It’s been suggested that individuals with type 1 diabetes make as much as 180 extra health-related decisions every single day. Even when blood sugar is in range and under control, the constant mindfulness and decision making demanded by the condition might be stressful and exhausting.
This can be a letter that our Executive Editor Allison Caggia wrote to her father to assist him understand a day within the lifetime of type 1 diabetes. She has shared it persistently with colleagues and friends.
Dear Dad,
I’m writing this letter to allow you to understand how much of my time and mental capability has to go to diabetes. That is what 24 hours looks like. It’s intricate and everywhere in the map. A day within the life.
Each day is different, and more often than not nothing is smart. I spend my days, 24/7/365, trying to regulate something that can not be controlled. But I do one of the best I can with what knowledge I actually have.
When things go flawed, I try to not beat myself up about it. I attempt to do not forget that I could get hit by a truck tomorrow, so I would like to live for today. But sometimes I fail, and I confuse my self-worth with how well I’m managing my blood glucose. It’s mentally and emotionally draining.
While my low-carb way of eating helps, it actually isn’t a solution. There are over 42 variables that affect your blood sugar – insulin and food are only two of the numerous aspects. Add in stress, lack of sleep, exercise, hormones, and the magic unicorn on Mars (no really, we are saying this since it’s true), and sometimes as hard as I try, things don’t go my way and it really messes with my mental state.
Blood sugar highs scare you for the long run, and lows are scary short-term. After I’m low sometimes I won’t even know and won’t feel a 35 mg/dL! That’s not only scary, it’s dangerous. Some people will not be coherent at that level, or could even pass out. And yet sometimes I’ll feel shaky and super irritable at 60 mg/dL.
Every low I feel is a reality check of what I’m up against.
Listed here are my last 24 hours, starting after dinner at an Italian restaurant last night. I believed this could provide you with a glimpse into my world. Remember that for most individuals with diabetes, this could be a relatively uneventful 24 hours. No scary lows and no crazy highs, yet you’ll see I’m still combating numbers each inside and out of doors my comfort zone.
I spent much of today high, and I actually have no clue why. It’s hard to determine if I just stay content with high blood sugar, or take insulin to bring it down, which could wind up making me too low.
In between all these logs are many glances at my Dexcom continuous glucose monitor (CGM) and the constant thought that I would like to dedicate to managing this condition.
7:30 pm
Immediately after dinner – no pasta for me, I ordered chicken in a mushroom sauce – my blood sugar is at 177 mg/dL and rising. I determine to not take a correction shot and trust that my mealtime insulin would eventually take effect.
9:30 pm
I’m at 110, which implies that I made the proper call two hours earlier. If I had taken a correction shot at that time I might have completely tanked.
9:35 pm
I determine to double-check the accuracy of my continuous glucose monitor. My old-school glucose meter says 112 mg/dL, so my Dexcom seems accurate. They don’t at all times agree.
10:05 pm
My blood sugar is stable at 100 mg/dL, and I need a snack. I actually have to watch out how much insulin I take since the insulin in my body from dinner continues to be lively. If I take an excessive amount of I’ll be “stacking” insulin which might only lower me drastically. I did this just yesterday and wound up with blood sugar within the 40s. Most individuals would feel terrible when their sugar was so low, but sometimes I actually have hypo unawareness, a really dangerous condition. For this reason it’s vital that I wear my CGM, which sounds an alarm when my blood sugar gets too low.
10:30 pm
My CGM fell off! It had been on my body for greater than two weeks, my longest session ever. They’re only imagined to last 10 days, but I hacked mine (to lower your expenses – the sensors are very expensive!) to increase its life. The adhesive finally failed. It only lasted so long because my diabetes friend taught me find out how to use Skin Tac wipes.
Now I actually have to determine if I’m going to insert a complete recent sensor, which might protect me overnight, or if I should risk a break from alarms and a more comfortable sleep. If I insert the sensor now, I would like to stay awake past midnight to calibrate it. [editor’s note: Allison had a Dexcom G5, which requires immediate calibration. Newer models don’t need to be calibrated in the same way.]
I made a decision to take the night off. I’ll insert a brand new CGM sensor tomorrow.
11:00 pm
I take my nightly Lantus injection. I test my blood and am back at 147 mg/dL, but since I just had a snack and took some insulin, I determine to attend and see what happens.
11:45 pm
My bedtime finger prick check shows 80 mg/dL. That’s an ideal number for me in the course of the day, but at night I prefer a bit cushion to avoid going low. I determine to set an alarm so I can check my blood sugar in the midst of the night. I arrange my nightstand with two test strips, my meter, and my pricker.
1:30 am
I roll over in bed for my overnight blood sugar test. My finger prick shows 100 mg/dL, which is enough cushion to not go too low overnight. I can close my eyes and never worry, which is an incredible feeling!
7 am
This was my first time sleeping through the night in weeks! Apart from that one blood sugar check, that’s.
My morning blood sugar is 170 mg/dL, which is taken into account “in range” but definitely higher than I need it to be. The small snack I had at 10pm can’t explain this blood sugar rise. My dawn phenomenon will need to have kicked in overnight. Within the morning, hormones and insulin resistance mean that my blood sugar naturally rises anywhere from 30-50 mg/dL upon waking.
If I had been wearing my CGM, an alert would have woken me earlier, and I might have taken insulin to counteract the rise.
I’ll take a correction shot now, but must also think about my eating and exercise plans over the subsequent few hours. I choose a conservative shot of 1.5 units, which will not be enough to counter my dawn phenomenon and canopy my low-carb breakfast, but it’s going to help be certain that I don’t go too low during my morning workout. I also take my morning dose of Lantus.
After making breakfast and packing lunch for the family, I must have simply enough time to place in a brand new CGM. It’ll be two hours before it’s able to calibrate with two-finger pricks.
9:10 am
Getting the youngsters off to highschool was hectic, and I didn’t have time to placed on my CGM. I don’t have time now, either.
I test my blood sugar again with a fingerstick, and I’m at 157 mg/dL. The insulin cut the spike from my high-protein breakfast (two hard-boiled eggs), but wasn’t enough to bring me back down from the natural morning rise. But that’s okay: I need to be a bit high before my workout. Cardio can bring blood sugar down and likewise makes me more insulin-sensitive. This provides me an excellent cushion.
10:15 am
After the gym, I finger prick and my blood sugar is at 80 mg/dL and I’m finally back in the peerlessly healthy range! It’s an excellent thing I didn’t take more insulin earlier.
11 am
I finally placed on a brand new Dexcom sensor.
12 pm
The sensor continues to be warming up. I would like to quickly eat lunch before a piece meeting, so I test my blood: 103 mg/dL. I take 1.5 units for the lunch I’m about to eat quickly before my meeting.
2 pm
My recent Dexcom sensor is able to be calibrated with two-finger pricks – 126 and 112 mg/dL. Those numbers are absolutely nice by me after lunchtime.
3:30 pm
I’m hungry for a snack. My Dexcom reads regular at 102 mg/dL, and I don’t really need to take one other shot and risk affecting my good results. I determine to have some cheese, which can not move my blood sugar much in any respect.
5:30 pm
Dexcom says 80 mg/dL which is strictly where I need to be. I head out to dinner at a restaurant that I already know can accommodate my low-carb preferences. I order zucchini linguini with chicken and shrimp, a meal that ought to let me avoid a spike. I take 1.5 units of fast-acting insulin, which ought to be good for the protein and sauce.
7 pm
My Dexcom currently says 130 mg/dL. Looks like I got my insulin-to-carb ratio right this time. I make a mental note to myself for next time. Every meal is one other data point, and a likelihood to enhance my control.
7:45 pm
Suddenly my CGM alarm goes off — my blood sugar is at 158 mg/dL with a diagonal arrow up, meaning that it’s going to probably proceed to rise. I ate a whole lot of protein at dinner, and protein rises are delayed, so I’m likely spiking from the chicken and shrimp.
Before I take a correction shot, I determine to double-check with my glucose monitor. The finger prick says 102 mg/dL! The CGM isn’t at all times accurate, especially in the primary 24 hours. No insulin is essential.
8:30 pm
Now my CGM is sounding an alarm that I’m low. And now it craps out and reads no number. I test my blood and it’s 107 mg/dL, go figure.
9 pm
My CGM began to work again and reads 94 mg/dL.
10:20 pm
My CGM alarms high … and this time it’s accurate! My glucose meter confirms that my blood sugar goes up. I take 1 unit as a correction shot.
11 pm
I determine to have a late-night snack. Normally I’d take 1.5 units of fast-acting insulin, but I have already got 1 unit on board so I determine to be conservative with my dosing in order to not go low overnight. To be secure, I’ll wait for at the least an hour to see where I land before going to sleep. I may have more insulin, or I may have more sugar. It’s truthfully anyone’s guess.
Dad, imagine it or not, this was actually a stellar day for an individual with type 1 diabetes. Despite the lows and highs, the corrections and the false alarms, I spent a lot of the day in a healthy range.
As you’ll be able to see, a whole lot of time and thought went into today. Some days don’t go so well and might be very scary — but I carry on plugging away! Hope this is useful!
Love,
Allison