This past week, my blood sugar control has been crappy, crappy, crappy. (See Wednesday's post for a mood check). At first, I chalked it up to a typical short-lived SUS episode. But now I'm getting kind of pissy about it, because this seems to be a more permanent issue: could my insulin-to-carb ratio needs be changing yet again?!
Why doesn't this $%#^@ disease ever go on autopilot, just for a month or two?
OK, I have to remind myself that everything else in my life is going extremely well -- kids, marriage, camping on the coast last weekend, 11.4 Jewish holidays in the month of September, book club, upcoming trip to Disneyland, writing, writing, and more writing. Crazy-busy. All good. So I guess it's like they used to say in Tales of the City: "You can have a hot lover, a hot job, and a hot apartment, but you can't have all three at the same time." As in: "You can have a hot personal life, a hot job, and smokin' hot blood glucose control, but you can't have all three at the same." *Sigh*
So my endo and I are now talking FAST LANE. Meaning we both want me to try Apidra, the new super-fast-acting insulin analog from Sanofi-Aventis. We've heard good things about its effects on post-meal glucose levels -- our great adversary in this lifelong fight for steady BG control.
I'm excited to try it, and even note that the company is offering $20 coupons off your copay for your first 5 Apidra prescriptions. But my endo has quite a drill in mind for me. She wants me to:
1) Wear my DexCom Seven continuous glucose monitor again for two weeks straight.
2) Get a Glycomark test at the outset of Week 1 to check my current postprandial levels.
3) Then carefully log everything I eat that week.
4) At the start of Week 2, I should load my pump with the Apidra.
5) Then I attempt to match the diet I ate the week before...
6) ... and get a second Glycomark test at the end of Week 2 to assess whether my postprandials have really dropped, i.e. has the Apidra significantly knocked down my post-meal glucose levels?
7) Finally, the DexCom results will also show the difference.
Whew... I'm going to need to get out of the 3x AYSO soccer/ holiday-bonanza/ traveling/ multiple-presentation/ mile-a-minute FAST LANE in order to schedule a two-week period to "do my diabetes," if you will. I'm planning on hitting it right after that Disneyland trip I mentioned above. Come on, who eats well there?
Meanwhile, there are even more new super-rapid-acting insulin products on the way. One is called ViaJect from Biodel Inc., a privately-held biopharma firm out of Danbury, CT. They've announced promising results from human trials, and claim that their product is potentially safer than today's insulin analogs because it "more closely mimics the natural spike of first-phase insulin release in non-diabetics, possibly reducing the risk of hyperglycemia." And it may cause less weight gain as well.
As the OC's resident market critic Scott Strumello notes, it's nice to know the Big Boys of the insulin arena will have some off-label competition. As long as the stuff is easy to get hold of. It's tough making too many pit stops at the pharmacy and various doctors' offices when you're living in the FAST LANE, you know.