Highs Won’t Ruin My Happy

High blood sugar isn’t fun.

When I experience it for prolonged periods of time (say, 2+ hours), I’m far from a happy camper. I anxiously check my Dexcom every 5 minutes until I see my blood sugar start to come back down to range. I gulp down glass after glass of water. I stack insulin (only sometimes). And I will even march or dance around in place as a means of getting my number to come down faster.

Needless to say, my mood tends to be pretty foul when I have a high blood sugar…

…except on the occasions when I refuse to let it steal my happiness.

One such event recently occurred. I was away for the weekend to attend a wedding that I was so dang excited to go to. I couldn’t wait to get all dolled up and spend some quality time with my partner and his friends. It was the first large event that I was going to since the pandemic began, and I admit there were some nerves despite being fully vaccinated. However, I felt better knowing that 1) everything was taking place outdoors, 2) I was surrounded by other like-minded individuals, and 3) I would still be taking extra precautions (e.g., using copious amounts of hand sanitizer all weekend long) to make sure that I was protecting myself and others, too.

I just wanted to have fun without worrying about the what-ifs…delta or diabetes be damned.

High blood sugar was no match for me and my happiness bubble.

And I just wanted to live in what I’ve since dubbed my “happiness bubble”, otherwise known as my own personal la-la land, in which everything is lovely and safe and none of the world’s many issues can penetrate.

An ignorant and naive place? Yes, for sure, but one that allowed me to embrace everything about the weekend:

It allowed me to enjoy every bit of food and drink all weekend long, even though it caused crazy high blood sugars.

It allowed me to forget about my diabetes for awhile and just soak up the company of others and the (truly beautiful) environment that I was experiencing.

It allowed me to feel bliss that I hadn’t really felt since before the pandemic.

Sure, it’s not sustainable to live this way all the time, and it definitely is not an effective diabetes management tactic. However, it was beyond worth it, just for a weekend, to live in my happiness bubble that high blood sugars or diabetes couldn’t ruin, no matter how hard they tried.

Do You Know About Monogenic Diabetes?

This post was originally published on October 28, 2019 here on Hugging the Cactus. I decided to share it again today because I think it’s important to raise awareness that there are more than two types of diabetes. As I reread it, I realized that even someone like me, a person who has diabetes, still has a long way to go when it comes to understanding how each type differs from one another. Read on to learn more…

It was the statistic that impelled me to learn more information:

“Approximately 1 in 50 people with diabetes have monogenic diabetes.”

Mono-what?

I was staring at the giant banner bearing this statistic in the exhibition hall of the Friends for Life Falls Church conference. I read it a few times before I finally walked over to the table at which two women were seated. One of the women was an associate professor at the University of Maryland School of Medicine and a human geneticist. The other woman was a typical T1D for several decades of her life before she received a proper diagnosis of monogenic diabetes. Ever since that revelation rocked her world, she’d gone off insulin and took sulfonylureas (a type of drug that stimulates the pancreas to release insulin) to maintain healthy blood sugar levels.

Just how many types of diabetes are on the spectrum

Naturally, the whole concept was simultaneously foreign and fascinating to me. I wanted to know more.

As I discovered that evening, monogenic diabetes is best explained by its name. “Mono”, of course, meaning “one”, and “genic” meaning “relating to genes”. Therefore, it’s a type of diabetes that is caused by changes in a single gene.

Here are some “fast facts” that I learned about monogenic diabetes:

  • Most cases of it are misdiagnosed as type 1 or type 2 diabetes
  • Proper diagnosis of monogenic diabetes sometimes changes treatment from taking insulin to a pill, or no medications at all
  • There is an emerging clinical spectrum when it comes to genetic testing for diabetes. At the time of this writing, the following situations are when it’s recommended to undergo a genetic test to determine whether an individual has monogenic diabetes:
    • The individual received a diabetes diagnosis within the first 6 months of life
    • The individual’s diabetes does not follow typical characteristics of type 1 or type 2 diabetes – this might mean that the individual is non-obese or has a strong family history of diabetes
    • The individual has a stable fasting blood glucose between 100 and 150 mg/dL
  • From the pamphlet I picked up that featured stories from individuals with monogenic diabetes: “I was 21, taking metformin and aspirin daily and sitting in a type 2 diabetes class with three much older participants. Despite dropping my BMI from 26 to 23 my A1c had risen to 6.4%, not a high number, but certainly one worth watching. I knew of no one else in my family with diabetes. Eventually I did get that dreaded diagnosis, and because it didn’t seem to be type 1, they said it was type 2. Fast forward 2 years and my sister now had ‘GDM,’ (gestational diabetes mellitus) twice, my dad finally admitted to having ‘borderline sugars’ since he was in college, and I got my genetic results back saying I had GCK-MODY (GCK being a gene that can have a variant that triggers monogenic diabetes, MODY being maturity onset diabetes of the young). It changed everything: gone were the pills, gone was the restrictive diet and exercise plan, and when my son was born with high blood sugars, we did nothing, because he was like me, and there is nothing that needed doing.”

Now, if YOU are like ME, all of that might read like some mumbo-jumbo. It took a few weeks of me reflecting on it to decide whether I should even write this post, because I feared that it might cause some people to be paranoid about whether or not they were misdiagnosed with their diabetes (I admit that I was worried about that for myself in the days after learning about monogenic diabetes).

But the big takeaway here that I thought should be captured in a blog post is that it’s important for patients to advocate for themselves when things just don’t add up. There were a few more stories from individuals with monogenic diabetes in the pamphlet I got, and there was a recurring theme in all of them: Doctors kept telling these patients that their diabetes was atypical, but it wasn’t until these patients sought genetic counseling that they began to understand why.

It goes back to what I said at the beginning of this blog post: I find this variant of diabetes to be intriguing. It makes me wonder whether we should continue to define diabetes in such a black-and-white manner (either you have type 1 or type 2). I’m curious if diabetes is more of a spectrum of diseases that present similar symptoms, but require different levels of treatment and management. It’s certainly interesting food for thought, and considering that diabetes continues to be a semi-mystifying condition to many researchers and doctors, it won’t surprise me if future studies eventually uncover more types of diabetes.

Anyways, enough of my musings on genetic testing and speculations on how many types of diabetes are really out there. If you’d like to know more about monogenic diabetes, I was guided to several different resources. Check them out below:

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. πŸ™‚

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.