Diabetes Musings

I haven’t been able to stop thinking about a really enlightening article I read at Diatribe in recent weeks. Cherise talked about a glass ceiling that she had for the number of carbs she entered into her pump, and explored why she was hesitant to declare the actual number of carbs that she was eating.

I’ve lost count of the times where I’ve subconsciously entered 30 grams of carbs into my pump, even when I know I’ll probably be eating more.

30 grams is the number I’ve been conditioned into thinking is the ‘right’ amount of carbs for a meal. Many corners of the diabetes community send out messages that less insulin is better, and even worse, demonise food choices.

Today, my mentality has evolved to eat as much as I need to meet my own needs and not some unrealistic ideals of what is right. However, I can’t think of too many times where I will enter more than 30 grams into the bolus calculator of my insulin pump. It’s more of a wait-until-my-blood-sugar-starts-going-up until I’ll top up with more insulin.

30 grams also feels like a safe number. Even moreso after weeks of nasty hypoglycaemic episodes caused by a combination of hot weather and correcting extremely stubborn blood sugars until I’ve over-done it. You know, the ones where I have to stop what I’m doing completely because I can’t concentrate and I feel yucky.

My time in range has been suffering, for a while now. It was definitely a contributing factor to the fatigue that led me to take a pump break over Christmas. But even now that I’m comfortably settled back into pump life, that problem is still glaringly obvious.

50, or 60% at best, does not reflect my best effort. I know that I’m not supposed to judge myself on my numbers, but I feel guilty at seeing so much yellow and red on my Dexcom Clarity reports. Not to mention that my diabetes just feels so much harder to manage.

One of the hardest things about managing diabetes is that the dynamics are always changing. There are times where I need less insulin because it’s hot and I’ve been more active than normal. Then there are times where I need more because I’ve been ‘slacker’ than usual. You always have to stop and think about what’s going on, and what to do to fix the problem.

The lockdown that much of Western Australia was plunged into earlier this month, quite honesty, came at just the right time. It was just the perfect chance to take away some of those distractions – that background noise that comes from the daily grind – and just give my diabetes a little bit more love and attention that I can’t always seem to muster.

I think Cherise’s post couldn’t be more accurate, especially in the context of my own hesitation to go beyond 30 grams – and it will definitely be a focus for me going forward.

I never imagined that I’d be spending the festive season detached from my insulin pump, but that’s just how badly I needed this break.

I was fatigued from insulin pumping, both physically and mentally.

I was tired of having that pump attached to me, rolling out of my pocket in bed, slipping down from where I tuck it inside my waistband, or giving those vibrating demands for my attention.

I was also tired of simply pumping insulin. I had tired of pre-bolusing, I was tired of looking basal rates, I was tired of correcting highs and then suspending my way out of subsequent lows. I had simply tired of putting in the effort, and it showed on my time in range.

This break was exactly what I needed.

It was nice not to have a visible reminder of my diabetes on me all the time. Lantus was a really nice set and forget when it came to basal rates, and it kept me relatively steady in the background. It was nice to simply lounge about, or leave the house with a noticeably emptier pocket.

Shorts weather also made it uber convenient to stick needles into my thighs, even under the dinner table while eating out. Although admittedly, I did feel just as reminded of my diabetes every time I was out and had to physically make a point of stopping to give a shot.

In those first few days I often found myself reaching for my pump when my blood sugar was trending low, and this was a good way for me to snap out of suspending my way out of lows, among some other bad habits that had been creeping in.

However, I also found it a lot easier to go high without my pump. Partly because I didn’t have the convenience of being able to efficiently correct when I was on the run. But also partly just…because. I suspect that perhaps I was missing that extra action from the rapid acting basal on my pump.

Once I went high, it took a lot more effort to bring myself back down. It was moments like these, where I was still cruising along at 12 after several correction shots patiently waiting for my blood sugar to budge, that I really missed my pump.

My last pump break was two and a half years ago. During each of those pump breaks I had taken prior, I seriously questioned whether insulin pumping was the best fit for me. I’ve only been pumping for four and a half years, mind you.

This time round, it didn’t take very long at all until I was itching for my pump back. After the first two weeks, I had to convince myself to keep going, knowing that two weeks was not enough of a break.

It kind of reinforced the realisation I’d come to last year, where I had finally reached a point where I was firmly an insulin pumper. Where I has comfy – dare I say liked – the kit that I was using, and that this was the method of insulin delivery that worked best for me.

I’ve been back on my pump for a few days now, feeling a little less fatigued, a little more refreshed and a little more appreciative of the tool I am using to administer insulin.

Ready for another year of diabetes.

My blog turns six today.

I’d always been fascinated by blogs. I loved the way they offered a space for writers to share their own daily thoughts, and also the way they offered a space that readers might look forward to visiting every day.

When I first started writing here, I had no real idea what this blog would look like.

There was nothing out there (that I was aware of at the time) that wasn’t medical or professionally geared around diabetes. Especially in Australia. Diabetes just sounded like something that I should write about.

I just wasn’t convinced that anyone would be interested in reading about it.

Joining in Diabetes Blog Week was probably the thing that encouraged me to just write. Not to mention connecting me to so many d-peeps all over the world. I realised it didn’t have to be perfect, it just had to be me.

It’s hard to believe I’ve managed to fill so many of these pages, let alone fill so many of these pages about diabetes.

Honestly, thanks for coming along on this journey with me and for helping to make the great big world around me that little bit smaller.