Anne Cooper (@anniecoops) writes:
Since I’ve been thinking more about my diabetes I have come to realise that its a lot more complicated than I lead people to believe. As someone once said to me ‘diabetes is a dark art’.
Its not just as straightforward as taking insulin to cover the food you eat, even if that’s what many nurses learn. Well, of course at the very simplest level it is, but there are so many other factors to think about.
I found out from my sensor that I am more insulin resistant in the morning than the evening so need a different carbohydrate to insulin ratio between 6 am and 12 pm, so not only do you have to be good at sums you have to be able to tell the time too. And of course there are some foods that just don’t seem to work out; for me pastry and fish and chips just guarantee a hike in blood glucose no matter what I seem to do. Other people complain about pizza or pasta which I seem to manage fine – its so individual and therefore there are few hard and fast rules and its a lot of personal learning.
I also discovered that I was hypoing at night and getting a resultant rise, which meant I was sometimes waking with an unexplained (till now) high blood glucose. I also have some dawn phenomena, a rise in blood glucose caused by the normal production and release of growth hormone which results in a rise in blood glucose in the mornings. Its common but means that the basal (base amount of insulin given continuously via pump) has to be adjusted to different rates over the day. I currently have a pattern that delivers 5 different amounts in the day. Confused yet?
If I am doing something stressful at work then, counter-intuitively (you expect a low blood glucose) I need to take extra insulin. If I am running a workshop all day for example I would increase my basal rate by 25% overall. I’m doing a big presentation this week so I will need to test quite a bit and probably adjust to take account of a probably high otherwise I will feel poorly.
There are so many things to think about. It really is, as I’ve said before, very complicated and no one person with type 1 diabetes is completely like another. I don’t think about it all the time but neither can you have a day off. So, I’ve decided that I am really a white witch who struggles to manage the dark art of diabetes. I quite fancy myself as the white witch from Narnia, slaying the dark monster diabetes.
[AS: Click on the title link above to read Anne's full post on her anniecoops.com blog]