The blood sugar and the corn muffin (or diabetes selective memory)

Somewhere on a road trip in New Jersey my friend and I stopped at a diner for lunch. Honestly, I haven’t eaten a muffin, scone, bagel…in years, and years. But for some insane reason my mind said, “Oh, let’s have a corn muffin today.” A treat. Oops, without knowing it I was experiencing “diabetes selective memory.”

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When we sat down at the diner for lunch it was 2:20 PM and my blood sugar was 74. An hour later, after taking what I thought would cover the amount of the muffin I ate – half the muffin – I saw this.

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Yikes, I took more insulin. A short while later I saw this…yikes, I took more insulin…

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The high point, no pun intended was 202. Then it began to come down. Luckily I never crashed. It settled at 112 at 6 PM.

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This experience was a stunning display of a remarkable head space we fall into that my friend termed, “diabetes selective memory.” Who was I kidding, two units of insulin for that fluffy yellow, spongy carb bomb called a corn muffin? I knew better, somewhere in my global memory.

When my friend came up with the term she’d been denying the fact that eating¬†lots of carbs and fat shortly before bed raised her blood sugar to almost 300 at 3 am even though when she went to sleep her blood sugar was perfect.

She knew better. She saw the rise night after night but somehow wiped it completely from her memory. I too chose to not remember what a muffin will do to my blood sugar. Yes, it had been a long time since I ate one, but still, this was a clear case of DSM.

Was it worth it? Not so much. Maybe if the muffin had been more delicious I could say yes. But it reminded me that if I have one again in another ten years, I’ll bring two insulin pens to make sure I can cover the rise. ūüėČ

Insulin’s indirect path. Diasome is working to change that. Plus, my post for them – on innovation.

It’s a funny thing that we’ve known for a long time injecting insulin is a poor way to get it into our system. It doesn’t go directly where it’s needed and its path isn’t the same path as when insulin is released in a body that makes it. Yet, even though we’ve known this for – ¬†ever, few have done much to improve this faulty system.

I don’t normally put stock in research companies working on tangly problems like this, but I’m intrigued and attracted to the idea that a company named Diasome is working to change this. They regard where insulin goes as important as dosage and timing. And so do I.

On another note, I wrote a guest blog post¬†for them as they want to bring thought-provoking thinking from the diabetes space onto their site. I wrote about innovation, what we’ve seen over the years — and what we haven’t. Clue – it has nothing to do with technology.

Diasome’s explanation of where injected insulin goes and where it should

diaTribe, one of the best resources for diabetes news and information

If you don’t get diaTribe delivered to your inbox weekly, you should. Obviously if you’re reading this either you or someone you know has diabetes and you like to learn.

diaTribe is the online newsletter put out by the amazing Kelly Close and her team. It captures what’s happening regarding new medicines, guidelines, devices, policies, conferences, people, thinking and the wonderful Adam Brown’s weekly musings about staying on-road with type 1 diabetes.

Just today as I’m reading through the five or six articles, each a page to a few pages, the topics are as ever about things I want to know.

Sign up for your free newsletter here. This is a look at how it comes into your inbox and this week’s issue:

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We should be shocked by how much and why diabetes is in the news

I am happy that diabetes is in the news almost every day. We are getting more exposure and understanding from the general public. And I am sad it’s in the news every day because the reasons that is so are unforgivable.

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In the past few days I’ve read three articles that make me ill. Literally, they turn my stomach. The first was in the New York Post about a young man who died because he could no longer afford his insulin. When a doctor recommended a cheap, over-the-counter brand, he took it thinking the cost savings would also help his pay for his upcoming wedding, “Diabetic groom-to-be dies after taking cheaper insulin to pay for wedding.”¬†¬†

When the never-to-be-groom’s body was found he had suffered multiple strokes, was in a diabetic coma and his blood sugar was 17 times what’s considered normal.

Then I read in the Washington Post, “A Detroit diabetic was deported to Iraq, where he’d never lived. He died from lack of insulin, family says.”¬†Jimmy Aldaoud, who was born in Greece and lived in America his whole life was, under Trump’s ramp up to get rid of immigrants, rounded up by Detroit’s ICE, Immigration and Customs Enforcement, and deported to Iraq – a country of his heritage that he’d never been in. ¬†He died for lack of insulin in Iraq.

I want to puke.

Then today I read on facebook an article a fellow T1D posted that CVS Pharmacy has decided they will not fulfill scripts for blood sugar testing strips beyond three a day. While this is a Medicare guideline, Medicare allows people with a written note from their doctor to get as many strips as their doctor prescribes. CVS has decided they will not. They say if you want more, go somewhere else.

I want to know what world I am living in. I want to know how safe I am, an average, educated, fairly healthy, fairly financially secure 65 year old woman  with type 1 diabetes? In my 47 years of living with diabetes I have never feared my condition would threaten my life Рnot in this way. To not be able to get the medication I need. And will my Dutch-Indonesian husband be rounded up one day walking to the grocery store and deported somewhere?

I can no longer say I am safe. I don’t recognize this country anymore. I don’t understand how people can do this to other human beings. And I feel a deep sense of dread.When articles like this come out every day I can only say do the best to keep yourself safe, we are all at risk.

Remedying blood sugar always trumps intermittent fasting and keto

 

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I was recently talking with a friend who was bemoaning the fact that she hates it when she has to break her nighttime or morning fast to treat a low blood sugar. So do I. And just these past two nights I’ve had to do it. I was around 78 mg/dl at 11 PM both Tuesday and Wednesday nights. I waited and watched my CGM til midnight, but no movement. Drat! I have to get up now and eat something, double drat!

Of course I hate it when I have to eat and I don’t want to. I’m not hungry and all I can see is the extra calories I wouldn’t eat if I didn’t have to raise my blood sugar.

Now that many of us are doing very low carb diets, keto or intermittent fasting, there’s even more chance your blood sugar may go low and you’ll have to remedy it with sugar.

I have to accept that’s diabetes and that’s just how it is. Getting blood sugar in a safe place, ESPECIALLY BEFORE GOING TO BED, ALWAYS TRUMPS maintaining your particular style of eating. We just have to not worry about those calories. They’re not much and if they’re worrisome you can eat a tiny bit less the next day.

Of course if this is a daily or nightly event for you, then it’s time to readjust what could be off. Did you take too much insulin? Did you exercise? Are you sick? Did your neighbors paint their house pink? You get it, there are so many variables at times you’ll have no idea.

But I think the reason I’ve been going too low at night this week is, even after 47 years with type 1 diabetes, I periodically, habitually forget that I am extremely sensitive to the action of insulin in the evening. So while it might take me 1 unit to cover a prune in the morning, it will take 1/2 unit at night or even less.

Then there’s also the, geez, how’d that happen? Tuesday night I treated my low with a prune which should have raised me 20 points. I ended up going up 60! Wednesday night I warmed 1/4 cup of almond milk and stirred in a teaspoon of honey. The results the next morning were a satisfying 95. ¬†Suffice to say, you won’t always win this game either.

But that extra prune or peach or spoonful of honey or two glucose tabs is not going to turn you into a glutton or gorilla or put on 20 pounds. And you can always eat a wee bit less the next day. But not waking up in the morning, now that’s something I’m never, and you should never, be willing to risk, as best you can.