One of the most constant things about being a Type 1 diabetic is how inconsistent blood sugar (BG) management is. Having to be my bodyâ€™s pancreas gives me a whole new appreciation for how magnificent the human body is. God was very smart when He designed our bodies, something that is very evident when a part stops working properly like the pancreas.
In a person without diabetes, your pancreas, liver (which releases sugar for energy) and endocrine system work in minuscule and complicated ways to maintain a steady BG usually between 80-100. Doctors still havenâ€™t figured out all the factors involved in keeping BG balanced. And even with how far technology has come, itâ€™s impossible for anyone to replicate all the body functions that keep BG balanced. Being a full time pancreas is very difficult.
There is a list of known factors that affect BG (and likely more that we donâ€™t know about). Not all food is equal, fats, protein and fiber affect how quickly or slowly carbs are digested. Trial and error is needed to try to match mealtime insulin (called a bolus) with how BG will rise or fall. But the most frustrating thing is that you can do it perfectly one time, then the next time you eat the exact same meal and bolus the exact same way you get a completely different result. 1+1 sometimes does = 5 because there are hidden factors (numbers) that I am unaware of.
Other factors that can affect BG are weather, activity level, illness, hormones, stress, emotions, change in sleep, changes in schedule, the list is long. And many times how those external factors change BG is different. Maybe last time the weather was hot, BG went up 10% but the same exact weather rises it 25% the next time. Even knowing the weather may change numbers doesnâ€™t mean itâ€™s possible to predict how much, itâ€™s always a guessing game.
The hardest days are the rollercoaster days. BG goes up, extra insulin is given, it goes too low, too many carbs are eaten in response, it goes back up again, more insulin is given then it goes too low again. These rollercoaster times are exhausting as it is very stressful on the body. And sometimes getting off the rollercoaster is REALLY hard.
Extended lows or highs are also very hard on the body. An extended low (an hour +) is rough. How do you keep eating more (trying to raise it) when you are beyond full and about to make yourself sick if you keep eating? There is no choice but to keep going because it is very important to get that BG up! And often with low blood sugar the brain fog is bad and itâ€™s hard to make good choices.
Extended highs are hard too as running high makes you feel sick (headache, lethargic, nauseous). Extended highs (4+ hours) can be difficult to pinpoint the issue. Is the insulin bad, is the site bad, is there an external factor (like stress or the weather) causing the high not to respond? These extended highs can lead to what is called a â€œrage bolusâ€ which is purposely giving double or triple the insulin needed (despite all the pump alarms warning not to) because everything else hasnâ€™t worked. All us diabetics will reach a point of frustration where we just want it to come down so we can feel better even at the risk of going too low. That is typically when the rage bolus happens. And even when BG finally comes back into range, it can take a few more hours to start to feel better.
I have always been a logical/analytical person and this unpredictable nature of BG management is probably the hardest part of being diabetic for me. I want to figure out what works and stick with it. I want to plan and prepare and know whatâ€™s going to happen. 1+1 should ALWAYS = 2 in my opinion but Type 1 diabetes just isnâ€™t that way. It requires patience, perseverance and flexibility, areas I have grown in but can still be uncomfortable. It takes a lot of hard work whether you feel like doing it or not.
The next time you encounter a Type 1 diabetic, my blog will help you know how to empathize with that person. This is a difficult disease that takes a lot of hard work and most of us make it look easy. But you probably donâ€™t see the tears and frustration that are a part of being a Type 1 diabetic. You donâ€™t see the sleepless nights trying to get BG back in range so that sleep can happen (itâ€™s harder to sleep when out of range). But we fight this disease, we fight to keep living life as normal as possible. And even on the rough days, the fight is worth it.