Brunching with ‘Betes

Confession: I’m a brunch lovin’ millennial who also really hates brunch.

The reason I hate brunch (besides waiting all morning long to eat my first meal, I get hangry) is that it annihilates my blood sugars.

Breakfast Alley
It’s not uncommon for me to spend several hours after brunch trying to correct a high blood sugar.

It probably has a lot to do with the aforementioned fact that the timing of a typical brunch is typically not favorable when it comes to my basal rates and insulin-to-carb ratios. On a normal weekday, I’m used to eating breakfast within an hour of waking up. My body and my blood sugars are very much so accustomed to this pattern, so when it’s interrupted, it shouldn’t be any wonder why they don’t respond well.

It’s not that I don’t try. I do everything I can to offset the lateness of a brunch meal by running a temp basal and ordering as low carb as I can. And it seems to work well, up until I get up to leave the table and head home. Often, I find myself correcting two or maybe even three times after brunch, and it’s extremely annoying.

Maybe I could help curb spiking blood sugar by ordering just one mimosa, as opposed to two or even three (or just skip drinking them altogether, but seriously, I’ve had enough mimosas in my life to know how to properly bolus for them). Maybe I could insist to my friends that brunch plans should be earlier and force all of us to wake up early on a weekend morning. Maybe I could skip brunch plans altogether.

But that would be accepting defeat. Just like I refuse to let diabetes ruin any aspect of my life, I won’t let it stop me from enjoying brunch with whomever I please. I’ll figure out how to avoid post-brunch highs, I just know it. It’ll just take a little more time and patience…and several more brunch outings. Yum.

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Testing for Accuracy, in Addition to Blood Glucose

This post originally appeared on Hugging the Cactus on March 21, 2018. I’m republishing it now because of a recent experience I had with my meter reporting inaccurate and inconsistent blood sugar levels. Has this ever happened to you? Drop a comment and let me know.

Blood glucose meters serve the sole purpose of checking current levels of glucose in the blood. Pretty self-explanatory, right? And it’s equally obvious that it’s crucial for all meters to generate accurate results so PWD can make the right treatment decisions based on those numbers.

Unfortunately, though, accuracy isn’t always what I get.

The other day, I was running low before bedtime. I corrected with an organic rice crispy treat (honestly, it was a million times better than the brand name kind). I waited nearly an hour for my blood sugar to come up. When my CGM wasn’t showing any progress, I tested: I was 47. It’s rare for me to be that low, so I tested again. 52. I believed it, especially since I was experiencing several hypoglycemic symptoms.

B. J. Palmer

I chugged a glass of orange juice and plopped down on the couch to wait for signs of improvement. Before long, I was freezing cold – a sure sign I was coming up, because I had been sweating 20 minutes prior. But I didn’t feel comfortable going to bed yet. I wanted to see if my CGM would show an up arrow. When it finally did, I made my way upstairs to brush my teeth and wash my face. In the middle of my routine, though, I decided to glance at my CGM again – and saw the dreaded ??? screen.

I decided then that the Dexcom should be out of commission, a.k.a. not trusted at all, for the remainder of the evening.

I ripped it out and inserted a fresh one, not really caring that it would wake me up in two hours to be calibrated. I would need to set at least two alarms for the middle of the night, anyways, if I decided to go to bed disconnected from my Dex. So it just made sense.

Once that was done, I tested again. I was pretty tired at this point and really didn’t want to have to eat something else, so I did it as quickly as I could. In my haste, I jostled my meter just so – enough that I saw the test strip, already marked with my blood, move slightly as it brushed against my PDM and was placed next to it.

113 mg/dL flashed upon the screen. Normally, I’d be thrilled! But I furrowed my brow. Something just felt…off about that reading. So I tested again.

206.

What?!

I tested a third time – 203. Okay, something was definitely wrong. Either that 113 was wrong (likely) or my meter had just produced two wildly inaccurate blood sugars in a row (less likely).

This is one of the many times that it’s convenient to live with another PWD. I asked my mom if I could borrow her test kit and see what result it generated. Seconds later…a twin 203 popped up on the screen, reassuring me that the 113 was a fluke on my meter.

Relief with the reality and irritation with the technology washed over me simultaneously as I went to correct the high with a bolus. I was glad I wasn’t heading down again, but irked that my meter had failed me. True, it was a bit of human error there, but aren’t we at a point in technological advancements where this sort of thing just shouldn’t happen? I put my life into the “hands” of my meter, Dexcom, and OmniPod. They should produce results that are undoubtedly accurate.

I guess we aren’t quite there yet.

How Moving to a New State Impacted my Diabetes

A few short days ago, I made the move from Massachusetts to Virginia…and just as I predicted, the whole process has been emotionally draining. I’ve cried more times than I can count. I’ve busted my butt trying to get settled as quickly as possible. I’ve been eating poorly as a way to cope with my emotions. And my blood sugars have been all over the place as a result…again, just as I predicted, but still a bit disheartening.

I knew to expect some diabetes turbulence from the get-go. After all, a seven-hour car ride doesn’t exactly bode well for anyone’s blood sugar. But surprisingly, the drive to Virginia was probably when my blood sugar was most stable. I was snacking a little (okay, a lot) on the drive because it gave me something to do other than cry and talk unintelligibly to my boyfriend (my trusty driver) and it was far from healthy snacks…think fast food breakfast sandwich, Reese’s cups, and trail mix. Could’ve been worse, could’ve been a whole lot better. I think that because I was well aware of the high carb content of my snacks of choice, it motivated me to stay on top of my blood sugars and give myself micro-boluses as needed.

So that was all well and good.

Then came the actually moving-in process.

You are a rare gem.

Box after box and bag after bag were transported from the car, up three flights of stairs, and down a long hallway. It’s no wonder that I went a little low from all that back-and-forth, though I did think that riding the elevator as needed would’ve prevented too much of a drop. And if I could go back in time, I’d like to address the day that I took off from work to do the bulk of my unpacking and adjust my temporary basal settings to something like a 50% decrease for six hours or so. That’s because as I sorted through clothing, emptied boxes, and organized all of my possessions, my blood sugar just did not want to stay put at a comfortable level. Over the course of the very long day that I spent unpacking, my blood sugar dropped low enough that I had to stop what I was doing to eat three times. It felt like I was constantly stuffing my face with food, which was frustrating and the last thing I wanted when all I desired was to get settled.

That’s the physical component of moving – a lot of labor; more specifically, lifting, tidying, hanging, folding, unfolding, and if you’re me, cursing.

But there’s an emotional side to it, too, that I would guess affected my blood sugar just as much as the physical aspect did.

I’ll be honest: Tears were shed. Anxiety felt like it would swallow me whole at points. Doubts ran through my mind as I wondered whether I was strong enough to be so far away from family and friends. I was feeling – and am still feeling, TBH – so many different emotional swings that I am fairly certain that I can blame my blood sugar swings on them.

I’ve said it before and I’ll say it again: I know I need to give myself time to adjust. I’ve got to take it day by day, hour by hour, moment by moment. I need to let myself feel the way that I feel and remember to be kind to myself, especially where diabetes is concerned.

It just helps to write it all down.

A Pod Failure Won’t Foil my Fun

I had just zipped up my coat when I heard a faint, high-pitched beeeeeeeeeeep emerging from somewhere in the vicinity.

My mom and I exchanged looks. “Uh, oh,” we said simultaneously.

“It isn’t me,” Mom said, patting her pod.

“It can’t be me, it sounds too far. Are you sure it’s not the refrigerator door that was left open?” I asked, as I unzipped and peeled off my coat.

She didn’t have to answer the question, though, because as I took my coat off, the beeping sound grew louder. I looked down at my abdomen and cursed. Yup, my pod had just failed.

I wasn’t totally surprised that it happened. The dry winter air was triggering excessive static electricity that weekend, and the sweater I chose to wear that day seemed to be charged with it. I couldn’t move my arms without hearing little sparks going off. If I was smart, I would’ve changed my top to one that was less filled with static. But I had somehow managed to convince myself that there was no way my pod could possibly fail due to my clothing choices.

I know better than that.

The real kicker in this situation is that we were obviously headed out somewhere – we were hoping to go to our favorite bar for a quick drink. But with the pod’s failure occurring at basically the most inopportune time, we were left with a three choices:

  1. Stay home. Take out the insulin, wait a half hour, and resign ourselves to the fact that it just wasn’t a good night to go out.
  2. Go out, but take a syringe and a vial of insulin with us. That way, I could give myself a shot, if need be, while we were at the bar. We could head home after the one drink and I could change the pod once we were back.
  3. Go out and take a total risk by leaving all extra diabetes supplies at home, and just wait until after we had our drink to change the pod.
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A cocktail by the candlelight.

I like living on the edge sometimes, but option #3 is just way too dangerous. So we went with option #2. If you’re wondering why we didn’t just opt to wait a half hour (insulin needs 30 minutes to come to room temperature before it can be put into a new pod), it’s merely because we didn’t want to stay out late. And yes, a half hour can make that much of a difference to me and my mom!

So we left the house with an emergency insulin vial and syringe in tow. And it’s amazing how much better it made me feel to know that I had both, just in case.

Fortunately, I didn’t need them. I monitored my blood sugar carefully during our hour-long excursion, drank plenty of water, and deliberately chose a lower-carb, whiskey-based cocktail that wouldn’t spike me. And I was able to enjoy every last sip of it before returning home and changing my pod soon after walking through the front door.

I do have to say, though, that under different circumstances, I’d absolutely make different choices. If we weren’t less than three miles away from the house, and if we’d planned on staying out for more than a single drink, then you bet your bottom dollar that I would’ve changed my pod before going out. But in this situation, I made the decision that felt right for me, and felt comforted by the fact that I had backup supplies in case I needed them.

 

Can the Dexcom G6 be Restarted? (and Other FAQs)

I’ve been lucky enough to have the Dexcom G6 CGM in my life for just over six months now. In that time, many people in my life – both T1Ds and non-T1Ds – have asked me countless questions about my experience with the device. I thought it’d make sense to address some of the most commonly asked questions here, in the hopes that I can provide some insight to those who are curious about the Dexcom G6.

Question: Can the Dexcom G6 be restarted?

Answer: In my experience, no. I cannot get the G6 to restart like I could get my G5 to restart. But take my “no” with a grain of salt, here, because I know of other people who HAVE had success restarting their G6 sensor, making its life extend much longer than the 10 days guaranteed by Dexcom. I have only tried to restart the G6 once, with absolutely zero success, following the process outlined here. My advice to those who want to try to restart their G6 is to do so cautiously, and make sure you’re not trying to do so with the last sensor in your stockpile.

Question: Is it actually safe to take acetaminophen (Tylenol) on the Dexcom G6?

Answer: Yes! I’ve noticed that acetaminophen can be taken safely on the G6. I did not anticipate for it to be unsafe, seeing as it was advertised as one of the big improvements Dexcom made from the G5 to the G6. I’ve taken Tylenol a handful of times without noticing any issues with my CGM readings, but as always, be sure to monitor your blood sugar carefully and perform a manual finger stick check if your symptoms don’t match up with your CGM.

Question: I can’t get my Dexcom G6 sensor to stay put for the full ten days. How do you make it last?

Answer: There’s tons of ways you can help ensure your G6 sensor stays stuck on for the entire ten-day duration. I always make sure that my skin is completely dry before the sensor makes any contact with the site. Avoiding any excess moisture is key in helping it stay put. If I notice the sensor starting to peel around the edges after a few days of wear, then I use a Pump Peelz CGM adhesive to keep it in place. Those tend to work really well for me. In times of serious adhesive doubt, I also use Skin Tac wipes, which basically glue that sucker down. One last tip I recommend is to avoid sites that come into contact with a wide variety of surfaces. In other words, a sensor that’s placed on the abdomen may fare better than a sensor on the leg, because the odds of the sensor getting accidentally knocked off due to contact with clothing or other objects are lesser. You know your own body better than anyone, though, so trust your own judgment when it comes to CGM placement.

Capture
Modeling my G6.

Question: Is sensor insertion truly painless?

Answer: For me, G6 insertion has been pain-free approximately 85% of the time. It’s stung slightly a handful of times, but I’ve found that it only hurts when I choose a site that’s not particularly fatty. That’s why I generally stick with my abdomen – either side of my navel – or the back of my arms for G6 insertion.

Question: Is the G6 really that much more accurate compared to the G5, or any other CGM on the market?

Answer: Yes and no. That may not be a very satisfactory answer, but I’ll explain why that’s my belief. Overall, the G6 seems to be more accurate for me than the previous Dexcom CGM models I’ve worn. Are the number always on point compared to what appears on my meter? No. Do I wear the Dexcom CGM to have an accurate picture of what my exact number is at a given moment in time? Kind of, but I also know that this isn’t totally realistic. After all, users of the Dexcom CGMs know that it measures blood sugar levels in five-minute intervals. It can’t give me a clearer picture of what my blood sugar changes are minute-to-minute. So with that in mind, I find that the G6 is really excellent for monitoring trends – seeing how rapidly my blood sugar is falling or rising, or seeing how it changes gradually over time. The patterns are more important to me than the precise numbers; at least, that’s how I feel in my current stage of diabetes management.

I can’t really speak to other CGMs on the market, such as the Freestyle Libre or Medtronic’s CGM. But what I can say is that I’ve heard less-than-stellar reviews about both. It’s important to remember, though, that they’re not meant to be the exact same as the Dexcom CGM. The Libre itself isn’t really continuous and can’t provide users with information until they chose to wave the receiver over the sensor. And as far as I’m aware, the Medtronic CGM communicates directly with Medtronic pumps, and I’m not sure how seamlessly the systems work together.

Bear in mind that when it all comes down to it, I’m answering these questions with my experience, and my experience alone, in mind. Dexcom is and will always be the number one resource to go to with any questions regarding their CGM devices. But hopefully, the information I’ve shared here will at least help someone who is curious about the G6 feel more motivated to seek additional information. I stand by the fact that it has revolutionized my own diabetes care and management, and though it’s far from being flawless, it’s still an invaluable tool to have incorporated into my daily routine.

Grazing: My Bad Habit

A handful of peanuts here, a couple of slices of cheese there.

A pile of popcorn followed by a spoonful of peanut butter.

A few pretzels and a small smattering of chocolate chips – because chocolate.

These snack combos, as strange as they may be, all describe some snacking behavior that I also refer to as “grazing”. Grazing is all about taking little bits of food when I’m not necessarily hungry. I equate it to eating out of boredom, except I’m not indulging on full meals or anything, I’m simply munching because the food is there and my blood sugar is acceptable enough to the point that I can freely snack without having to bolus, or worry about significant blood sugar jumps later on.

In other words, grazing is a habit I’m trying to break.

grazing

I’m not stupid. I know that the aforementioned foods I choose to graze on contain carbohydrates. Whether trace or moderate, they’re still there. And I choose to ignore them.

I don’t know why. If I want to have a snack, then that’s okay, as long as I take insulin for it. But I guess my rationale for grazing is that I’m taking “itty bitty” amounts of food that will minimally impact my blood sugar, if at all.

Then again…it’s not exactly logical when those small snacks DO wind up impacting my blood sugar. Usually, the spike happens several hours after, and each time I get angry at myself for a) not having enough self-control to resist grazing and b) not taking insulin for it when I do give in to the bad habit.

Nearly 21 years of diabetes and I’m still occasionally blown away by the minutiae of it: how just the slightest smackerels can take a toll on the straight-lined graphs I strive to achieve daily.

How Time Traveling Affected my Blood Sugar

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?