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.
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.
One Friday per month, I’ll write about my favorite things that make life with diabetes a little easier for me.
This month’s favorite thing is so damn obvious that it’s kind of shocking I haven’t written about it yet on the blog: my OmniPod insulin pump.
I love the friggen’ thing.
My OmniPod PDM.
I don’t know if it’s because pumping works better for me in general over multiple daily injections (MDIs), or if it’s because the OmniPod is simply the perfect pump for me. Honestly, it’s probably a combination of the two. I love how convenient it is – I can deliver insulin any time, any place, I don’t have to worry about tubing getting caught on random objects, and it lasts me for three full days (of course, only if it’s working properly…I’d estimate that it does about 90% of the time). And I love that my dosages are so much more precise compared to how they used to be when I was doing MDIs. It gives me more control, knowing that I can dose in .05 increments according to my current blood sugar levels and carbohydrate intakes.
However, it is merely another piece of diabetes technology, meaning that it does have some flaws. Sometimes pods fail for the silliest reasons, such as coming into contact with static electricity. And other times pods don’t work for no damn good reason at all, without giving the user proper notice (in the case of bent cannulas, something I recently encountered).
But for the vast majority of the time, I love my OmniPod. I’m still surprised to how quickly I adjusted to the system – the first week or two was tough, but then it was relatively smooth sailing after that period. I think it was easy for me to get used to another wearable device, because I’d already been wearing my Dexcom for a couple years by the time I got my OmniPod.
Will I wear my OmniPod for many years to come? Or will I want to switch things up and give another pump a try? Only time will tell, but for now, I think I’ll stick with what I know best in the world of insulin pumping.
High blood sugar and low blood sugar are both incredibly draining. One turns me into a grump who can’t drink enough water and the other turns me into a shaky, sweaty, slurring hot mess who can’t string a simple sentence together. Needless to say, neither situation is fun.
But there’s one even worse than that: the roller coaster situation. It’s best illustrated using a CGM graph like this:
I added the little graphic of psychedelic teddy bears riding a roller coaster – it seemed to illustrate my point well.
It’s what I use to describe blood sugar that won’t level out to my target range. It just goes up, up, up, and falls dramatically – just like an actual roller coaster – once the high is corrected. And boy, does that drop down take my breath away.
But then wait, there’s more! After the crash and the inevitable need for lots of sugar (and fast) is satisfied, the blood sugar soars back up again, leaving me frustrated as I take another bolus to fix it…
…only for it to happen again. And again.
Get me off this ride!
When I’m stuck on these blood sugar roller coasters, it’s mentally and physically exhausting. I question my every action over and over again as I try to do the “right thing” and make my numbers level out, only to end up berating myself for getting into this situation in the first place.
I’ve never been a fan of roller coasters in real life – they make me a combination of anxious and nauseous that I’ve dubbed “nauxious” – but I’d rather ride one that goes upside down than experience the T1D roller coaster situation again any time soon.
No carbs. No dairy. No meat. No processed foods. Strictly vegetables, fruits, and shakes for the next three days. 72 hours – I could do it, right?
Last week, I completed a 3-Day Cleanse. My goal was that it would help me feel a little bit refreshed after a couple weeks of nonstop gluttony. I figured it’d help reset my system and make me feel less bloated and tired. I didn’t want to do a typical “cleanse” though, the kind that forces you to stop eating any and all food and stick with juices. That’s why I did this particular program – I would be eating real foods on a regular basis throughout all three days. The bonus was that it would be foods I’m familiar with and are generally low carb, which could only mean good things for my blood sugar.
My routine for all three days would follow this format: Wake up, drink a glass of water, blend a shake together with one serving size of fruit. I’d have a cup of herbal tea one hour after breakfast, and one hour after that, I’d have a fiber-filled drink. Lunch would consist of another shake, one serving of vegetables, one serving of fruit, and one spoonful of hummus. I’d have an afternoon snack of baby carrots and one spoonful of almond butter with another cup of herbal tea an hour after consuming the snack. Dinner would be one last shake, one cup of vegetable broth, and a spinach salad with olive oil and lemon juice drizzled on top. I could have a final cup of herbal tea any time in the evening.
I didn’t expect to learn as much as I did throughout the program, but those three days taught me a lot about how the things I put into my body impact not just my blood sugar, but my state of mind. Here’s what happened during my cleanse:
Day 1 – This day was by far the easiest to complete. Despite dialing back the amounts and types of foods I was consuming, I didn’t feel hungry at all – everything sated me. I was really enjoying watching my Dexcom CGM graph because it barely budged. I stayed right around 90-110 mg/dL for most of the day, probably because I was eating minimal carbs. Fewer carbs means less room for error, and this concept was definitely cemented into my mind by the end of the cleanse. I went to bed with a slight headache at the end of day 1, but a smile on my face. This would be a breeze!
Day 2 – My CGM sensor went kaput by mid-morning, and I was PISSED about it. I wanted the ability to continue tracking my blood sugars on this cleanse, and suddenly it was no longer available to me (because oh-so-conveniently, it was my last sensor in stock). Fuming over my CGM situation, I started feeling slight pangs of hunger shortly after having my fiber drink. I ate lunch as soon as I could after that, and spent much of the rest of the afternoon fighting a headache and dreading going home to see – not eat – my mom’s delicious home cooking. On the brighter side of things, my digestion seemed to be improving already and I felt a bit less bloated.
Day 3 – I went from “Oh, this cleanse will be a breeze!” to “OMG THESE ARE THE LONGEST THREE DAYS OF MY LIFE GIMME REAL FOOD AGAIN BEFORE I HAVE A MELTDOWN” in less than 48 hours. That’s gotta be a new record. I distracted myself as much as I could from my misery by burying myself in my work, which helped to a degree. But I couldn’t fight the lightheaded sensation that seemed to grip my entire body. I was confused by that – I though only eating real, plant-based foods would eliminate crummy feelings. Maybe I was experiencing a sort of withdrawal as my body got used to this new diet? I can’t confirm that, but I suspect that after a few more days, I likely would’ve felt much better…or hungrier. I’ll leave it to speculation because there is no way I’m doing this again any time soon. But MAN, am I proud of myself for completing the cleanse without cheating, not even once.
So if I felt THAT miserable toward the end of the cleanse, then why am I glad that I did it? Mainly, I’m astonished at how much easier it was to maintain my diabetes and “desirable” blood sugar levels in that three-day time period. Even without my CGM, I was still getting great results. It reinforced something that I already knew: that the body will react accordingly to the quantity and quality of foods that are used to nourish it. It made me realize that perhaps I should toy with cutting down my daily carb intake and upping my veggie/fruit/protein consumption to find out whether that positively impacts my blood sugar in the way that I think it will. This doesn’t mean I’m starting a low-carb or keto diet; rather, I’m simply going to follow a more thoughtful one.
To sum it up, this three-day cleanse/torture act/lesson (whatever you want to call it) helped make my understanding and appreciation of food much stronger, which makes it worth it in my book.
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.
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.
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.
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!
“Sun-kissed skin so hot/We’ll melt your popsicle…and your insulin” – Katy Perry (with some help from Molly Johannes)
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.
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.
Last week, I wrote about some anxiety that I was feeling the day before I was due to see my endocrinologist. Now that the appointment has come and gone, I feel like I understand the reasons why I was so nervous…
Reason #1: Some part of me must’ve known that my A1c has gone up over the course of the last three months – it rose half a point, much to my dismay. I confessed to my doctor that I’ve been a little careless, particularly in the last month or so, when it comes to carb counting and healthy eating. Luckily, she wasn’t critical of me, but I almost wish that she’d reprimanded me in some way. It would’ve been the talking-to that I felt I deserved.
Reason #2: My endo permanently switched locations: She’s now based at the medical center that I used to go to when I was seeing a pediatric endocrinologist. I hadn’t been back there in about eight years, and boy, it brought back some unexpected emotions. I must admit that I had to hold back tears as I walked into the building. I don’t know why all the feelings hit me so hard, but I suspect that it might have been because of the flood of memories that flowed through my mind. It also symbolized the journey I’ve been on in just the last eight years of life with diabetes, in which I:
Transitioned from injections to a pump.
Stopped using Lantus.
Started using a Dexcom.
Improved my A1c/overall health significantly.
Decided to become a more active member in the diabetes community.
Those are some major changes, and the magnitude of them practically knocks me out as I think about the last 20 years I’ve had with diabetes.
Just making some awkward faces while I wait for my doctor. Also, I love that the exam room has a full-length mirror in it: It’s perfect for taking pictures/killing time while I wait!
Reason #3: I was meeting all sorts of new people, which is very nerve-wracking to an introverted extrovert like myself. I was used to the receptionists and nurses at the old location. I got to know them and vice versa. It made going to appointments a little easier. At this new/old location, though, I don’t know a soul except for my doctor. A reassuring smile or light conversation would’ve placated me on this visit, but perhaps those things will come in time.
Anyways, now that I’ve had time to think about the emotional aspects of this appointment…I’m going to switch gears and start doing the things that I need to do and that I am capable of doing in order to get my A1c back to where I want it. I know that I’ll get there. As my appointment wrapped up, I looked my endocrinologist in the eyes and promised her that the next time she saw me, I’d be down more than half a point. And I intend to fulfill that promise.
One Friday per month, I’ll write about my favorite diabetes products. These items make the cut because they’re functional, fashionable, or fun – but usually, all three at once!
One of the most crucial components of a T1D toolkit is the glucometer, also known more simply as the meter. This little device instantly measures blood sugar levels in a person with diabetes: stick a test strip in the meter, poke a finger, and wipe a drop of blood on the test strip in order to get a blood sugar check within seconds from the meter.
Ideally, a meter is used multiple times a day by a person with diabetes – the exact number depends on how often they prefer to check their levels. Personally, I check my blood sugar five or six times each day, so I’m using my meter fairly frequently. As such, it’s always been important to me that I have a meter that is accurate, user-friendly, and compact.
Fortunately, I found all of that with my Verio IQ meter.
I can’t imagine checking my blood sugar with any other meter.
The slim, bright white device fits nicely into my Myabetic case, making it easy to tote around with me everywhere. It’s pretty trusty and generates results commensurate with my CGM. It doesn’t run on batteries; rather, it can conveniently be recharged every 10 days or so. But my favorite feature of my meter is the back light: If I need to wake up in the middle of the night to check my blood sugar, I don’t have to switch on the lamp that sits on my nightstand. Rather, I merely stick a strip into the meter and it lights up on its own, making it easy for me to see where to wipe my drop of blood. After five seconds elapse, bam, my blood sugar reading pops up on the screen in bold numbers.
I can’t remember exactly when I started using my Verio IQ – definitely prior to college – but I’ve stuck with it for at least eight years now because it works so well for me. When I got onto the OmniPod three years ago, it never even crossed my mind to give up my Verio in favor of using the PDM to check my sugars. It might seem crazy to others that I carry around one superfluous device, but it’s what works for me.
Last week, I received not one, not two, but FIVE packages in the mail. No, I didn’t go overboard with some online shopping – it was all deliveries from Dexcom to help me get my CGM up and running again.
You might be wondering: Why were there so many packages? In theory, I just needed a couple of replacement sensors and a new transmitter – couldn’t it all go in one box? Well, I wound up getting a little more than just the aforementioned supplies…
Not pictured: another two boxes I received from Dexcom. Not sure why they couldn’t send everything in one large box, but beggars can’t be choosers.
That’s because I had the stupendously (emphasis on the STUPID-sounding part of that word) great idea to power up my old G5 CGM while I waited for my G6 materials. I had a few G5 sensors leftover from before I made the transition to the G6, and to my knowledge, I had a working G5 transmitter. So I followed the procedure to get my G5 going: I inserted a G5 sensor (ouch!), snapped the transmitter into place, and started the warm-up on my G5 transmitter.
But something was…off. The Bluetooth icon was blinking in the upper left-hand corner, and I couldn’t see how much time had elapsed in the two-hour warm-up period. At a loss as to what to do next, I left the receiver on overnight to see if it would ever pick up a signal from my G5 sensor/transmitter, to no avail.
That’s when I made the “fatal error” of shutting the system down and trying to restart it. This triggered the G5 receiver to enter a reboot cycle that wouldn’t stop. Any time I pressed the circular home button, the system would buzz and the screen would light up, as if it was about to start working. After 45 seconds or so, the screen would go black again. There was no way to interrupt this reboot loop – even sticking a paper clip into the tiny hole in the back of the receiver wouldn’t correct the faulty software.
So now, not only was my G6 out of commission, but my G5 was a goner, too.
After a few phone calls to Dexcom technical support, I had answers as well as supplies sent my way. I learned that there’s a known error with the G5 system that causes the reboot cycle to launch. I should have waited longer for the G5 transmitter to connect with the Bluetooth on my receiver (i.e., I should’ve waited for the Bluetooth icon to stop blinking), but it wasn’t necessarily my fault for having a device with a known software issue. I would receive a new G5 receiver because my old one was still under warranty, as well as a G5 replacement sensor. I would NOT get a G5 transmitter, because I’m convinced the battery on the current one is still good, but I was informed that once a transmitter is activated, the battery keeps going until it runs out of juice. Interesting. That means that it could, in theory, stop working any day now, because the transmitter was activated and last used in April 2018.
Hopefully, I’ll never have to get another G5 transmitter because I’ll be able to rely on my G6 from here on out. It gives me comfort to know I have backup G5 supplies, but I’m pretty much married to my G6 at this point. Dexcom kindly sent me the required new transmitter for the G6 system, which arrived on Thursday of last week. I got a return kit for the old G6 transmitter the previous day, and on Friday, my new sensors came in along with a return kit for my defunct G5 receiver.
Sure, it was a lot of packages to sort through in the mail. And it was mildly frustrating that I had to wait two days between getting my new G6 transmitter and compatible sensors. But the most important thing is that I’m now reconnected to my G6 and feeling thankful that Dexcom delivered when I needed it most.
This past Saturday afternoon, my Dexcom G6 sensor stopped working. It wasn’t sending data to my smartphone app or my transmitter, so I was forced to fly blind…at a party with tons of people I’d never met before, an impressive food spread, and few beverage options other than beer from a keg or spiked punch.
Definitely not a good time for my Dexcom sensor to go kaput, especially considering I was getting on a plane the next day and didn’t have a backup. And I wouldn’t get my hands on a fresh sensor for a couple more days, when I would return home from my adventures in Washington, D.C. and Nashville, Tennessee.
So yeah, it was pretty much the worst timing ever for my heavily-relied-upon diabetes technology to fail.
How did I handle it? It might sound incredibly obvious, but…I just reverted back to life before a CGM, meaning that I tested my blood sugar much more often than I do when the ol’ Dexcom is up and running. At the aforementioned party, I sucked it up and pulled myself away from conversations to check my numbers every so often with my meter. I still participated in barbecue and beer consumption, but I dialed it back because I couldn’t be sure of what direction it would send my blood sugar in, or how quickly it would happen.
As for the rest of my trip, and my travel days, I remained diligent. I’d test and correct as needed approximately every two hours. I set alarms for the middle of the night so I could be certain that I wasn’t too high or too low. I went back to relying on sensation – was I feeling thirsty because my blood sugar was high? Was my shakiness a sign of an oncoming low? It surprised me how easily I slid back into those routines, but I guess that after so many years of practicing them, it makes sense that I was still in tune with my body.
No data…no problem.
And, perhaps most shocking of all, I remained pretty calm about the whole situation. Normally, it’d send me into a panic and I’d chide myself over and over for not having a backup sensor. But, really, I carry around enough diabetes junk – adding a clunky sensor insertion device into the mix sounds excessive. After all, the sensors are supposed to WORK for the full ten days that they guarantee. It gets exhausting, having to anticipate technology failures when they should never happen, so I shouldn’t be upset with myself for not carrying more than the essentials.
The lesson in this experience, I think, is to be unafraid to depend on my intuition. I literally grew up managing my diabetes with hardly any technological aid, and I can do it again now in a heartbeat as long as I trust myself and the process.
I recently ran in my first-ever 5K race. In the weeks leading up to the race, I experienced a variety of emotions – particularly self-doubt – that made me question whether I could really do it. Would my diabetes cooperate the morning of the race? Should I eat a big breakfast before running, or go into the race fasting? How would I handle correcting a low blood sugar while running? What about a high blood sugar? Was I even competent enough to run?
All of my diabetes anxieties aside, I’ve always hated running. HATED it. I played field hockey every fall when I was in high school, and we were required to run a timed mile before the start of each season. I dreaded this mile because I usually wound up finishing the mile last, or close to last – my asthmatic lungs and negative attitude helped ensure that I would give up running halfway through and resort to walking a sluggish, defeated pace.
So like I explained in a recent blog post, making the decision to go through with this 5K wasn’t easy. But I wanted to take on the challenge and prove something to myself.
I did it!
My puppy greeted me after I crossed the finish line.
AND I DID IT!!! I’m pleased to say that I completed the race on a gorgeously sunny Saturday morning along with hundreds of other runners. I was totally proud of myself for accomplishing this goal, especially since I had less than a month to train for it. Plus, I learned a few things about myself after participating in the race:
I should have more faith in my ability to manage my diabetes. I spent so much time dwelling on the “what ifs” (a bad habit of mine) regarding what my diabetes might do during the race that my stomach was doing somersaults as I approached the start line. But as soon as I turned my music up and started running with everyone else, my doubts vanished. And better yet, I was absolutely fine throughout the race. I didn’t eat anything beforehand and went into it with a blood sugar of 142, and I stayed pretty steady for most of the 3.1 miles (I did start to spike soon after crossing the finish line, but I’m certain that was because of the adrenaline). I simply did what I’d been doing during my past month of training, and my experimentation with fasting vs. non-fasting paid off.
My blood sugar stayed steady throughout the race.
I started to spike after crossing the finish line. I blame it on the adrenaline rush.
I’m a lot more determined than I realized. I’ll admit that there were a few points throughout the race when I wanted to give up. I was breathing hard and my legs were starting to ache, but not once did I stop running and slow down to a walk. I pushed myself to keep going, even though I didn’t want to, and my determination helped me achieve my personal best running time.
I’m ready to train for future races. This experience awakened something in me that wants more challenges. I’m still not in love with running, but I think I am a fan of trying things out of my comfort zone. I want to continue to get faster and stronger so I can try tougher races and physical tests. It’s almost like it’s an outlet for me to tell my T1D that it can’t stop me – that I’m stronger than it no matter how hard it tries to knock me down.
Hugging the Cactus 