My Worst Week In Years - My Recipe For T1D Disaster
You might have read my posts about running marathons, nailing my meals, keeping my time in range over 90% for months.
You might have read my thoughts on the decision fatigue of living with diabetes, on stress management and its fundamental importance in living with this condition.
You might have also had a glimpse on my two latest articles, where I shared my two cents on how I deal with burnout, how I recognize I am in a diabetes crisis and how I dig myself out of it.
It’s funny how all of these thoughts I’ve shared in my articles look as the perfect set of reads I need in moments like the one I am living now.
The past two weeks have been some of the most challenging I’ve ever experienced, due to a combination of work, health and family situations. And my time in range and blood glucose variability are the perfect summary of it all. The last seven days I’ve been in range about 60% of the time with chronically high glucose levels (162 on average), and big spikes overnight.
…I am 99% responsible for this!
I won’t make this a long article, but I’ll share what it’s been spinning in my mind as I was living this hell, and how I decided to stop it.
First of all, I was tempted do blame external circumstances so many times I have almost lost count. But I didn’t. Sure, there are stressful situations coming from the outside, from other people and contexts, but there are good and bad ways to deal with them, and I’ve chose the bad ones for days. It would’ve been extremely easy for me to shrug it and attribute my messy type 1 diabetes metrics to “the universe that is angry at me“. I am just unlucky that my life sucks and have to live with this thing, right? Easy way out: I don’t have to take any responsibilities and can just assume I am doomed.
Yes, emotional and physical stress will elevate your blood sugar. Yes, lack of sleep will screw up your insulin sensitivity quite a ton - and there have been days I’ve slept three hours, waking up at 3AM because being in bed was just a painful frustration. Yes, all the pain of one year was carefully juiced in ten days. Oh, what a painful existence! Oh, everything I eat or do seem to cause a spike, damn you diabetes! Easy and comfortable claims, nice pats on the back, but no solutions.
Before giving up completely and let victimhood take over, there are many areas to consider where I have not been responsible. These areas (food I eat, schedule of meals, tracking and logging food intake, adjusting boluses…) are the foundation of successful Type 1 Diabetes management, I’ve missed out on all of them for some days, and the results were the logical consequence. Let’s go one by one.
Work rhythms were hectic, and I was eating with no schedule.
This caused me to stack injections upon one another without really calculating the right dose.
I was also eating more nervously, allowing food to get into the system faster than usual.
The food I was putting in my mouth? Bread, peanut butter, snacks. Then yes, some fruit and vegetables, but mostly comfort foods. Eaten at random times and with random injections (see points 1 and 2). So I have been likely overeating my calories.
Since I had no schedule or plan for my meals, I was not tracking what I was eating, and I was not logging my foods. Too many things to do, to attend to, something had to give right? So I had no view on what was going on.
I wasn’t sleeping well at all, and felt unrested and in fight mode for most of my waking hours, forgetting any logic or guiding principles for my actions.
In essence: I was eating refined foods that spike my blood glucose, I was eating fats that made me more insulin resistant, I was eating nervously, I was eating more than usual and also more frequently. I was not calculating the right amount of insulin to inject pre-meal, but was adjusting it afterwards. I was not tracking my foods, so I had no idea how many grams of carbs or calories I was getting.
You see what I mean? It was too easy for me to blame life, the universe that gave me type 1 diabetes, and the fact that life with it will be a miserable mess. But before I reach this point, there are so many things under my control and responsibility and that I was deliberately ignoring that when I realized this, I almost felt like I had become crazy.
Of course it will be a mess, if I am not taking care of all the basic stuff and habits that are required for it to not be a mess!
But what really made me flip the switch was when this blood glucose storm nearly interrupted one of my runs. It was an important session, a long one, and after a mere fifty minutes my CGM indicated 106, with an arrow pointing down. I had to fill my mouth with so much sugar that running almost became uncomfortable afterwards. But I rescued myself somehow. When I came back home after the session, I felt the frustration. My poor management of diabetes almost ruined running, the thing I love the most. That was too much. That must not happen. And most of all, I had carefully built this entire situation with my own hands. Health is my top 1 priority, and I was not taking care of it.
This was sufficient for me to understand what was going on and take back control. I remembered I have agency.
And I journaled, and I cleared my mind with some long silent walks, and I came back to the basics actions: logging, tracking, eating well and being intentional about my health.
It only took one nearly ruined run to remember why I do what I do, why I want to be the healthiest diabetic ever, and why it matters. Life can be good, I just needed to remember I can make it so, if I choose to.
