Random thought at 2:30 am

When I was young, from as early as I can recall up to high school, I would often spend a Saturday night at my grandmother's house. Each night before bed she would give me a bowl of cereal "so I wouldn't feel hungry during the night." There was little chance of that actually happening since hunger and an Italian grandmother are two words seldom used in the same sentence, but it meant a lot to her and I certainly wasn't complaining. No doubt that is one of the reasons why I was always a bit overweight. Nothing like a bowl full of Frosted Flakes before bed.

I was reminded of this at 2:30am this morning, as I write this entry. I just woke up with a low of 60 and decided I needed to treat it with more than some glucose tabs. So now I'm enjoying a bowl of Life cereal in the middle of the night. Why? At 11:30 pm I was at 68 and had taken 3 tabs and dropped my basal rate to 0.5 for an hour. But that evidently wasn't enough to bring my BG back up. It must have been those damn homemade coconut macaroons I had earlier in the evening; I must have over covered for them. Anyone have any idea how many carbs in a homemade chocolate covered coconut macaroon?!

Letter to a New Diabetic: Your first low

Dear Concerned:

Sorry to hear what happened, but it was a good lesson to learn early. It's a real learning curve, isn't it?

Two things caught my eye when I read your letter. First, you took insulin for a meal and then did not eat the meal. Second, you went for a walk without factoring in the affect it may have on your blood sugar level.

The first one is a huge mistake. If you give yourself a shot insulin, you MUST eat the meal or take some carbs to cover for it because your blood sugar will drop. In my experience, meals are missed either voluntarily or involuntarily. The voluntarily misses can be prevented by simply making sure you eat as much as you bolused for, whether you are hungry or not! The involuntarily misses are much more difficult. For example, I usually do not bolus at a restaurant until the food is at my table. I've had too many situations arise where I give myself insulin for my meal and then the food doesn't arrive for whatever reason. I've also had the situation arise where I became sick after the bolus but before I could eat.

The second issue is that you went for a walk. While perhaps not medically accurate, practically speaking exercise often increases the effectiveness of the insulin. So before you exercise, you need to check your blood sugar and either have it a bit higher, or have your meter and some carbohydrates with you as you work out/walk/run, whatever. It's a real pain in the ass, to be frank, but you do have to exercise. I've done some experience where instead of using insulin, I've used exercise to keep my blood sugar down. If you try it be sure to track your data and carry something to eat, such as the glucose tabs. For me, even something as common as mowing the lawn will cause me to get low, so I'll either eat before or keep an eye on my sugar level. A lot of people like the small boxes of Juicy Juice which are 15 carbs for those sudden lows. They are cheap and you can keep one or two in the car and drink them even when they are warm. Mmm, hot juice!

Hope this helps,

Niko

Making the low go

Tuesday 5/11 – Making the low go. Tell us about your favorite way to treat a low. Juice? Glucose tabs? Secret candy stash? What’s your favorite thing to indulge in when you are low? What do you find brings your blood sugar up fast without spiking it too high?

Every diabetic has had to deal with a low blood sugar having no idea as to how much lower it will go before it levels out and/or begins to rise. When this happens to me, I treat using one of the following:

The best: glucose tabs. Essentially 4 grams of pure energy. They are so sickly-sweet it's hard to really overeat them.

A good alternative: a small can of orange pop. I've found this works pretty well because (a) there is only half a can, (b) it is drinkable, which is nice when chewing becomes an issue, and (c) you can drink it when it is warm and it doesn't taste bad.

The common: one of the problems I have with just glucose tabs is that they bring you up but there is nothing of substance there. In those cases (read: 2:30 am) I sometimes opt for a bowl of cereal and rice milk. 1 cup of each does the job. The trick is to stop eating after one cup. Better said than done, particularly when you a bit "out of sorts."

And now a quick story of a diabetic nightmare:

It was a large slice of chocolate birthday cake covered in frosting. Ever diligent, I computed the amount of carbs necessary to cover and gave myself the bolus. About the time my insulin pump beeped that it had injected all of the requisite insulin my stomach decided that it didn't want any cake. In fact, it didn't want anything inside it and caused me to run to the toilet and throw up.

So now I had absolutely nothing in my stomach and enough insulin coursing through my bloodstream to cause a serious medical situation. I grabbed a Coke from the refrigerator and did my best to chug it down, then threw it up, chugged more down, threw it up. It was awful. Adding to the problem is that due to its carbonation, it is pretty hard to chug large amounts of Coke. It is also sickly sweet, nauseatingly sweet.

I was eventually able to get enough sugar into my system to balance out the insulin, but the experience haunted me for a long time. I stopped bolusing before meals and would wait until after I had eaten. I've gotten over that, but still I rarely bolus until the food I've ordered has been delivered.