think that was because we were not using different body parts and rotating sites. Scar tissue had probably formed on my very small legs, even though the animal insulin I was using required only one injection per day. By the time I was in my twenties I was using my upper abdomen, and my blood sugar reports improved. There was no meter for measuring my blood sugar at home until the mid 1980's, so the biannual reports from the doctor's lab was the only thing I had to determine how I was doing. A1c's were not available until 1980.

In the 1990s I had a meter and much better insulin. Several injections were required each day, and I was still using my upper abdomen. Eventually it became very difficult to push the needle into my skin. I actually had some needles bend, and had to get a different disposable syringe, reload and try a different spot. I had not been told that this might be scar tissue, no doctor had ever mentioned that. No doctor had suggested alternating sites. Maybe my doctors in the 1990s assumed I knew about this since I had been type 1 for 50 years at that time. In the new century I was using basal and bolus insulins, and doing as many as 8 injections every day. The toughness of my skin in my upper abdomen made it necessary for me to start using my lower abdomen and upper legs. It was common sense on my part that caused me to make that change. My blood sugar tests improved significantly, but I still did not know it was because I had moved away from the toughness in my upper abdomen.

In 2007 I started using a pump, and things were going very well until I tried my upper abdomen. I got a 'No Delivery' alarm on my pump and did not know what that meant, so I called the Medtronics help line. After a long discussion it was decided I had scar tissue. That was the first time I had heard those words. A very young sounding lady at Medtronics made that diagnosis, but my very experienced doctors had never mentioned it. This made me very angry, and it has taken me a long time to stop feeling bitter about it. At least one doctor should have told me about site rotation. I have permanent scar tissue in my upper abdomen and can never use it again. The skin will always be tough, and the insulin absorption almost nonexistent. I tried using my upper ab earlier this year, and saw very high blood sugar in the next few hours. I am presently using my lower ab and upper legs, rotating infusion set locations. If I don't change sets after three days I start seeing high blood sugar. That is because scar tissue is beginning to form there. I keep the sites about one and a half inches apart, and change every three days. I have now had A1c's in the 5.5-6.4 range for almost ten years. Finding someone who told me about scar tissue has greatly improved my control. I will never know why I managed to avoid diabetes complications for the many years that I was not rotating sites, and having so much high blood sugar. I have some mild nerve damage, but my overall diabetes health is very good. That almost seems like a miracle to me.

I have frequently advised pumpers to rotate sites, and not use a site longer than three days. Most of my friends who pump are doing that, but I have met online pumpers who say they are using an infusion set for more than three days. One pumper says he uses sets for as much as a week, without having problems. I did not think that was possible. To keep scar tissue problems from occurring, and poor absorption giving very high sugar results, I strongly advise all pumpers to rotate sites, and avoid using a site more than three days.

I feel so lucky to have avoided serious complications after experiencing scar tissue and high blood sugar for so many years. I wish I could meet the young lady at Medtronics, and give her a big hug! lol

Friday, May 17, 2013

Joslin Medalist Meeting, May 11, 2013

The 2013 Joslin Medalist meeting was held on May 11. There were more than 150 medalists present at the meeting. Every medalist has been type 1 for 50 years, or more. I was not able to attend because my wife was ill. She is well now. The link below connects to a video on Youtube. Medalists speaking at the meeting are shown. One medalist received the first ever 80 year medal. See him at the beginning of the video. 

https://www.youtube.com/watch?v=xHa8SFkICzo

Sunday, May 12, 2013

A Mother's Day Poem

Mother's Day Poem to all you Wonderful D-MOMS!

A poem in memory of the author, Gary Hempleman, for all children with diabetes.

She walks down the hallway in silence so deep,
Keep watch over him, as her little one sleeps.
With meter in hand, she opens his door,
Making sure not to wake him as she crosses the floor,
She sits on his bedside and brushes his hair,
As he dreams of shooting baskets, without a "D" care.
She holds his hand softly; his fingers so small,
As she watches and wonders why "D" came to call.
While she watches him sleeping, so peaceful and warm,
The forces inside him fight a constant "D" storm.
Will he ever be free of shots and blood testing?
She sits and she wonders as she watches him resting.
The beep of the meter breaks the silence of the night;
A small drop of blood tells if everything's right.
The seconds count down to the final display,
I hate this damn meter; i want to throw it away.
The number is fine, one down, a lifetime to go,
As he turns in his sleep, will he ever know?
Why does this "D" happen to someone so small?
My son is my hero, but my baby most of all.
She turns at his doorway, looking back one more time,
It's a nightly routine of the very worst kind.
She walks down the hallway and time passes by,
As she sits in dark silence and quietly cries.
I have to stay strong, and for him i will fight,
We'll battle this "D" with all of our might.
I'll teach him to master and conquer this foe,
This "D" will not stop him, i promised him so.

Tuesday, May 7, 2013

In Praise of Moms of Type 1 Kids

My Facebook friend, Linda Palmer, wrote the following blog today. I think that all the moms of diabetic children should have the opportunity to read it.

"As Mother’s Day quickly approaches, I thought today would be an excellent opportunity to talk about the lifelong influence a mother has on her children. I read stories every day on facebook from the Diabetic Online Community (DOC) about the sacrifice moms make for their Type 1 Diabetic kids. These are terrific moms who would walk on hot coals if they thought it would help. Each and every one of them would take on their child’s suffering if they could. They would trade places with them in a heart beat! That’s a mother’s love – and there is no substitute for it!

Today is NATIONAL TEACHER’S DAY but I want to recognize the mothers of Type 1 Diabetic children. They are so diligent, and in the process they are sleep deprived and frustrated with the disease, but they have their kid’s backs! They will be there if the world walks away. All moms are great, but the mom of a Type 1 Diabetic is a Super Hero!

God gave you these wonderful children
To love on with all of your heart.
They'll grow to be fine men and women
Because you cared for them at the start."

Here is Linda Palmer's Facebook page:
https://www.facebook.com/groups/513736392026588/