When my Routine Failed Me
One of the most frustrating aspects of living with diabetes is the endless list of external variables that can impact my blood sugar. The mental checklist to consider before bolusing or eating is prohibitively long: recent exercise, future activity, illness, menstrual cycle timing, past meals, future meal, insulin efficiency, test accuracy… I’m tired just listing the factors, let alone thinking about each one before I give an injection!
The thing is it’s the unconsidered factor that typically wrecks havoc on my blood sugar. Today is a great example. My fasting blood sugar was 136 mg/dl at 5:15 a.m. Per my normal routine, I injected 1 unit of insulin before heading to the pool. This combats my dawn phenomenon while working out and my blood sugar will be in range post-swim. However with just a few minutes to go in our workout, my blood sugar started to feel low. As I tested my blood and simultaneously reached for two raisin boxes, I instantly knew what had caused this low as the 47 mg/dl popped up on my meter: I started a new vial of Humalog last night.
I posted back in March about the struggle to know when insulin has gone bad. Yesterday it was all too obvious that I needed new insulin as my blood sugar hovered around 200 mg/dl despite multiple injections and little carbohydrate consumption. When my bedtime blood sugar was finally in range, I knew that the new vial was working more efficiently than the old one I’d just tossed out. But, at 5:15 in the morning, that experience was a distant memory.
Sometimes I think that the routines and habits we establish with diabetes management can sometimes be the thing that causes us to trip up. Since I “always” give 1 unit of insulin before swimming, I didn’t take the extra few seconds to consider other factors that might influence this morning’s blood sugar response. Maybe that’s the thing to look out for – what patterns and habits do I rely on? Can they always be trusted?