Lapses in Perfect Diabetes Care
While recently reviewing past blog posts I'd written, I noticed that I often project the image of a perfectly controlled diabetic. This couldn't be farther from the truth! First of all, perfection is an unrealistic expectation with this disease. Furthermore, I tend to write about goals and ambitions for my diabetes management and health care efforts. Focusing on goals has a dual purpose, it motivates me to stay disciplined and hopefully it inspires other people in their quest for better blood sugar control. Well, today I want to diverge from my typical approach and share with you some of my lapses of discipline and the unfortunate consequences.
As a bit of a preface, I should note that I've curbed my attempts at dieting. After a couple weeks of restricting my calories (See Kelsey's post "What I've Learned by Counting Calories"), I noted a marked decline in my milk production. My priority right now is definitely Sienna's health and nutrition above my own weight loss goals. So, for the time being I'm eating pretty much what I want when I want and enjoying the calorie burning benefit of breastfeeding!
Unfortunately, when I drop my guard and decide to eat "what I want, when I want" I tend to crave goodies, especially chocolate and baked goods! My sweet tooth has been raging! I guess I'm a bit of an extremist, so when I don't pay close attention to what I eat, it's all downhill from there.
My latest string of poor choices has resulted in fasting blood sugars around 300 mg/dl the last two mornings! Events like this remind me why testing in the middle of the night is so critical when you are focused on tight blood sugar control. However, as a mom, right now I'm more interested in uninterrupted sleep than great control!
I know why my blood sugar crept up so high during the night. On Saturday evening, we had jambalaya with smoked sausage for dinner. It's one of my husband's favorite dishes and we don't have it very frequently because of the high fat, carbohydrate, not to mention sodium content. My blood sugars were great after dinner, which lulled me into complacency. I had a bedtime snack of peanut butter and jelly on the end slice of a loaf of whole wheat bread and bolused appropriately for my treat.
The culprit for my high fasting blood sugar was all the fat in our dinner. This happens every time I have smoked sausage (or other high fat dinners) and I seem incapable of recognizing the issue before it occurs.
Case in point, Sunday night... my mother-in-law is visiting and she made some of my husband's favorite dishes. We had a delicious, authentic Mexican meal with flour tortillas, pinto beans, rice, and beef in a spicy red sauce. I bolused aggressively because white rice always spikes my blood sugar severely. My blood sugar was great at bedtime and nearly 300 mg/dl by six o'clock this morning! Yes, I completely forgot to account for all the fat.
Clearly, these good postprandial blood sugars are a result of delayed blood sugar rises because of the meal's high fat content. Rather than recognizing this fact, I feel confident in my ability to bolus appropriately for dinner and then arrogantly go to sleep without plans to check my blood sugar for seven hours or more.
I need to start a mantra: "How much fat was in that? What's it going to do to your blood sugar in a few hours?" We'll see how that works.