Hungover From a Day of Rollercoaster BGLs

I feel well and truly hungover after a day of dealing with rollercoaster blood sugar levels.

It started with the slice of thick cut raisin toast I had for breakfast. Probably not the most sensible choice of breakfast, but I felt like it. My blood sugar was a lovely 6.8. I’ve been working diligently at producing straight lines overnight and into the morning, and I felt ready for a challenge. So I pre bolused my insulin, drank my coffee, dressed, prepared my toast and ate it.

My FreeStyle Libre showed a perfect 6.9 and steady when I arrived at work, and I was able to put my fears of the toast spiking me to the back of my mind as I started work.

About an hour later I checked again, only to find a 13.1 and an upward trend arrow on my Libre. Nowhere near the 20s territory that raisin toast could potentially send my blood sugars, but still a surprise considering the increased intensity of my physical activity at work yesterday morning. I’ve been producing some spectacularly stable lines through the mornings, so seeing that 13 was rather irritating.

I watched that 13 slowly go down to 12.2 and then settle at 11.0. I should have just left it. I still had close to 2 units of active insulin on board. I was working intensely and I knew the insulin would be extremely sensitive. But the frustration of that 11 got the better of me, and I gave a correction bolus of half a unit, as suggested by my pump.

No more than ten minutes later, before the insulin bolus would have even had time to kick in, my levels were already showing signs of descending. I felt so frustrated. I knew that I should have just left all and good.

As I watched the downward trend arrows on my Libre, I decided to have my morning tea of coffee and a small banana. As I watched my levels enter hypo territory, I added another 15 skittles into the mix and went back out to work.

I refused to check my levels for another hour to avoid any more impulsive actions, until I saw that I had rebounded to 13.3 with an upward trend arrow. I had very little insulin left on board from breakfast, so I entered my reading into my pump and gave half of the suggested correction dose.

I thought I had been extremely cautious, yet within half an hour I was plummeting once again. Not wanting to over-treat this one, I cautiously ate 12 skittles. I ended up needing another 8. My levels bounced back into range, before eventually falling back to hypo territory again by lunchtime.

I felt doubly exhausted from a morning of intense work, combined with rollercoaster glucose levels. By this point it was lunchtime, and all I really craved was sugar. A jam donut and a chunky Kit Kat joined my toasted sandwich for lunch. It was a crazy, crazy ridiculous carb count, but I knew that I would be able to get away with not spiking too high while I was working.

If I had just accepted that raisin toast will naturally send me higher than oats, I might not have had the rollercoaster day that I’ve just had.

Although surprisingly, my glucose levels didn’t go any higher than 14.3mmol all day. Silver linings, right?

Does An Insulin Pump Make Me Lazy?

In a recent blog post, I expressed that my insulin pump has offered a greater level of convenience in giving my insulin doses. I lamented that I was often slack with carbohydrate counting, weighing my portions and delivering insulin in a timely manner when I was on injections. This led to a few comments from social media trolls that accused me of getting an insulin pump because I was lazy.

Of course, I could absolutely count carbohydrates, weigh portion sizes and pre-bolus insulin on injections. But there were a number of other factors that lead to my ultimate decision, which I wrote about hereI felt failed so often despite my best efforts, that I simply lacked the motivation to do those things that I should have.

So in hindsight, maybe ‘lazy’ was the wrong word to use. I only used it in the context of trying to be honest. However, an insulin pump is definitely not a lazy decision.

Attending an insulin pump information evening was not lazy. Doing my research was not lazy. Making an appointment to discuss pumping with my diabetes educator was not lazy. Going home and giving myself three months to think about the pros and cons of pumping was not lazy, despite how tempted I was to say yes. Being active and seeking out options that may improve my health is not lazy. Wanting to better manage my diabetes is absolutely not lazy.

The very first thing that Gwen drummed into my head is that an insulin pump is not any easier than injections. In hindsight, I would argue that it is much more work compared to injections. There’s a good reason why clinics like to make sure that their patients are deadly serious about it and prepared to make a commitment. Wearing an insulin pump is a big responsibility. Just read every post I’ve written here in the past three months.

I am very conscious that I’ve been writing a lot about insulin pumping here of late, but that’s simply because my insulin pump is a big part of my diabetes at the moment. I certainly don’t have an agenda to ‘push’ insulin pumps onto anyone. I don’t believe that one is any better than the other. I simply believe that different methods of insulin delivery may suit some better than others. There’s a big difference between giving advice, and sharing my experience in the hope that it might inspire you.

Insulin pumps and diabetes tech are often the hot topics among bloggers and diabetes websites, and it sometimes does leave injections looking under-represented. But then again, don’t we all feel we are in the minority in some context or another? I feel in the minority because I can’t play sport to save my life. I feel like I’m in the minority because I don’t work in an office. At work this morning, I’ll be in the minority because I’m the only person who watched Australian Survivor last night. And in the DOC, I feel in the minority because I don’t use a CGM. 

Truth be told, I couldn’t care less about being in the minority! I’m happy to go for a walk instead of a run. I’m happy that I’m employed, earning money and have goals that I’m working towards. I love Survivor. And I’m happy to prick my finger 15 times a day, because that’s what works for me.

It comes back to the point I made last week in this post about inclusiveness. If there’s a topic that speaks to you, then please do add your voice to the conversation. And if I’m reading it, I promise I’ll treat it with absolute respect.

Finally, an insulin pump does offer me the convenience of dosing insulin under the table, or when I’m on the go. Dealing with diabetes every day for the rest of my life is already hard enough, and I refuse to feel guilty for it.

First hba1c Result Post-Pump

The very last thing that I was expecting to hear was that my hba1c had gone up after three months on an insulin pump.

I mean, I wasn’t expecting dramatic improvement straight away. I knew full well that my pump is not a magic wand. I knew that my glucose levels were fluctuating far too much pre-pump. When we looked at my Ambulatory Glucose Profile with Gwen back in May, she said just as much to me.


But I definitely believe that this variance is much tighter today. I feel I don’t peak above 15mmol half as often as I used to. Lows aren’t too bad either, but they are definitely a work in progress. I’ve been putting so much work into my diabetes. More than I used to on injections.

So I guess I went in there, mentally prepared to hear that my a1c result was the same. But definitely not half a point higher than my last one.

For a while now, I’ve stared at half decent a1c results. The doctors have been quick to dismiss me, but I’ve never truly felt satisfied with my results. Deep down, I knew that my levels were fluctuating far too much. I knew that I was peaking way too high after meals, and having far too many lows. I knew that my a1c result was not an accurate representation of what was going on with my levels. But I never had the courage to ask for help. I pushed these thoughts to the back of my mind, telling myself I would fix that problem before my next check up in six months time.

But I never quite got around to it.

So, I guess there was a damn good reason for the rise in my hba1c result last week. For the first time in a long time, I have a clear picture of where my glucose levels actually sit. It definitely means that I have made some progress. But at the same time, my goal post feels a lot further away. I am realising just how much hard work lies ahead of me in order to get that a1c to where I want it to be.

As I made a long drive home in peak hour traffic and pouring rain, it was hard not to feel disappointed. It was really hard not having Gwen, who recently retired, there with me that day. She had been with me all the way through my journey, and I’m sure that she would have understood exactly where I was at. I’m sure she would have known exactly what to say.

I dream of the celebratory dinner I’ll have when I get my a1c to where I want it to be. I dream of the satisfaction I’ll feel. The grin on my face. The sense of achievement. The victory. Feeling somewhat in control of this unpredictable disease. And the cake.

I am motivated. I know that I have made some solid progress in these last three months. I know that I am going make it to that dinner table one day.

Is the DOC Inclusive?

I’ve only been a part of the Diabetes Online Community for a little over a year.

When I nervously took part in an OzDOC chat for the first time, I felt very welcome. Strangely welcome, because the discussion was so friendly it looked like these guys all knew each other in real life. Somehow Renza stumbled upon my (very crappy at the time) blog, and offered me encouragement. Mike was one of the first people to leave me a comment, welcoming me into the Diabetes Online Community. I later learned he worked for a little site called Diabetes Mine and had included my post in their monthly blog round up. 

I found my place in this community quite easily, and I continue to participate quite actively. It stimulates me, it offers me support when I need it, and it inspires me to do better with my own diabetes.

Yet the other day, I felt compelled to agree that I sometimes I do feel hesitant to speak up because my opinion might differ from that of the majority.

To this day, one of the hardest things for me to accept is that not everyone is going to agree with me. I constantly try to remind myself that we are all different and naturally won’t agree on everything, but it’s still hard. I guess I find it hard to separate the difference of opinion with a dislike for my character. Silly, I know…

There have been some issues circulating around in the DOC that people have really strong opinions about. #DiabetesAccessMatters and Low Carb High Fat diets, are two examples that come to mind. Sometimes as a witness to these intense discussions and advocacy, I do feel hesitant to jump in with an alternate opinion for fear of being attacked or banished from a community I genuinely do love.

Social media only gives us a really small window into a person. When I first jumped in, I knew nobody with diabetes. I know for me, even just meeting a small group of peers at DX2Sydney this May has given me a lot of perspective in regards to the person with diabetes versus the Twitter window. It was a really valuable experience that carries me forward in my online activity to this day.

Some of my peers in the Australian community have set a great example for me in the use of diabetes social media. When I write here, I am increasingly conscious of trying not to “bash” the alternative opinion, or claim that my opinion is the right one, instead focussing on my own experience.

One thing I do admire is this community’s eagerness to comment and voice their thoughts. I often struggle to fit my ideas into 140 characters, and I’m terrible at keeping up in fast paced Twitter conversations. It often feels easier to lurk than to comment, and I feel I could be more inclusive by not being a stranger so often! 

I feel that Diabetes Daily and Diabetes Mine also do an outstanding job of being inclusive of the wider DOC. Diabetes Daily feature a wide variety of perspectives on diabetes management that I find myself reading more and more of. And you need look no further than the @diabetesmine Twitter feed to see how engaged the folks at Diabetes Mine are with the wider community.

Reading Renza’s post on the issue of inclusiveness yesterday really put my mind at ease. We don’t have to agree with one another, but we certainly need to be respectful so that others don’t feel afraid to voice their thoughts. 

I don’t really know how I come across online. But I hope that others would feel that I am respectful towards other opinions, even if I don’t agree all the time. 

Be kind to one another.

Three Month Pump-aversary!

The very first thing Gwen emphasised to me last year was that using an insulin pump would not be any easier than Multiple Daily Injections. Boy, oh boy, was she right.

These past three months have been by far the most challenging I have faced since being diagnosed with type 1 diabetes six years ago. I have gone through site failures, occlusions, ketones, frustrations and burnouts that have lasted for several days on end. It has required enormous patience, a commitment to learn, and it has seen me agonise over many a decision. I have been through it all. I have poured my heart onto these pages over the last three months.

There have been a lot of low points that I have talked about quite candidly over the past three months. There have been a few times where I’ve reached breaking point. Times where I have found myself pacing up and down my room, deliberating over whether to rip my pump out and take a break for a couple of days.

But every time I have contemplated removing my pump, I knew that I really didn’t want to say goodbye to that added level of precision. I have never truly felt ready to say that this wasn’t for me.

Stability during the night is miles better compared to injections. I felt that when I was using Lantus, I could never get the dose quite right. I felt that I needed to eat a similar number of carbohydrates each day in order to achieve that smooth coverage I needed during the night. I felt that if I ate more than normal, my basal wouldn’t be enough to keep me stable through the night. Then if I were to skip a meal the next night, my basal would likely send me plummeting at 4am.

For the first time in my life, I have confidence that my basal rate keeps me stable. When I give a correction at 1am, it actually works and sends me back into range by the time I wake in the morning. When I go low during the night, it’s only through my own fault.

I could never seem to get my breakfast insulin dose just quite right. In the months leading up to the pump, I noticed that I would end up frustratingly high after eating virtually the same thing for breakfast each morning. Now my pump delivers extra basal insulin to cover the extra glucose that my liver dumps when I wake up each morning, and my breakfast insulin dose actually does it’s job!

Highs are also so much easier to manage with the pump. I remember stubborn highs that were so resilient they needed multiple insulin corrections that didn’t make any sense. Now with the pump, I know that highs are a little less sensitive to insulin. When my levels soar into the 20s, I can set a temporary basal rate of +200% to get things moving a little more quickly. When i think about it, I don’t think my levels peak above 15mmol half as often as they used to. And when they do, they don’t stay there for too long at all.

On pump day, Gwen reminded me that I was the kind of person who wanted that extra level of precision. I knew that I wanted to be able to customise my insulin delivery to match the hour of the day or a specific activity. I feel that my insulin pump has given me that.

The pump has given me an added focus and drive with my diabetes. I am working my butt off with carbohydrate counting, pre-bolusing and watching my portion sizes (which I could easily do without the pump, too). I guess what I’m trying to say is that my diabetes goals seemed unattainable on injections. With the pump, they do. Hence, the drive to keep up the hard work rather than being lazy.

I’ll hopefully have an a1c result at the end of today. I have a good feeling that it will likely be around the same mark as it was in May, and I’m pretty content with that. Over the years my a1c results have been ridden with too many peaks and troughs, so I’m pretty pleased that those peaks are a little less peak-ey today.

As I reach the three month mark on an insulin pump today, I feel like I can finally focus on some of my other diabetes goals, which feel far more in reach than they ever did on injections.

Thanks for all of your support and encouragement over the last three months. I really couldn’t have done it without you all cheering me on.