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Riva Greenberg

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Saved by My Insulin Cap

Posted: 07/19/2012 1:06 pm

I have what's recently grown into a nasty habit. First thing in the morning, as soon as I wake up -- usually around 6:30 a.m. or 7 a.m. -- I walk into my kitchen. No, that's not the nasty part.

I stand glazed over my glucose meter for my first reading of the day. Then I almost always take one unit of my rapid acting insulin to keep my blood sugar from rising like Mt. Vesuvius before I get to eat my breakfast.

Then I take my thyroid pill and pull my long-acting insulin pen out of the cup where I keep it, so I'll see it and take it at 9 a.m. each morning.

Sorry, that's not the nasty habit either -- those are the good habits. But recently, I've been so focused on getting to my computer as soon as those morning bits are over -- since I'm finishing writing my third diabetes book and have a timeline of it being published by late summer -- that everything else goes to hell for the next few hours. The worst being I am forgetting to take my 9 a.m. long-acting insulin injection.

True, I no longer watch the morning news, because even though it's on, I'm at my computer not paying attention. In fact, it was a shock when I learned way after the fact that Tom Cruise and Katie Holmes broke up! I do make my breakfast and manage to eat it, although sometimes a few hours later I'm not sure that I did.

But the really nasty bit, as I alluded to before, is more than once I have forgotten to take my 24-hour, long-acting, once-a-day insulin shot at 9 a.m. Me, who is fully committed to having my best health. Me, who is Virgo-born and inherently disciplined. Me, whose middle name is "organization" -- well, my parents didn't give me a middle name. Me, who eschews the 30,000-foot view because I love the details. Yes, the same me who has thrived on forsaking spontaneity for order.

When twice I forgot to take my long-acting insulin shot earlier this summer, I was fortunate enough to catch my mistake by 10:30 a.m. I immediately reasoned with myself that no real harm was done. After all, when I travel internationally I spend the first three days guessing when to take my long-acting insulin.

Yet, yesterday I didn't catch my error until 5 p.m.! The first clue that I'd missed my shot I ignored: My blood sugar reading before lunch was higher than usual, even after my daily sweat-soaked one-hour walk after my same everyday breakfast. Then my blood sugar reading two hours after my usual salad and grilled chicken lunch (beginning to see the regimentation?!) was atypically high.

As that seemed worth following, I checked my blood sugar again at 5 p.m., and it was still high. Now at least I had the smarts to register a perplexed and suspicious look on my face, a scrunch I know I wore while I picked the long-acting insulin pen out of its cup and looked at its cap.

I happen to have a cap with a digital timer that shows how many hours it's been since I took my last shot. It stared back at me with a "32:08." I was stunned. I had never seen a number like that before.

Had I really entirely forgotten to take my shot this morning? I looked long and hard at the numbers, and that was a very long half minute I stared at the numbers. I wanted to make sure I couldn't have misread it as 32 minutes, which of course made no sense because that would have meant I'd taken my 9 a.m. shot a half hour ago. Had I done that certainly I would have remembered this entire incident.

No, that "32:08" when I counted back from 5 p.m. meant the last time I had taken that cap off the pen to take my shot had been 32 hours ago -- 9 a.m. yesterday morning.

Incredulous, but resourceful, I told myself this was no worse (provided it doesn't happen again) than having just flown to Japan and having no idea how to dose for the day. Then I took my shot: two-thirds of my usual dose, figuring I only had two-thirds of a day left to cover, and returned to my manuscript.

This is all to say, 1) sometimes bad things happen to good people 2) don't beat yourself up, just remedy the situation and try to do a little better next time 3) technology is producing some great new diabetes devices 4) yes I'm writing a new book called Diabetes Dos & How-Tos, which you should look for early fall. It's everything you need to do to live healthfully with diabetes -- and recommendations how to do them, and 5) if you want a cap on your insulin pen that will tell you when you've messed up, go to Timesulin.com. (Currently pens are available in Europe and on the web site in Euro. If you have a friend in Europe, or a Swiss bank account, lucky you. Otherwise stay tuned for the projected U.S. launch next year.)

Note: While I was given a Timesulin insulin cap at the IDF World Congress in Dubai, in full disclosure I have no commercial ties with Timesulin, nor have I been asked to write this, or any other article, for them.

Riva speaks to patients and health care providers about flourishing with diabetes and is the author of "50 Diabetes Myths That Can Ruin Your Life and the 50 Diabetes Truths That Can Save It" and "The ABC's Of Loving Yourself With Diabetes." She is finishing her third book, "Diabetes Dos & How-Tos," due out this fall. Visit her website DiabetesStories.com.

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