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.