How does that even happen?

I was asked such a simple question, "How does that even happen?" It left me with just a smile because I knew what a lengthy explanation it would need and I didn't think I had it in me. Until now. 

I often describe my life as a science experiment and of course I am half kidding when I say it but the reality is it is so very, very true. One of the best ways to talk about diabetes is to share what a mealtime looks like. Prior to sitting down to a meal you and your doctor have come up with a plan for how many units of insulin to give for a certain amount of carbohydrates. For this example let's use 1 unit of insulin for 10 grams of carbs. Now the food is placed before you. But wait are you sitting in a restaurant and are trying to guess if that pasta dish has 2 or 3 cups of pasta? 1 cup of pasta generally counts for 45 grams of carbs. Now will you eat the whole thing or just half? What sauce is on top? Yep carbs are in sauce! You want a breadstick too? Ok well you can look the carb contents up online or maybe you have been diabetic for 21 years of your life and have eaten here before so you think you remember it has 25 grams. Now you should always pre-dose the insulin because it takes 15 minutes to kick in (with the insulin I take) so do you guess when the food will arrive from the kitchen and pre-dose? Or maybe that one time you had to wait for an hour for your food is haunting you and you don't want to pre-dose just in case it takes longer than expected but if you wait to dose when the food arrives then either you watch your family eat while your insulin kicks in or you dose and start eating but you will pay for it later because your blood sugar will be 300 before the insulin is getting on top of the carbs. Then it will finally start to drop your blood sugar back to normal.... So how much are you giving? 2 cups of pasta and 1 breadstick? 11.5 units of insulin. 

Eating at home definitely gives me less stress because I can weigh my food and portion control and I can eat protein rich pasta (chickpea pasta) which actually affects my blood sugars so much nicer but you guessed it....it requires a special setting on my insulin pump to give me some insulin now and some over the course of time. Now I really would be using it in the first scenario at the restaurant too but I didn't want to overwhelm you. The reality is a meal with that many carbs should be dosed over time because the carbs will be broken down inside your body over time. I am constantly thinking about all of these things when I have food in front of me but I have been doing it for so long you probably don't even realize that I have counted my carbs before the waitress even puts all the plates on the table. And that's just the food aspect of diabetes. 

Let's talk about puberty for a hot minute. Hormones are evil to diabetes! I once took care of a diabetic camper (I volunteer where I used to go as a camper, normal camp stuff just a whole bubble of diabetics) who was taking 1 unit of insulin for 1 gram of carbs. That means he would have taken 115 units for that same pasta meal. He was in the heart of puberty! We did adjust his insulin a bit that week but that's a story for another time. Want to talk about female puberty? It never ends. Well until menopause. Ok I am a bit dramatic but the reality is my insulin requirements decrease DRASTICALLY during the week of my period. And I don't even think every female diabetic responds the same way to those hormones. Once I reached college my hormones did settle down a bit and I definitely got my blood sugars in a better spot but still once a month I knew when I was dosing for meals that week I could round down not up. 

Let's talk about exercise. So do you exercise at the same time of day every day? Or do you wait for the motivation to bring you to the workout and then you go for it! Well what happens when you are six minutes into a workout and now feel like crap because your blood sugar is 65 but you only have a small window of opportunity to workout so you down a packet of fruit snacks and continue because those squats don't work unless you actually squat? Well that's dangerous and not going to get you anywhere. You should wait until your sugar is coming up before continuing. I always hated when I would go low during a workout because it meant more calories had to go in my body and less calories were getting burned off of my body. So frustrating but after years of trial and error I know what workouts work for me and they don't involve much running. 

Let's talk about pregnancy. It was one of the most amazing, terrible experiences of my life. My son is truly a miracle. Remember those hormones I was talking about earlier. They are on FIRE when you are pregnant. Now mealtime was even more complex because I was requiring MORE insulin because baby was growing which is a wonderful thing but the less carbs you eat the easier it is to manage those swings of up and down blood sugars. Those swings are bad for baby because the more glucose in the blood the bigger baby gets and the bigger baby gets the faster baby has to be evacuated and the faster baby has to leave mom the less time for baby to develop. Hence not eating lots of carbs. You have heard of cravings while pregnant right? Oh and my favorite time, vomiting and nausea? So all my son ever wanted was carbs. He has my husband's Italian blood for sure because I could eat pasta ALL day when I was pregnant with him. I was also sick to my stomach for 7 of the 9 months so carbs were the only thing to calm that down! 

So how does that even happen? How does my sugar go low? Why does my sugar get high? How does that even happen? I hope you found the answer somewhere in here. I haven't a clue why or how it happens some days. Other days I can tell you I took my insulin too late. Some days my job requires more from me and I can't eat when I should so my blood sugar is too low by the time I react. This only scratches the surface. I juggle more than the few things I talked about here on a regular basis and that is just what life looks like for me. I promise I have my great days and I have my terrible days, I love this disease and hate it, I learn and grow with it all the time. Most importantly, I am living with it. The advances they have come out with make my life easier. One day I may have a true robotic pancreas and I can only dream that I will see that day when I can say I have a "cure." For now, I continue to battle this science experiment with every fiber of my being because it's the only option I have.