Sugar and T1D: Friends, Not Foes

For someone who doesn’t eat sugar…. you sure do know how to bake….damn those were good

My coworker sent this to me via instant message as a way of thanking me for the cupcakes I’d brought into the office that morning. Before 11 A.M., a dozen and a half or so “butterbeer” flavored cupcakes I’d created were devoured by my coworkers, who gave rave reviews on their taste, much to the delight of this wannabe pastry chef.

This particular message of praise, though, made me simultaneously smile and cringe: It was that comment, again. The one about sugar and not being able to eat it.

Everyone in my office knows that I have type 1 diabetes. And because I make it my mission to spread awareness of how to react in certain situations that a T1D might encounter, most people I work with know that in cases of low blood sugar, fast-acting carbohydrates (i.e., sugar) are essential as they’re the fastest way to fix a low.

Calais University
Sugar saves my life from time to time…and no, that’s not an exaggeration.

But every now and then, I’m reminded that no, people don’t always remember what you tell them about diabetes. It goes to show that there’s always room for more advocacy…which is why I write about diabetes and won’t stop talking about it to those who want to know more.

As a result, I’m constantly telling people that I can and do eat sugar; in fact, it saves my life from time to time. Maybe that’s the subconscious reason why I love baking cupcakes, cookies, and more: For a girl who relies on sugar sometimes, I sure do know that a baked good every now and then is what helps me stay alive.

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4 Things That Make Traveling with Diabetes Easier

Throughout June and July, I’m going to be a travel fiend. I’ve got plans to travel by plane at least twice, and by car countless times. My trips will vary in length from just a couple hours to eight or nine hours. My head’s spinning just thinking about it, but I’ve got to get it together enough to think about how I can make traveling with diabetes a little bit easier. Given my past travel experience, I can think of four things that are absolute musts for me to take on any trip…

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Some of my favorite things to have with me when I travel.

4. Packing cubes
I always thought packing cubes were a total gimmick…until I actually started using them. I got a set of four for Christmas and they’ve really turned me into a much more efficient packer. They help me visualize the space that will be taken up in my suitcases, and what’s even better is that one of the cube’s is the perfect size for my diabetes supplies. I can fit 15-20 pods, a handful of CGM sensors, various device chargers, alcohol swabs, IV prep wipes, and more into the compact little cube. It’s so much better and more organized than the lame-o gallon-size Ziploc bag that used to store all my diabetes supplies for a trip.

3. My Myabetic backpack
I don’t know how I ever traveled with a purse as opposed to my Myabetic backpack. I can fit way more things into my backpack than I ever could put into my purse, and I love that there are specific compartments in the backpack for certain diabetes supplies. I know exactly where things I might need during a flight are stored, eliminating that panicky feeling I used to get when I would dig frantically through my purse in order to find my tube of glucose or my PDM.

2. Snacks and water
This is an obvious one. In my opinion, traveling with diabetes shouldn’t even be attempted without a refillable water bottle or at least two emergency-low-blood-sugar snacks. Even though it’s basically diabetes 101, I’m guilty of going places without water or snacks…and I’ve always regretted it. There’s not much worse than being in an unfamiliar place and unsure of where the closest food and water is located, especially when dealing with a blood sugar crisis.

1. My CGM
The most important tool in my travel kit is, without a doubt, my CGM. More specifically, my receiver is key, particularly when I’m traveling by air. I am religious about turning my phone off for the duration of a flight (just a weird paranoia thing, don’t judge me), so my receiver becomes my go-to whenever I want a status update on my blood sugar without taking out my meter and kit. It helps me handle any weird blood sugar spikes and drops that occasionally happen when I travel, and it provides me with a peace of mind that makes traveling with diabetes much more bearable.

 

Brunching with ‘Betes

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

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

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

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

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

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

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

Type 1 Diabetes…the Uninvited Bachelorette Guest

T1D is an unwelcome presence in my life, but I’ve made peace with it. However, it doesn’t stop me from worrying about how its existence might affect others in a wide variety of situations.

Take a bachelorette party, for instance…I wasn’t sure how my diabetes would respond to a weekend spent in Saratoga Springs with my soon-to-be-married cousin and the gaggle of girls who would accompany her to a few different wineries, a comedy show, and other various shenanigans. I went into the situation hoping for the best, but expecting the worst.

I Volunteer To Drink! (1).png

What does “expecting the worst” mean? Basically, it meant that I was preparing for the apocalypse. The bachelorette weekend was barely 48 hours total, but I was so paranoid about something going wrong with my diabetes that I packed twice the number of pods that I would need, extra insulin, spare syringes, Glucagon, and a low-blood-sugar-snack stash. Although I had a rough idea of what our itinerary looked like for the weekend, I still wasn’t 100% of what we would be eating and when, which as any T1D could tell you, is kind of a major concern when it comes to taking proper care of diabetes – and that concern is intensified when alcohol gets thrown into the mix, as it unquestionably would on our quest to find the best winery in Saratoga.

My worry only grew when things didn’t exactly start as I envisioned them. We hit the road around 4 o’clock in the afternoon that Friday, and picked up the delighted bride in Western Mass a short while after 6 o’clock. I expected that we would stop for food soon after the bride joined our caravan of cars bound for New York…only to be proven totally wrong when I discovered that most people were too excited to stop and eat. “No problem,” I said to myself. “I’m sure that by the time it’s 7:30 or so, people will be hungry.”

No such luck. As I watched my blood sugar slowly drop, my stomach roared with hunger as I thought about the last meal I ate, nearly seven hours ago. I knew I should speak up and ask the group to pull over, but I was scared. I didn’t want to be “that” person who was making such demands, especially since I was merely a passenger in the car and not driving.

But it was almost 8 o’clock and I knew that if I didn’t eat soon, it wouldn’t bode well for the rest of the night. My body tends to rebel if I go to sleep soon after eating a decent amount of food, and my blood sugars usually make me pay for the lateness of the meal. I feebly requested a stop to the girl who was driving, and discovered that she desperately needed to make a trip to the ladies’ room – at last, my chance for food! I called one of the girls in the other car to let them know that we would all be hitting up the next rest stop. “And Molly needs to eat!” The driver yelled into my phone before I could hang up. I felt myself blush, not wanting to be a pain in the ass…but little did I know, the girls wanted me to speak up.

When we all met at the rest stop, everyone asked with genuine concern how I was doing. As I assured them that I was much better now thanks to my Subway sandwich, I was gently scolded by the bride – my cousin – for not saying something sooner. Each girl agreed and I promised them that I would be better about letting them know about potential blood sugar issues for the rest of the weekend.

The funny thing is, though, that I really didn’t have any problems whatsoever. I was very surprised, due to the fact that we were eating late/inconsistent/not-very-healthy meals each day, drinking a few different kinds of alcohol, and spending less time than I anticipated moving out and about…normally, that’s pretty much a recipe for disaster. I can’t help but wonder if I avoided problems because I did everything the “smart” way – ate plenty of food to combat the effects of alcohol, took extra insulin as needed, and stayed hydrated all day, everyday. It certainly is a formula for success, and deserves credit for taming the unwanted bachelorette guest all weekend long.

Now if only I can replicate this for the upcoming wedding weekend…

T1D and Grocery Store Paralysis

Yellow roses, gallon-sized Ziploc bags, and iced tea. That was all I need at the grocery store. Three items. I should’ve been in and out in five minutes flat, but diabetes had other plans.

It was the morning of my cousin’s bridal shower and as one of her bridesmaids, I was running amok, getting myself ready and prepping like crazy for the party. As a result, it was the kind of morning that left me little time to consider my diabetes and how it might be affected by the day’s events.

I Volunteer To Drink!.png
It’s strange to feel such panic and confusion in a grocery store, of all places.

So I didn’t really think twice about having a bagel for breakfast. Normally, I avoid bagels because eating one tends to make my blood sugars run a little high several hours after consuming it. But a bagel was a quick and easy breakfast on such a busy morning. After devouring the cinnamon bagel smothered in cream cheese (hey, if I was going to indulge on a carb-heavy breakfast, I wasn’t about to skimp out on the spread for it), I got a phone call from my aunt, who asked me to run to the grocery store before I made my way over to her house for final bridal shower set-up.

She gave me a very short, very manageable list of three items to get at the store, so I was certain that it would be fast trip. Once I was showered, dressed, and finished with my make-up and jewelry, I loaded up my car with various decor for the party and headed to the grocery store. I parked in a spot far away from other cars so I could pull out of the parking lot easily, and hoofed it into the store.

I’d just loaded my basket with 18 yellow roses (the only 18 yellow roses in the store, in fact), when my CGM started blaring my low alarm from within my backpack. I was surprised – I figured there was no possible way that I’d go low because of the bagel.

And that’s when what I’ll call “T1D paralysis” hit me.

I froze. I couldn’t remember which aisle I might find plastic Ziploc bags in, let alone that I should grab some glucose tablets from my backpack to correct the low. It sounds ridiculous, but truly, I felt paralyzed and panicked as the alarm went off again, this time more urgently as my blood sugar was tumbling down faster than I could’ve predicted.

By some miracle, I did eventually snap out of it (after what felt like 3 hours but was probably only about 5 minutes). Shaking, I found the plastic bags I needed and zoomed over to an express checkout lane, babbling nonsensically to the cashier as he rang me up. I booked it to the car, cursing myself for parking so far away, and collapsed into the driver’s seat. It was only then that I remembered I needed something for my blood sugar, so I fished a box of raisins out from my purse and wolfed them down.

I sighed as I sat there in the car, waiting for my blood sugar to come back up. Three items at the grocery store was all I needed. But what I wound up with in addition to them was a scary feeling of helplessness – completely and utterly immobilized in a setting in which I was the only one I could rely on to help myself – that freaked me out. I don’t know whether it was the abnormally carb-y breakfast or the stress of party preparations, or some combination of the two, but I do know that this sensation isn’t something I want to encounter again any time soon.

 

 

Why I Refuse to Quit Carbs

This is an original post I wrote that was published on Hugging the Cactus on January 26, 2018. I am republishing it now because there’s been some buzz on the Diabetes Online Community recently about different diets people with diabetes “should” and “shouldn’t” follow…and this sums up my feelings on being told what choices I should make when it comes to my own health!

Recently, a random person on the Internet criticized my choice to incorporate carbohydrates in my daily diet. Thanks for the unnecessary judgment, stranger!!!

I’m not really upset about the comment, though, because it prompted me to reflect on why I consume carbs.

Have a slice!
*Oprah Winfrey voice* I. Love. Bread.

For me, it’s about more than just enjoying (relishing, adoring) the taste of carb-heavy substances both starchy and sweet. Carbs also help me achieve balance in my blood sugars. For instance, I find that consuming a serving of carbohydrates at dinnertime keeps me steady as I move through the evening hours. Say that I’m eating grilled chicken with a side salad for dinner. That’s a good meal by itself, but I like to complement it with a carb like half a cup of mashed potatoes or brown rice. I’ve noticed that the carbs kick in more slowly when they’re consumed with minimal or zero-carb foods, thanks to the power of the glycemic index.

The glycemic index is, in short, a measure of how quickly the carbohydrate content of foods will affect blood sugar levels. Since learning about it in college and subsequently researching the glycemic indices of various foods I eat, it’s been an immensely useful tool in determining the makeup of my meals throughout the day. Knowing the glycemic index of a wide array of foods also helps me figure out the timing of my insulin doses; in turn, preventing crazy spikes or crashes after eating.

I can’t shortchange carbs for the fact that they literally save my butt sometimes, too. When I’m experiencing a low blood sugar, nothing BUT carbs will bring me back up to a normal level. Whether it’s carbohydrates from healthy fruits or straight-up candy, it’s giving my blood sugar the surge it needs to keep me going. Like many things in life, it’s a matter of moderation – making sure I don’t consume TOO many carbs when I’m experiencing a low.

If you’re someone who thrives on low carb, high fat diets, that’s great! I know that many people find this to be a successful method in achieving target blood sugars. But for me, my tried-and-true technique of balancing carbs, fats, and proteins is always going to be my ideal strategy. Just because that’s what works for me doesn’t give anyone a right to criticize me for it. I’m here to live my best life, as we all should try to do. Shouldn’t we encourage one another to thrive, instead of judging?

The answer, if you didn’t realize, is YES.

Is it Possible to Eat Pizza Without Encountering Blood Sugar Problems?

My short answer to that question is YES. Yes, it’s absolutely possible to eat pizza – and just about any food, in my opinion – without experiencing turbulent blood sugars.

It all just comes down to serving size, timing, and method of insulin delivery. Piece of cake, right? (Or should I say, piece of pizza?)

Have a slice!

Well, it really isn’t THAT simple. Other factors include the exact type of pizza (Is it gluten-free? Are there toppings? Is the crust thick or thin?), whether or not other food/drink is being consumed with it, whether exercise or inaction will follow in the hours after eating it…truly, there’s all that (and more) that people with diabetes need to think about when eating any type of food.

But what’s different about pizza is that it has a particular combination of fat and carbohydrates that can make it a tricky food for people with diabetes to figure out how much insulin to take and when to take it. It’s a little easier for those of us who have insulin pumps, because we can utilize the extended bolus (or square wave) feature that allows us to give a certain percentage of a mealtime bolus at once, and select a time later on to receive the rest of the bolus.

If that last sentence didn’t make any sense, here’s an example of what I mean:

It’s dinnertime – 5:30 P.M. I have two slices of pizza that I plan on eating. One’s plain, the other has BBQ chicken on it. I figure that there’s 50 grams total of carbohydrates in the two slices of pizza. My blood sugar before eating the pizza is 130 mg/dL. I put that number into my pump, and also input 50 grams of carbs. My pump wants me to take 8 units of insulin to cover the pizza. Instead of administering the full 8 units at once, I hit the “extend” option and opt to take 75% of the dose now, and the remaining 25% an hour and a half from now. So I get 6 units of insulin at 5:30, and 2 units at 7:00. This extended bolus typically has the power to prevent my blood sugar from crashing and spiking hours after eating said pizza, and in turns, saves me from dealing with a massive headache and questioning why I ever ate pizza in the first place.

Granted, an extended bolus isn’t the end-all, be-all. It relies heavily on me and my ability to count carbs correctly and time my boluses perfectly. But I have had fantastic success using it, particularly in a recent situation in which I ate two large slices of whole wheat pizza, a side salad, and a bit of pita bread without spiking beyond 160. I can’t say whether it was the whole wheat crust that helped me out (maybe it has a lower carb count compared to regular crust?), or if it was just supremely accurate calculations on my end, but it really doesn’t matter to me in the end…because I know that I can eat and enjoy pizza – and again, virtually any food – without my diabetes ruining it for me.