Diabetes Musings

One of the things that I feel most passionate about when it comes to diabetes is language. Perhaps second only to peer support. I quite often find myself thinking about the deeper impact of things that I see shared on social media, things said in presentations, things written in articles and how that might make other people feel.

Language Matters. Language has the power to influence the way we think, feel and behave. Language has the power to become reality. (So much so, that Diabetes Australia wrote a whole position statement on it…)

I have to admit that one of the things that doesn’t quite sit right with me lately is the suggestion that it is of the utmost importance that people with diabetes be controlling their blood sugar right now. Or something to that effect.

The way that reads to me, is that it’s only going to be the people with poorly controlled blood sugar who will be at greater risk of Coronavirus. In exactly the same vein as the suggestion from a few weeks ago that ‘only those with pre-existing conditions will be at risk.’ We don’t throw people under the bus in the diabetes community. If you ask me, that’s a really poor way to motivate someone to take care of themselves.

I can’t help but think about how some people in our community might be feeling about these messages. Let’s say, for example, someone who is newly diagnosed and is not seeing the 5.5 that’s on the box of their blood glucose meter very often. Or in the case of my life in the past week, the story of my extremely stubborn blood sugars that are resistant to the same amount of insulin that was sufficient last week. I must admit that even I’m feeling a bit invalidated by this messaging.

I have absolutely no problem with anyone who might feel inclined to use this time to provide additional focus towards their diabetes, if they see fit. (Although I would love to know where you are finding this spare time, because I certainly haven’t found any…) I have absolutely no problem with encouraging good hygiene, good health behaviours and preparedness. Go and have a look at Diabetes Australia’s socials.

But diabetes is a tough gig. When you live with diabetes, every day is diabetes day. Every week is diabetes week. Every month is diabetes month. I refuse to believe even for a second that people with diabetes aren’t trying. I can honestly say that I don’t know a single PWD who isn’t doing their best, under extremely trying circumstances.

I’m not going to suggest that it’s not important to manage blood glucose, but a number isn’t the only marker of people’s efforts in their diabetes management.

People with diabetes deserve a medal just for continuing to show up each and every day during an extremely challenging time.

This morning, I got my flu shot.

Flu shots haven’t traditionally been something that I’ve made the effort to get done. I don’t tend to catch colds all that often. I usually look after myself by regularly washing my hands, which is something I have been doing well before the government began telling us to. Did I mention that I’m slack when it comes to scheduling an appointment when I could be putting up my feet?

However this time last year, I’d only just started my degree. I knew that the last thing I wanted was to catch a cold or worse while I was anxiously studying for my first exams in several years. So, I figured I’d get it done.

Then of course, comes this year. If there ever was a year to get a flu shot, this would probably be it. No, there’s no vaccine against Coronavirus, but there is a vaccine that will help to make it less complicated. And it’s free to people with diabetes.

I asked my GP how he was going amongst all of this, and he equally seemed to be doing it tough right now. With patients reluctant to visit practices, he’s been inundated with phone calls requesting prescriptions and free advice over the phone. He’s also been offering free bulk billing to thank his patients for their support – even though I would have been happy to pay his very small out of pocket fee.

He also noticed the extremely shabby Dexcom on my arm, and couldn’t believe how big it was compared to FreeStyle Libre. He also couldn’t believe that pumps and CGMs don’t talk to each other yet. If only…

Anticipating some spectacular insulin resistance, I put a temp rate of 150% on as soon as I took a seat in the waiting room. Then, I drove down to the beach and walked it down along the coast in this spectacular weather we’ve been having this week. I added another 50% to my lunchtime insulin dose, and surprisingly my graph is looking as spectacular as the weather outside today.

Yesterday was A DAY.

I had plenty of revision to do, but I couldn’t take my eyes away from my rising Dexcom graph. My blood was boiling. I felt anxious, and somewhat helpless. I couldn’t concentrate, despite my best intentions.

I’d only just replaced a cartridge of spoiled insulin the evening prior, after battling high blood sugars all weekend. Not to mention the insulin resistance that’s been brought on by the cooler weather. So I was still feeling more than a little paranoid, but also assumed that I was more than likely overreacting.

I gave a correction, but I still couldn’t take my eyes away from that graph. Do I set a temp basal rate? How long should I wait until correcting more? Has this insulin cartridge gone bad as well? Could that whole packet of insulin cartridges be bad? Maybe I should have waited until my insulin was at room temp before filling my cartridge last night?

Then, the rational side of my brain started waging an internal war against the irrational.

You’re being stupid. You woke up a bit higher than usual this morning, and that is what normally happens when that is the case. You’re seriously going to throw out a second cartridge of insulin!? That’s so wasteful.

Lunch panned out okay, but only thanks to the wave of active insulin and temp rates I’d used to bring down my breakfast. But after an up arrow following my afternoon coffee and cookie, I knew that my paranoia wasn’t for no good reason.

I opened a brand new box, and pulled out a fresh cartridge, hoping against all hope that this would be my third time lucky.

Things are playing out much nicer today. I’m still playing around with temp rates, but overall I feel that my body is responding properly to insulin again. I now have a box of insulin cartridges in my fridge, from which I’ve drawn two bad vials, that I’m feeling pretty dubious of. I probably won’t throw them out, but I don’t foresee that I’ll be game enough to use them again in the near future.

I hate days like these. Days that are unpredictable, days that take away my valuable time and days that have me doubting myself. I’m not used to having days like these. I like predictable. I like knowing what to expect when it comes to my diabetes.

I know that when I’m paranoid, there’s probably a damn good reason for it.

My only resolution this year was to sleep better.

I wasn’t exactly having any trouble sleeping, but I felt that a good quality sleep was sorely lacking from my life. My mornings often looked like silencing my alarm, remaining in bed for another ten minutes as I willed myself to get up and moving, and then begrudgingly getting ready for work but lacking a real sense of refreshment.

Towards the end of last year, I was even noticing a surge in blood sugars as soon as I hit the hay. Stress hormones, perhaps?

I did bring this up with my endo last year, but my blood sugars were in a really good place. I had bloodwork done with my GP last Winter that also painted a picture of good health, but brought me no closer to solving my problem.

Since January, I have been making subtle changes to my behaviour to help better support my sleep.

I’ve been making a dedicated effort to ‘switch off’ at least an hour before bed. I make a conscious effort not to stay up and push through with uni work, reminding myself that it will still be there tomorrow and that excellent organisation of my time will avoid any buildup of work.

I switch off my devices, and turn off my phone’s connection to the internet at 9pm. Admittedly, up until Coronavirus, I was really good at this and spending significantly less time on social media.

I switch off the lights and just rely on my bedside lamp until I go to sleep. I was leaving the verticals in front of my window slightly ajar to allow the early morning light to seep in. But that’s kind of redundant now that it’s still relatively dark at 6am.

In that hour before bed, I’ve been getting back into both TV series and reading – two things that I’ve seemingly lost in the past year. My latest binge recommendation would have to be This Is Us. I’m a slow reader, but so far I’ve gotten through Mark Manson’s Subtle Art of Not Giving a F*** (I really don’t get the hype on this one) and the Pursuit of Happiness. Admittedly, ABC’s Coronavirus blog has since filled my reading quota and I haven’t quite managed to pick up another book since those two.

I was running the Sleep Cycle app on my iPad beside my bed while I slept. Sleep Cycle is a great app which tracks my sleep using my device’s microphone. It wakes me up in a 30 minute window, at a time when I’m in the lightest phase of my sleep and theoretically able to wake up easier. I have since weaned myself off it, as it was getting tiring having to having to constantly charge another device.

The other night, my sister walked past my MacBook and commented on how ‘orange’ the screen looked. I explained that I’m using an app called flux, which warms the colours on my display in the evenings and helps reduce strain on my eyes. Admittedly, I was breaking my rule that evening and pushed through until 10pm. Historically, this would be enough to worsen my sleep in a heavier/groggier sort of way. While flux isn’t an excuse to make a habit of working late, it did made a world of difference that night.

Admittedly, those stricter habits I was religiously doing every night in January have loosened. I sometimes leave my WiFi on until bed, and I do engross myself in my phone as soon as I wake up. I’m blaming Coronavirus for that one.

But overall, I do feel a lot better than what I did towards the end of last year. I’m sleeping a lot better, and I’m waking up a lot easier. If anything, I think my blood sugars are also more predictable overnight and those surges has subsided.

Quite honestly, sleep is just as important as the food that I eat, the activity that I do and the insulin that I take.

Its been a worthwhile investment.