Minty Apple Juice

Some weird food combinations actually work – I know this for a fact because I Googled it and the Google machine is always right…right?

Okay, so maybe I’m not brave enough to try combos like olive oil and ice cream or oreos in orange juice, but at least I can tell you about an odd food pairing that most definitely does not work.

And that, my friends, is anything minty with apple juice.

I should know because I got to try this less-than-delightful combo two nights in a row…thanks to diabetes.

If you’re guessing that I experienced a low blood sugar immediately after brushing my teeth and chose to correct it with apple juice both times, then you’re a smart cookie (or at least a cookie who can put two and two together).

On the first occasion this happened, I figured that drinking a juice box for the low was probably the wisest decision because I wouldn’t have to worry about getting food stuck in my teeth – I could maybe even drink the juice without needing to brush again.

I was very wrong about this.

10/10 would not recommend drinking apple juice right after brushing teeth.

The moment I started drinking my apple juice, my taste buds were rocked by the unpleasant union of minty freshness with tart sweetness. It was truly disgusting and I wanted nothing more than to brush my teeth again…but laziness and exhaustion (from both my day and my blood sugar) caused me to collapse into bed instead. I fell asleep with that weird bitter taste lingering, much to my chagrin.

So you can bet that when the exact same thing happened the following night – my Dexcom alerted me to a low within 60 seconds of me finishing my teeth brushing – I forced myself to brush my teeth again because I simply couldn’t stand the minty-apple-y taste.

And I decided to make a mental note, after this second encounter with nasty minty apple juice, that I would check my Dexcom before brushing from that point onward.

The 1 A.M. Cupcake

Zzzzz…huh? What’s that? I was sleeping so deeply…

Oh, I’m low.

Dazed, I roll out of bed and suddenly become aware of how hot I am. Beads of sweat are rolling down my back, making my pajamas stick to my skin. I look at the number on my Dexcom – there isn’t one.

It just says LOW.

I grow more alert and turn to my test kit to do a fingerstick check and verify my Dexcom reading. My meter says that I’m 44.

And suddenly, I’m feeling that low. I need sugar, stat. I could open the bottle of glucose tabs conveniently perched on my nightstand, chew 5 or 6, and then get settled into bed and fall back asleep relatively quickly. But the desire to get downstairs and eat the contents of my kitchen strikes, even though it’s 1 A.M. and eating too much at this time of night wouldn’t be good for either my blood sugar or my sleep hygiene.

Ignoring my more rational side (as well as my glucose tabs), I grab my phone, my meter, my PDM, and my bathrobe and stumble down the stairs in the dark. I turn on the ceiling fan in my living room in a desperate attempt to cool down faster before I walk into the kitchen.

My eyes fall on a cupcake sitting innocently on the counter.

This isn’t a picture from this particular incident – nobody wants to see me when I’m this low – but this is one of the cupcakes that I’d made. Violet always wants me to share.

I don’t think twice – I tear the wrapper off and three bites later, it’s gone.

I collapse on the couch, directly under my ceiling fan. I am a sweaty mess. This low is hitting me hard. I put the TV on in a futile attempt to distract myself while I wait for the cupcake to kick in, but instead of paying attention to what’s on the screen, all I can feel is gross for choosing to eat a damn cupcake at 1 in the morning instead of doing the “right” thing and treating my low from the comfort of my bed with glucose tabs.

20 minutes later, I start to feel chilly. I’m no longer perspiring and I feel all of my low symptoms subside. I’m better, so it’s time to head back upstairs and try to fall back asleep.

I toss and turn for a bit, cursing diabetes and its middle-of-the-night low blood sugar curveballs, and the stupid 1 A.M. cupcake that my diabetes somehow convinced me to eat to treat a low instead of waiting to have it at a time that I could actually enjoy it.

Diabetes strikes again, I think as I drift back to sleep.

Trying to Outwalk a Low Blood Sugar

I was a mile into my regular morning walk when the beeps started.

Dammit.

The beeps were coming from my Dexcom app on my phone and they were alerting me to a low blood sugar. Rather than correcting the low, though, or even opening up the app to dismiss the alarm, I just kept walking.

Outwalk the low blood sugar, Molly.

Outwalking a low blood sugar is easier said than done.

I really couldn’t understand why my blood sugar was low in the first place considering that I had no food in my system or insulin on board (other than my standard basal rate). Fasting workouts tend to virtually guarantee stable blood sugars for me, which is wonderful because otherwise exercise tends to make me crash. But what was different about this morning? I was utterly befuddled. My Dexcom alarm chimed a second time.

Outwalk the low blood sugar, Molly.

Even more confusing was my complete and utter determination to not treat the low blood sugar until I got home. I had glucose tablets on me, so it’s not like it was a matter of lacking a treatment. Rather, I think I was more focused on maintaining my fasted state for as long as possible, since I almost always do an exercise circuit (weight lifting, cardio training, HIIT intervals, etc.) when I return home from my morning walks. My low alarm rang a third time, just as loudly as it had before.

Outwalk the low blood sugar. You’re only 15 minutes from home.

I was deaf to my Dexcom’s persistent alarms for the next 15 minutes as I somewhat floundered down the road home, letting my impatient puppy tug me along. It’s almost like she knew that I was low and was trying to hurry me home, and I was 100% okay with that because my brain was starting to get fuzzy.

Outwalk the low blood sugar…

At long last, nearly half an hour after my first low alarm sounded, I was crossing the threshold of my front door and fishing my phone from my bag. I tapped through my notifications and cleared the low alert, noting that I was 66 mg/dL and definitely needed to eat something before continuing on with my morning routine. I sighed, set my sight on the kitchen (where a low blood sugar food stash awaited me), and resigned myself to the fact that I couldn’t outwalk the low blood sugar this time.

5 Ways Hot Weather Affects Diabetes

This blog post was originally published on Hugging the Cactus on August 6, 2018. Call it an “oldie but goodie” because the ways in which hot weather can affect diabetes haven’t changed in the last few years and they won’t be changing any time soon…and with summer just around the corner, it’s good to remind ourselves of the extra precautions we might want to take in order to combat the heat. Read on for more on the ways summer weather can affect people with 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.

Mr. Sun, Sun, Mr. Golden Sun, please shine down on me (and don’t make me go low or high…)
  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.

3 Things That Make Low Blood Sugars More Tolerable

This post was originally published here on Hugging the Cactus on August 21, 2019. I’m sharing it again today because it’s the perfect little companion to Monday’s more hateful post geared towards high blood sugars.

Okay, to be TOTALLY honest, low blood sugars aren’t – and won’t ever be – fun. Nine times out of ten, they can be inconvenient, upsetting, and even scary (depending on how low it is). But like most things associated with diabetes, I try to look at the bright side every now and then to remind myself that it could be worse. So even though I don’t welcome low blood sugars in just about any circumstance, I decided to look at them, and their less-than-pleasant side effects, from another perspective. Hence, this three-item list that explains what makes low blood sugars slightly more tolerable to me.

#1: The sweat. I detest sweating. I don’t care if sweat is the result of a good workout or a day spent at the beach – it’s gross either way. And it’s definitely not an attractive low blood sugar symptom. But…on the other side…I tend to sweat a LOT when my blood sugar is low and it makes me feel like I’ve just had an excellent workout without any effort or exertion on my part. So I guess it’s kinda like gleaning the health benefits that you’d get from sitting in a sauna for a bit? IDK…it’s a bit convoluted but just agree with me on this one.

#2: The excuses. I’ve made it a personal mission to try to avoid using my diabetes as a scapegoat. There are times, though, that it really does prevent me from doing something in a timely manner/when I’m asked. For example, if I’m experiencing a low blood sugar at work and a colleague comes by to talk to me and ask me for something, I do find it’s best to let them know that I can’t attend to it right away because of the blood sugar. Nine times out of ten, people understand, and they let me treat it accordingly. And it gives me time to just relax and deal with it, taking the stress away from a situation by simply being honest about it (so I guess it isn’t really an excuse, but sometimes I feel a little guilty about using a low as an out on something. Low guilt is real, people!).

#3: The cake. (Or really any food when you’re low. Because it all tastes delicious. But nothing is quite as satisfying as cake.) I think the inspiration for this blog post came when I was enjoying a big, fat slice of cake in order to bring my blood sugar back up. My goodness, some foods just taste beyond amazing when I’m using them to treat a low. The sweeter it is, the more satisfying it is to both my taste buds and blood sugar levels. And anyone who has experienced a low blood sugar before (people with and without diabetes) can attest to the fact that food is simply a million times better when it’s being consumed at a time that your body is URGENTLY telling you to feed it.

Alright…now that I’m looking back at these three things, I’m kind of laughing at myself. Because I can TRY to make low blood sugars a more positive thing, but let’s be real, they still kind of suck. But I guess there’s no harm in trying to be upbeat about them.

5 Things That Make My Blood Sugar Crash Quickly

Have you ever noticed that certain activities have a swift and obvious impact on your blood sugar levels?

Well, if you aren’t a person with diabetes, then the answer to that is probably “no”…but I digress! Recently, I realized that there are five things that absolutely, definitely, without-a-doubt make my blood sugar plummet before long. Here’s my list – what’s on yours?

1 – Vacuuming. I live in a fairly small condo – less than 900 square feet total – but when it comes time to vacuuming the floor, it takes me a good chunk of time to do a thorough job. Maybe about 30 minutes total. So it shouldn’t be surprising that by the time I’m done, I’m normally a little sweaty and often in need of a snack because all that moving around has made my blood sugar drop.

Who else “celebrates” vacuuming their entire home by cracking open a fresh…juice box??

2 – Baking. This might be surprising because I’m the type of baker who must lick the spoon and sample the finished product as soon as it’s done, so you might assume that this activity makes my blood sugar go up. Not so. And this is because I am also what I call a “frantic baker”. I shuffle around the kitchen, rifle through cabinets, curse when I can’t find an ingredient and need to rush out to the store to get it…now you must get the idea. I’m always in motion when I’m baking, which pays off in the end. I need to try my baked goods in order to boost blood sugar that went low in the process of creating them. This is one of the many reasons why I love baking!

3 – Playing with my puppy. Little Miss Violet is four months old now and more rambunctious than ever. She loves fetching, running, chasing…and nine times out of ten, I’m fetching, running, and chasing right along with her. Before too long, Violet’s winded and on her way to dreamland while I’m on my way to the kitchen to grab something that will treat my low blood sugar.

4 – Cleaning the bathroom. A self-professed neat freak, I have a very specific process when I’m cleaning the 1.5 bathrooms in my condo. This process probably isn’t the most efficient because it involves a lot of walking up and down the stairs to gather various cleaning supplies, but it does do one thing well: lower my blood sugar, of course.

5 – Walking. This is pretty dang obvious because any sort of physical activity/exercise is bound to make my blood sugar drop, but not in the same way that walking does. I swear that 10-15 minutes of walking at a normal pace is enough to drop my blood sugar by about 100 points – that’s how effective it is for me. Walking is my sneaky little trick when my blood sugar is a tad too high: Instead of taking insulin to correct it, I just have to get a quick walk in and I’m falling fast in no time.

The Truth About My Carb Counting

One of the many reasons why I love the diabetes community is that I’m constantly learning new information, finding inspiration, and enjoying support from my fellow friends living with T1D. Sharing our stories with one another leads to us finding that it’s more than diabetes that we have in common.

Here’s an example: My friend, Cherise Shockley, recently wrote an article for DiaTribe in which she made a confession to herself regarding how she counts her carbs. I recommend reading the extremely well-written article to get a full sense of what she discovered, but in short, Cherise recently realized that her carb counting is inaccurate because of the “glass ceiling” for entering carbs into her pump for bolus calculations. In other words, Cherise’s personal maximum of carbs that she was comfortable with dosing for using her pump wasn’t aligning with the actual amount of carbs she was consuming. This excerpt explains part of it:

That was my moment of truth. I told Natalie I ate my favorite chocolate chunk cookie that day. She asked me how many carbs the cookie contained, and I told her 68 grams; she wondered why I only bolused for 55 grams. I paused before I replied – I did not know the answer.

Natalie then asked me if I had a glass ceiling for entering carbs in my pump. She explained that this means even though I know I eat 63 carbs, I will only enter 50 carbs in my pump because anything higher than that concerns me. What she said was interesting; I had never heard anyone describe it to me in that way.

-Cherise Shockley

When I read this, I said, “Yes! Finally, someone is able to articulate exactly how I handle carb counting!”

This is the truth about my carb counting: I have limits when it comes to how many carbs I will bolus for at a time, but those limits do not apply to the actual number of carbs that I consume.

In my 23 years of life with type 1 diabetes, I never knew the meaning behind my carbohydrate glass ceiling.

To explain, I am only comfortable with bolusing for a maximum of 60 grams of carbohydrate at a time. I do not know how I came up with this particular number, but I do know that there are situations (e.g., holiday celebrations) in which I am absolutely consuming more than 60 carbs in a sitting, and yet I only bolus for that amount.

Still confused by what I mean? Read the full article to understand, but this excerpt from it helps to explain why this fear of bolusing for more than 60 carbs at a time exists for me:

To learn more about carbohydrate glass ceilings and why some people have one, I talked to Dr. Korey Hood, a professor of pediatric endocrinology and psychiatry and behavioral sciences at Stanford University who has lived with type 1 diabetes for over 20 years. Dr. Hood told me that all parts of diabetes management can be challenging, and carb counting is particularly tough because it is hard to be accurate and precise. He always recommends people with diabetes meet annually with their diabetes educator (CDCES) to get a refresher on different aspects of diabetes management, including carb counting.

Dr. Hood said that the glass ceiling is most likely due to one of two issues – worries about hypoglycemia or the meaning behind taking such a big dose of insulin. Dr. Hood said that “many of us with diabetes, particularly those on insulin, worry about going low. Why wouldn’t we – it is a terrible feeling! We often experience fears of hypoglycemia because we had a terrible low in the past and have a desperate desire to avoid it in the future. When we worry about hypoglycemia, we scale back our insulin dosing. This prevents the low but also likely results in high glucose levels. So, it really is not a good strategy.” 

-Cherise Shockley

This was a major revelation for me because suddenly I realized what my reasoning is for my carbohydrate glass ceiling: I have a hypoglycemia fear. I have experienced scary episodes in the past (fortunately, none of which have required medical attention). I have friends who have experienced severe hypoglycemic episodes, and when a colleague of mine experienced a low episode that was so bad that I had to call 911 for him, it left a mark on me. So on the occasions that I do eat more than 60 carbs in a sitting, I simply don’t take the amount of insulin that I should to account for those carbs, and I wind up going high, exactly as Dr. Hood describes in the quote above.

When it comes to diabetes, there is no such thing as “perfection”. My blood sugars cannot and will not be perfect 100% of the time. But one thing that I do have control over is doing the absolute best that I can with carb counting and bolusing. It’s time I hold myself more accountable to my carbohydrate glass ceiling…in fact, it’s time for me to smash through it.

A ginormous thank you to Cherise for being so open and honest in this piece and for inspiring me to own my carbs, too.

The Worst Time for a Low Blood Sugar

There’s never necessarily a good time to have a low blood sugar: Whenever they happen, they’re bound to be at least a little inconvenient.

But I was thinking about it the other day and it occurred to me that there is most definitely a worst time for a low blood sugar…at least, for me.

And that time is the middle of the night.

I love sleeping, but like many adults, I simply don’t get enough of it. So when something like a low blood sugar interrupts my slumber, it’s downright intrusive and honestly a bit scary, because I always have an underlying fear that I’ll sleep through my Dexcom alarms.

Take a recent middle-of-the-night low blood sugar for example…I was dealing with a lingering low at 1:30 A.M. I’d only been asleep for a couple of hours when I heard my Dexcom sound. I ignored it the first 3 times it went off, but something – my intuition, maybe – told me to roll over and at least check to see the level that my Dexcom was reporting.

I was somewhere in the 60s: low enough that I needed a juice box. I promptly drank it and got settled back under my covers, assuming that I would shoot back up in no time.

Nothing like waking up to a screaming Dexcom that demands you to eat sugar, stat!

Not quite. I don’t know how many minutes later, but I looked at my Dexcom again and it said I was 56. I did the whole “confirm the number with my meter” shtick and ate some glucose gummies to supplement the juice box. I was irritated and my eyes were oh-so-heavy, but from there I forced myself to turn the television on and try to get distracted by a show so I wouldn’t fall back asleep until I knew that my blood sugars were stable again. Before too long, I was heading up, so I did my best to lull myself to sleep, though I tossed and turned for awhile before I finally did drift off.

All in all, I lost about an hour to an hour and a half of sleep because of this one instance! Not all of my lows are like that – sometimes I can fix them in 5 minute flat, other times they keep me up for upwards of two hours – but it doesn’t even really matter. It’s more so the principle of the thing.

Plus, think about how freakin’ ridiculous it is that people with diabetes have to eat something sugary to come up from a low – that in itself isn’t wild, but it IS grating to have to do in the middle of the night when you aren’t hungry and were enjoying a deep sleep. Also…ever try drinking orange juice after you’ve brushed your teeth? It’s unpleasant, to put it mildly.

So you have it: The middle of the night is the absolute worst time for a low blood sugar, in my semi-expert opinion.

My Lowest BG: How I Handled It and What It Taught Me

There should be an asterisk after this blog title…because this is going to be about the lowest bg that I can really remember and have an actual blood sugar to associate with it.

Let me elaborate…

My real lowest low happened when I was in high school – I got out of bed one morning, stumbled down the stairs, and slurred to my mom that I wanted a bowl of Special K cereal for breakfast (she couldn’t understand what I said and promptly panicked before realizing I must be low). I don’t know what my blood sugar level was that morning because I neglected to do a fingerstick check, but I do know that it was a downright freaky incident that’s cemented in my memory.

But another new incident recently occurred that shook me in a similar way.

It was 1:30 A.M. I was nodding off when I heard my Dexcom alarming. I checked it and was somewhat surprised to see that I was 92 with two double down arrows. (I say “somewhat surprised” because in the earlier evening hours, I spent 3-4 hours chasing a stubborn high blood sugar and definitely wound up stacking insulin doses.)

Even though I wasn’t feeling any low symptoms, I decided to start treating the low. I ate two boxes of mini raisins, equaling about 20 carbs…

…and swiftly grew worried when I saw the number on my Dexcom app to continue to drop.

Below 55.

Okay, let’s have another box of raisins.

Below 50.

Alright, let’s do a fingerstick check.

42.

Sheesh, I’m fumbling around in the dark, trying to locate my meter…

LOW.

By the time my Dexcom said “LOW”, it was confirmed on my meter that I was, indeed, quite low. 35, to be exact.

If only my Livongo meter knew I needed a whole lot more than a tablespoon of sugar, jam, jelly, or honey…

And that was a number that frightened me.

Thank goodness I wasn’t alone when I was dealing with this 35 (that wound up lingering for a solid 15-20 minutes before slowly creeping up about 45 minutes after I ate my first box of raisins).

Thank goodness I had someone there to make sure I had plenty of sugar in my system before I fell asleep.

Thank goodness I had a can of regular ginger ale, some Reese’s, Dove chocolates, and popcorn all within arm’s reach (yes, I really did need to eat all those carbs in order to treat this one low).

Obviously, I recovered from this scary low, but it taught me that now that I’m living alone and won’t always have someone around me in the middle of the night, I should start thinking about inviting someone to follow me on the Dexcom app.

The next day, I talked to my parents about what happened and the three of us agreed that my dad will receive notifications if/when my blood sugar drops below 55. I feel a lot better knowing that he has access to my levels and that he knows to contact me if I’m low.

I’m not exactly grateful that I experienced this very low blood sugar…but I do appreciate that it’s reinforced the importance of having a nightstand fully stocked with low treatments as well as making sure that my family has a way of checking in on me when I may need their support.

How Diabetes Told Me It’s Too Early for Christmas Decorations

We all know that 2020 has been a sucky year, so it’s not exactly surprising that immediately following Halloween, the world seemed to throw itself into the holiday spirit.

Between the commercials on TV, Black Friday sales, sparkly decorations, baking galore, and Hallmark movies, the Christmas season kicked off early and with major vivacity. Normally, I’m the kind of person who prefers to enjoy one holiday at a time, and I was somewhat repulsed to see all the Christmas merchandise in stores before Halloween was over.

So even though Thanksgiving hasn’t even come and gone yet, I’ve abandoned any remaining willpower I’ve had to hold off on decorating for Christmas. Like the rest of society, I simply couldn’t hold back my desire for some cheer!

One afternoon last week, I decided to haul up my Christmas tree and its accompaniments from the basement and start the process of decking the halls…

…but my diabetes had other ideas.

Maybe my diabetes would’ve liked it better if I decked the halls with glucose tablets and test strips…

I’d just finished assembling my modest tree when I heard my Dexcom alarm sounding off, alerting me to a low blood sugar.

And I hate to admit it, but it didn’t surprise me – I’d felt the oncoming low for about 10 minutes prior.

I just wanted to decorate so badly that I was willing to ignore my blood sugar in order to embrace the Christmas spirit!

Alas, not too long after I heard that alarm, I knew I had to change my priorities as I started to get sweaty and a little woozy…so I left my tree naked and sought out a low treatment, slumping at my table in defeat while I ate it.

My diabetes told me it was too early to decorate for Christmas at that moment in time…

But you know that I told my diabetes otherwise later that night when I spent hours trimming the tree!

‘Tis the season and ain’t no way that my diabetes will prevent me from basking in it.