Everyone is unique, that is a concept we are all familiar with. It is no different in the Type 1 diabetes community. Although there are many things similar, each person is different too. We have different bodies, different insulin needs, different blood sugar (BG) patterns, different responses to stress, environment and food. No two Type 1 diabetics manage their diabetes exactly the same way. Many of the things I share about here in my blog are fairly universal Type 1 issues. Because I am well connected with the online Type 1 community, I have learned pretty well what is most common. But even when dealing with common issues, there are always little differences too.
Many Type 1 diabetics have trouble bolusing (getting the right insulin dose and timing) for pizza. After some practice, I really don’t have any issues with pizza anymore. I have learned how to bolus for it based on my needs and the vast majority of the time, I get it right with no issues. But rice is my nemesis! No matter how many times I have tried, I just can’t get the bolus right. I can find no consistent pattern to follow, my body responds differently each time. So most of the time I don’t eat rice or anything made mostly from rice anymore because trying to get the bolus right isn’t worth the stress for me. I haven’t yet met another Type 1 who has the struggles with rice that I have.
A huge debate in the Type 1 community is whether to eat “normal†or follow a special diet like keto or low carb. There are many Type 1 diabetics who choose to eat a normal American diet, processed foods with added sugars and carbs. There is no medical reason why that is any worse for a Type 1 diabetic than it is for any other healthy person. But there are other Type 1s who choose to eat low carb or some other diet they feel is more healthy and that is fine too. But no study has shown that one is more healthy for Type 1 diabetes than the other. I find I personally have better control when I eat low sugar so that is what I choose to do but I don’t judge another Type 1 diabetic that chooses not to.
How a Type 1 chooses to handle highs and lows is different too. I’m perfectly comfortable cruising in the 90s or even 80s while other Type 1s will eat something if they are under 100. I like to keep tight control and get alerts on my CGM if I’m over 130, other diabetics set their alert at 180 or 200 so there are fewer alerts to attend to. Some will feel low symptoms if under 100, some never feel low symptoms at all (I typically won’t feel low until I’m in the 60s or lower). All these differences affect how we manage our diabetes, how we set alerts, when we choose to take action.
Almost everyone has something commonly referred to in the diabetic community as “dawn phenomenonâ€. The liver typically releases extra sugar in the early morning hours to give you extra energy to get up and get moving. In those with a healthy pancreas, your body releases extra insulin to convert that sugar to energy. For those who are insulin-challenged (Type 1s), we have to adjust insulin doses to control that extra release of sugar.
80% of Type 1 diabetics get that dawn phenomenon in the early morning hours (around 4-7am). In the other 20%, there is either no dawn phenomenon or it comes at another time of day. For many years, my surge was around 2-6pm. Then it shifted from 7pm-midnight. Now over the past few weeks, it’s shifted again to 2-5am. The timing of this surge is nothing any of us can control and no one is certain why some people have the surge at a time other than the early morning hours. I have never met another Type 1 who has their timing shift like I have. And although 80% do have that surge in the early morning hours, the exact timing and how the individual chooses to dose for it can be different (and is handled differently depending on if the person uses an insulin pump or injections).
There are not only physiological differences that affect Type 1 management but different styles of management. When it comes to insulin pumps and CGMs, different brands will work better for different people. They all have pros and cons, it depends on the individual what features are most important and what cons they can live with. I have been on the most popular brand of insulin pump and it hasn’t been a good fit for my needs and body chemistry so I’m in the midst of changing to another brand. I haven’t liked this brand I’ve been on but I know other Type 1s who love it (as well as others like me who dislike it). There are others who have tried an insulin pump and still prefer injections. I may not understand why anyone would prefer multiple daily injections over a pump but that is where different styles and preferences come into play!
These differences are also why many Type 1 diabetics don’t like unsolicited advice from non-Type 1 diabetics. More often than not the advice being given is only true for Type 2 diabetes (if you haven’t learned this from my blog yet, Type 1 and Type 2 diabetes are managed and treated very differently, read more here). And what you heard worked for another Type 1 diabetic might be specific to how they manage it. Always feel free to ask a Type 1 if you can ask questions but refrain from giving advice unless you know the person and their diabetes REALLY well.
While we as Type 1 diabetics have far more in common than not, no two of us are exactly alike. Even my endocrinologist (diabetes specialist doctor) admits I know my own diabetes far better than she ever will. So you may get to know one Type 1 diabetic and then meet another who does things a little differently. That is normal! We all do our best to manage our disease as best as we can but what works for someone else may not work for me. And that is just fine. It’s just another reminder that every person is unique â¤ï¸