Two Different Lists Lead to the Same Conclusion

I like lists. I like them so much because I like to pretend to be an organized person who always has tasks to complete (the former is definitely false, while the latter is pretty much absolutely true). I also like lists because making one feels like an accomplishment in itself, and who doesn’t like feeling accomplished?

Freedom is the atmosphere in which humanity thrives. Breathe it in.
What can I say, I’m a list girl. (But not a hand model; that’s definitely not my perfectly manicured hand in the above photo.)

So I must admit that I felt pretty damn good about myself after making these two diabetes-related lists, because not only do they pull weight as blog post material, but they also help me understand something about me and my diabetes. So here they are:

List of things I should do on a daily basis for my diabetes:

  • Check my blood sugar using my meter 6-8 times per day (upon waking up, before I go to sleep, before I eat a meal, and in-between meals to make sure I’m on track)
  • Change my lancet (LOL)
  • Look up carb counts for every meal using apps and/or nutritional facts
  • Monitor my Dexcom carefully and do fingerstick checks when I disagree with it
  • Take a correction bolus for every blood sugar that’s over 150 mg/dL
  • Eat plenty of fruits and veggies AND drink plenty of water

List of things that I actually do on a daily basis for my diabetes:

  • Check my blood sugar whenever the heck I feel like it; after all, my Dexcom is usually accurate
  • Change my lancet only when I remember, which is like…once or twice a month
  • Eyeball my plates of food and make “educated guesses” on carb counts
  • Monitor my Dexcom OBSESSIVELY – sometimes even every 5 minutes, depending on the situation – and freak out when it doesn’t match my fingerstick checks
  • Take a correction bolus for blood sugars that are 200+ only
  • Eat what I’d like (which, in addition to fruits and veggies, is a wide variety of things) and drink probably not quite enough fluids

When I compare these two lists, I come to the same conclusion: I am lazily in control of my diabetes. I know exactly what my current routines are and just because they aren’t the “right” ones, it doesn’t necessarily mean I’m doing anything “wrong” in terms of my diabetes care and management. Sure, I’m not doing anything the textbook way, and I admit that I’ve gotten a little lazy with things like carb counting and correction bolusing, but so what? The important thing here is that I can recognize the areas where I need and want to improve.

For starters, I’d like to stop depending so much on my Dexcom. I want to learn to check it less – maybe take it out half as often as I do now – so I can strengthen my ability to recognize low and high symptoms. I’m also hoping to use measuring cups and nutritional information more often to make better informed decisions when it comes to how much insulin I give myself at mealtimes. It’ll add a few extra steps to my day, but these are habits that I followed for a long time and that are worth reintroducing to my routine.

As far as everything else goes, I’m not going to sweat them too much…of course, it will be nice if I remember to change my lancet more frequently and be more proactive about correcting high blood sugars, but really, these are matters of minor concern. I think I make my best diabetes progress when I take things one step at a time, so that’s just what I’m going to do.

The Holy Grail of Glucose Tabs

I feel a desire to share with the world that I’ve found it.

Erm…what is “it” though?

Why, glucose tablets, of course. Not just any old glucose tabs. I’m talking about glucose tabs that are actually delicious. The kind that are obviously effective and can quickly raise low blood sugar, but that are also so tasty that I sort of want to eat them by the handful out of the jar.

I’ve got your curiosity piqued now, don’t I?

Well, then, I’ll let you in on the secret “holy grail” glucose tabs that I’ve been enjoying…

The holy grail of glucose tabs.png
I never thought I’d do a mini photo shoot for glucose gummies, but then again, I never thought I’d do a lot of the weird things I’ve done in my life so far.

Spoiler alert: They’re not technically tabs; in fact, they’re gummies.

I’ve written about glucose gummies in the past and it’s safe to say I was fairly underwhelmed by them. They had flavor and texture issues, and ultimately, they were pretty disappointing. I’d counted on them to change the glucose game, but this rendition of Walgreens-brand glucose gummies totally failed to do that.

So a few months ago, when I noticed that Walgreens had given their glucose gummies a makeover, I figured I’d give them one last chance to impress me.

And SWEET SUCCESS, THEY DID IT!

There are some similarities between the old and new gummies; namely, three gummies has 10 carbs…just under the amount of carbs that are usually in three standard glucose tabs. The old and new gummies are both also covered in sugar crystals (I’m not sure if that’s intended to make them look appetizing?). Otherwise, they couldn’t be more different from one another in terms of color, shape (old gummies were ring-shaped, new gummies are kind of gumdrop-shaped), and obviously, palatability.

What’s different about the gummies this time is that they improved on every major complaint I had about the previous version. The best, biggest improvement had to do with texture. Previously, the gummies were stale and difficult to chew quickly. These new gummies are very soft and don’t leave you with that sticky teeth feeling that’s typical of most gummy candies.

The flavors are also much better. Before, the gummy flavors were super artificial tasting. The grape, orange, and apple flavors were almost medicinal and hardly tasted like their genuine counterparts. Now, the gummies still come in three different flavors, but they’re all of the same variety: blueberry, raspberry, and strawberry. The mixed berry combination just works here. There’s no odd after taste and, when eaten together, a three or four gummies at once just tastes like a small handful of conventional gummy candy. Not my personal favorite kind of confection, but it definitely is much more appealing than regular old glucose tablets.

Maybe I’m overselling Walgreens’ glucose gummies version 2.0, but really, after 22 years of diabetes, there are just some things that are worth getting excited about…even if they seem insignificant in the grand scheme of things.

The Expired Test Strip Experiment

Nearly every diabetes supply I own comes with an expiration date. Insulin vials, pods, ketones testing strips, and Dexcom sensor/transmitters are among the items that I’m always closely monitoring to ensure they’re still fresh and usable, but test strips? They’re basically the last thing that I worry about.

So I was curious when I recently noticed that my current test strip vial has an expiration date of 12/31/19. Would these strips still measure my blood sugar accurately, or was the New Year’s Eve expiration hard and fast?

I wanted to find out.

The Expired Test Strip Experiment
An introductory blog post to a potentially ongoing experiment.

My experiment design was rudimentary: I’d simply continue to use the 12/31/19 test strips until the vial was empty. I’d check any blood sugar results that I was unsure about against my Dexcom readings, and in cases that I deemed necessary, I’d use test strips with a far-off expiration (July 2020) to see how they matched up with the expired strips.

To my slight surprise, though it’s only been about a week since the old strips expired, it doesn’t seem to affect things much at all. They’re just as accurate as newer strips and my Dexcom.

In fact, in many cases, the old strips were only off (according to my measurements) by no more than 9 points. Not bad. I’ve had a wider spread in results between strips from the exact same vial, so the fact that the old strips were so close to new ones was interesting to me. And four days after the strips expired, I checked my blood sugar (I was 263) and used a new strip to double check that (it read 262). A single point difference is pretty impressive.

So now I know that I’m safe if I use test strips a week after they’ve expired…which is great! But now I’m sort of curious to see just how far out from the expiration date I can use them. I might hang onto this vial of test strips for a few more weeks and continue to test them against newer test strips. I might not (because really, when it comes to diabetes, there are just more important things to be worried about…and I might not want to push my luck and end up wasting strips). We’ll see what I end up doing.

I think that the more compelling questions to stem from this experiment are 1) how many other diabetes supplies are safe (up to a certain limit) to use after expiring and 2) why are supplies labeled with expiration dates if, in the grand scheme of things, they seem to function just fine after expiring? Could it just be a nasty trick played on people with diabetes by prescription drug companies…?

Those are the kinds of questions that really make me wonder.

The Emotions of a Low Blood Sugar

This post was originally published on Hugging the Cactus on October 8, 2018. I decided to re-up it today because I think we could all use a little reminder that diabetes is different for everyone. Remember…your diabetes may (almost always will) vary.

Previously, I’ve written about what it feels like to have low blood sugar. While many people with T1D feel the same symptoms as me when they experience a low, there are even more who experience a wider variety of emotions and sensations.

Renza, a T1D Twitter friend of mine, did a little investigating into how others would describe what it’s like to have a low blood sugar. She sent a tweet that read:

friends. I’m crowdsourcing (again). If you had to use ONE WORD to describe how hypos/lows feel to you, what would it be. Go!! #Hypoglycaemia

She received nearly 100 responses, which I’ve compiled into the below graphic.

Capture

Looking at this word collage is a bit startling because it represents the vast array of feelings associated with low blood sugar. Most of them are negative. A handful of them start with the prefix “dis”, which describes something with an opposing force. A couple of them relate to feelings associated with eating. And just about all of them can be summed up as sensations that I wouldn’t wish on anyone.

To me, this graphic serves as a stark reminder that diabetes is more than just a chronic illness that affects the body: It affects the mind, too.

Dealing with Diabetes When You’re the Maid of Honor

No, no, no. Not today diabetes. Dammit.

The morning of my cousin’s wedding, I woke up to a blood sugar of 237 after a night of fighting elevated levels. There was no rhyme or reason for the high blood sugar – I hadn’t eaten a single thing for 16 hours at that point, but I had changed my pod an hour or two before going to bed.

Why You Should Get a Flu Shot (If You Haven't Gotten One Already) (2)
When you’re the MOH and you also happen to have diabetes, you worry about a lot more than just your speech or your makeup.

WTF was wrong? Was the pod’s cannula bent? Was I high due to wedding day jitters? Would the highs persist all day?

These were the thoughts racing through my mind almost as soon as I woke up the morning of my cousin’s wedding.

I didn’t have time to worry about my MOH speech, or whether my hair would turn out the way I wanted to, or even to drink a celebratory mimosa while I got ready with the rest of the bridal party – I was too preoccupied by my elevated blood sugar.

All I could bother to think about was a potential solution before we all walked down the aisle.

Somewhere between applying my eyeshadow and having the 111th bobby pin secured in my hair (yes, it truly took 111 bobby pins to make my intricate braided up-do possible), I remembered “The Incident” from last year. I’d slept through a high blood sugar that, the following morning, refused to come down. As my frustration grew, so did the pain in my belly that lead me to the bathroom, where I came very close to passing out. One ambulance trip and ER visit later, I discovered that my pod’s cannula was bent, leaving me with no doubt that a pod malfunction was responsible for the whole ordeal.

With that memory vividly replaying in my mind, I made the executive decision to change my pod a couple hours before we were due at the wedding venue. And I can’t even begin to explain how happy I am that I listened to my intuition to do so. Upon removing it, I noticed blood at the site – not as bad of a sign as a bent cannula is, but a possible indicator of a problem. By the time we were in the venue’s bridal suite, my blood sugar was sitting pretty at 90 and I was finally able to focus on the beautiful, meaningful afternoon.

Sure, it was a stressful morning and far from an ideal situation, but I am extremely proud of myself for how I handled it. I didn’t panic the way I normally do. I didn’t shed any anxiety tears. I kept the issue pretty well-concealed from the bride, who shouldn’t have to worry about her MOH’s health on her special day. My calm approach paid off, and though it sucked to waste almost two days’ worth of insulin when I disposed the wonky pod, I knew I should pay closer attention to the fact that I did what needed to be done.

And even better was that my diabetes mostly cooperated with me the rest of the day. It didn’t stop me from delivering a fantastic speech with the matron of honor. It didn’t prevent me from enjoying some tasty wedding food, cake and all. It certainly didn’t keep me from tearing up the dance floor with my enthusiastic family. And it didn’t end my night early as I went out with my boyfriend, the newlyweds, and the matron of honor and her husband to a bar to shoot some pool and continue our celebrations.

Turns out that dealing with diabetes when you’re the maid of honor has a lot to do with keeping a cool head and living in the moment, two things that are so important to do in a variety of situations.

My Diabetes Woke Up When September Ended

Apparently my diabetes has a theme song.

“Wake Me Up When September Ends” by Green Day is the song in question.

The entire month of September, I felt like my diabetes was asleep or something: It didn’t respond the way it should have to my regular dosages of insulin. 

It was truly maddening. I did everything I could to get to the bottom of the mystery.

Why You Should Get a Flu Shot (If You Haven't Gotten One Already) (1)
It’s like my diabetes had it penciled in on its own calendar to get its act together starting on October 1st. 

I thought it was rotten insulin. Nope. I thought it was maybe a bad batch of pods. Nah. I thought maybe there was something wrong with me (well, yes, I’m definitely a weirdo but for real, there was nothing out of the ordinary going on).

I thought I was going to go nuts, trying to get to the root of the problem and coming up with potential causes only for each one of them to be shot down.

I was not happy to be taking higher doses of insulin than needed, and I wanted answers. Luckily for me, I had an appointment scheduled with my endocrinologist (my last one with her, for now, I hope) at the end of the month, so you can bet it was a major topic of conversation.

We came up with a plan for me to resume Metformin. I didn’t really want to, and there’s certainly more on my feelings about that to come in a future post, but I was desperate to reduce my daily insulin intake and find some sort of stability in my CGM graphs between meals.

So I started Metformin…again. And the difference was noticeable within days.

My diabetes woke up to the insulin doses I was taking, and I felt such an immense relief that I can’t really even describe.

Oh, and you’re welcome for getting that Green Day song stuck in your head.

 

The Curious Case of Rotten Insulin

I spent half of the month of August high.

NOT THAT KIND OF HIGH.

I’m talking about blood sugar here, people.

And I’m not talking about scary-high levels. I’m just referring to levels that are higher than I’d like – between 160 and 200. And I’d stay stuck right in that range, even after bolusing quite aggressively.

I chalked it up to stress – life has been a little unkind to me this summer. I also blamed it on making less-than-healthy food choices, and questioned whether I needed to seriously start thinking about taking Metformin again (even though I had a shitty experience on it).

In other words, I took the brunt of responsibility for my highs. I was angry with myself for letting my diabetes get out of my control, and was just starting to accept responsibility when it hit me that it might be something other than my body rebelling against me at play here.

As it turns out, I should’ve suspected an outside factor from the beginning. That’s because my insulin had, somehow, gone bad.

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The vial in question…it caused me a boatload of stress.

I’m still very confused about how or why it happened. My insulin had an expiration date that was like, 2 years from now. The contents within the vial were totally clear – discoloration would’ve indicated an issue – and everything about this vial of insulin looked completely fine.

It was, and still is, an utter mystery to me as to how or why the insulin spoiled.

If nothing else, the case of the rotten insulin made me wonder…why hasn’t anyone developed strips that can check the effectiveness of insulin yet?

Can somebody please get on that (and give me partial credit for helping to spark this genius idea)?