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.

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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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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.

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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.

 

 

Fearful and Falling in Target

What do they pump into the air at Target? Is it Afrezza or something? Because that seems like the only logical explanation for the phenomenon that seems to occur to most other fellow T1Ds when we step into a Target store.

Low blood sugars tend to happen at Target. Also known as “Target lows”, they can occur at any Target, big or small, no matter how long or short the shopping trip.

I experienced one last week. And it was severely exacerbated by the fact that I was visiting one in my new city for the first time by myself.

You are a rare gem.
Damn you, Target, for making my blood sugar go low during basically nine out of ten visits.

As you can see from my CGM screenshot, my blood sugar was definitely not low – not even close to it. I was in the mid-250s by the time I headed to the store, which is absolutely NOT where I like to be. But I didn’t take a correction bolus or even raise my basal insulin temporarily, because I guess I just had that feeling about my Target trip. I didn’t bother checking my CGM again after I parked, figuring that I’d do my best to make it a quick trip with minimal purchases.

Forty minutes (I’d been aiming for 20) after I’d stepped into the store and one semi-full cart (oops) later, I started feeling panicky and gasp-y. I told myself no, no, no, I wasn’t going low, I was just maybe reacting strangely to the scent of all the cleansers in the aisle I was occupying. I could deny it all I want, but in the back of my mind, I knew that I needed to pull my cart over, dig through my backpack, and locate my CGM so I could at least be informed of what my blood sugar was doing.

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Honestly, Target and all other retailers should just make glucose tablets free to any shoppers who are having a low moment.

So I did just that. Upon checking my Dexcom app and seeing that down arrow, I practically started hyperventilating. That’s when the following series of thoughts flew through my mind:

Okay, just get to the checkout…

Ugh, why is there only one open?! Guess you’ll have to self-checkout on low brain. Great…

OMG, Molly, you know you can only scan one item at a time…go faster!

You are NOT going to go down in this Target. Not today!!!

By some miracle, I successfully purchased my items and booked it to my car. Once I loaded everything inside, I suspended my insulin and shoved three glucose tablets into my mouth at once, chewing them so fast and furious that it probably deserved its own movie by the same name…(oh, but that’s taken *tee-hee*).

Normally, I would wait for my blood sugar to come back up before even thinking about driving home…but this wasn’t exactly a normal situation. I was on my one-hour lunch break from work, and I was rapidly approaching the 59-minute mark. The rational part of my brain (the way, way, super-far-back part) knew that I would be okay after about 15 minutes or so, but I was just so stressed about being alone in a strange city and wanted nothing more than to return to the safety of my apartment, pronto.

Of course, I had no idea how to actually get home – I needed my GPS to get to and from Target, and I’m sure I’ll need it to get basically anywhere for the foreseeable future – so I plugged my address into my phone’s GPS app.

And yet I STILL managed to take a wrong turn or three as I anxiously drove back to the apartment.

Less than 15 minutes later, I was parked and my shopping bags and I were inside my apartment. And that’s when I fell apart, feeling stupid for letting the low happen and getting lost on the way home…and feeling extra dumb for crying so hard about it.

Yeah, methinks that I’ll be running a temporary basal reduction the next time I plan a Target trip. I don’t want to be fearful and falling again any time soon.

 

Should I Have Called 911?

Unintentionally, I set a personal record the other day. I experienced my lowest low blood sugar – 34 mg/dL. I was alone. And it was terrifying.

Around 1 A.M., I woke up to my CGM buzzing and alerting me to what I presumed was a mild low blood sugar. I definitely felt like I was low, so I quickly ate three glucose tablets without checking and confirming my low on my blood glucose meter. And soon after that, things got really weird.

I tossed and turned for 15 minutes as I tried to fall back asleep. But I just couldn’t get comfortable. To make matters worse, a bizarre, numb sensation invaded my left arm. As I became more and more aware of it, my breathing started to run a bit ragged – almost like I was having a panic attack. Between the breathing and the numbness, I knew something was very wrong.

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What would you have done in this situation?

So I bolted upright in bed and grabbed my meter and kit to do a blood sugar check. And that’s when the number 34 popped up on the screen. I swore out loud, and almost immediately began sweating profusely. As beads formed around my hairline and streams trickled down my back, I reached for my bottle of glucose tablets as well as my phone. I ate three more tablets – wondering why the three I’d eaten 15 or so minutes ago seemed to have no affect – and contemplated dialing 911. After all, I was completely alone and there was no telling whether I’d pass out or need assistance from someone. In that moment in time, I craved talking to someone, anyone, who might be able to stay on the phone with me while I waited for my blood sugar to come back up.

Like a complete idiot, though, I decided not to call 911 and instead took to Twitter…*insert face palm here*. I know what you’re thinking, why the eff did I do that? Two reasons: 1) I wasn’t exactly thinking clearly and 2) I knew that someone, somewhere, within my diabetes online community would be awake and possibly willing to talk to me.

Thank goodness my intuition was right…my sweet friend, Heather, who I had the pleasure of meeting IRL five years ago, responded to my tweet a few minutes after I posted it. She offered to call, but by this point in time, I had made it downstairs and into the kitchen just fine and was helping myself to a cupcake I’d baked earlier in the day (oh, how convenient my passion for baking can be…sometimes). I exchanged a few tweets with her back and forth, and before I knew it, 45 minutes passed from the onset of my scary low blood sugar symptoms. I ambled back upstairs to my bed and checked my blood sugar before getting settled back into it. I was surprised to see I was only 72; after all, I’d consumed about 50 grams of carbohydrates in the last hour, and for me, that’s a lot! Most of my meals don’t even contain that many carbs!

Bemused and exhausted, I slumped against my bed frame and distracted myself by scrolling aimlessly through social media channels. My body and my mind craved rest. Much to the relief of both, I was able to get it before long, once I got confirmation from my CGM and my meter that I was finally above the 100 mark. I knew that I’d likely go up much higher (and I certainly did, waking up at 289 the next morning), but at the time, I just didn’t care. All that mattered was that I was going to be okay.

I’ve been reflecting on the incident on and off the last few days. I’m trying to process what happened and how it happened – was it my new Metformin that triggered it? Was it stress that I had experienced earlier in the day manifesting itself? I drank one beer before I went to bed, could that have done it? Did I take too much insulin before bed, even though I was certain I hadn’t? Lord knows that it could’ve been any combination of those factors, or none of them…but I can tell you this: I haven’t taken Metformin since it happened out of fear. I’ll talk to my endocrinologist soon and revisit my dosing plan with her. I can also tell you that, even as I continue to process the entire ordeal, I’m feeling so lucky that I was lucid enough to take proper care of myself. I know there are many other T1Ds who can’t say the same and have experienced much more awful low blood sugar incidents, so I’m simply counting my blessings right now.

What would you have done, had you been in my shoes? Would you have called 911, a family member, a friend? Would you have waited it out?

When Diabetes Makes You Eat More in Between the Appetizers and the Main Course

Normally, I don’t eat snacks after I’ve had a starter course at a restaurant, and my order’s in for my entree…because that’s just weird. I’m going to a restaurant to eat food, anyways (presumably a meal), so why on earth would I need to eat a snack in between courses?

Diabetes. Duh. Diabetes is always the answer (or root of the problem).

How annoying it was to start feeling shaky and sweaty, only to discover that my blood sugar was almost in the 60s soon after devouring my app and placing my dinner order. How irritating to know that the two chicken wings I just ate contained virtually zero carbs; therefore, would not do anything to boost my blood sugar any time soon. And how obnoxious it was, looking around the crowded restaurant and realizing it’d likely take some time for my meal to come out – and that the food I’d ordered was also relatively low carb (a bun-less turkey burger with side salad), and would also do nothing to correct my low.

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You can see that I held off on correcting the low for as long as possible…but then the shakiness started.

Can you tell that I was just a bit irked at the situation?

I did what I had to do – reach into my backpack to grab one of the leftover granola cups from the pack of two I’d started earlier that day. I ate it quickly, crushing the wrapper in my hand and shoving it hastily back into my bag, hoping that no one saw me eating food that wasn’t from the restaurant like a wackadoodle.

And I swear, within five minutes, our food was out. I was happy but also just mad that I had to snack in between my appetizer and my main course. But diabetes is like a petulant toddler – it doesn’t care what you want or need, it just demands. It’s more demanding than any person or thing in my life. It’s exhausting, but there’s no choice other than to just oblige its needs, even if it means eating when you don’t want to.