Category: Blood Sugar

Diabetes: A Condition of Consistency

mollyt1d1 Comment

“Consistency is key” is a well-known adage for a reason: It applies to many things in life, including diabetes.

This has resonated more and more with me over the last few months, as I’ve experienced greater interruptions in my day-to-day routines. The most obvious change has affected my Monday through Friday lunch hour at work. I usually need to go home three out of five days to take care of my puppy – feed him, play with him, and make sure he hasn’t totally destroyed anything in the few hours since I last saw him. I don’t mind this at all, because I love my little Clare-bear, but on days that I have to be with him, my diabetes is definitely affected.

For starters, I have to eat my lunch much later than I normally do on non-Clarence days. Technically, I could eat my lunch when I go home to see him, but I have a very narrow window of time – approximately thirty minutes – to be with him. It doesn’t seem fair for me to go home, pour out his kibble, then spend the majority of our half hour together putting together and eating my own lunch. So I spend my lunch break giving the puppy my full attention, which makes us both pretty happy.

Clarence
My Clare-bear certainly knows how to keep me, and my diabetes, on our toes!

Eating lunch during my allotted break is ruled out, so I have to decide whether to eat it before or after my stop home. I usually end up forcing myself to wait until I get back from feeding Clarence to eat, but this is easier said than done for a few reasons: Sometimes, my blood sugar will crash while I’m with the dog, so I have to eat a snack to correct it because my actual prepacked meal is waiting for me in the office refrigerator. Or I have to scramble from one meeting to home and then back to the office for another meeting and won’t have a chance to sit and eat until 2 o’clock, which means that I have to sit through an afternoon meeting without a full attention span because all I can think about is my grumbling stomach. On those days, I’m pretty hangry by the time I get to eat, and even more so irritated when my blood sugar retaliates at me later on for waiting so long to eat.

That being said, I’ve had to make peace with the fact that my weekday/lunchtime blood sugars will be a bit all over the place. I know that things will be easier when Clarence gets older, but for now, I’m determined to enjoy his puppy-hood without diabetes interfering too much. And if nothing else, it reminds me how important it is to stick to the basics with diabetes: Eat regular, healthy meals and the habit will reflect well on blood sugar and A1c.

The T1D Taste Test: My Unofficial Ranking of Drugstore Glucose Supplements

mollyt1d1 Comment

You may have heard of glucose tablets, but what about glucose gummies? Or liquid glucose, or glucose gel? Have you tried any of these forms of glucose?

B40CD359-8AE4-46A5-88E0-0E745CDE2A8C
The four forms of glucose (that I’ve tried).

I’ve used them all, and I’ve formed some pretty strong opinions about each of them. I thought it’d be fun to rank them in order of most appetizing to least appetizing, because while they can effectively and efficiently correct low blood sugar, they certainly aren’t created equally:

  1. Best Tasting: Glucose Tablets. I can hardly believe that the most boring variety is the winner here, but it blows the competition out of the water for several reasons. For starters, glucose tablets come in an array of flavors. Orange, raspberry, fruit punch, grape, tropical, and sour apple are among the flavors I’ve tried over the years, and most of them are palatable. Plus, glucose tablets are most akin to actually candy: I’ve described them as giant Smarties to inquiring friends in the past. While actually Smarties are more fun to eat, glucose tablets are their closest counterpart in the diabetes world, making them a number-one choice in low blood sugar situations.
  2. Runner-Up: Glucose Gummies. I’m awarding second place to glucose gummies, mainly because of their novelty. It’s not particularly a standout in other categories like taste and texture. The gummies only come in three flavors: grape, orange, and apple, leaving something to be desired in terms of variety. And all three of those flavors taste a little…off, like there’s a little too much artificial additives going on. Maybe this was done deliberately to distract from the texture of the gummies, which tends to be hard/stale in my experience. It’s nice that the gummies have a layer of sugar on them to convey the likeness of real gummies, but that stuck-to-your-teeth feeling makes it harder to appreciate the gummies for what they are.
  3. Third Place: Glucose Gel. I’ve only ever found glucose gels in the fruit punch flavor at Walgreens – do they actually come in other flavors? Besides being one-note, the gel is a unique texture situation…not quite a liquid, not quite a solid. Gels aren’t a mainstay in my low blood sugar kit because I’m not fond of having to slurp them out of the pouch like a tube of Go-Gurt; in fact, I’d much rather have yogurt from a plastic tube than a gel because the yogurt is much tastier. The gel is just too artificial, with a medicinal aftertaste. And it doesn’t help that the consistency of it reminds me of hand sanitizer.
  4. The Loser: Glucose Liquid. It’s surprising that the glucose liquid wound up in last place, because on the surface, it had a lot going for it. I liked that it came in a small bottle and it seemed like it would be super easy to consume. All I’d need to do is pop the cap off and swig it down. But MAN, the taste was HORRIBLE! I thought I’d like the mixed berry flavor, but it tasted so supremely saccharine and fake that I could scarcely force myself to swallow it. I know, I know, it’s liquid glucose, it’s supposed to be very sweet. But this stuff was just over the top. I definitely will not be buying glucose liquid again any time soon. I’ll stick with my tried-and-true tablets.

Do you agree with my rankings? Did I miss any form of glucose that can be bought in most drugstores, and you think I should give it a try? Let me know in the comments!

Four Factors that Impacted my Diabetes in Las Vegas

mollyt1dLeave a comment

Recently, I returned from a trip to Las Vegas with my best friends in the universe. It was awesome to take a vacation with them, especially in a place that’s virtually a playground for adults.

Before I went on the trip, I knew to expect some sort of disruption with my diabetes care and management routine. I did as much as I could to prepare myself for every potential scenario, from packing extra snacks and supplies, to asking the DOC how I should account for a sudden change in time.

While my preparation really did help, I still encountered the unexpected when it came to my diabetes on the trip. Four factors in particular come to mind…

  1. The heat – At first glance, this is a no-brainer. I’ve been to many hot climates on vacation, so it isn’t news to me that intense sun can make blood sugar go low quickly. We were literally in the middle of the desert, so I knew it would be important for me to watch my numbers closely, as well as keep myself hydrated. But I think the fear of going low all the time was a little too strong, which meant that I was running a bit higher than I’d normally like for most of the vacation. My paranoia about drinking plenty of water, though, was not a joke. I pride myself on being good about staying hydrated, but I struggled to keep up with the dry desert heat. I can’t help but wonder: If I’d been better about drinking water, would it have benefited me during some of the stickier high blood sugars? Speculation can only get me so far now; however, all signs are pointing to probably yes.
  2. The strip – The Las Vegas strip is less than five miles in length, but the whole stretch of it, marked by hotels, stores, casinos, and ginormous flashing lights, feels incredibly long. Nevertheless, my friends and I naively believed that we could skip taking taxis and walk all over the place. For the most part, we could, but it was definitely dicey when we walked nearly a mile and a half from the Cosmopolitan to the Rio one evening. It influenced my blood sugar in a positive way – the exercise brought my levels down to a nice and stable place – but that didn’t mean it wasn’t scary to walk practically on the highway at nighttime.
  3. The alcohol – I’m well aware of the fact that different kinds of alcohol can have different affects on blood sugar. To minimize blood sugar swings, I stuck with the less-sugary options as much as I could (i.e., opting to order a rum or whiskey with diet coke), only getting fancier drinks when I was consuming fewer carbs at mealtime. For the most part, this strategy worked well and proved to me that a little extra thought can go a long way when it comes to deciding how to treat yourself. But it also reminded me why I don’t have weekends like this often – it’s exhausting enough to take care of myself on a daily basis without alcohol being a factor. Throw it into the mix and I’m watching my blood sugar so carefully that my CGM’s battery is drained in half the time it normally takes to zap it.
  4. The pizza – The scientific answer to the reason why pizza is tough on blood sugar involves the glycemic index and some fairly complex calculations…boring! All you really need to know is that it takes a long time for pizza to have an affect on blood sugar due to its high fat-to-carb ratio. As a result, it tends to be a “treat” food for me that I only indulge in every once in a while. But when in Vegas…you have as much of it as possible. Pizza was one of the quickest and easiest food options for me and my girlfriends throughout our trip, so we ate it multiple times. I don’t regret a single cheesy, delicious bite…but I am slightly remorseful for not doing a better job bolusing for it. The first time we had pizza, I didn’t give myself enough insulin. The second time, I gave myself too much and went low, though that may have happened because I didn’t finish both slices like I thought it would. The bottom line? I didn’t realize that pizza would be a dietary staple on this vacation, and I’ll probably refrain from eating so much of it on future vacations.
IMG_6890
A slice a day does not quite keep blood sugar at bay. But it’s tasty as hell.

Despite the diabetes curveballs I encountered, I enjoyed my trip to the fabulous Las Vegas. I managed the challenges as best as I could without letting them interfere too much with what I wanted to do. Plus, it helped that my best friends were with me the entire time. I have to give them credit for making the most of my diabetes difficulties, too. For instance, I felt badly about sidelining them in the Bellagio on our last night there due to a low blood sugar that crept up on me after walking (the strip!) and over-bolusing (the pizza!), but they really rolled with the punches and made the most of it. In fact, I’m pretty sure they experienced their favorite people-watching moments while we sat and waited for my sugar to come up (I got a kick out of the weird people coming in and out of the lobby, too, but was slightly more focused on raising my number).

Thank you, Kortney and Roshani, for accompanying me on an incredible girls’ trip and for being my best friends in the world. Maybe Las Vegas 2020 needs to happen – now that we know to expect, perhaps my diabetes will be a more cooperative travel companion the next time around!

How Time Traveling Affected my Blood Sugar

mollyt1d3 Comments

I traveled through time last week.

No, I didn’t use a magical device or step through a portal. It’s much more boring than that: I flew across the country, east coast to west coast, to spend a few days in Las Vegas.

Okay, there’s no way in hell that I could justifiably describe my Vegas trip as BORING.

But my point here is that flying through a couple different time zones is totally trippy. And, of course, it impacted my blood sugar. Because why wouldn’t diabetes just cooperatively come along for the ride?

I knew I should anticipate some sort of blood sugar swings going to and from my destination, I just wasn’t sure of when and how they’d hit. But I did know that when I landed in Vegas, the first thing I needed to do was adjust the time on my PDM (my insulin pump). Surely, my blood sugar would not react kindly to thinking that it was three hours later than it truly was in my new time zone. My question, though, was when should I do this? On the plane? After we landed? Should I adjust it slowly, in one-hour increments? Or should I dial it back entirely in one go?

Normally, I would’ve asked my endocrinologist what to do – but I forgot to bring it up during my last appointment with her a few weeks ago. So naturally, I asked the next best source: the Diabetes Online Community (DOC).

The answers I received were varied…

…nevertheless, I appreciated the immediate replies. I decided to quit stressing about it so much and focus on getting to the actual destination, vowing to keep an eye on my blood sugar for any suspicious trends while on the flight.

Five and a half long hours later, my travel companions and I arrived at our hotel. While in line for check in, I fixed the time on my pump and glanced at my CGM (which I didn’t bother adjusting, since none of the settings on it or my meter were dependent on time). I was steady at 97 mg/dL…not too shabby at all. And I’m pleased to say that I maintained that decent graph for the next day or so. I was nonplussed by the phenomenon, but I couldn’t complain about it.

The next few days are a different story, due to some “lifestyle choices” I made while in Vegas (c’mon, you know all I mean by that is eating junk food and imbibing alcohol). But that’s a tale for another post, coming soon.

This one’s about time travel, and while I had no issues flying TO Vegas, I did encounter trouble flying home FROM Vegas. My friends and I chose to a red-eye flight, which I don’t regret per se, but I’d never done one before and didn’t realize how much trouble I’d have falling asleep on the plane. It was disorienting enough leaving one place at 9 P.M. to arrive in another at 5 A.M., but add a freezing cold aircraft, turbulence, and an unsettled stomach to the mix, and you’ve got a recipe for disaster. As I tossed and turned in my seat, violently shivering a few times, my blood sugar was very slowly, incrementally, rising. I didn’t realize how much until we landed and drove home, where I had to bolus for an out-of-the-blue 308 mg/dL. I was so bloody tired, yet sleep evaded me further as I anxiously waited for my blood sugar to budge – which it did, but not for several, agonizingly long hours.

It definitely didn’t help matters that I wasn’t eating regularly; at the time of our arrival home, I hadn’t eaten real food in about 36 hours due to nausea that wouldn’t seem to leave me alone. I’d muscled down toast and a couple of granola bars, but not much else. I’d like to think that my entire body was just rebelling against me for spending the weekend eating too much pizza, staying up too late, and drinking a little too much whiskey, because that train of thought at least helps me make sense of my lack of appetite and recurring high blood sugars.

I’ve been back on the east coast for a couple days now, and I’m relieved to report that things have settled down. I’m eating regular meals (and I actually feel hungry for them), and besides a few flukes in my CGM graph, my blood sugars are mostly back to normal. I wish I could say that there was some big takeaway from this all: that I know exactly what to do next time I travel through time zones, or that I know just what to do to prevent it. But that’d be silly, because with diabetes, there are just too many variables. At least I CAN say that I know to take it in stride next time, to roll with the punches. Monitor my blood sugar like a hawk, correct as often as needed, eat normal meals as much as possible, and drink plenty of WATER. In any case, isn’t that what diabetes is all about…

…regardless of time travel and/or sorcery?

 

Banana, No Bolus

mollyt1d1 Comment

I ate a banana the other day without needing to correct for it. My blood sugar prior to eating it was 96 mg/dL. I sensed and oncoming low, and trusting this instinct, I decided to skip bolusing (taking insulin) for it. Two hours later, I was 108 mg/dL.

How did I do it?

Did my pancreas suddenly start working again?

Was it a low-carb banana?

Was sorcery involved?

I’ll explain how it happened; no, my pancreas didn’t suddenly decide to start secreting insulin; no, because low-carb bananas aren’t even a thing; and sadly, no, though I do wish I was well-versed in real-life wizardry and/or witchcraft.

IMG_6602

It happened because I was running around like a maniac that entire morning. High activity levels can do a number – that is, lower the numbers – on a diabetic’s blood sugar. Between walking my dog, playing with him some more outside, and running errands, I scarcely had a chance to catch my breath from the time I woke up until noon. It was still mildly surprising, though, since bananas are a notoriously high-carb and fast-acting food. I’d expected to be at least 50 points higher from the initial blood sugar.

I was pleased with this outcome, but I still think that the voodoo magic – ahem, science – behind diabetes is just plain weird sometimes.

 

Money Talks, Low Blood Sugar Slurs

mollyt1d1 Comment

Somewhere between Class A, B, and C share mutual funds, I got lost. That familiar fog clouded my brain and I had trouble focusing my gaze on anything, let alone absorbing any of the information being shared with me. I felt like I must’ve nodded my head so many times over the course of the conversations that I probably resembled a bobble-head. Words tumbled slowly, awkwardly, out of my mouth: I babbled “yup” and “right” over and over again to show that I was still engaged, even though I absolutely wasn’t.

What was wrong with me? I was having a low blood sugar in the middle of my (first-ever) meeting with a financial advisor. Stellar!!!

Obviously, I made it through the meeting fine. I got back to my car, tested my blood sugar, discovered that I was 66, and corrected it with three glucose tablets. I wiped my hands together, watching glucose dust puff up into the air like a cloud, and chided myself for not taking action sooner than that moment. I suppose I didn’t want to alarm the advisor by sticking a needle into my finger in the the middle of our meeting, but that hasn’t stopped me from doing what I must do, medically speaking, in other situations. Ordinarily, I would have calmly explained, “I have type one diabetes. I think I’m experiencing a low blood sugar right now. Do you mind if I check my blood sugar here, or could you please direct me to a place where I can do that?” I would also let the person know that I’d be fine either way, I just wanted to be sure so I could focus my energy back onto them and not my diabetes.
IMG_6428

I’m not really sure what was different about this particular low blood sugar event, but I didn’t do the “right” thing because I didn’t want to be rude and interrupt the advisor’s train of thought. But waiting nearly thirty minutes into experiencing these symptoms could have caused things to turn out much differently. My blood sugar could have gone even lower, and it could have become an embarrassing or scary situation for both of us.

I guess this’ll serve as a reminder to myself to speak up. It’s okay to interrupt, because my health and safety (and potentially the health and safety of another person) is at risk. It’s not rude, it’s good common sense.

My Involuntary Hiatus from the CGM

mollyt1dLeave a comment

Currently, I’m on a break from my CGM for an unknown length of time.

This temporary split wasn’t mutual; rather, it was due to a series of coincidences that occurred much to my chagrin. The short version of the story is that my CGM transmitter died a week earlier than I had anticipated. I thought it would be pointless to order a replacement since I was expecting the new Dexcom G6 to arrive at my house before the transmitter expired. When I learned there was a delay that would cause me to wait a little while longer, I realized I didn’t have much of a choice to go ahead and order a replacement G5 transmitter. After all, it was fly blind without my CGM for just a few days versus the possibility of missing out on that data for weeks.

fullsizeoutput_75dThe choice was obvious, and as I write this, my G5 replacement transmitter is on its way to me.

Though there’s comfort in that fact, I feel weird not having my CGM data available to me. It’s kind of nice to be wearing one less medical device on my body, but that’s really the only benefit of being without my CGM. The information it provides to me is invaluable, and an involuntary break from it makes me feel uneasy. I’m constantly reminding myself that I managed diabetes just fine for the first 15 years I had it without a CGM’s aid, which does offer a small amount of comfort. But it also reminds me how important the CGM has become in my daily care choices. Twenty-four hour, real-time updates of my blood sugar help me live a life less interrupted by my diabetes, something that’s extremely difficult to give up after 20 relentless years of dealing with it.

You really don’t know what you’ve got until it’s gone – even if it is only for a short period of time.

I’ll make the most of this situation. It will at least help me get in tune with my body’s signals when my blood sugar is high or low, which is definitely not a bad thing. And it makes me appreciate something that not every person with diabetes is lucky enough to have access to: serving as a humbling reminder of my fortunate circumstances.

Instagram vs. Reality

mollyt1d3 Comments

What does Instagram vs. reality mean?

It’s best explained using pictures. Take the following, for instance:

Beautiful, perfect Instagram
Cold, hard reality

The first image is basically the ideal Dexcom graph. It depicts steady, on-target blood sugars for hours.

It makes the image next to it look that much uglier. The second picture shows blood sugar that rose rapidly over a short amount of time and flattened out at a level so high that it exceeds the Dexcom maximum number.

Instagram: The social networking site that promotes flawlessness. You scroll through a feed and see images that convey society’s notions around perfection. And it’s annoying. The rational part of you knows that, surely, the stunning blonde swimsuit model on your feed probably has cellulite, only you never see it because it’s airbrushed and filtered away. That’s why it’s equally unrealistic to share nothing but the “perfect” blood sugars with the diabetes community. Diabetes is FAR from being sunshine-y and unicorn-y all the time.

The reality: Diabetes is up-and-down, mentally and physically. It’s not always going to behave the way you want it to, even if you’re doing all the right things and trying your best. That’s why I like sharing the good and the bad – it makes the victories that much sweeter, and the less-than-triumphant moments more educational.

“I’ll Have a Regular Soda, Please.”

mollyt1d1 Comment

A funny thing about life with diabetes is that new experiences occur all the time. For example, this was a first for me the other day: ordering a regular soda at a restaurant instead of a diet.

Why was this necessary? I chalk it up to a few different factors that affected my blood sugar: 1) I did strength training earlier in the day, which can make me go low several hours after the fact. 2) I ignored the diagonal down arrow that had appeared on my CGM, because I really didn’t think I’d end up below 100 mg/dL before dinner. 3) It took a long time for our dinner to come out, and I’d made the rookie mistake of bolusing soon after ordering the food. 4) I also think I miscalculated the carbs in my dinner – I’m used to ordering this particular dish, a cajun chicken salad, with a beer or two. But since I gave up alcohol for Lent (more on this in an upcoming blog post), I wasn’t getting the extra carbs from the beer, which I forgot to take into account.

So yeah, in hindsight, I could’ve seen the low blood sugar coming. But I just didn’t anticipate some of these occurrences, such as our food coming out late. This particular restaurant is usually timely, but since it was a Saturday evening and the bar was rapidly filling up, I should’ve connected the dots.

IMG_5443
Diet Coke has a special place in my part, but in a hypoglycemic emergency, it just won’t cut it.

Shoulda, woulda, coulda. There was nothing I could do about my rapidly dropping blood sugar, unless I bit the bullet and ordered a regular soda. Shoving my diet root beer to the side, I flagged down my semi-bemused bartender and asked for a regular Pepsi, trying to ignore the fact that he was joking about how “diet just wouldn’t do it for me any longer, eh”.

If only he knew that the circumstances required sugar, stat.

It only took him about 60 seconds to deliver the Pepsi, but it felt like a long time. My CGM alerted me to an urgent low and things around me were a little fuzzy. I was trying to engage in conversation with my companions, who knew that I was going low, but maybe weren’t aware of how quickly I was going down due to my determination to appear normal.

Once my Pepsi arrived, I gulped down several sips and sighed with relief as my dinner appeared soon after. I wolfed down every last bit of it within 15 minutes, taking breaks only to drink a little more soda. I knew I needed to control how much I drank, because I didn’t want to end up sky high later on in the night.

Fortunately, my blood sugar was coming back up to normal within no time, and I actually didn’t even go higher than 172 mg/dL for the remainder of the night. A huge win, all things considered. Even though it was a somewhat scary experience, I’m glad I did what I needed to in order to take proper care of myself…even if that meant drinking regular soda, which was actually pretty gross. How do people actually enjoy that saccharine sludge?!

How I Learned the Importance of Carb Counting

mollyt1dLeave a comment

One recent evening, I was rummaging through the kitchen pantry and noticed a bag of “veggie stix” stashed away, waiting to get opened. The sight of the bag instantly brought back memories of a time I was blatantly irresponsible with my carb counting and insulin dosing…

IMG_6147

…It was my junior year of college. I had plans to meet with a friend for dinner at seven o’clock. While that’s a standard suppertime for many people, it was kind of late for me. So that explains why I decided to treat myself to a snack a couple hours before it was time to go, just to hold me until I had my meal. My snack of choice? A bag of veggie stix just like these were sitting in the kitchen of my on-campus apartment. I thought I’d help myself to a few, believing (naively) that I had enough self control to know when to stop shoveling them down my gullet. That’s right, instead of doing the right thing and counting out a bunch before stowing the bag away, I was blindly consuming handful after handful without dosing for a single stick.

I can’t even use the defense that these veggie stix are strangely addicting – they really are, they taste a little like those potato sticks that used to come in cans – because I knew what I was doing wasn’t good for me. I just didn’t care. I had munched my way through half of the bag when it dawned on me that it would probably be smart to stop myself from eating more. I rolled up the bag, returned to my room, and did some homework until it was time to meet with my gal pal.

Little did I know that my blood sugar was rising to potentially dangerous levels.

I didn’t find out how high I was – over 400 mg/dL – until I reached the sandwich shop and had a plate full of chicken pesto carb-y goodness waiting to be consumed. My face must’ve shown my shock, because my friend asked me if I was alright. I quickly explained to her my mistake, and took an extra large bolus to cover my food and correct my blood sugar. Once that was done, I somehow managed to stop panicking long enough to enjoy the dinner with my friend, even though I couldn’t eat a bite of mine until an hour or so after injecting my insulin.

Although it sucked to go through this, I’m kind of glad that it happened because I learned a major lesson from it: ALWAYS count my carbs. It doesn’t matter if I WANT to be lazy or pretend that my diabetes doesn’t exist, I HAVE to hold myself accountable. It may be mentally draining and a bit of a nuisance, but it’s my own health here. It’s up to me, and me alone, to manage it.

And by the way, I did just help myself to the above bag of veggie stix. I had exactly 24 pieces, which equals exactly 5.4 grams of carbohydrates – a much smaller amount than what I ate that one night five years ago.