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Thursday 12 September 2013

Japan: 5 days in

It has been quite a hectic few days in Japanland. I have never been so happy to have CGM. This one so far is holding up extremely well and has been nearly always bang-on with its readings, to the point where I have felt comfortable giving my fingers a little break and testing only at wake-up and before bed unless my CGM says I'm close to hypo, & I'll test then to confirm.

D has NOT been behaving itself so I am running my sugars higher at between 10 - 14. If I take insulin with a meal I will be low at 1 hour post meal but if I don't take it I reach about 15. Tokyo is extremely hot and if you add a BGL of 15 to the humidity it makes for extreme tiredness that makes travel hard. So we have settled on a routine of no insulin for breakfast, 1 to 2 units for lunch depending on car content and about 2 u for dinner.

Basal wise I am pretty much on suspend from the moment I wake up until we are back at the hotel at night - suspended for about 12 hours a day. I have discovered that I also need to do a temp basal at night. I'm not sure of the rate yet as I am still waking up with hypos (which has never been an issue before) at about 3 - 4am and then again from 6 - 8am. I'm quite thankful for the CGM for this, as normally at night I silence it because of pressure problems, but surprisingly it hasn't had these this time - must have picked a good spot. I don't feel hypo at all when I wake so smiles all around for CGM just rescuing my butt 2 times a night.

Total insulin usage has dropped from 40u a day to about 15.

At home I tend to be a bit* fixated on getting good numbers, but right now I just want to enjoy my holiday without D getting in the way. If I have higher BGLs for 3 weeks then I have higher BGLs for 3 weeks.

To sum up with a positive note about D in Japan: I bought this ultra-deliciously cute case to use as a day kit when I get back to Aus:


Its inspirational as well. My fave is 'Take it easy, I can assure you everything will turn out fine'. Ahhhh happy bear.

Japan: Nikko Edomura Wishing




Monday 9 September 2013

Japan: Take 1

My 1st day in Japan has come and gone. It was adventurous and exciting and you can read what I did at my other blog, 'Tonyobyo in Tokyo'.

Being that this is my diabetes blog, I will be chronicling my diabetes in Japan. Which so far has been a bit of a challenge. All I can say is: Thank gosh for CGM and 10kg cabin baggage allowances (I will upload a photo later of the massive amounts of D stuff I managed to squish into 1 bag).

The plane trip, diabetes wise went ok. I ran myself higher, at about 10 - 13 to avoid the post-landing hypo that I always seem to get. I changed the time on my pump and was set to go diabetes wise for that day.

Today went not so awesome. I did a set change - 1st set change in the Northern Hemisphere for me! That was fine. I inserted my CGM, for which I had bought a new box of sensors just for our Japan trip. The CGM had kicked in and asked for a calibration at about 10.30am. I calibrated with a BG of 7.1. About 1/2 an hour later I was getting alarms from my CGM and caught my hypo at 3.7. Yay for CGM! My CGM was accurate the whole day which was great - I think I stopped about 4 or 5 more potential hypos that would have added to the 3 I did have.

Definitely recommend CGM for ttravel for that peace of mind and abilitgy to manage before the event in terms of hypos/highs.

The rest of the day I spent battling becoming or actually being low in the extreme humidity of Tokyo. My estimation at the end of the day was that I had had my pump disonnected or on suspend for about 8 hours all up during the day. I even tried a temp basal of 30%, which didn't work.

At dinnertime, despite having been on suspend for 3 hours (aka NO insulin delivery for 3 hours) my BG fell to 4.1 again so we had a rushed dinner at something that resembled a Mo's burger, but was called 'Buckers' or something equally as weird. I gave myself only 1/2 the recommended insulin at dinner and ended up on 4.5 2 hours later.

The highest I reached all day was 10.9, with the lowest 3.3 thanks to my CGM.

Excuse my Red undies in the background


Tomorrow is a new day. I'll try a 10% temp basal (which will equate to less than 0.05U/P/H) tomorrow and see how it goes.




Sunday 8 September 2013

The Pre-Japan Travel List

PUMP
1 ½ boxes of infusion sets
1 ½ boxes of reservoirs
30 Alcohol swabs
3 spare batteries

CGMS
transmitter
charger
5 x sensors
10 alcohol swabs
Clear over-tape

INSULIN
scripts for NovoRapid & Lantus
6 vials of insulin (NovoRapid)
NovoPen Echo & instructions
1 x box of pen needle tips

BLOOD GLUCOSE MONITORING
8 x boxes of testing strips
2 x IQ meters (+ recharge cable), 1 x standard Verio meter
1 x double-pack spare batteries for non-rechargeable meter
Lancing device x 2 + spare lancets

MISC
Doctors note
Hypo stash (Jellybeans, glucotabs)
Sharps clippers or container
Alan (aka Calorie King)
Ketone strips & Ketone meter with spare batteries
Tape
Id Card with emergency contact
Cold pack
Glucagen
Medical ID bracelet