Tag Archives: hyperglycemia

Diabetes is hard. But we’re worth it.

Diabetes. Our lives with diabetes is a balancing act.

Keep those numbers in between 80 mg/dL and 120 mg/dL. We know that a hemoglobin A1c reading under 7.0% is optimal. As we also know, there are studies that show that people who achieve this are more likely to spend a fair amount of time with hypoglycemia (dangerously low blood sugar) than people who don’t. Among other things, hypoglycemia can potentially do damage to our hearts and our brains. Of course, if our A1c is over 7.0, we’re faced with a number that makes us feel like we’re not successful. It makes us want to do all that we can to get it under that number. Even though that could possibly mean additional risk of hypoglycemia. That’s a lot to consider.

But wait… there’s more. The closer our numbers are to perfect, the closer we are to bad lows. What do we do when those lows occur? We treat them, with juice or peanut butter sandwiches or cookies or Nutella or whatever works. Or all of those things, plus a couple more. Because above all, hypoglycemia is scary. It’s a near-death experience that shakes our confidence and makes us want to make it go away as quickly as possible. So sometimes we over-treat. Which leads us to hyperglycemia (high blood sugar) later on. And pretty soon our glucose management looks like this:


The hyperglycemia? In a word, that’s frustrating. Partly because we’re aware (we’re more than aware) of the complications it might bring years down the road, and partly because we don’t want our hard work go to waste just because we decided to eat something because it would save our life. Hyperglycemia makes us sluggish, tired, thirsty, and again, frustrated. And while we can encounter it after over-treating a low, we can also encounter it due to a bad injection site, bad insulin, or a crazy metabolism that can have us under 100 one day and over 300 the next. While the “eat 15 grams of carbohydrates, wait 15 minutes and check” idea is the standard for treating lows, it can take hours to come down from those highs. It may take the ingestion of copious amounts of water, lots of exercise, trimming our diet, extra insulin, or any and all combinations of the four to bring us back into range. Or back down into hypoglycemia again.

Add to that the fact that we’re more susceptible to infection, more likely to encounter eye and foot problems, under additional risk of heart trouble and stroke, and also facing people in our lives who just don’t understand why these things are true and want to blame us instead of helping us, and you can see why diabetes ain’t no kiddie game.

Yet we go on living our lives, in wondrous and amazing ways. We often have parents and spouses and girlfriends and boyfriends and just friends who help us and give us the strength to know that we’re worth all the trouble. If you’re not living with diabetes and you encounter someone who is, remember that diabetes is a moving target, it’s always, and it’s hard. The best thing you can do is live our lives alongside us, displaying the assets of perseverance and empathy that all people living with diabetes possess. Just ask us… we really are worth it.

Highs vs. Lows.

Seems to me there’s a disparity in dealing with high glucose versus dealing with low glucose. Okay, maybe it’s not as serious as a disparity, but I’m trying to keep this light here, okay?

When my BG is low, I find that there are many things that I can use (read: ingest) to get myself back into a safe range. Among them:
– Juice

Glucolifts (Cherry… yum)

– Honey

Goetze’s Caramel Creams (addictive)

– Fruit

Level Life Glucose Gel (kinda like the Mandarin Orange)

– Smarties (which are Rockets north of the border)

– Rockets (which are Smarties here in the USA)

– Insert your favorite here (Nutella, Maple Syrup, etc.)

– And, as a last resort, Glucagon
That’s at least nine items that I can use to bring up my glucose from an unsafe level. Having low BG is no picnic, of course. But those options almost feel like a reward for suffering through hypoglycemia. Almost. But not quite.

But what if my glucose is high? What if my pump has an issue delivering insulin, or it’s a hot day and the insulin loses its effectiveness, or I under-bolus for lunch? Now, I’m hovering near 300 mg/dL and I only have three options available to combat the high BG:
– Insulin

– Drink lots of water

– Exercise (while drinking lots of water)
That’s not a lot of options. And they’re not very appealing either. Also, if you have Type 2, you may not be on insulin therapy, so you may be left with only two options. Woo-freakin’-hoo.

In a way, having fewer choices when you’re high takes a lot of the guesswork out of what you need to do. You’ve just gotta do it, right? Using one, or two, or three methods. And it’s likely that you’ll have to wait to get yourself back into range. I mean, when you’re low you drink some juice, pop some glucose-laden product, and you’re often back in range within minutes. When you’re high, you can give a correction bolus of insulin, drink lots of water, and go for a run, and you’ll still have to wait some time before your BG comes back down.

I think this disparity in available options and time needed to correct explain why I absolutely hate being high, and why I try to do everything I can to avoid it. That doesn’t mean that I’m doing everything I can to be low. It just means that I don’t worry about being low as much as I worry about being high, if you know what I mean. Plus, I’ve got to admit, I hate how it makes me feel.

I suppose I could use this discussion to push for development and approval of faster-acting insulin. But I’m not thinking about that right now. I’m thinking about how high BG makes me feel, physically and mentally. And how that’s completely different from how I feel about low BG.

What about you? Do you worry more about high BG than low BG? Do you still worry about low BG, but secretly like the fact that it allows you some seemingly guilt-free indulgence? I’d love to hear what you think about both ends of the glucose spectrum.

Hating the highs.

All things being equal, yesterday was a pretty good day. Only things were not all equal… diabetes doesn’t play that way. Okay, well, maybe it wasn’t just the diabetes. Let me explain:

We woke up early (for a Sunday, anyway) at about 6:00 a.m. When I reached the kitchen, I did the normal stuff… make coffee, let the dog out, feed the dog and cat, and check my BG: 81 mg/dL. Great start to the day, right?

I promised to take The Great Spousal Unit over to Blackwater National Wildlife Refuge near Cambridge, Maryland on Sunday. So after breakfast, we took off for Maryland’s Eastern Shore– a little over 2 hours away by car. By the time we were nearly there, we stopped for gas and I also needed to make a pit stop (badly). I should have guessed something was going on.

So we go off to the refuge, and it’s beautiful even though we didn’t see much compared to most trips there. After we finished, I decided to make a quick side trip over a public road that goes right through the middle of the preserve. It was there that Maureen spotted the only bald eagle that we saw all day. Wish I had a photo, but he flew away before I could snap it off. After that, and an equally quick sighting of an osprey, we headed off to Cambridge for a late lunch.

Again, I really had to go, but I didn’t think too much of it because I knew where my BG was in the morning, I knew what I didn’t overdo breakfast, and I bloused accordingly. Also, my infusion set had already been in for going on four days, and it had been working well. It was surprising when I checked just before lunch and found a 237 mg/dL on my meter.

Okay, I’m frustrated, but again, I bloused accordingly. I made sure I would be good by about 5 o’clock at the latest. Wroooong.

We took our time coming home, and the way back over the Bay Bridge, through Annapolis, and up to Baltimore wound up taking about 3 hours. When we arrived home (and after I ducked into the bathroom), I checked my glucose again: 249 mg/dL.

Now I’m mad. I almost never have a consistently high day like this. I’m ready to bolus the living daylights out of anything that moves. But I regained my composure and decided to change my infusion site instead. After changing, and to be sure I’m getting all of my bolus this time, I decided to do an injection to cover where my BG was sitting, plus the very limited amount of carbs I was ingesting at what was really more of a grazing than dinner. At this point, I’m absolutely sure that everything will be fine, even with (or especially because of) a new infusion set. Wanna guess how that came out?

I wait until 8:00 to check, and whaddyaknow? I’ve hit a new high for the day! 331 mg/dL. This is where the term “rage blousing” comes from. If it weren’t so late in the day by now, I probably would have rage bloused my behind off. Instead, I decide to do two more things.

One was to do another injection, right away. I figured this still had to be my best option to bring my glucose down.

The other thing I did was something I should have done much earlier in the day. Instead, I waited until I tested again at around 10:30, and saw 348 mg/dL on the meter. When I changed my infusion site earlier, I did not change my reservoir. I had about 100 or so units left in there, and I didn’t want to just toss all that insulin into the trash. So I changed my site and hooked up the old reservoir. But by now I’m thinking, maybe the insulin is bad somehow. I don’t know how this happens… I can’t remember it ever happening before. But, of course, now I’m ready to try anything, so I filled a new reservoir and hooked it up. I know this isn’t how you’re supposed to do these things, but hey, sometimes things don’t go according to plan. Once this was complete, I had pretty much given up, and I went to bed.

And gloriosky, when I woke up this morning, I was right back at 81 mg/dL all over again. Fiiiinnnnaaalllly. Hmmm…. Bad insulin. Who would’ve thunk it? But then again: When you consider this diabetes beast we’re all fighting against, it seems to make perfect sense. In a crazy, don’t count on anything, not gonna play fair kind of way.

I don’t like you, your highness.

Please excuse me for a moment while I rant. It’s been a strange month or so around here. These frickin’ high blood sugars are driving me crazy.

I’ve been very lucky. Since about six months before I went on pump therapy, or about three years ago, I’ve been doing absolutely great managing the glucose. My A1c results have been super.

At my last appointment with my endocrinologist, she was concerned that I was managing things a little too well (my words, not hers), and she had me make a couple of adjustments to my basal rates. So now I have to get used to seeing numbers that are above what I would like.

That’s hard enough for me (not too hard really, but still…). But the last month or so has seen a lot of days where nearly every BG reading is higher than 180.

I don’t like it. I don’t like how it makes me feel. I hate that dry mouth, go to the loo more than usual, feeling lethargic, grab another bottle of water, wait to eat feeling.

And I really don’t like thinking about what this is doing to my future A1c result coming up in December. I mean, I know this is probably not a big deal in my overall diabetes care. But just this short time North of the Border is starting to really do a number on my psyche.

So, what to do? Well, I probably need to listen to my own advice. I’m fond of telling my fellow PWDs that yesterday is yesterday, and you can’t change it. Today is what counts, and if you can put enough good todays together, you’ve got a great future. This isn’t the end of the world, after all.

But I’m pretty mad about it right now. Better get ready, high glucose. I’m coming after you. And I’m not giving up.

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