Diabetes at Work

Playing the Diabetes Card

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A few weeks ago, I was consulted about some potential changes to my position at work. I felt that what had been asked of me was huge, and very unexpected. It was a big step out of my comfort zone. It left me feeling stressed and with blood sugar levels that were through the roof in the hours after I first found out.

I knew that this change was not going to be great for my diabetes, either. It was going to mess majorly with the routine that I had become ever so familiar with over the past four years. I knew that it would make me unhappy and ruin my attitude towards my job.

I pulled out my pump and explained to my boss that I had diabetes. That the little pager-like device attached to my hip delivered all of my insulin, and that I had only just finished fine tuning the insulin delivery settings after three months. I went on to say that I thrived on a routine, and that I didn’t really feel too comfortable messing with it to such a huge extent so early on into my pump therapy.

I felt terrible. I felt so small, and so defined by my diabetes that day. I absolutely hated myself for having to fall back on diabetes as an excuse. I absolutely hated that first impression I had given to my relatively new boss, of both diabetes and otherwise. I couldn’t even begin to imagine what he would have thought, as he asked me if there was anything he could do to help make this change happen.

I was prepared to go back and make a compromise that I felt more comfortable with after much thought, but ended up being offered an even better option.

I felt absolutely terrible for using my diabetes as an excuse in that situation. Very rarely do I use my diabetes as an excuse for anything. Morning coffee. Christmas lunch. Taking on extra responsibilities at work. Helping others. Doing handy work myself to save hiring someone.

But two weeks into this compromise, I realise that it was well worth speaking up. I knew that I would have been unhappy with the original change, and that it would not be good for my diabetes and general wellbeing at all. I know that I am miles happier than what I would have been. And as one of my work Mums reminded me yesterday, this would not have happened had I not spoken up.

The reality is that I do have diabetes, and it can afford me some special privileges if I see fit. Taking into account the special privileges that I’ve been given in trying to operate a broken pancreas for the rest of my life, I think we can just about call it even.

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Highs After Exercise

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It’s amazing how something as simple as a conversation has given me some much needed clarity in recent weeks.

For several weeks, I’ve been giving corrections to stubbornly high glucose levels in the afternoons after I’d finished work. Highs that have made afternoon tea difficult to manage. Highs that have made my dinner time insulin dose less effective and pre-bolusing a complete waste of my time. Highs that have often carried through to bedtime and even resulting in a disappointing waking number.

I didn’t think that there could possibly be anything wrong with my afternoon basal rate, because I knew that it was fine on non working days. I thought maybe I was disconnected in the shower for too long. I thought maybe I was eating too much at lunch. I thought maybe it was time to give up the toasted sandwiches slathered with butter, and cheese oozing out of the edges. Maybe buy those addictive donuts from Woolies less often?

When I recently sat down with my new diabetes educator and my Diasend logbook, she instantly pointed out a recurring pattern of red readings in the afternoons. I knew that afternoons had been a problem area. I can see the afternoon ascent in my Ambulatory Glucose Profile.

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Yet in all these weeks, I had never really stopped and thought twice about it.

It took my educator’s small suggestion of increasing my basal rate in the afternoons for me to finally make sense of all of this. Could these afternoon highs possibly be an after-effect of my physical activity at work all day? Could my body be responding with extra glucose as I put my feet up in the afternoons and breathe a sigh of relief that the day is over? A quick google search confirmed that this indeed, could be a possibility.

The most incredible thing is the positive flow on effect that this small change has produced in the past two weeks. Since increasing my afternoon basal rate from 2-5pm on work days, I find that my BGLs stay in range through the afternoon. My dinner time insulin dose is far more effective, and I no longer receive frustrating highs after an accurately carb counted dinner. Overnights have also been looking much healthier, which will ultimately account for a large chunk of the hba1c result I am chasing.

As my educator reminded me, I can easily be doing this at home as well. I have the tech that is capable of uploading my data to the computer. I have Diasend, the software that compiles all of my data into one easy to read report.


Judging by my Diasend report that is now looking a little less red, I really need to be making the time to do this more often.

Hungover From a Day of Rollercoaster BGLs

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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?


FreeStyle Libre: Second Time Round!

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At lunch time on Saturday, my meter came back with a 3.8. Not satisfied with the result, I walked over to the other meter sitting on my desk, which came back with a 4.7. I decided to do a best of 3 with the second meter, which produced an identical 4.7.

As I picked up the collection of discarded test strips strewn on my desk, it occurred to me that I am using test strips like water at the moment. I mean, I do use test strips like water. But I have never relied on them as much as I have now. And it kind of scares me.

I’m still fine tuning my insulin pump. I’ve made a lot of progress in the past week or two, but I’m not quite there just yet. I’m a perfectionist, I suppose. My diabetes educator has even gone on to suggest as much, having taken a step forward with the insulin pump. I can see it myself, in the great attention to detail I apply towards my basal rates and blood glucose monitoring at the moment.

Yet it scares the hell out of me, that somehow, this might become the new normal. I am scared of relying on glucose monitoring so much, instead of having confidence in my own actions. I am scared that I am becoming too compulsive and obsessive with my diabetes. Most of all, I am scared that I might never get this right.

I’ve recently used my second FreeStyle Libre sensor that I received from Abbott at DX2 Sydney, and naturally, I’ve discovered a few things that I didn’t the first time round. You can find out more about what the FreeStyle Libre is in my first review here.

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The Libre has been a life saver for me at work. I don’t need to walk over to my desk to check my blood glucose levels. I don’t need to worry about how dusty my hands are. It takes a lot of the pressure away from basal testing, where I would ideally stop what I’m doing to check my glucose levels every half hour. It offers a level of convenience that glucose monitoring doesn’t. Not to mention some the weird looks I get!

Most of the time, the results have been extremely accurate – to the nearest 1mmol. However, there have also been times where the accuracy has been difficult to trust.

It’s been hard to rely on the Libre’s readings when my glucose levels are moving significantly, particularly in the first 2 hours after meals. At work, I’ve often felt the need to go and double check with a finger prick before making a decision on a reading of 14 after breakfast.

I’ve also found that the Libre pronounces very small movements in glucose levels. For instance, I remember having an espresso with a tiny amount of milk one morning. I watched my Libre trend upwards to 9 or 10mmol, when in reality the movement wasn’t so big. It did eventually “catch up” with my meter, but I had to remember that the drop did not actually represent my blood glucose dropping.

That being said, I really need this extra flexibility with my blood glucose monitoring at the moment. I recently purchased another two sensors, which will hopefully make things a little easier for me over the next couple of weeks.

I’m just hoping that this reliance on heavy glucose monitoring doesn’t become the new normal. I really want to go back to having more confidence in my own diabetes decisions.

Wordless Wednesday: Testing, Testing

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Basal testing is a necessary evil of using an insulin pump.

After a week of rough blood sugar levels, I decided to start my second FreeStyle Libre sensor that I received at DX2 Sydney to help fine tune my insulin requirements while I’m at work.

Not only did I manage to get through a Monday morning without breakfast, without coffee, and without a banana, but I managed a fairly steady line all the way through.

Small victories.

Happy hump day!

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