A Temporary Diabetes Cure

I always envied people who experienced a diabetes “honeymoon” period. I used to think, how nice it must be to have some extra time to prepare for fulltime life with diabetes and not quite rely on insulin injections right off the bat! I also always assumed that, after 25 years living with diabetes, that the honeymoon phase had absolutely skipped over me, and I was positive I’d never get to experience it.

Turns out, my diabetes – that saucy little minx – likes to keep me on my toes as it recently surprised me with an abrupt 48-hour window of time in which it seemed like my diabetes was cured.

That’s the only way I can describe what transpired. It was the strangest thing. One day, I woke up, ate breakfast, and took insulin for it – just as I always do. Except instead of my blood sugar spiking or even leveling out after eating, it started to drop, which was strange because I ate a fairly typical meal that morning. At the time, I thought nothing of it and just ate some extra carbs before my blood sugar went too low.

No big deal, right? But this phenomenon happened again, following both my lunch and dinner. It was especially inconvenient in the evening, as I had a volleyball game and wanted my number to be up so I could play. I had some fruit snacks before the game to keep my levels up, but was surprised when even after that, I was dropping by the tail end of our third and final match. I remember being out on the court, trying to track the ball as my team bumped it back and forth over the net with the other team, knowing full well that my blood sugar was going low but feeling determined to stay in the game until it was over. The moment the final whistle blew, I ran to grab even more fruit snacks, and felt both annoyed and confused by the whole situation.

The following day, I decided I wasn’t going to mess around anymore. I wanted to cut my mealtime insulin doses in half to see if that helped me at all. It was a solid idea, but it didn’t prove to do much to help as I again dropped after breakfast and lunch. Okay, so clearly that course of action wasn’t enough. Maybe I could try switching from automated mode to manual on my Omnipod 5 PDM and put myself fully in control, rather than leaving it up to technology. I set a temp basal decrease to ensure I was getting very little basal insulin, and resolved to enjoy my pizza dinner that evening with friends.

Of course, pizza is notoriously difficult to bolus for, so I knew I’d have to do even more extra work in order to prevent my blood sugar from dipping. So not only did I take half the amount of insulin than normal, but I also did an extended bolus so that I wouldn’t get it all upfront. I ate two fairly large slices of pizza and also had a generous serving of chips that I technically didn’t include in my bolus calculations. So imagine my bewilderment when, 2-3 hours post-pizza, I was still going low. I poured myself a glass of regular soda, and it became my companion for the remainder of the evening. I’d take sips as I saw my graph report blood sugars that never went higher than 110, but fluctuated for the most part between 60 and 90.

It was wild, and I was actually getting pretty worried about the whole situation. I couldn’t make sense of it. I ran through all the variables that could’ve caused this to happen – was I wearing my pod in a strange site? Was it because of my period? Could it be due to my activity levels or changes in the weather? I weighed so many possibilities in my mind and came up with nothing definitive, so I went to my next best resource for input…the diabetes online community.

I asked around for input and was – as always – so grateful to the folks who reached out and served as thought partners with me. Based on what I learned, the most likely culprit is hormonal changes. In fact, perhaps it was a bit of a birthday gift from my diabetes as I ushered in a new age/phase in life. It’s still totally bizarre that it happened, but a friend reassured me of her own experiences with the same temporary phenomenon as she’s experienced menopausal shifts. So, maybe…just maybe this was the explanation I was looking for, and perhaps the whole thing happened to signify the start of my upcoming cycle.

I won’t ever know for certain if that was indeed the cause of my temporary reprieve from diabetes, but at least I can find a little comfort in knowing that I got through it (as my blood sugars and insulin needs bounced back with a vengeance the following day) and that I had the support and feedback from friends and strangers alike the whole time.

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The Last Time I Cried About My Diabetes

It was around 4 o’clock in the morning. Rain was pounding relentlessly outside my window. The power must’ve gone out, because flickering lights and the sudden sound of my heat turning back on woke me up with a start.

I tried to let the sound of the falling rain lull me back to sleep, but it was loud. I tossed and turned, doing my best to resist the temptation to check my phone and mindlessly scroll through various feeds until I felt sleepy again, but before long I gave in. As I almost always do every time I unlock my phone, I tapped on the Dexcom app so I could see what was going on with my blood sugar.

At that present moment, I was 92 and steady, but what my graph indicated to me in the previous couple of hours made me audibly gasp.

I had fallen to below 55 at some point in the middle of the night, and stayed in fairly low territory for nearly two full hours before making the slow climb back up.

That’s when it came surging back to me: The memory of waking up, some hours before, to the sound of an urgent low alarm. And then me totally ignoring it in favor of sleep.

The realization hit me as hard as the rain was striking against my rooftop, and then the tears welled in my eyes. I lay there, crying quietly, as I tried to accept the reality that choosing sleep over fixing my low blood sugar could’ve been an extreme error on my part. What if the rain and the power outage hadn’t woken me up? I recognized that given my current blood sugar graph, I would’ve been just fine, but regardless I had still slept through a low and that frightened me – I’m not sure if I’ve ever done that before. Just as I was beginning to really freak out, I felt a rush of gratitude toward my Omnipod 5. After all, it had seemingly detected the low blood sugar and then lessened my basal rate (or perhaps completely stopped delivering any basal insulin altogether) in order to bring my blood sugar back up. I felt as though the system had possibly just saved my life.

So I couldn’t help but lay there and let the tears fall, marveling at the technology that I felt indebted to at this particular moment in time, before I found myself drifting off into a dreamless sleep again.

Sudden as Lightning

It was as sudden as lightning, when it streaks across the sky just before the rain begins to fall, signs of a storm that that refuses to go unseen or unheard.

“It” being the sweat that began to bead on my forehead, then trickle down fast and furious as I grew more and more aware of a low blood sugar episode.

One moment, I was sitting cool, calm, and collected. I was alert and engaged in the conversation happening around me. And then boom, the sweat started and my concentration on my surroundings ended. Voices grew more distant as I honed in on my outward appearance. Panic struck – could others see how sweaty I was getting? Were they noticing my incessant fidgeting, a coping technique I have when my blood sugar drops and I get paranoid about maintaining an air of everything being just fine? My foot, already jiggling up and down as part of my fidget routine, seemed to pick up the pace as I began to get a grip on the reality that I needed to do something about this low before I further deteroriated.

The door to the room opens. I dart out, walking briskly down the hallway to where my low blood sugar supplies sat waiting for me. I gobble down a pack of fruit snacks as quickly as possible, and then force myself to sit. The sweat’s gotten worse and I worry about it being visible on my clothing. Seconds melt into minutes, somehow, though I pay them little attention as all I can think about is having this low blood sugar episode end, please please please, as soon as possible. I desperately want to escape to a restroom for privacy (and to mop the sweat off my body), but I’m immobilized by the low and also slightly nervous that it’s major enough that I might need help from someone in the vicinity so it’s a terrible idea to isolate myself from others. I push that thought out of my mind – I just need to give the fruit snacks some more time to work, that’s all. Keep it together, you’ve got this, stop freaking out so mu-…

…and just as suddenly as it had struck, the sweat dissipates. My shaky hands steady themselves. I regain an awareness of my environment. I exhale, relief flooding throughout my body as I realize that I’m recovering from the low.

Sudden as lightning, both in how it had struck and then how it had disappeared, leaving hardly any trace that it’d been there at all.

Tingly

I knew something was wrong when my tongue inexplicably began tingling.

It was a sudden, prickly sensation – almost like I had pins and needles on my tongue. (This is a sensation I get in my feet when I’ve had them in a certain position for too long and I need to get the blood flowing properly again. A quick Google search taught me that just about anyone can experience this, so odds are you already know what I’m talking about.) And it lingered for a solid 20 minutes, making my entire mouth feel as though it was simultaneously numb and on fire from the unrelenting feeling.

This is my new(ish) low symptom: tongue tingling.

And I hate it.

It only seems to occur when my blood sugar hits the 50s or 60s, which doesn’t happen too often. But when it does, it hits me so abruptly that it catches me off guard every time. It’s an unpredictable phenomenon – usually, my first sign of a low blood sugar is feeling shaky/sweaty/dizzy. Once I feel those initial signs of a low, I’m pretty good about being quick to do something about it by grabbing something sugary to eat…and when tingly tongue strikes, it can make the entire eating experience unpleasant because it almost feels like I’m having an allergic reaction to my low snack. And it lasts longer than it takes for my Dexcom to pick up on a recovering low blood sugar.

I’ve genuinely been worried that I was having an anaphylactic reaction in addition to a hypoglycemic event, prompting me on more than one occasion to run over to the closest mirror to check and make sure that my mouth and face aren’t swelling up or turning red. Let me tell you, it’s enough to deal with the low blood sugar sensation – feeling like I’m having an allergic reaction on top of that makes a normally easy-to-deal-with low that much, well, suckier, to be blunt about it.

I classify it as only sorta, kinda new because I’ve dealt with something similar in the past. In fact, roughly 4 years ago, I wrote about “a fuzzy towel tongue” feeling that I experienced after a low blood sugar. It’s funny that I wrote about it because I think at the time, I only ever felt that a handful of times, and the symptom seemed to disappear. But now, it’s apparently back with a vengeance, as the tingling feels much worse now than the numbness I’d felt a few years back.

At least I know that I’m not alone. I’ve talked to my fellow T1D mother about this and she’s also experienced it, in addition to the folks I’d interacted with in the context of my original post on the matter. It might not be fun, but there’s (quite literally) strength in numbers.

The Emotions of Low Blood Sugar

This post was originally published on Hugging the Cactus on October 8, 2018. I’m sharing it again today because as I sat down to write a new post, my blood sugar tanked…frustrating the hell out of me by taking away any and all creativity. But it did remind me of the timelessness of this post, and how the emotions of a low blood sugar can be so varied. Read on for more…

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:

#Diabetes 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.

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.

The Inconvenience of Low Blood Sugar

Blood sugar drops (and spikes, for that matter) are never convenient, per se. They often take my attention away from the moment or experience that I’m in, and it just so happens that there are times when it’s a bigger deal than others.

Case in point? The blood sugar plummet I dealt with in the middle of reactive dog class for my pup.

Let me set the scene: It was a warm October evening in New England – perfect weather for walking a dog around the neighborhood. That’s exactly what my classmates and I were doing: We had about a dozen dogs that were only just outnumbered by humans getting walked in repetitive loops. The challenge was to test the dogs for their reactivity and correct them whenever they tugged too hard on their leashes or got too excited by another dog, person, or squirrel that was also out and about.

The training exercise itself wasn’t difficult; in fact, it was nice to watch the sun go down and chat with the other dog owners in the class while I kept my dog by my side. But what made it a challenge was when all that walking in circles finally caught up with me and my blood sugar and I started to feel an oncoming low.

I was stressed about it, because I was feeling the shaky/dizzy symptoms of a low, but was struggling with finding a good time to correct it. After all, it would’ve been kind of weird for me to randomly start gobbling down some fruit snacks in the middle of a conversation with the other dog owners, and I really wasn’t up for explaining diabetes to everyone and taking attention away from the training. I thought I was in the clear when it was my dog’s turn to be walked by another trainer – my hands were free and I totally could’ve eaten something quickly – but I balked at it because again, I found myself engrossed in conversation as I was given pointers for walking Violet.

In hindsight, I probably should’ve excused myself from the training exercise to sit down and eat my fruit snacks, but I simply wasn’t in the mood for dealing with my stupid diabetes at this point in time. This is the one hour per week that I’ve got with my dog that is solely focused on training her, and I wanted to be present in the moment. But I’ve got to acknowledge that I can only take good care of my dog if I take care of myself first, and I neglected to do that as soon as I should’ve in this situation.

Ah, well. It was what it was, and luckily the low happened towards the end of the class so I was able to eat my fruit snacks in the privacy of my car without having to explain myself to anyone. Next time, I’ll be better prepared with a sugary drink (like Gatorade) that will be much easier to consume without explanation while walking my dog.

What Happened When My Blood Sugar Crashed in the Grocery Store

I knew something was wrong when the walls of the soda and seltzer aisle felt like they were closing in on me, Star Wars-trash-compactor style.

You would think a blood sugar is no sweat (pun intended) in a place where food is so easily accessible, but this experience was far from it.

On a recent trip to the grocery store, I went low. And when I say low, I mean low – I wasn’t just shaky, I was sweating literal bullets and having a hard time seeing straight in front of me.

My boyfriend – thank goodness he was there – knew something was wrong just by looking at me. He suggested that I grab some fruit snacks from my backpack and I heeded, tearing open the small foil packet and tossing the contents back as quickly as I could. I chewed, grimacing as I tasted the strangely saccharine, perfume-y gummies, but I barely cared about the taste. I just wanted to feel better. That’s when my boyfriend placed a hand on my back, noting my clammy state, and escorted me over to the dining area at the front of the store.

“Just stay here, I only have a few things left to grab. Maybe you’ll be feeling better by checkout time,” he said, before asking me if I was okay to be left alone.

I was. I hated that he was seeing my like this, in this vulnerable, sweaty state that seemed impossible in the chilly air of the grocery store. I told him I would sit and wait there for him, fighting the feeling that I was a small child waiting for a parent to finish up some boring adult task. As I nearly collapsed onto a chair, all I wanted to do was shrink so nobody could see me: It seemed as though all sets of eyes in the vicinity were locked on me, the perspiring wonder who looked quite unwell.

I was only on my own for about 5 minutes, but time dragged as I anxiously awaited my boyfriend’s approach to the checkout line. I thought I’d wanted to be alone as I let the fruit snacks kick in, but turns out the opposite was true. I clung to his side as I slowly registered that I felt safer around someone who knew exactly what was wrong with me and how to handle it if things got worse.

As we exited the store and loaded the groceries into the car, I noted that my shakiness was dissipating, as was the beads of sweat on my body. This low episode was over and I was relieved to be on the other side of it. I was also relieved that I didn’t have to go through it alone: turns out lows are a bit more bearable when you have someone else with you to help you through them.

What It’s Like to Wake Up in the Middle of the Night with Low Blood Sugar

You stir suddenly from a dreamless sleep, knowing that something must’ve disturbed your slumber but not quite sure what it may have been.

This blog post was inspired by a recent middle-of-the-night low that went…well, exactly as I wrote it here. I wrote in the second-person perspective so you might be able to imagine what it’s like, if it’s something you’ve never experienced before.

Reflexively, you reach over to where your phone is perched on your nightstand. You check your notifications and confirm what you’d been hoping wouldn’t be a problem tonight: Your blood sugar is low and you must do something to fix it.

You unroll a couple of Smarties from their package, almost surprised at how dexterously you do so. After all, it’s an odd skill to have honed over the course of your life to be really good at opening up packages of the food just moments after you were sleeping soundly, but you’re accustomed to it. You chew up the Smarties as quickly as you can, grimacing slightly as their sweet-sour taste mingles with traces of toothpaste from when you brushed your teeth before bed. You sink back against your pile of pillows, sighing, as you wait for your blood sugar to come back up.

You wait. You wait some more. You scroll mindlessly through various apps on your phone. You’re not feeling better. You wonder to yourself, how much more do I have to do to fix this? You wish you weren’t alone right now. Low blood sugars are scary to deal with on your own, especially when they sneak up like this in the middle of the night.

Your mind begins to spiral as those nasty “what ifs” enter your thoughts. What if you plummet further? What if you lose a lot of sleep over this one pesky low? What if you don’t recover from this low and…?

Just as you begin to think of the most unpleasant scenario, you realize that your shakiness has subsided. The sweat on your skin has dried and your vision seems to be less foggy – it’s hard to tell in the dark, but not wanting to turn on anymore lights, you settle back into bed more comfortably and close your eyes.

You hope you can go back to sleep quickly. You hope that you don’t have to wake up again for the rest of the night for any blood sugar-related issues. You hope that you aren’t exhausted because of this one tomorrow.

You hope that tomorrow night is different, but with diabetes, you never know.

5 Ways Hot Weather Affects Diabetes

I’ve posted this on Hugging the Cactus a couple of times now – once in 2018 and again last year. I’m sharing it a third time today because we are in the throes of summertime now that July has arrived, and I needed a little reminder as to why it’s important to take certain precautions when it’s hot outside to take the best possible care of myself and my diabetes…

The summer heat seems to be here to stay in Massachusetts. We’ve experienced several weeks of soupy, high-heat weather that *almost* makes me long for cooler, autumnal days…but not quite, because that just means winter (and snow – blech) is right around the corner.

Truly, I do enjoy the summertime. To me, summer is about trips to the beach, ice cream consumption (and lots of it), barbecues with family and friends, long walks in the neighborhood, and endless outdoor adventures. Aside from all of those lovely things, summer also means that it’s time to be a little more diligent when it comes to my diabetes. That’s because hot weather can play some cruel tricks on a T1D’s body. What do I mean by that? Here’s five ways diabetes can be affected by hot weather.

Another thing to know about hot weather and diabetes? It will most definitely trigger ice cream cravings. Bolus accordingly.
  1. Dehydration can lead to high blood sugar. Everyone knows that it’s important to stay hydrated when it’s hot out, but it might be less common knowledge that dehydration can directly affect blood sugar. There’s a scientific explanation for this: If not properly hydrated, the body sees an increase in blood glucose concentration because blood won’t flow as easily to the kidneys, making it difficult for the kidneys to get rid of excess glucose in urine. The best way to prevent this, naturally, is to drink plenty of water and monitor blood sugars.
  2. Sunburn can drive up blood sugars. I’m very familiar with how a sunburn can result in higher blood sugars; in fact, just last week I was dealing with a particularly gnarly sunburn on my thighs and belly that not only made my numbers higher, but also really hurt. My skin was literally damaged, so the stress from the injury lead to retaliation from my blood sugar. Luckily, it only lasted about 48 hours, but those couple of days were challenging as I dealt with sticky highs that were practically resistant to insulin. And for the record, I DID apply sunscreen – numerous times – when I was at the beach. Next time, I’ll seek shade under the umbrella.
  3. Sweat can make it difficult for devices to stick. I don’t know a single medical device that’s immune to prolonged exposure to moisture/water, but that doesn’t prevent me from spending as much time as I can outdoors/at the beach/by the pool in the summer. Thank goodness for Skin-Tac wipes and medical adhesive tapes that help preserve my precious pods and sensors!“
  4. Insulin can overheat. There’s a reason why insulin vials come packaged in cartons with directions that specify what temperature insulin should stay at in order for it to be safe to use. Insulin can spoil easily when it reaches a certain temperature, so it’s important to store it in a cool place when the weather’s warm. I alternate between a mini portable cooler (that can hold 3 vials of insulin) and a pouch from FRIO – both do an excellent job at keeping my insulin cool.
  5. Low blood sugars can occur more frequently. Summertime is prime time for outdoor activities that result in higher energy expenditure. So it’s no wonder that blood sugar tends to plummet in hot weather. Looking at it on the bright side, it’s an excuse to eat even more ice cream – but it also means that monitoring how I feel and checking blood sugars often is that much more important.

Regardless of the diabetes challenges it may cause, I love summer weather, and I know I’ll miss it the moment the first snowflake falls this year.

A Security Blanket

I never thought I’d come to think of a nasal spray as a security blanket, or something that would provide me great ease of mind, but that’s exactly how I feel about my Baqsimi prescription.

I’m all stocked up on Baqsimi for the time being.

Baqsimi is a nasal glucagon that is a million times easier to use (or at least, understand how to use) in an emergency situation than those old red kits from the days of yore. In all my years of diabetes, I never could remember step-for-step what the process was like for using glucagon – in fact, I had an app downloaded on my phone just so I could practice it every so often as a refresher, but even with the app I felt ill-equipped to use glucagon on myself, or anyone else for that matter.

That’s why when I first heard about Baqsimi a few years ago, I breathed a sigh of relief. Finally, there was an option out there besides glucagon! The freedom to have choice, rather than be forced to stick with something, goes a long way in life with diabetes…in life, period. I was excited that I could choose to keep Baqsimi on hand just in case I ever did experience a severe hypo, a possibility that has always frightened me, especially when I started living alone a year and a half ago.

And when I was recently taking inventory of my diabetes supplies, only to discover that my Baqsimi was expired, I made it a priority to get it refilled as soon as I could because of just how much I’d reaped the benefits of peace of mind. So I made a point of calling my doctor and asking for fresh prescriptions for both Baqsimi and insulin, because it just so happened that I was running low on my Humalog stash.

A couple days later, I went to the CVS drive-thru, picked up the prescriptions, and drove home. While driving, I couldn’t help but feel so grateful that it was actually easy for once to do something for me and my diabetes that was necessary and would provide me comfort. If only it could be like that every time.