One big adjustment for me as a Type 1 diabetic was having to learn to plan. It’s not that a T1D can’t ever be spontaneous, it’s just harder. I have always liked routine but I’m also one who will wake up and decide to ditch routine for the day and do something different. It’s not that I can’t still do that but I can’t be completely spontaneous, I have to stop and prepare first.
Being a Type 1 requires daily planning (which I usually try to do the night before). Before leaving the house, I have to make sure I have everything I might need (and the list is long). My biggest struggle is using something up and forgetting to replenish. It requires developing new habits which I’ve done more or less but sometimes I still forget. There is nothing like the panic of having a low and realizing I don’t have enough low snacks left, especially when pulled over on the side of the road without a store nearby. That can be downright dangerous! I try to keep back up supplies in my car too but those are even harder to remember to replenish.
Exercise is another challenge for me. Most forms of exercise cause blood sugar (BG) to drop. If I’m already on the lower side (pretty much anything under 120), I will go too low. Also having active insulin from a recent meal (for 3 hours afterward) is not a good combination with exercise as it will speed up insulin absorption and cause a low. So exercise can rarely be spontaneous and has to be planned. I’ve been in regular PT lately and I’ve learned how to time my sessions so that I don’t go too low. But it’s not foolproof!
Eating takes more planning too. Insulin has a 20 minute delay from when it’s injected (called a bolus) to when it starts working. That time is the same whether it’s given through an insulin pump or an injection. To keep BG from spiking too high, it is best to pre-bolus 20 minutes before starting to eat. That means I already have to know exactly what I’m going to eat and how many carbs it is. Most of the time I try to underestimate how hungry I am since it’s better to add a little more insulin once I’m in the meal than to get full but still have to finish what’s on my plate because that’s how much I dosed insulin (bolused) for.
Also I am not the only diabetic who has given a pre-bolus, gotten distracted doing something else and lost track of time and forgotten to start eating on time! I find that I have to set a timer on my phone so I don’t loose track of how long it’s been. And honestly there are other days when there just isn’t time to pre-bolus. Yes I know I’m going to spike but who has time to always wait 20 minutes to eat? No diabetic that I know! But if you are ever eating a meal with me and I ask for an estimate of when the food will be ready, it’s likely because of trying to time the pre-bolus. If the food is late, you will know why I’m rushing to the front of the line!
I also NEVER carried a purse before having Type 1. Keys/ID and money I carried in my pockets. In my opinion, anything else wasn’t important enough to always have with me (and honestly a purse always seemed too “girly†for my taste). But once I had to carry insulin, pump supplies, low snacks, etc a purse became required in my life. Most Type 1 guys I know have the cool sling backpacks to carry their Type 1 supplies. Fanny packs aren’t uncommon either!
Traveling is something that also takes a bunch more planning as a Type 1. Pump and CGM supplies can’t just be picked up at the corner pharmacy, most brands are only available through mail order. It’s recommended to bring 50% more than expected to use because something unexpected always happens. And everything has to be packed in a carry on (if flying), these are supplies my life depends on, I can’t risk them getting lost. And since travel/vacation often brings spontaneity not typical in every day life, I have to prepare for every possible contingency. Airlines are required to allow an extra carry on for medical supplies and believe me I need it! And most diabetics will take advantage of pre-boarding for those with medical needs because it is vitally important our supply bag is near us on the plane (and often won’t fit under the seat in front).
I have to plan for emergencies too. Whether that be natural disaster, fire, accident, sudden hospitalization, anything. I’ve learned the hard way and I now keep a months worth of supplies in a large toiletry bag which is kept in an easy place to grab. It has everything in it I could possibly need (except insulin which has to be kept refrigerated and can be bought at any pharmacy). There have been multiple occasions now when I got stuck away from home unexpectedly for days and someone was able to grab it and bring it to me. That may not happen to everyone but it happens in my life. No one else would have any clue what I would need so it’s nice to have it packed and ready for when it’s needed! If I use anything from it, I leave it out until it’s restocked. Be prepared for anything since my life depends on being prepared!
So while being a Type 1 diabetic takes more planning, it can be done. It quickly just becomes a part of life and I can’t remember anymore what it’s like to be completely spontaneous. And good BG always in range is not a realistic goal anyway and most would agree that having a spontaneous day every now and then with tight BG control off the list of goals is perfectly fine and healthy. So if you want to invite me to have a spontaneous day with you, I’m there! Just make sure I get a minute to grab my essential supplies â¤ï¸
