4 Tips on How to Handle T1D, Treats, and Temptation

If you regularly read this blog, then you know that I’m not a strict person with diabetes, in the sense that I don’t really restrict the foods that I include in my diet.

I’ve always been of the mindset that my diabetes can’t dictate what I choose to consume, though it might limit the actual quantity of a given food type that I eat.

So while my fridge and freezer is almost always stocked with fresh and frozen fruits/veggies/proteins, my pantry often stores more shelf-stable (and usually less healthy) things like crackers, cookies, and even candy. In fact, a full week post-Easter, my cabinets contain 3 bags of jellybeans, a chocolate bunny, and several Reese’s eggs. And it’s very tempting to reach into the cupboards and help myself to as much sugary sweetness as I can stomach in one sitting – screw my diabetes/blood sugar, I’ve got delectable confections to consume!

I don’t even like jelly beans very much, but that doesn’t mean that I doubt my ability to crush this bag in one sitting…

But of course, I know that indulging my cravings will only wreak havoc on my blood sugar levels, so I’ve found a few ways to curb temptation but still keep tasty treats in my home. Here’s 4 things that have worked for me:

  1. Only eat these treats when my blood sugar is low. I call this “medically necessary” candy consumption, and let me tell you, it makes low blood sugars a whole lot more tolerable when they’re treated with something that’s more fun and yummier than chalky glucose tablets or juice boxes.
  2. Keep them out of sight. I do my best to shove bags of treats in the very back of my top cabinets. That way, if I’m tempted to dig into them, I remember that I won’t be able to reach them unless I get a chair and rummage through the contents of the top shelves…and usually, that’s enough to take away my desire to snack on something sugary. I’m not saying it always happens, but laziness will typically beat my sweet tooth.
  3. Pre-portion single servings of treats. I have a real problem with snacks that come in bottomless bags – it’s hard to know when to stop and my blood sugar always suffers the consequences. So I like to study the serving size on bags and use it as a guide to portion out single servings of treats. It’s much easier to bolus for whatever it may be (or treat a low blood sugar as described in tip #1) when I know the exact carbohydrate count; after all, a few handfuls of an unknown number of Skittles have far more carbs than a single serving of 15 Skittles.
  4. Be picky about the types of treats kept in the house. My kryptonite is most definitely Reese’s cups…I love the salty/sweet combination of peanut butter and chocolate almost as much as I love my dog. So I recognized that a bad habit was forming when I kept a little bowl out in my living room filled to the brim with mini cups. I was breaking every single one of the above rules with this practice! After I realized this, I put the bowl away and stopped buying Reese’s every time I went to the grocery store. I still have other things around the house that will satisfy my sweet tooth (before Easter, I bought a package of dark chocolate Oreos that I’ve easily kept around for the last 6 weeks because they don’t tempt me in the same way that Reese’s cups do), so I’m really not depriving myself at all.

Temptation can be tricky to navigate when you have T1Ds and love sugary treats as much as I do…but as long as you can come up with ways to cope with temptation like I did, then you don’t have to feel guilty for giving in to your cravings every now and then. I sure don’t!

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.

The Bad ‘Betes Habit I’ve Tried to Break for 23 Years (and It’s Still a Work in Progress)

Bad habits are notoriously difficult to break.

Nail-biting. Forgetting to floss. A social media addiction. Swearing. Luckily, I only struggle with two out of the four of those (I’ll let you figure out which ones are a big fuckin’ problem for me while I go check my Instagram account real quick).

When it comes to diabetes-specific bad habits, though, well let’s just say that in more than two decades of life with diabetes, there’s a biiiiiig bad (Buffy the Vampire Slayer fans, think Big Bad like Evil Willow or Glorificus) habit that feels impossible to break.

And for me, that’s snacking freely without bolusing.

When I’m snacking throughout the day, I am not nearly as adorable about it as this cartoon girl (and I am almost never snacking on something as healthy as the piece of fruit she’s cutting up).

When I say “snacking freely”, I think it’s more accurate to call it grazing…I’m not eating large quantities of food or anything particularly carb-heavy, but it is usually enough to impact my blood sugar, at least moderately.

I’ve acknowledged this as a bad habit in a previous blog post, but for the first time, I’m really taking a step back and thinking about how if I stop doing this, I might see a tangible change in not just my blood sugar levels, but my A1c.

Don’t get me wrong, my A1c reading isn’t the most important thing to me (I’d rather focus on time in range, or the amount of time I spend each day below my high limit and above my low limit). But it is something that does come up, and will always come up, during appointments with all of my healthcare professionals. It’s definitely not something that they will be ignoring any time soon, and this year, I’d like to have an A1c that I’m a little more proud to own.

So I’m going to actively try and break this bad habit.

Whenever the desire to snack/graze strikes, I’m going to do what the pros recommend: Have a glass of water. Walk outside for a few minutes. Play with my puppy. Find a task around the house to focus on instead. Actively seek something else that will consume my time instead of me consuming something that will ultimately have a negative impact on my blood sugar as well as my mood. Be more careful about portion control when treating low blood sugars, because I can really spiral and eat half the damn kitchen when correcting a low, and it ain’t cute. And when all else fails and I need a snack (no shame in that game) actually take a freaking bolus for it because it’s okay to eat something extra throughout the day, I just need to stop being lazy and measure out whatever it is so I know exactly how much insulin I need to cover for it. That part isn’t rocket science, so I should stop treating it as such.

All bad habits are difficult to break, and I know one that’s been around for most of my life will make it particularly challenging…but it’s a new year, a great excuse for making a positive change with my eating habits and blood sugar levels, so I say bring on the challenge.

How Raising a Puppy is Similar to Dealing with Diabetes, Part 2

Just about three years ago, I was helping my parents raise their puppy, Clarence. And naturally, with me being who I am, I found that raising him was a lot like dealing with diabetes – and wrote about it in this blog post.

Now that I’m a puppy parent, I revisited that post and found that there are even more similarities between the two.

For starters, one of the biggest parts of diabetes management is the constant monitoring involved in it. As it turns out, the same can be said about raising a puppy! Much like my blood sugar, I am watching her like a hawk during all waking hours. I’m prepared to pounce on her if she’s chewing up a puppy pad or squatting down to her business indoors, just like I’m prepared to act when my blood sugar is going higher or lower than I’d like.

Raising a puppy is only this cute and sweet about 2% of the time. (Okay, total exaggeration here, but I’m writing this after Violet decided to do her business in her playpen just after I had her outside.)

Also, as it turns out – shocker – having a puppy around is exhausting. My sleep has been interrupted several times over the last few weeks by Violet’s whimpers. Before, I used to only have to worry about a Dexcom alarm waking me in the middle of the night, but now I have to respond to her cries, too. Fortunately, having a puppy isn’t totally like having diabetes in this regard, because at least I can nap when she’s napping! (We all know that diabetes never sleeps…)

Another similarity, one that I don’t mind so much, is the frequent exercise that Violet needs. Just like my diabetes tends to be “better controlled” when I exercise each day, Violet also responds really well to playtime. The best part is that after a nice, long session of fetch or tug-of-war, she tends to zonk out afterwards, which I see as the puppy equivalent of having the coveted 100 mg/dL blood sugar.

However, there are tons of obvious differences between raising a puppy and managing diabetes. But the best, perhaps biggest one of all? Violet improves (well, when she doesn’t have an accident indoors) my overall mood and mental health. I know that her ability to do this will only increase over time as she matures. And I know that having her around will help me through the tough diabetes days that I’m bound to face in the future, and for that and so much more, I’m thankful for my little pup.

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.

Is the Livongo Blood Sugar Meter Accurate?

It occurred to me the other day that even though I wrote a couple of blog posts and even made a video about it, I still haven’t addressed one major component of my new Livongo blood sugar meter: its accuracy.

How does it stack up to my Verio meter? More importantly, do I think it’s accurate?

Well…the answer isn’t cut-and-dry because I think it can be accurate…as long as my blood sugar isn’t above 200.

How did I arrive at this conclusion?

I conducted a little experiment.

Bear in mind here, I’m no expert in experimental design, so I established a simple setup for this. During the period of approximately two weeks, whenever I checked my blood sugar, I used the same drop of blood on test strips for two different meters: my Livongo and my Verio.

And the results were interesting, to say the least.

Whenever I was about 80-180, my results from the Livongo meter and the Verio meter were within about 10 points from one another. One instance, I was 86 on the Livongo and 92 on the Verio. Another time, I was 105 on the Verio and 113 on the Livongo. The meters never reported the exact same number at any point during my experiment, but I was happy whenever they showed similar results.

Things got dicey, though, any time I entered the hyperglycemic range.

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That 163 and 165 show how at times, the two meters were in agreement with one another…but then there’s that 231 and 262. Those are just a little too different for my liking.

It was weird and I can’t explain it, but the Livongo would report that I was anywhere from 20-50 points higher than what was on my Verio at a given point in time when my levels were 200+. This really surprised me, because I’d suspected that my Verio skewed a little higher compared to most other meters, so I never thought that the Livongo would prove me wrong about that. At times, it was truly maddening: On one occasion, the Livongo said I was 251 and my Verio said I was 204. That’s the difference of at least 1-2 units of insulin for me in order to correct that high! Even more frustratingly, because I didn’t trust the result from either machine, I checked my blood sugar again immediately and the Verio said 242, while the Livongo said 228.

WTF?!

That particular example was extremely confusing because I didn’t know which piece of technology to trust. And that’s the big thing for me: I need to know that I can depend on whichever blood sugar meter I’m using to deliver accurate results.

So again, remember that I’m no good with numbers, and that this is simply an estimation…but if I had to guess how many times the Livongo agreed with the Verio, I’d say it was no more than 7 out of 10 times. And I’m super bummed about that, because I’d genuinely hoped that I could trust my Livongo meter and use it full-time whenever I was taking a break from my CGM. Given the fact that it seems to be accurate when my blood sugar is in range, though, I suppose I could use that as motivation to work harder to prevent hyperglycemic readings…but I’m not perfect and I know that they will still happen from time to time. And I deserve a piece of technology that will accurately report them to me so I can make the best possible treatment decisions.

In theory, I still like the Livongo: It has a great design and some of its features (e.g., test strip reordering) are totally unique. But in practice? It leaves a bit to be desired.

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.

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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.