By Christie Leist
I have always been a planner. I thrive on Post-it Note reminders; I buy bus tickets home to New Jersey months in advance; and once, during an emotional breakdown in college, I referred to my hand-written planner as “the love of my life.” And I meant it. Ok, I’ve done this more than once.
My type 1 diabetes tries to threaten my love affair with planning on a daily basis. There are seemingly endless factors that have the potential to throw my blood sugars out of balance and leave me out of control. I need to put on my planning shoes any time that I am about to ingest anything that isn’t water.
They say that by failing to prepare, you are preparing to fail; a statement that no doubt rings true for anyone with diabetes who hasn’t had an emergency juice box on hand when a hypo strikes.
It’s not that I mind thinking about how different kinds of food and insulin will affect my blood sugar levels throughout the day, but as unforeseen or forgotten factors turn-up, sometimes the plan must change.
The best I can do—the best any type 1 can do—is to pause before taking insulin and really think about what plan makes sense on that day and in that moment. Taking this most precious moment to prepare, however cumbersome it may seem, can save you hours of worrying and probably reduce wrinkles (at least that’s what I tell myself!)
Everyone’s blood sugar patterns are different, but these are the questions I run through in my mind before I take insulin to (hopefully) avoid a drastic drop or spike.
I might be pancreatically challenged by nature, but I’m a planner by habit. It’s my key to survival. Make planning the cornerstone of managing your diabetes by jotting down 5 go-to questions to review before taking insulin. While everyone’s lifestyles and blood sugar patterns are different, here are 5 factors I consider. I hope applying these questions to your own diabetes management might give you some inspiration to start your own love affair with planning.
If my next snack or meal is going to be in a couple of hours, I know I can relax because this means I have another opportunity to correct a blood sugar level problem soon. This can get tricky when you have a party or social event that you want to stay hungry for, but dropping a unit to be at prime snack level (oh, and of course, blood sugar level) for that Chinese buffet is worth a single moment of planning beforehand.
Anyone who has hit a 300+ blood sugar level at a Chinese buffet (everyone has their coping mechanisms) knows how important it is to know how to eat your favorite guilty pleasure without feeling too guilty afterward. Before engaging in a “risk meal” consider what happened the last time you ate the exact same thing. I used to keep notes on my phone by recording what I ate and what my blood sugar level was. This way, you can refer back to your note next time you want to eat that bad-for-diabetes-food and plan accordingly. I like to work with food instead of around it.
Exercise can have a delayed effect on blood sugar. I always work out early in the morning, when I tend to see my highest numbers of the day, so my blood sugar is relatively steady through around 1 pm. This means I don’t need to drop units at lunch because I rarely see a harsh drop right after exercise. I do, however, need to consider my activity level (even if I worked out hours prior) in the late afternoon and into the evening because that is when my exercise-induced insulin sensitivity kicks in. It can be awkward chugging a juice box on the train ride home from work, so I actively skip insulin for my 3:30 pm snack.
Pancreatically challenged or not, everyone has “low days.” Those of us who do have lows in a more literal sense, need to keep that in mind when taking insulin on a low day. Sometimes lows respond very quickly (and even a little too well) to an emergency juice box, meaning a juice box might bring you up from 60 to 200. In my experience, having juice alone, even if it cures the problem in the moment, doesn’t always work long-term. If it’s a low day, it might be necessary to drop units or choose higher protein options later in the day to make sure another blood sugar low drop doesn’t sneak up.
If there will be alcohol in my system, I am taking less insulin. Alcohol has made me drop overnight one too many times. This is another scenario where planning around what you’re ingesting is more satisfying and safer than just hoping for the best. If an engagement that involves drinking pops up, factor in a snack before bed; avoid being in a position where you could drop out of control.
The importance of being a planning girl in a diabetic world? Living your life, the way you want to live it. Eat the food that you want to eat. Do the things that you want to do. Your plans for tomorrow, next week, or next month may not unfold as you expect, but that’s ok. If you know that changes to your plan are inevitable, you’ll be more prepared to make new plans when a challenge presents itself.