My Forever Love for Juice Boxes

I write to you today with a frog in my throat, feeling humble, scared and grateful.

Last week, immediately after my Endo appointment, we headed to FL to have a reunion with 2 other families. I felt like a badass driving down because my A1c returned to a territory I want to stay in, reading at 5.6 (a non-diabetic range). Yet, just when I think I have a routine, a plan, momentum, I realize I am at a loss.

Days into the trip I woke up with a blood sugar of 383 mg/dL. “Wtf?!” I haven’t seen a high like this in years.

Is it bc we ate a late dinner? I always have a high fasting when I eat late; but not this high. Was it the Prosecco I drank last night?? Maybe the alcohol made me low, I didn’t wake up, and glucagon shunted into my bloodstream??

Maybe it’s because I’m not sleeping enough? I was often the first to go to bed because I know less than 6 hours of sleep makes blood sugar control hard, but I’ve had 2 newborn babies and my blood sugar never behaved this bad.

Was it because I was less active than being at home? I was still running and swimming. Was I dehydrated severely? No.

What’s going on? Is the insulin bad? It worked fine yesterday and the day before and since then I haven’t stored it differently. I had it on the bathroom counter; maybe the room got too hot when we had our showers?

I take action – I’m aggressive with my basal/Tresiba for the day, upping my dose from 8 units to 12, then layer on another 2 units, making it 14. I take an intramuscular injection to correct the high.

Is it the heat? I always go really high with high humidity and temps above 80F. But I’ve lived in Australia with 100-degree temps and no a/c and it never got this bad.

Two hours later I’m only at 220 mg/dL, arrow across. Blood sugar goes up 2 points. I take more insulin.

Trying my best to keep my fears and frustrations to myself, I head to the beach with everyone.

I see diagonal down on my CGM. “Yay, the insulin is working.”

I have some dried mango in my beach bag in case the insulin begins working too well.

I’m in the water and run back to our things, aka my phone to read my blood sugar via my continuous glucose monitor (CGM) and grab my daughter her floaty.

Double arrow down reading 45 mg/dL. Where is the mango??? I eat it.

Five/ten minutes pass and my friend comes back to get her son a snack.

I actually start feeling really scared. I started praying. The mango isn’t doing a thing, still 2 arrows down (this means my blood sugar is dropping 4 points per minute).

My friend pulls out a cooler with juice boxes for the kids. Amen! Juice will help.

I chug the juice.

I’m so low my CGM can’t read my blood sugar. CGM reads, “LOW” double arrow down.

My friend has no idea I’m scared for my life at the moment. Am I going to go into a seizure?

I ask my friend to get my husband. I start crying. Am I going to die because of this damn high blood sugar, now firing back?

Thirty minutes in, I level out, head back to our house and over-analyze everything for the next 2 days with 1 more similar low blood sugar scenario. The second time I used maple syrup to bring my sugar up, followed by a juice. I asked my husband to hold me until the carbs kick in. 

I threw out my current pen of Fiasp for fresh insulin starting day 2, but I robotically took the same Tresiba day 2, and I was hesitant to take another full dose of a new bottle. So now day 3, it’s confirmed on what the problem was…

Spoiled Tresiba/basal insulin.

Sometimes I think I’ve got this disease, but it can be mean, scary, horrific. Diabetes teaches me day in and day out to make my time count and I’m so grateful for my insulin, my CGM, my juice box, my life.

I had a great trip overall, diabetes won’t taint it, and I’m happy to be home to ground myself and make a difference in this world. 

This scary event was a gentle reminder of what it may feel like to be newly diagnosed with type 1 diabetes or going through a confusing time of diabetes management. There is always something to learn, and I should have been more bold with changing out my insulin sooner.

Diabetes and Womanhood

Granted I have yet to learn what it feels like to be in menopause and the likes, I surely know how to ride the insulin roller-coaster from past pregnancies, 12 months of nursing and frankly, being a fertile woman. It’s not an easy road, and typically, with a normalizing cycle, my first sign I need to adjust my insulin based on hormone influxes (ovulating/menstruating) is a high blood sugar reading without good reason. Also, let’s be honest, there are a few cravings too.diabetesexpertmomnutrition

So is it fair to say it’s harder to be a female than a male in controlling blood sugars because our monthly hormonal, and eventually menopause changes? I don’t know, as I only know what it’s like to be in these shoes, but I fathom we all have our own challenges. Yet, what can a solution be or a plan for keeping and having the best blood sugars possible? Let’s see:

  • Basal testing. Have you heard of this, or tried it? To have the best A1C or best blood sugars, we want to ensure we are on the right dose of insulin, let it be multiple daily injections or an insulin pump.
    • Furthermore, it can also be helpful to have a second basal rate for the week before a female’s (on insulin) period. The extent of time to use a second basal will take some individual experimenting. Some women will use a higher basal the week before and during a period, where others need less insulin as blood sugars plummet upon a period. Take notes each month, even if you just insert a few sentences in your calendar. We all say we will remember next month, but trust me, these notes will be handy. A quick example of how I use 2 basals: my normal, non-period basal is just shy of 10 units, and then my PMS basal is 11.5 units of Humalog. As you can see, I just need a pinch more of insulin, but it’s so helpful.
    • Know that with every month, the fluctuations and impact a period has on someone not only varies with the person but can vary from month to month.
  • Enhance insulin sensitivity. How?
    • First look at lifestyle. Are you moving throughout the day (get your lymph system flowing), are you active enough, drinking enough water, sleeping 7-8 hours (at least), managing stress, engaging in positive things, socializing, etc?
    • We want to move every 30 minutes. This can be as basic as standing up to fill up a water bottle or using the restroom. A fast-paced walk is even better. As soon as we start to sit, enzymes that help break down fat decrease by 90%, and if we were to sit for nearly 24 hours, insulin sensitivity drops 24%.
    • Drink half of your weight in ounces, and keep juices, coffees, sodas, caffeine to a minimum. If you want to have a cup of Joe, match that amount in water, and do not count this fluid intake towards the half of your weight/ounce goal. Being and staying hydrated is one of the easiest and cheapest ways to be your healthiest. Where is your water bottle?
    • Secondly, remove inflammatory foods from your diet. It’s becoming more common sense that processed foods and fried foods don’t optimize our health, but also assess how gluten, dairy, corn, soy, wheat, and eggs make you feel. Perhaps pull one, or all, of these out of your diet for 1-3 months to truly test. In the process flood your body with nutrient-dense foods. See below with more tips on diet.
    • How rich is your diet in magnesium? If like most Americans, it’s scarce, and therefore I have a standing recommendation for most people with diabetes to take supplements, including magnesium.
  • Decrease PMS and menopause symptoms. PMS and menopause symptoms are not normal. Heavy cycles, extreme hot flashes, mood swings, weight fluctuations can be minimized by resolving the imbalance of hormones, blood sugar variability, resolving a nutrient deficiency and or better handling stress. Some basic thought starters to get going on this:
    • Eat more real food (produce, high quality fish and animal protein, good fats, lentils, beans), than processed foods, man-made oils and grains. In all, strive for > 6 cups of vegetables a day, chew your food, enjoy the gift of having readily available food and have some delicious chocolate. Have each meal highlight vegetables as the main dish, fill up on sides with satiating and delicious protein and fat. Also, don’t shun carbohydrates, just experiement with what limit works for your energy levels, satiety and blood sugar control. Our thyroid thrives on carbs, and the best ones include starchy vegetables, fruits, and legumes (if tolerated).
    • Nurture your liver. Yup the liver, our fat-burning machine and hormone metabolizer. It’s hard to say which organ is the most important in our body, as one needs to lean on the other, but the liver is pretty high on the list. Help the liver out, by avoiding overeating, choosing high fiber foods, bypassing canola oil, sunflower/safflower oils, margarine, and fried foods. Eat colorful meals and snacks and go easy on alcohol. I love sipping on dandelion root tea too.
    • Optimize gut health. Follow the advice on eating low inflammatory food, but also foods that feed your gut. This certainly includes fiber-rich vegetables and certainly probiotic and prebiotic foods (think garlic, artichokes, onions). If consuming foods rich in probiotics isn’t realistic, consider a supplement.

While there are loads more I can list, these are the top things to consider when you are feeling moody from hormones, and maybe even moodier with blood sugars that don’t line up.

Please share your thoughts on these recommendations, and let us know what works for you.

Cheers to you and good health,

Kelly

Resources:

http://www.diabetes.co.uk/periods-and-diabetes.html

http://www.medicalbillingandcoding.org/