Diabetes and Room for Error

I have a confession to make: I’m a bit of a perfectionist. I know that perfectionism can be my own worst enemy and hinder me from accomplishing goals, but it’s just the way I am in some situations – particularly, with my own diabetes.

My diabetes perfectionism means that there is very little room for error when it comes to dosing insulin properly for the foods that I eat. Like many people with diabetes, I strive to bolus as accurately as possible to ensure better blood sugar outcomes, but I don’t always succeed at this.

That’s why I try to reduce the amount of possible error by being very specific about the number of carbs I consume at mealtimes. In fact, I have a self-imposed carbohydrate limit of about 60 grams of carbs per meal. I don’t know where this number came from, and I definitely exceed that from time to time, but for some reason I never input a number greater than 60 carbs into my PDM even when I know I’m probably eating more carbohydrates than that.

This is because of my fear of the room for error, and the potential consequence being a severe hypoglycemic event.

Something I learned by writing this post? My inner perfectionist is at war with my comfort with room for error.

In other words, even when I may be exceeding my “comfort carb count”, I know that the room for error grows with the amount of carbs that I consume. More carbohydrates = more insulin = a greater room for error, something that freaks me out and that I attempt to control by only bolusing for what I feel is an agreeable amount. I’ve written about this phenomenon of mine before and my desire to get over it, but as I continue to work through it, I think it can only be done if I change my thinking about the margin of error that I’m willing to tolerate.

This is where it all comes full circle and I begin to understand how perfectionism, the room for error, and my diabetes management all play off one another…which is to say, they don’t fare well together whatsoever. Because my room for error is low, I don’t dose correctly for some meals, which drives my inner perfectionist crazy because it’s at conflict with my inner scaredy-cat who’s afraid to dose the right amount because I don’t want to deal with any negative outcomes. I’m literally in conflict with myself, which is a wild thing to realize as I write this blog post, but it’s the truth and I’m glad I’m uncovering it.

It will absolutely take time, but as I begin to let go of some of my perfectionist tendencies, I’d like to learn how to also usher in a greater comfortability with the room for error. I’m looking forward to exploring this and hope that I can reconcile the two so me and my diabetes can live in better harmony.

Pumpkin Spice: A Very Nice Diabetes Treat

This post is adapted from something I wrote and published on Hugging the Cactus on October 1, 2018. I decided to revisit it as a reminder of the many ways pumpkin spice can be enjoyed this time of year that won’t wind up making my blood sugar spike!

Since pumpkin spice manifests itself in many carb-laden treats this time of year, you might be wondering exactly how I can get away with enjoying a mass quantity of the stuff. And no, my method doesn’t involve dosing tons of insulin so I can down endless amounts of pumpkin spice M&Ms, ice cream, Oreos, yogurt, muffins, or any other kind of pumpkin-spicy product you can imagine (including the dearly beloved pumpkin spice latte).

I love a pumpkin spice latte, but I don’t love what it does to my blood sugars…so I find a way to enjoy the flavor that’s carb-free.

It’s much simpler than that – all that I do is make it my mission each year, right around mid-August, to find as many carb-free or low-carb pumpkin spice products as possible, buy them, and revel in them for the following three months. I’ve been a bit behind this year, but I’m stoked to stock up on favorites from the last few years which includes… gum, tea, coffee, butter (yes, pumpkin spice BUTTER), peanut butter (with pumpkin spice literally swirled in it), English muffins…the list can go on and on, and it does, considering that the gamut of pumpkin spice offerings only increases year after year.

I’ve hunted down foods that have both pumpkin spice and a lower carb count, like Halo Top Pumpkin Pie ice cream or FiberOne bars (ugh, they’re so good it’s not fair). I’ve even mixed it up by combining pumpkin spice with some more manageable carbs, such as plain oatmeal. I just can’t get enough, especially since this is a seasonal offering that plays pretty nicely with my diabetes.

No Sugar Free Ice Cream for Me

I have strong opinions about ice cream. Potentially controversial ones:

  • Chocolate ice cream is the weakest flavor out there.
  • My ratio of ice cream to mix-ins is…gimme ALL the mix-ins. The more chopped-up chunks of goodness, whether it be cookie dough or candy, the better.
  • Ice cream tastes best when it’s a little softened – like, almost to the point of being soft-serve consistency. I used to microwave my ice cream for about 20 seconds when I was a kid before eating it and loved every drop of my ice cream “soup”.

See? I warned you. Those are some triggering statements I just made about my personal ice cream preferences. But one not on that list, that I think most people would happen to agree with me on, is that sugar-free ice cream just ain’t it.

Even my parents’ dog, Clarence, can’t resist a delicious serving of ice cream (of course, he gets the special doggie kind, saving the good stuff for us humans).

“Oooh, Molly, look! They have sugar-free ice cream on the menu, are you going to get some?” One of my truly well-meaning girlfriends asked me this, ever-so innocently, on a recent ice cream outing.

I remember raising my eyebrows incredulously as my eyes scanned the regular list of ice cream compared to the sugar-free options. There were dozens of delectable-sounding regular ice cream flavors: all the traditional ones, plus more exotic ones like cotton candy, blueberry pie, s’mores, German chocolate cake, coffee kahlua cream…and then in direct opposition to that were TWO, yes TWO meagerly sugar-free choices: black raspberry and coffee.

I turned to my friend and, as non-condescendingly as I possibly could say it, told her that those “choices” had to be a joke and that furthermore, sugar-free ice cream just ain’t it for me. If I’m going to eat ice cream (and I’ve consumed LOTS of it this summer, let alone throughout my lifetime), then I’m going for the real stuff – no question about it. So with the air cleared on that particular matter, we both got matching ice creams (the blueberry pie flavor with blueberry and graham cracker swirled in a vanilla cream base) and enjoyed the heck out of them.

Worth every drop of insulin.

A Weekend of Bagels, Pizza, Ice Cream, and…Good Blood Sugar?

Would you believe me if I told you that last weekend, I ate mostly carbs for 36 hours straight and totally avoided high blood sugars the whole time?

I looooove carbs. Almost as much as Oprah Winfrey loves bread.

It sounds wild, but it’s the truth! I went on my annual weekend getaway with my college besties and it was the loveliest time filled with sunshine, conversation, and tons of delicious food. I can’t remember the last time I ate that much in such a short window of time, but it was all worth it, especially because my blood sugars didn’t pay the price for it for once.

Here’s the breakdown of what I ate:

  • Friday:
    • 2 slices of Mediterranean-style pizza and 3 chicken tenders for dinner, the first official meal of the weekend trip
    • 2 glasses of wine
    • Handfuls of crackers and cheese because who doesn’t love that with wine
  • Saturday
    • 1 blueberry bagel accompanied by 1 fried egg for breakfast
    • Salad and heaping scoop of ice cream for lunch
    • Pita chips for a snack
    • Panko-crusted haddock with jasmine rice and veggies for dinner
    • 2 cans of cider (and maybeeeee a glass or two of bubbly)
  • Sunday
    • 1 everything bagel slathered in goat cheese plus 1 fried egg for breakfast
    • 2 slices of leftover pizza for lunch, which is also when I arrived home from the trip

It definitely wasn’t my healthiest, most balanced weekend of eating, but I’m more than okay with that because it was about enjoying my time with my friends and indulging a little rather than stressing the whole time about bolusing and blood sugars. And you know what, I think that my laidback, let’s-just-savor-this approach is partially the reason why I had such stellar weekend blood sugar levels. That, coupled with extended boluses for most of my meals (you know that pizza and bagels contain alllll the slow-acting carbohydrates), really helped me achieve the relaxing weekend that I wanted.

Now if only I could get away with this on a regular basis – as I write this, my blood sugar is coasting from a peak of 248 back into the low 190s after I dared to consume a bagel at lunch in the middle of my busy workweek. But it’s all good, and maybe just evidence that I should try to remember to live in the moment on weekends of fun like this one and prevent diabetes/blood sugar from taking center stage. Perhaps that’s the key to more stable numbers.

If nothing else, this serves as a reminder to me that even with diabetes, I can still enjoy a sh*t ton of carbs every now and then.

My “New” Low Blood Sugar Treatment of Choice

The concept of a “low blood sugar treatment” makes me giggle, because it implies that the glucose (sugar) needed to bring levels back within range is basically medicinal. Sugar? As medicine??? Kind of, sort of, pretty much when it comes to fixing a low.

Over the years, my preferred low treatment has taken many forms. In the early days of my diabetes, it was usually glucose tablets or orange juice. In most of my youth, juice boxes were number one, but as I got older I felt ridiculous carrying those around, so I switched to fruit snacks and kept glucose tablets around as an old reliable. In college, I loved mini boxes of yogurt-covered raisins (they were great for less urgent lows, with roughly 10 grams of carbs in one teensy little portable package). And in my adulthood, I’ve rotated through a mix of all the aforementioned items, but with a brand-new one entering the forefront for me as of late.

And that new one is…Smarties!

One of the many Smarties stashes I’ve got scattered around my home.

Yup, Smarties, the classic candy that just might be the most ideal low blood sugar treatment I’ve used in recent years. There’s solid grounding behind that logic: For starters, Smarties come bundled up in tiny rolls that are easy to slip just about anywhere – a pocket, a glovebox, a nightstand, and the list goes on. Smarties don’t melt and withstand just about any weather condition. They’re also perfectly portioned, with one roll containing 6 grams of carbs so it’s convenient to eat just one for a slightly low blood sugar or 2-3 for more stubborn lows. There are even giant Smarties rolls that are great for when I need a quick blood sugar boost before a workout – I just eat one or two individual giant-size Smarties and I’m good to go. And despite being reminiscent of chalky glucose tabs, they do taste significantly better and I swear they dissolve faster compared to their drugstore counterpart.

All those pros and nary a con for me to nitpick…I think I’ve finally found the best low blood sugar treatment for myself – for now, anyways.

Yes, I Can Eat Cheesecake and Pizza.

Yes, I have diabetes.

Yes, I can eat cheesecake and pizza.

Yes, I can actually eat whatever I want – I just have to know the carbohydrate content of whatever I’m consuming (and being mindful of portion size doesn’t hurt either).

Yes, I’m telling you this because at the time of this writing, that’s actually what I had for lunch this afternoon: homemade pizza and cheesecake. The pizza crust was store-bought, but everything else – from the sauce to the cheesecake crust to the strawberry topping – was made by me and it was damn good.

Funny story: I sent a picture of my cheesecake (shown above) to my coworkers and because I have terrible lighting/I’m not a food blogger, someone thought it was a photo of baked beans and I couldn’t stop laughing.

I guess I’m just taking a moment to 1) congratulate myself on semi-mastering the home-cooked versions of these two foods, but also to 2) reflect on how there’s so much stigma, STILL, on what people with diabetes can/can’t or should/shouldn’t eat. It’s wild to me that there are countless people in our world who misunderstand that a diabetes diagnosis automatically eliminates certain food groups from an individual’s diet.

Let me say it louder for those in the back who can’t hear: People with diabetes can eat whatever they want. Diabetes varies from person to person, and so do dietary preferences – so just because one person with diabetes might follow a strict keto diet, it doesn’t mean that ALL people with diabetes do. It doesn’t make it right or wrong for a person with diabetes to choose or not choose to eat certain things – period, bottom line, end of the story.

And by the way – I took a big old bolus of insulin for aforementioned pizza and insulin and my blood sugar didn’t spike past 188 mg/dL several hours later – score! So I’m also using this blog post to remind myself that it’s okay to eat “treat” foods like this from time to time, and that does not make me a bad diabetic.

When Diabetes Disrupts Dinnertime

I collapsed onto my dining room chair, grappling with a dinnertime dilemma as my hands shook from a swiftly dropping blood sugar:

Do I correct the low now with something sweet, and wait to eat my dinner awhile, or do I wolf down my meal and stay seated until my blood sugar stabilizes?

Both options come with their own set of pros and cons. In the first scenario, I’d be eating dessert before dinner – nothing totally groundbreaking, but not overly appealing and requiring me to account for the sweet’s extra carbs in my dinnertime bolus. But at least I wouldn’t deal with low symptoms all throughout my meal. In the second scenario, I wouldn’t be enjoying my food at all; instead, I’d hoover it down like a human vacuum and keep all my fingers and toes crossed that the complex carbohydrates would kick in as quickly as possible. On the bright side, I also wouldn’t have to eat or bolus for any extra/unwanted sweets if I went with the inhale-all-the-food choice.

But what both options have in common is that they also completely ruin the dinner experience for me by either delaying the timing of my meal or rushing me through it, neither of which is desirable.

Hey, diabetes…you weren’t invited to the dinner table.

That’s just life with diabetes, though – dealing with a series of undesirable scenarios. In this particular situation, I ended up eating my dinner as quickly as I could and my blood sugar came back up about 20 minutes after I was done with it. I was simultaneously annoyed and relieved. Sure, I didn’t get to enjoy dinner at the pace I wanted, but at least my blood sugar was back to normal. And I suppose it just makes me appreciate all the other meals that I get to eat that aren’t disrupted by diabetes, and those totally exceed the ones that do (thank goodness).

The Daily Drink that My Diabetes Dislikes

I remember my first-ever cup of coffee. I was around 10 years old. I had it at my grandparents’ house, where much of my family was gathered for some sort of holiday or other occasion. Coffee was being served with dessert, and I asked my mother if I could try some – I wanted to know why all the adults in the room were so enamored with the seemingly innocuous brown beverage.

I’d like to say it was love at first sip, but I think it was only after I poured in a hearty amount of cream and 2 or 3 Splenda packets that I felt any affection for coffee. But once I did that? I was a goner. Coffee became a staple for me. I’d get it from Dunkin’ Donuts at the mall whenever I went shopping with friends, pour a cup on the weekends to have at breakfast, and when I was feeling fancy, I’d go to Starbucks and get a couple of pumps of sugar-free syrup to jazz up an otherwise ordinary order.

But whenever I try to add anything like milk, real sugar, syrups, or whipped cream…coffee gets real dicey for me and my diabetes.

Coffee can get real confusing for a person with diabetes.

In other words? I’m at a loss as to how to bolus for things like lattes, mochas, or cappuccinos – let alone any of the crazy, carb-loaded concoctions that you can get at cafes or Starbucks.

As a result of my confusion around coffee drinks and, let’s be real here, my laziness (because I could look up carb counts, but the sugary spike that my blood sugar could experience after having one of these drinks make it not even worth it for me to do research), I tend to drink coffee black. And luckily, I like it that way. But that doesn’t mean that I’m not tempted from time to time – like when the local coffee shop that’s just a half-mile away from my home introduced a winter drink menu with things like an Irish cream latte, eggnog latte, and gingerbread latte on it. I seldom give into the impulse to try those kinds of drinks, but they sounded too good to skip out on.

So rather than have all 3 at once – because I’m not totally reckless like that – I did give the seemingly-lower-carb option a try (the Irish cream latte), while my boyfriend got the eggnog latte. I figured it was the best of both worlds because I could have a fancy drink to myself while also getting to try one of the more sugary options.

And guess what? My blood sugar didn’t spike after I drank it, not even a little bit. I think the secret to my success was being super active all morning long after I got the latte (I was busy running errands and tidying up my home for guests that were coming over later in the day). My insulin intake for the latte, coupled with lots of movement, seemed to prevent any disastrous blood sugars – and I think it also helped that I ordered almond milk in lieu of regular milk to go in the latte. Whatever the actual cause(s), I was just thrilled to learn from this little experiment that I can enjoy specialty coffee drinks after all – probably not all the time, but definitely as an occasional treat, which makes me a happy and well- caffeinated T1D.

Carbs, Christmastime, and a Conundrum

I can’t believe Christmas is just a couple of days away!

It feels like the Christmas season just started, but really, I’ve had visions of sugar plums dancing in my head a whole lot longer than 23 days now.

Not just sugar plums, though. Christmas cookies. Homemade caramel sauce. Spiked hot chocolate. Reese’s trees (and bells, and nutcrackers, and any other shape Reese’s comes in)…

Conundrum: I love baking. I love Christmas cookies. I love tasting Christmas cookies that I’ve baked. As such, the above image of my Irish cream cookies is very tempting to me.

Needless to say, I feel like my sugar consumption is at an all-time high lately, no doubt due in part to the endless array of seasonal treats that seem to be readily available to me. This is partially my fault – I always have a stash of Reese’s in my home, and baking is one of my favorite hobbies (I feel obligated to try my creations before doling them out to friends and family, y’know, for quality assurance purposes). I should know better because I am very aware of the fact that I have little self-control, but said self-control is completely lacking lately.

So my conundrum is: Do I consume all the carbs this Christmastime and just have a “IDGAF” attitude about it? Or do I go ahead and enjoy all the delicious, carbohydrate-laden sweets of the season with minimal guilt?

I think the solution lies somewhere between those two extremes.

I won’t deprive myself of carbs, but I’ll be deliberate in how I go about eating them. I’ll pre-bolus so sugary spikes won’t appear as often in my Dexcom graphs. I’ll look up carb counts when I can. I’ll enjoy things in moderation, eating one treat at a time or sharing with others when I can so my carb intake gets automatically halved. And I won’t stop baking – it’s one of the things that brings me joy in life, so I know better than to cut out that entirely.

Besides, the Christmas season is so fleeting. I should indulge a little here and there and remind myself that it’s not just about the carbs and blood sugar spikes that cookies cause…it’s also about the holiday traditions associated with cookie baking and the memories made when eating them (and all the carbs). That fuzzy feeling makes me feel a whole lot better about my carb conundrum; coupled with my plan on how to approach carb consumption, I’m actually looking forward to eating many more Christmassy confections over the next few days.

An Ode to Reese’s Cups

There is no doubt about it: My favorite candy in the entire world (in fact, one of my favorite foods ever) is the utterly irresistible Reese’s cup.

Something about the combination of smooth, salty peanut butter and sweet milk chocolate speaks to my very soul – or perhaps it’s more accurate to say my taste buds. I know that I’m not the only one who feels so passionately about Reese’s (in any shape or form) – in my immediate circle, it’s the candy of choice of my mom, my boyfriend, several coworkers, and countless of other T1Ds that I know in the community.

Oh Reese’s, how do I love thee? Let me count the ways.

Besides the impeccable taste, what is it about Reese’s that is so appealing to people with diabetes, specifically? I pondered this as I had a conversation with one of my coworkers who does not have T1D. She mused that it could be because of the higher protein/fat content of Reese’s compared to other candies, which could make it easier to bolus for. I found myself agreeing with this notion – Reese’s doesn’t cause major spikes to my blood sugar, unlike Skittles, Sour Patch Kids, or Gummi Bears. The peanut butter in a Reese’s probably causes it to have a lower glycemic index, meaning it takes longer to process in the system. And according to the very little research I’ve done, nutritionists tend to agree that Reese’s are a relatively smart candy choice for those reasons, and in spite of their higher sugar content.

Beyond this, though, I honestly don’t know why so many people with diabetes that I know rank Reese’s as their number one candy. But I do know this: We’re definitely right about it being number one. And I can get behind any excuse to eat more Reese’s – bolusing properly for every one that I have, of course.

So it was with zero shame that when I recently picked up my 90-day supply of insulin from the pharmacy, I also added 3 bags of seasonal Reese’s shapes to my basket…they are absolutely worthy of me using that insulin on in the coming weeks!