Temptations and how to sack them off

Temptation. It gets the better of us often. Whether it’s the temptation to ignore the alarm in the morning, the temptation not to do that work you’ve been putting off, or the temptation to eat the final slice of cake even though you know you shouldn’t. It’s one of the hardest feelings to resist, especially as a type one diabetic, when you’ve constantly been told you shouldn’t do the things you want to do.

Temptation plays a major role in living with the big d. This blog’s gonna talk about the different kinds of temptation you’ll face, the risks that come with giving into them, and how you can learn to IGNORE THE INTRUSIVE THOUGHTS.

It’ll be fun.

The temptation to eat food you should not eat

This particular vice played a huge part of my early years with the condition. Back then I was on a restrictive kind of insulin which meant I couldn’t eat any sugar. Crazy, right? I lived that way for seven miserable years, but let’s not get bogged down in that. Because I was told ‘no’, I naturally wanted to break the rules and do my own thing. I was a teenager, and rebellion came very easily to me. Whenever someone would leave a box of chocolates lying around, I would dip in and help myself with no regard as to what it was doing to my inner workings.

Christmas was always a particular challenge. Quality Streets? Thank you very much. It would start with just taking one, but one would soon turn to two, and two would soon turn into ten. Then I’d lie about where they’d gone because I felt guilty and a bit ashamed. I was a terrible diabetic at the time who never checked his blood sugar, so I’ve no idea what it was doing to me, but it can’t have been anything good.

Now things are better and diabetics can eat pretty much what they like, but there are still exceptions. If your blood sugar is going high, you shouldn’t eat anything else high in carbs until they’ve settled. But sometimes there’s an offer of pudding, or a sweet treat, or you’re still hungry. What could possibly go wrong if you just have a little bit more?

The risks of giving in

If you keep eating carbs while your blood sugar is high, you can probably guess what will happen next. There are two outcomes here:
1. You have more insulin for the food, doubling up on any insulin you’ve already had and potentially causing your blood sugar to PLUMIT later on.

2. You just chance it without extra insulin, potentially causing your blood sugar to go PROPER HIGH once you’re done.

Sounds like a lose-lose situation, doesn’t it?

How can you be a winner and eat what you like for dinner?

The way around it is, as it so often is, carb counting. If your blood sugar is high when it’s time to eat, you’ll want to know how much insulin you need for the food you’re about to have, as well as the correctional dose you need to take to fix the high.

I’ll use myself as an example, ‘cos I know me very well.

Let’s say it’s time for dinner and my levels are way up at 14. It happens. No biggie if you fix it and don’t make it a hobby. I’m about to have a jacket potato for tea (obviously with shit loads of cheese on top, and ketchup, and more butter than is advisable.) I do a quick Google for ‘carbs in a jacket potato’ and it tells me that in one large potato, there are 63g of carbs. I’m on a 1-1 ratio (so I have one unit of insulin for every 10g of carbs) which makes the maths for this fairly easy - six units of insulin for tea.

HOWEVER - as my levels were up at 14, I also need a corrective dose. I try not to correct with any more than three units of insulin, because sometimes having more causes a rapid drop. And as I’m about to eat, things could get confusing. So I add the three extra units to my six units to make a total of nine. Boom - potato time.

Once you’re comfortable with carb counting, you can feel confident about eating whatever you like, high levels or not.

The temptation to over-correct

Over-correcting is a recent nemesis of mine, and one I’m still not able to conquer. But maybe writing about it will help and we can learn together, like tiny ants learning to carry a leaf, or another, better metaphor.

Over-correcting is a very easy to trap to fall into, and one that can lead to serious problems. For me it goes like this: I check my blood sugar, it is low. I correct the low with some delicious lemony Dextro sweets. (Other flavours are available, but also much worse. Tropical? Get out.) I then check my blood sugar ten minutes later and it is still low, so I have more Dextro. I then my blood sugar in half an hour and it’s still a little low, so I have more Dextro. Before I know it I’ve seen a whole pack of Dextro off. My levels inevitably go up and up and up, until they’ve gone high. Then I get tempted to correct the high, so have some insulin. I check my blood sugar ten minutes later, still high, more insulin.

Repeat.

This creates a cycle that I like to call the rollercoaster effect. That’s not a medical term because I’m not a nerd, but it does capture how it feels pretty nicely. On my CGM app I can see my levels spiking high, dropping low, spiking high, dropping low. It looks like a rollercoaster, and my head feels like I’ve been on one for too long.

The risk of giving in

This habit knackers my body. It leaves me feeling hungover and agitated, and costs me a fortune in Dextro orders. In the long term, all these ups and downs will probably average out to a decent HbA1c - the test doctors do to work out your average blood sugar levels - but you’ll feel rubbish, stressed out and tired in the meantime. That’s not worth it. There’s also an increased risk of generally going into hypo and you don’t want that noise.

How to kick the habit

This is something I’m still working on. The arrival of CGMs and their accompanying apps has made it super easy to check your blood sugar whenever you want, which is great. The downside is you can easily find yourself trying to micromanage it, which is where I’m at now.

What I’m trying to teach myself is patience. If my blood sugar spikes after eating, leave it. That’s what it’s meant to do, especially if I’ve eaten something at the carbier end of the scale. Fast acting insulin works over two hours, so I need to give it that time to see what’s happening. Obviously fix any lows, but leave a high to play out until the insulin has had time to do its thing.

And that’s the key with all of this - time. Nothing is going to be instant, so I need to be patient and wait to see what each correction does, before giving in and correcting again.

The temptation to fix ‘false hypos’

Oooh, false hypos. They sound fun, what are they? Well, interesting fact! Your body gets used to certain blood sugar levels. If you’re consistently running high, it will stop recognising it as high, and the symptoms will start to fade. This is dangerous. The same is true if you regularly run low - you’ll lose all the useful warning signs that something is going wrong.

A false hypo happens when your body is so used to running high that when it dips to a ‘normal’ level, it panics and thinks you’re going low. It sends you all the warnings you’d expect for a legitimate low, only your blood sugar levels are absolutely fine and you don’t need to do anything about them.

This used to happen to me A LOT.

As I never used to check my blood sugar levels (seriously, maybe I did it once a week if I was feeling frisky. It was a mad time) it’s safe to assume my levels were always a touch high. So I’d be lying in bed when suddenly I’d get really sweaty and shaky. My vision would be blurred, my spidey senses would be tingling, and everything in my body would be screaming out for sugar.

On these occasions I’d check my blood sugar levels, only to find they were sitting pretty at six or seven. No need to panic, but oh boy, did I want to panic.

The temptation here would be to give in to those urges and treat the phantom low, getting your levels back up to the high figure your body was used to.

The risk of giving in

Treating a low that isn’t a low just gets you back up to high levels, keeping your body in that cycle of uncertainty. Maintaining high blood sugar levels is wank for your long-term health, and will eventually ruin all the things you’d rather not be ruined, like your eyesight, your kidney function, your fingers and your toes. Boo to that.

How to fix your body’s messed up senses

The only way to get over false hypos is to let them happen. And this will be hard. Your body will feel like it’s going cold turkey, and there’ll be a voice in your head saying “Feed me you dick! I want sugar NOW!” Ignore it.

Check your blood sugar every 20 minutes or so to make sure you’re not actually going low, and have a sugary snack nearby just in case you need it. The feelings might linger for a while, but eventually your body will get used to your new, good levels, and the false hypo will pass.

You might get them for a while, until your levels settle on the regular. It’ll be tough, it’ll be sweaty, but it’ll be totally worth it when your kidneys still work in a few year’s time.

There are loads of other temptations you’ll encounter in your life without a working pancreas, but as a general rule of thumb, just say no to them and you’ll be sound.

I’ll take that advice next time I think about over-correcting, which as I’ve just eaten, I imagine will be any minute now.

When the going gets tough

Diabetes and depression come hand in hand, sadly. Excuse the pun.

When I was diagnosed I was horribly depressed, and obviously finding out I had this incurable condition didn’t make me any happier. A lot of research has gone into the link between the two things, with plenty of evidence suggesting that one can cause the other.

But I’m not here to get all medical on you, because frankly I don’t know enough information and you should never take medical advice off anyone without the proper training. Instead I’m going to talk about what I do whenever diabetes gets me down, how I keep the blues at bay, and how I got over the HORRIFIC INJUSTICE of finding out being depressed may well have caused diabetes to come-a-calling.

Cheer up love, it might never happen

Depression can happen for loads of reasons, but unlike my wife I’m not a professional therapist, so I’ll not go too far down that rabbit hole. However I do have something my wife lacks - a useless pancreas, so I can talk a bit more confidently about that.

This is how I’ve found diabetes can cause depressive thoughts for me:

1. The very idea of having diabetes is sad.
   So you’re telling me I’m ill and it’ll never get better? Well that’s a bit shit. Most of the time I don’t dwell on this, but sometimes my mind wanders off into sad-land and I can’t shake the thought. Boo.

2. Bad blood sugar
   Not only is having bad blood sugar physically bad for you, it can take a major mental toll. Sometimes it’s just frustrating, sometimes it ruins plans, and sometimes it can cause a genuine hormonal imbalance in your body that puts you in a foul mood. There’s no winning.

3. The doctors
   I hate going to doctor’s appointments. Hate hate hate. I hate the smell of waiting rooms, I hate the sound of machines buzzing and whirring, and I hate seeing so many sick people everywhere I look. I know they’re important and I know I need to go, but that doesn’t stop me wanting to punch myself in the face.

4. Being told you can’t have tech
   There’s so much cool technology out there now, and I want it all. However it’s getting rolled out slowly, with the most in-need patients getting first dibs. I guess that’s fair. But there’s a selfish feeling that says ‘bad diabetics’ shouldn’t be rewarded. I know that is wrong and I’m sorry.

What a lot of this boils down to is a feeling of being out of control. I find that’s when I feel at my most lost - when there’s a problem that I can’t solve and a lack of progress is being made. It frustrates me with everything - like a radiator not working, or a lightbulb that needs replacing - but with diabetes it’s beyond my capabilities, so there’s no way to make the frustration stop. So do I just end the blog there and leave you to deal with it yourself? Of course not!

Take back control

If a lack of control is at the root of the issue, I need to take some of it back. Obviously I can’t just fix diabetes myself, because if I could I’d be rich and surrounded by chocolate, but what I can do is make little changes that make the hard bits feel more manageable.

Remember you’re more than just a diabetic

Diabetes is only one part of you. If you look after it well, you barely have to think about it most days, leaving you with plenty of time to enjoy other aspects of your life, such as learning the play the flute or political activism.

Spot blood sugar patterns

I can’t guarantee you’ll never have bad blood sugar again, but if you keep an eye on it, you might start to understand what makes it go bad in the first place. Understanding the reasons makes me a lot less stressed. “What’s that? A high in the middle of the night? It’s probably that entire birthday cake I ate before bed.” The more causes you notice, the more you can do to cut them out and get your sugars back where they belong.

Treat yourself

The doctors is still shit, but I always treat myself to a nice coffee after to make the pill easier to swallow. If a trip to your GP is the highlight of your day, then obviously your day isn’t going to be great, but if you then go for a snack/ a shop/ the cinema/ the gym/ whatever floats your boat, suddenly your day is looking dreamy.

Stay up to date with tech developments

Now this one’s a double-edges sword. Being aware of the latest tech can make you feel a bit jealous, but it also gives you the tools you need to ask about it at your next appointment. When I got my first CGM (continuous glucose monitor, for anyone who’s not a nerd) it was only because I’d done the research and knew it was available on the NHS. I emailed my consultant in advance to let them know I’d like it, they told me they’d get one in, and a few days later I was leaving the clinic with the future stuck on my arm. You’ve got the right to ask. The worst they can do is say no.

Feeling happy yet?

Depression doesn’t just go away, otherwise it’d be called ‘feeling a bit sad’. But hopefully if you can get a good level of control over your condition, you’ll soon feel better about it. You’re welcome to feel depressed about anything else - I can’t help you there - but don’t let diabetes be the reason you’re in a downer. NEVER LET IT WIN.

Burnout

Next year I’ll have been diabetic for as long as I wasn’t diabetic. I remember when I was diagnosed looking forward to that point - I’d be used to it by then, it would feel normal, and I would be able to stop looking back to a time before it was a problem.

What I hadn’t accounted for at 17 was quite how fed up of being diabetic I’d be all that time later. This is a story about diabetic fatigue, how it can affect you, and what you can do to get your mojo back.

How to spot the signs of diabetic fatigue

Just like diabetes itself, fatigue can creep up on you without any obvious immediate symptoms. But then BAM, out of nowhere you’re contemplating not having insulin and seeing what happens. Fatigue can be serious. For me, it felt like boredom. I just couldn’t be arsed with diabetes anymore, I wanted to live a life without it, and the thought that my life would always be like this was playing heavily on my mind.

Which felt daft, really. Nothing had changed. I look after my condition pretty freaking well, I’m in a good place in my life, I’m generally happy, so why was I feeling so blue about this?

The signs of diabetic fatigue I noticed were as follows:

• Being tempted to skip insulin

• Checking my blood sugar less frequently

• Finding the results of my checks frustrating

• Getting annoyed when people spoke about it

• An overall feeling of meh.

These symptoms will be different for different people, but as you can see they can be quite concerning. Skipping insulin isn’t really a viable choice for me, so my stupid head was obviously playing a prank.

Why does diabetic fatigue happen?

Fatigue can come about with anything if you do it often enough. Like sometimes you just can’t be arsed to get dressed in the morning, sometimes you get sick of work, sometimes all you want to do is lay down and weep. Anyone? Just me?

Diabetes is something you can’t ignore if you have it. It goes with you everywhere, playing a part in almost every aspect of your daily life and never really letting you ignore it for too long. It’s like a shadow, only one that will occasionally step in and trip you up.

For the most part, that shadow is easy enough to live with. I’ve had it for 16 years now, and 99% of the time I just accept it. But try doing the same thing every day for any amount of time and you’ll find it gets boring. Just ask my wife. EY OH.

What can you do to make the boohoos go bye bye?

I looked this up when I first started feeling blue, and the NHS gave a very NHS-ey answer about making sure you attend you regular appointments and looking after your glucose levels. WELL OBVIOUSLY, NHS. I was already doing all of that, so I needed a different solution. Here’s what I found helped:

Step 1. I cared a little bit less.

Part of what was causing me to feel fatigue was my quest for perfection. The arrival of constant glucose monitors has given us instant access to blood glucose levels, and with that comes the temptation to constantly check. For me, that meant correcting too often. I was treating lows that weren’t that low and fixing highs that would have sorted themselves. That was exhausting. It caused some genuine lows and some genuine highs, which then made me feel like I was going insane.

I reset my levels for what I classed as a low and a high, and vowed to myself not to correct until my little app told me I had to.

Step 2. I told people about it.

Diabetes can feel lonely. It’s a hobby only you can take part in, and sometimes other people trying to help just makes you want to push them away. But that only makes you feel worse. I talked to my wife and joked with my friends about it, and that made it all seem a lot smaller. This big thing that had been consuming me became a bit of a laugh, and when you laugh about serious stuff, it feels a lot less scary.

Step 3. I wrote it down.

Doing this right now is quite therapeutic. If a problem only lives in your head, it can consume all your thoughts. If you put it down on paper you can dissect it and find solutions. You can also delete it if it ends up being wank.

Step 4. I accepted it wasn’t only me that felt like this.

Turns out, every diabetic ever has felt bored of diabetes at some point in their lives. I spoke to a couple of them and realised I wasn’t going mad.

Is my diabetic fatigue fixed?

In a way, sort of. I don’t think about it as much now, and the whole ‘caring less’ thing is definitely helping. I guess it always lingers at the back of my mind, and maybe it always will - if you’re ever happy about being diabetic you’re a different breed to me.

Next year when I reach that fateful milestone, I’ll probably feel alright about it. I don’t know if it will be that ‘finally’ moment I was expecting back at diagnosis, but my memory is shit so I definitely won’t be able to remember a time before it.