There are certain variables with diabetes that are tough to control. When there’s one of them, the consequences can usually be mitigated with some mild adjustment. But when three notorious high blood sugar triggers all happen at once, the result looks like your CGM is trying to create an Etch-A-Sketch of Everest:
How the bloody hell did things get that bad you ask? Here’s how:
I went for a late afternoon jog, about four hours after last eating. When I have no food/bolus insulin on board, I often spike high about an hour after the exercise – it’s a result of hepatic glucose output. Liver sugar isn’t shut off by insulin alone since exogenous insulin doesn’t suppress glucagon. The only thing that can do that is Symlin, and I only take that with meals, and we didn’t eat immediately after the run. This was disaster-creator Number One.
Second, my pump was expiring, so I bolused two units, took off my pod, and showered post-run. I often get a spike in blood sugars when I change my pump, as discussed in this post. This makes a total of two giant shoves in the high BG direction.
Finally, post-run, post pump-change, we went out for dinner. Now you might be saying that this is one variable I had control over, and to a certain extent I did. The trouble was, the folks we were visiting in Portland voted to go out for sushi. And to share everything. Which meant there was no way around the sticky, sweet rice they use with sushi. Ok fine, I could have ordered my own separate, low-carb meal, and in hindsight I should have seen the other two high BG factors and done myself a favor, but I didn’t. I wanted to be out on the town in Portland and experience the same delicious meal as everyone else. Damnit.
Between the run, the pump change, and the high-carb sushi, I found myself pushing 400mg/dL by just a few hours after dinner, and feeling like utter and complete crap. Nothing to do but bolus the *&% out of that one, fill up my water bottle and hope the ketone strip didn’t change color. I make super-fun company during times like that. **Sarcasm**
This was an unlikely trifecta of confounding issues but it’s still just annoying all around. Aren’t I doing the right thing by going for a run on my vacation? Pumps have to be changed, I don’t have a choice about that – I didn’t plan for it to be the same day as that run and that dinner. And why can’t I have sushi with everyone else one day on vacation? And why the %$#@ did all three of these things have to happen at the same time!? Ug. Diabetes, you are one sensitive little monster.