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.

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.

Tricky Timing and the Power of the Pre-Bolus

Pre-bolusing: It’s the term that describes taking insulin before eating food. The “before” part in the definition is key, because the amount of time that “before” is can and will vary among people with diabetes. It depends on a few factors, including the amount and type of insulin being used, the amount and type of food to be consumed, current blood sugar levels, and so forth.

It’s one of those things that’s tricky to nail the timing of, but boy, when it works it’s so worth it.

Pre-bolusing works well, but only when the timing of it is perfect.

I have two examples to complement that belief, one in which pre-bolusing almost lead to a disastrous outcome and the other in which everything turned out ideally. I’ll start with the more chaotic scenario first.

In this situation, my boyfriend and I spent the night in New Hampshire to attend a friends’ wedding and had a pretty late night, which meant we slept in a little later than we had intended the next day…actually, a lot later. We only had about 20 minutes to race around our room, pack up our belongings, and get ourselves looking presentable before we had to check out of the hotel. Luckily, our scrambling paid off and we made it out in time, but sleeping in cost us the opportunity to enjoy a complimentary hotel breakfast. We decided that it made sense to stop for brunch on our drive back home to Massachusetts, so we Googled a diner that was on our route home and stopped there for a meal.

When we got there, the restaurant was pretty crowded, but we were seated and able to place our brunch orders almost immediately – a good sign. I assumed this meant we wouldn’t have to wait more than 20 minutes or so (that feels like a restaurant standard) for our food to be ready, so I went ahead and pre-bolused my mealtime insulin. After all, I’d ordered a hearty omelet that would come with breakfast potatoes and toast, so I wanted to be proactive about avoiding high blood sugar and get my insulin in system sooner rather than later.

Unfortunately for me, our food ended up coming out later rather than sooner. In fact, we waited nearly 45 minutes for our dishes to finally come out. In that period of waiting, I was getting more and more anxious about my decision to pre-bolus with each minute that passed without food in front of me. By the 30-minute mark, I was close to full-on panic. Even though my Dexcom wasn’t indicating that my blood sugar was low (it held out steady the whole time), I was worried that the system delay in reporting my blood sugars would fail to catch a serious low in a timely manner. I told my boyfriend what was going on, and without hesitating he went to his car to grab some packs of honey that he’d stored in his glove compartment in case of emergency. We talked it over, and decided that it was probably best for me to consume at least one pack of honey because we couldn’t possibly know when our food was going to come out, and at this rate, we wanted to play it safe rather than be sorry. That didn’t exactly lessen the sorrow and stupidity that I felt for taking a pre-bolus (even though I couldn’t have possibly known that our food would be so delayed, I still felt badly about the whole thing), but it was what it was. And ultimately, I felt like I paid the price several hours later, when I was dealing with the very same high blood sugars that I’d hoped my pre-bolus would prevent. So much for making the pre-bolus grade that time…

But that doesn’t mean pre-bolusing always fails! This brings me to my other example. My mom and I had a nice lunch together last week. Before we left to go to the restaurant, I noticed my blood sugar was a little high. I decided to give myself a correction dose, plus one extra unit of insulin, because I knew we’d be eating foods that aren’t typical for me to consume at lunchtime that could result in highs later in the day. So again, I was aiming to be proactive and prevent prolonged high blood sugar.

And this time, the strategy worked great! At the restaurant, I stacked that pre-bolus with my actual meal bolus (not always a recommended tactic, but it was useful here) and rounded out my afternoon with a blood sugar in the 120s – a win in my book. Thanks to my pre-bolus, I didn’t experience any pesky blood sugar spikes and still landed in range, which in turn showcases the power of the pre-bolus perfectly.

So just like anything in life with diabetes, when pre-bolusing works, it’s wonderful…but it definitely requires a little finesse to learn exactly when/how/where to use it.

How I Managed to Avoid High Blood Sugar on Thanksgiving

2021 marks the most triumphant Thanksgiving celebration of my life.

No, it wasn’t because of the accolades that my tasty apple bourbon pie received (though that was for sure among the highlights of the day). It was because, for the first time in recent memory, I avoided high blood sugar the entire day. I got up to 164 at one point, but that was a brief high point in an otherwise wonderful day of smooth blood sugar sailing.

How the heck did I do it?!

Good blood sugars all Thanksgiving-day-long makes for an extra grateful Molly.

Well, for starters, I did my best to follow the tips I outlined in this blog post. But I figured it would be helpful to describe exactly how I went about following these tips and to explain what did and didn’t work. So here’s the method behind my blood sugar success:

  • I started out my day with a walk and an English muffin for breakfast. The exercise made me feel slightly better about all the calories I’d be consuming later in the day, and the small breakfast kept my appetite satisfied until I sat down for my first real meal of the day. I knew exactly how many carbs were in that English muffin, too, which helped me not only dose for it perfectly but also kept my blood sugar steady in the low 100s right up until mealtime.
  • For my first Thanksgiving meal of the day (yes, that’s right – I was lucky enough to attend two feasts), I kept the portions on my plate small and mostly carb-free. I had a bit of turkey, a scoop of brussels sprouts, carrots, and a few pieces of cubed sweet potato. By my estimation, I had no more than 25 or so carbs on the plate, but I bolused for just under that amount because my CGM was alerting me to an oncoming low.
  • There was only an hour and a half between my first meal and my second, and I knew I was going to load up on carbs for my second meal. So I took my next bolus a few minutes before sitting down for food in order to give my insulin a head start. I loaded up my plate with all the good stuff – more turkey, mashed potatoes, stuffing, a roll, etc. I calculated that I was consuming at least 60 carbs (though I definitely ate more than that) and chose to wait an hour or two after dinner before taking more insulin because I was drinking wine and didn’t want to run the risk of the alcohol/insulin combo making me go low.
  • After the second meal, I spent the next couple of hours assisting with cleanup and chatting away, eyeballing my CGM every so often to ensure that my blood sugar wasn’t skyrocketing – and feeling very proud when it didn’t!
  • The final food event of the day was dessert at a relative’s house. Even though a few hours had lapsed between then and the second meal, I wasn’t as keen as I usually am to hit up the dessert table because there were far too many yummy looking options in front of me. I knew there was no way I could try every single item, so I settled for the two things I wanted the most: a pie of my pie and a cannoli. This time, I was aggressive with my insulin intake, bolusing for about 45 carbs for both desserts (I cut a smaller slice of pie and wound up splitting the cannoli with my boyfriend). I also decided to set a temp basal increase out of fear that my complex carbs from earlier in the day would catch up to me later in the evening.
  • Fortunately, my proactiveness worked like a charm and I actually went a little low by the end of the day! I couldn’t believe how well I finally executed my own advice.

All of that, and I didn’t even have any exercise after dinner or dessert. But I felt 100% in control the entire time because I chose exactly what I wanted to eat, I was familiar with all of the foods, and I didn’t make it a priority to consume as many pieces of pie as I possibly could. It felt awesome and it made me that much more grateful for the fact that I was surrounded by the people I love all day long.

And now that it’s December, I’m especially excited to see repeat success during the holiday gatherings happening throughout the month!

How My T1D and I Handled My First COVID Vaccine

Imagine my surprise when I went to write about today’s new blog post on my Instagram account and swiftly realized…I didn’t have a new post! Life’s busy and as a result, I’ve fallen a bit behind my blogging schedule.

Luckily, I have the day off from work today, so I’m able to whip up a quick post on something that people might be wondering about: How did my diabetes and I fare after receiving dose 1 of 2 of a COVID vaccine?

I am officially halfway there on the vaccine front.

I’m going to rapid-fire this one and sum it all up with some bullet points:

  • I got the Moderna vaccine
  • I felt 0 pain when I was injected – in fact, I didn’t feel anything and was surprised when the nurse told me I was all set
  • I had to wait 15 minutes after the dose was administered to make sure I didn’t experience any type of reaction
  • I had no reaction whatsoever
  • About 18 hours after I got the vaccine, I noticed some slight pain around the site
  • I could not see any marks around the site – no redness, no apparent injection location
  • The pain was only noticeable when I was changing my clothes
  • My blood sugar within the first 24 hours was mostly fine (I wasn’t eating super healthy so any high blood sugars can be blamed on my poor diet)
  • My blood sugar was fine 48 hours later, leading me to believe that the vaccine had 0 impact on my blood sugar levels (I had somewhat anticipated elevated blood sugar levels because my mother, who also got the Moderna vaccine, said her levels were higher 2-3 days later post-vaccine)
  • I felt absolutely normal! I got the vaccine three full days ago as of this writing and I can’t say that I’ve noticed anything different

That was my experience; remember, all people with diabetes (and without diabetes) are different and may experience different things. If you have any questions after reading this post, I highly recommend reading this post from Beyond Type 1 that tells you what you want to know about the vaccines. And here’s my little disclaimer to talk to your doctor about any concerns you have.

I’m glad that I got my first vaccine and that it was a hassle- and pain-free experience. I’m looking forward to getting dose number 2 at the end of April and will be sure to recap what it’s like then. In the meantime, I’m happy to continue masking up and practicing social distancing – after all, we’re in this together, and just because I got one vaccine doesn’t mean that I can’t do my part to help protect others.

The Best Time for Me and My Diabetes to Exercise

I am a phony morning person.

By that I mean that I pretend that I like getting up early in the mornings, but truth be told…I hate it. Oh how I long for the days that I could sleep in as late as I wanted and shun my very few responsibilities…

Even though I clearly don’t love waking up early, there is one benefit to it that truly lasts all day long. And that is getting my workouts done within the first hour or so of my day.

Listen, I’m not a fitness freak. I don’t have a ripped bod. More often than not, I’m working out so I can eat and drink the things that I like without feeling as terrible about it (only light sarcasm used in that previous sentence). But I do like exercising and try to do so every single day because, well, it’s good for me and definitely helps me to produce better blood sugars.

Exercising is a thousand times harder than it needs to be, though, when my blood sugar crashes halfway through a routine – which happened a lot more than I wanted it to when I was working out in the afternoons or evenings.

Fed up with the lows, I changed up my routine and that’s when I discovered the beauty of fasting morning workouts.

I am definitely not as flexible as this cartoon lady.

I learned that if I work out soon after I wake up in the morning and wait until after I’m done to eat breakfast, then lows almost never happen. It’s like magic. I’m able to get through my exercise routine (which is usually a half hour circuit of some sort) without having to modify my basal rates whatsoever. Since I don’t have any insulin on board (because I haven’t eaten any food yet), I’m only working out with my basal rate running in the background, so there’s a much lower chance that my blood sugar will really fluctuate when I’m exercising. Of course, mornings that I wake up with a low or a high blood sugar are a little more challenging, seeing as I either have to bring it back up to a good level for working out or get some insulin pumping in my system, but I wake up most mornings with my blood sugar in a range that makes me feel comfortable working out in.

All the diabetes business aside, I gotta say…my other favorite part of working out first thing is that it’s over with and done for the day. Ba-da bing, ba-da boom. It’s not looming over my head for the remainder of the day, and that’s a really nice feeling.

A.M. exercise is A-O.K. to my diabetes and me.

The Best Breakfast for my ‘Betes

I have a new favorite breakfast, both blood-sugar-wise and taste-wise, that I just had to write about here.

And that breakfast is: egg wraps! I take a low-carb spinach and herb tortilla, add eggs, sprinkle on some cheese, tuck in some turkey sausage or a scoop of guacamole, and wrap it all up for a totally delicious, lower-carb meal that I honestly can’t get enough of these days.

I love how surprisingly versatile this breakfast wrap is. I can lighten it by using scrambled egg whites in place of eggs with yolks, I can season it however I want (though my preference is everything but the bagel seasoning), and when I’m feeling spicy, I can add a few shakes of garlicky hot sauce for some zip. When I have fresh veggies, I’ll add those to the wrap, too, for some more color, flavor, and texture. Sprouts are really great in this kind of wrap, as is spinach or even chopped onions and peppers (I like cooking frozen ones with my eggs because they’re easy to have on hand at all times).

You’re probably wondering why I didn’t take a picture of my wonderful wraps for this posts and well…I ain’t a food blogger, I take awful food pictures! So just pretend this photo is a perfect representation of my new fave breakfast. Please and thanks. 🙂

So obviously this wrap is a winner in terms of taste, but it’s really excellent for my blood sugars, too. I don’t typically bolus for more than 15 carbs for this meal (the wrap is only 4 net carbs and everything else that I add in has negligible carb content OR I just bolus for the protein) and the low glycemic index means that I never see a blood sugar spike after eating one of my wraps. And let me be real: I love my breakfast carbs (waffles, pancakes, muffins, even cereal…omg they’re all amazing to me), but they’re a pain in the ass to bolus for properly. Even when I do nail my bolus for a high-carb breakfast item, I’m not always able to do a pre-bolus (in other words, take insulin 15-20 minutes before I eat to give it time to start working ahead of the carbs) and avoid that carb-induced spike…which means I end up skyrocketing shortly after I eat, only to level out later. That’s not the worst thing in the world, but I’d prefer to not experience any sudden blood sugar jump, period.

Need I sell the benefits of this breakfast any further?! Knowing myself, I’ll have a new morning staple before too long, but for now I’ll *wrap* up this blog post on my *eggs*cellent breakfast wrap before I get too *cheesy* with the puns…

…Okay, okay, I’ll see myself out now.

3 Moments When Diabetes Surprised Me

Despite the best of efforts to “control” all aspects of life with diabetes, the bottom line is that it can still be totally unpredictable from time to time.

Usually, these unexpected diabetes experiences aren’t exactly welcome…but sometimes, diabetes surprises me in wonderfully delightful ways.

Have you ever been pleasantly surprised by diabetes?

Here’s three of ’em that have occurred in semi-recent memory:

1 – That time I was able to eat an entire homemade blueberry muffin WITHOUT BOLUSING FOR IT. Um, that’s crazy, right?! I had planned on eating half of said muffin in order to bring up a low blood sugar, but, well, it just tasted so damn good that before I knew it OOPS the whole thing was gone. I hemmed and hawed for a long time over whether I should bolus for the excess carb intake, and finally decided that I would just monitor my blood sugar and correct it as needed. But, weirdly enough…I saw my BG slowly rise and settle into the mid-150s and STAY there. Absolutely amazing, right? Maybe blueberry muffins are the new cinnamon cure for diabetes…

2 – When a pod change coincided with said pod running on its very last unit of insulin. Talk about using insulin to the very last drop, right? I still don’t know how I managed to pull this one off, but all I know is that I wore a pod for the maximum amount of time (80 hours) and had just one unit of insulin left inside it by the time it expired for good. I wish I could make this happen with every pod change, but then again, it is a little nerve-wracking to go down to the wire like that on a pod…

3 – That one instance when I drank one cocktail too many and my blood sugar behaved perfectly. This was a total freak incident and let me say upfront: I condone drinking with diabetes as long as it is done by individuals 21 and over in a safe, educated manner!!! Okay, now that I have that out of the way…like other grown-ass adults, sometimes I like to unwind with an adult beverage…and like OTHER grown-ass adults, once in a blue moon (please acknowledge the pun) I go a little overboard. Now, normally when I go a little too hard, I pay for it the next day with a hangover and high blood sugar, but on New Year’s Eve? When I drank Prosecco and a beer and a frozen Irish cream cocktail that was insanely good but carb-o-licious? I wound up with stellar blood sugars (and only a slightly hangover that was likely me just being overtired thanks to my puppy)…a head-scratching occurrence that was an absolute pleasant surprise.

And these are just three happy diabetes accidents that I can think of – I’ve absolutely had others over the years. Dumb luck? Total coincidences? Events that happened because I actually do kind of know what I’m doing? Whatever you want to call them, I can for sure classify these moments as the good kind of diabetes surprises.

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.

T1D, A1c, and Time in Range

Time in range versus A1c…which measurement matters more when it comes to T1D care and management?

Well, I’m not exactly in a position to answer that, because I think the answer is unique to all people with diabetes. But I can explain what exactly both of these numbers are and how I view them.

A1c: Also known as Hb1c or hemoglobin A1c, this is a test that is conducted every 3 months (or as requested) by an endocrinologist. A patient gets blood drawn to determine the average amount of glucose concentration in the blood during that 3 month period. The result of this test is a percentage amount, with 5% being an average result for a non-diabetic individual. I consider the A1c result to be highly personal, so I don’t often share mine with others; however, I do refer to it when describing ways in which I want to improve my diabetes care and management.

Time in range: This value describes the literal amount of time that a person’s blood sugar is in “range” for a given period of time (e.g., one day, one week, one month, etc.). “Range” refers to above a person’s low threshold and below a person’s high threshold. One person’s defined range may vary greatly from another person’s, but for me, I have my low set at 80 and my high set at 180 on my Dexcom. In a perfect world, my range would be more like 80-120, but I have a higher threshold set to minimize the number of alarms that go off.

Add a heading
Diabetes…the chronic conditions with like, way too many acronyms.

So really, both are just two different ways of measuring blood sugar performance over the course of certain time frames. And while I try to bear in mind that these are both simply numbers that help me see part of the diabetes picture, and not sole indicators of how “well controlled” I am or am not, I do pay special attention to them and have certain goals for myself. (I strive for an A1c of under 7 and I like my time in range to be at least 75%: These are goals I came up with independently, without my endocrinologist’s feedback, because it’s what I feel comfortable with when it comes to my diabetes…other T1Ds feel differently, and that’s totally okay!)

It’s important to me that I remember that my “success” as a person with T1D is not defined by either of these numbers. In fact, I know many other T1D individuals feel the same way that they should be viewed as signposts along the road to achieving desired diabetes results. It can be hard to do, though, because of how much weight is placed on these numbers by medical professionals and from people across the Internet.

The bottom line? I try to tune out the background noise and focus on taking it one day at a time. By no means am I perfect, but nobody is, and I know better than to put pressure on myself to strive for perfection. Instead, I do the best that I can to maintain my A1c and time in range goals, while doing everything I can to keep the bigger picture in mind instead of individual numbers.