Blood Sugar Surprises

Patient Expert

Diabetes management thrives on routine and structure.  When my routine is interrupted or life is unusually chaotic, I always see it reflected in more erratic blood sugars spikes and crashes.

We moved this past weekend. There's a reason that people universally dislike moving... it's a pain Adding two small children who need fairly constant supervision and the whole process takes a lot longer!

My typical diet of avoiding processed carbohydrates was thrown out in favor of convenience.  I am well aware that  cleaning/packing/moving work tends to drop blood sugar, so I tried to account for the extra activity when bolusing. Therefore, I didn't have many lows. That was a minor victory.

The first diabetes misstep of our moving was forgetting my pens of Lantus at our old place.  We moved in stages and all the furniture was moved Saturday, so we slept at our new house that night. During  the many trips we made that day, I didn't pack any Lantus. That set the stage for Sunday to be interesting.

Here's how the day played out: While running to Home Depot, picking up final things from our condo, and modifying plans  so our sleeping children could get their naps, we drove through a fast food place for chicken. I ordered 2 pieces of grilled chicken.  However, they gave me fried chicken. I started to take it back, but my blood sugar was 88 mg/dl so I figured I could use a little of the carbohydrate from the breading. My blood sugar remained in range without any insulin. Success!

For dinner, I picked up takeout Mexican food at this place right by our house. I got rolled chicken tacos and ate three of them. My blood sugar was in range before dinner and remained very steady into the evening. For some reason, (I must have expected my blood sugar to bounce around) I tested 4 times during the last 2 hours before bed. The results were: 89 mg/dl; 124 mg/dl; 88 mg/dl; and 115 mg/dl. I gave my Lantus injection at bedtime and felt like I'd be in good shape for the night. Mateo woke up around midnight so I tested: 117 mg/dl. You can imagine my surprise and frustration when my fasting blood sugar at 6:00 a.m. was 304 mg/dl! In hindsight, I can see that all of the fat from my lunch and dinner meals must have delayed the release of glucose into my body. Also, the lack of long acting insulin from the night before may have had an impact on my blood sugar.

This experience has gotten me thinking about the impact of fat on blood sugar control. I'll have to pay attention to this a bit more and see if there's some tweaking to my bolus strategy that could help. Or, I may have to consider restricting fat in my diet. We'll see if it comes to that!