Today marks another World Diabetes Day.
A day to share that people living with any kind of diabetes can do whatever they set their minds to. We are not defined by our condition. Spreading awareness of all the facets of living with diabetes, including access to medication, daily management and mental health help people not living with this condition understand more of what we are dealing with.
Each year I’ve been involved in one way or another. This year I’m more detached. That’s because this year I’ve been experiencing diabetes burnout.
13 years of living with diabetes, five years misdiagnosed and managing without insulin, four years solely on long acting insulin and four years on a full insulin regime. Once I went the full gambit I managed brilliantly by taking very little insulin, implementing the law of small numbers. Low carb=low insulin needs.
Things changed in March 2020. I felt drained, arthritic, suffered from multiple digestive issues and became less and less tolerant to foods and more and more insulin resistant. A few friends in the diabetes community recommended I try a new approach. Namely wholefood, vegan, high carb, low fat. I was ready, and dove in. After just a few months, my numbers rocked in the 5’s, I felt awesome. My digestion improved. I added more and more variety back in to my diet. I had energy, I felt hopeful and I was willing to experiment and make mistakes.
But then…I had two severe lows in a row. Nothing to do with my diet and everything to do with a faulty injection site. My long acting insulin sending me into a near death nose dive. It’s been a slow recovery.
Yoga has always been my main support and anchor. My mat a safe space. On the mat I drop the uncertainty, creating room for reality. I am not the body, I am not my thoughts, I am not the one identifying with the thoughts. Even the thought of myself.
Even though I have the right perspective and incredible tools on hand, the raw reality of injecting 7 times a day, not knowing if I’ll make another mistake and go low, not knowing how my body will respond to a piece of sourdough with avocado has been unnerving.
So, I’ve had to take a deep breath, consider that yoga cannot ‘fix’ this very real physical issue and reach out.
Thank goodness for Twitter.
On a random scroll down my feed I found a Telehealth Diabetes Clinic in Australia. I resonated with their message. ‘You do diabetes your way.’ Made an enquiry and just a few days later scored an appointment.
Right now, I am working with a diabetes dietician and we are testing foods, working out how fast or slow a food is absorbed into my blood stream. It’s true nuts and bolts stuff and takes a ton of time. Eating the food and recording the results. Taking a few days to recover if I misfire, learning, adjusting and trying again.
This past week I learned how to make recipes and create servings for carb counts. It should be a no brainer, but I am TERRIBLE with math. There were lots of scribbles and diagrams to look at and screen shots and charts to work stuff out.
I’m committed to the process. Like doing full wheel or handstand for the first time I’m ‘doing it scared’. Terrified might be a better word to describe how it feels watching the arrows on my freestyle libre after a meal. There’s been lots of tears and glucose gummies under the bridge in the last two months. But I’m okay with that. Yoga has taught me discipline, persistence, patience and courage.
Happy World Diabetes Day!
with great respect…
When I was diagnosed with Type 1 diabetes all I knew about the condition was that I would be insulin dependent for the rest of my life. I didn’t think much about the details about the invention of insulin until I became more involved with diabetes advocacy. I was surprised to discover that before the discovery of insulin in 1921, a diagnosis of type 1 diabetes was a death sentence.
Diabetes is one of the most studied diseases in the history of medicine, whose first mentions trace back to a collection of Egyptian medical texts proposing a treatment of a decoction of bones, wheat, grain, grit, green lead and earth. The Indian physician, Sushruta, and the surgeon Charaka were able to distinguish between type 1 and type 2 diabetes, termed as “madhumeha” (literally, ‘honey urine’).
The term “diabetes mellitus” was introduced in 1674 by the British physician Thomas Willis who defined diabetes mellitus as the “Pissing Evil.” It was only in 1776, that physician, natural philosopher and experimental physiologist Matthew Dobson discovered that urine of diabetic patients is sweet because of excess sugar.
Before the discovery of Insulin doctors were confused as to what caused diabetes. Was it a problem with kidneys, a metabolic issue? Not knowing the cause, all manner of bizarre treatments were prescribed from high calorie diets to fasting to opium. The founder of the Joslin Diabetes Centre, advocated for severe, prolonged fasting and under-nourishment as a cure for diabetes, coined the “starvation diet”.
Discovering that the problem lay with the pancreas took many years and experiments.
To give you a long history and treatise on the discovery of Insulin is not my goal, rather I hope it will inspire reflection on the ground-breaking discoveries we make as humans and the miracle of medicine and science.
I’m not a science nerd. I am a physical, emotional type, a dancer. Diabetes has forced me to find interest in things I wouldn’t naturally be drawn to. It’s made me more rational, reasonable and logical and I am starting to like this new part of me. Especially right now in the midst of this pandemic.
I admit I have been trolling conversations on facebook, just to try and put myself in the shoes of my friends who are struggling in the current climate. The ones who are adamant that the vaccines we are being asked to take are dangerous, that the statistics and scientists are wrong, coerced or lying because there is a much larger plan at work. That our freedoms are threatened, that we are now living in George Orwells 1984. Not only that but we must take a stand and say no.
I agree these are unprecedented scary times. Yet… it seems to me there is a missing piece to this and this is where the discovery and implementation of life saving insulin comes in.
How did Banting and Best, the two famous men responsible for bringing insulin to the world figure out that insulin was the key? They had to experiment. Once they had the inkling they were on the right track, they injected themselves to see what would happen. The final step was to inject a person living with diabetes who was about to die.
I am here today because of these risky human trials, because of years and years of experimentation and research. This was raw, edgy medical experimentation.
Now here we are in 2021, living on a knifes edge, friend pitted against friend, the world divided. Some of us absolutely convinced that the discovery of a vaccine for Covid is a miracle and others certain it’s a long-term death sentence, the end of life as we know it and NOTHING in between.
But what if this vaccine like insulin, is the start of something truly beautiful. A new beginning, a way forward in science, medicine and technology that’s only just beginning. Maybe this mRna technology are the first signs of a cure for all the genetic incurable diseases we have today. There is a great deal of evidence in credible scientific journals to suggest this.
To my friends freaking out, angry or even just hesitant and on the fence. There are many issues on our plate today. The climate crisis for one.
If we are willing to believe climate scientists, why aren’t we willing to believe our medical scientists? What is the difference? Is one body more co-opted than another? Most friends are terrified of what we are doing to the earth.
Which then begs the question how can a nature loving, non-harming, vegan like me even think of injecting myself with a supposed gene altering vaccine I know nothing about?
Try a diagnosis of type 1 diabetes. It changed my perspective about everything. I have learned that sometimes to live a life in harmony with nature I have had to put myself first and trust science.
Life is precious and whatever keeps me living is precious. If that means injecting myself seven times a day with a lifesaving hormone, created in a lab from sequenced human DNA so be it. If it means taking an mRna vaccine so be it. I have way more years left in me to share, support and bring light to this earth
With great respect…
Something not many people know about me is that I am obsessed with sci-fi and dystopian stories. I was never a big Lord of the Rings fan, instead stick me in front of Star Trek and I’m as happy as a pig in mud. I am not quite sure why I’m so obsessed, but I think it has something to do with wanting to be just like my big brother when I was little, who along with my cousin, spent hours making meticulous Star Trek Enterprise models and filming action shots with them for fun.
Lately I haven’t had much patience for sticking my nose in a good novel, so I’ve been tooling through Netflix, consuming shows like Sense 8, Colony, Handmaid’s Tale and my current favourite ‘THE 100’
What is it about THE 100 that has me on a binge? It’s the unresolvable crisis’s that just seem to pile on top of each other in never ending succession, while going through every genre of horror, Sci-Fi adventure movie ever made. Think killer bees, the Lockness monster, the Blob, Frankenstein, Werewolves, Zombies, Cults, Raiders of the Lost Ark, King Kong, Jumanji, Invasion of the Body Snatchers, Soylent Green, Rosemary’s Baby, even Charlie and the Chocolate Factory. (yes, to me that’s a horror flick)
No matter what kind of decisions the characters make to ‘do better’ or save their people, things never resolve in the way one would expect. In fact, in the show someone always ends up dying, getting maimed, or emotionally scarred for life. Yet somehow, they pick themselves up after their super awful decision and try again, usually making an even worse choice.
This is exactly on my worse days how I feel about managing my diabetes. No matter what choice I make, the outcome will never be what I expect. Even when I have all the right information, all the best tech, and excellent support.
Somehow, I’m back at the Dropship, waiting for the next Grounder invasion or trying to make nightblood in Zero G without a spacesuit or worse stuck in a bunker during yet another nuclear holocaust forced to become a cannibal or die.
Of course, if you haven’t seen the show you have no idea what I’m talking about but rest assured. Living with diabetes is just as edgy, and all out terrifying on even my best days.
Learning to accept my decisions when it comes to day to day management is my new goalpost. Like the characters in the show, who have to accept that killing, and maiming is the way to get their ‘humanity’ back.
I am not really sure about that sort of self-reflection when it comes to diabetes rather it’s through constant revaluation of the 180 decisions I make a day that keep propelling me forward with positivity and faith.
Like today when I took 65% of my breakfast dose, because I knew I’d be teaching yoga, which would drop my blood sugar, except woops it didn’t so subsequently I spent most of the morning plateauing high, which then caused me to spike higher at lunch even with a correction, which in turn had me scrubbing the stove and vigorously moving furniture about which most likely will mean more insulin sensitivity by dinner and a low overnight. Adjusting like this over and over takes effort, discipline and awareness. Qualities I developed through my yoga practice.
Some people might think of yoga as Sci-Fi. All woo-woo weird stuff with buzz words like transcendence and higher consciousness. But in reality, yoga is what happens when all words, ideas, identifications and imaginations drop out. It’s the base. The thing that doesn’t change. The changeless is the nature of yoga which is you, the perceiver of every experience, every choice. Even when you make a terrible choice, taking you down a dark seemingly treacherous path to a place you know nothing about. Who you are, the yoga itself, is the constant. The pathless path.
With great respect
P.s Join me for a grounding nourishing all level practice perfect for these times we find ourselves in
I’ve just completed a course on Mental Health Aware Yoga. I took the course because I wanted to learn more about how to meet the needs of students dealing with mental health challenges. As I progressed through the course it became apparent that everyone at some point or other has dealt with some sort of mental health issue. In fact, nearly half the population has experienced a diagnosable mental illness at some point in their lifetime.
When I discovered yoga in my late teens, I realized the value of yoga in supporting me in dealing with my own challenges. As a young girl, after the sudden death of my mother I experienced anxiety. At the time it showed up as digestive issues and a fear of being by myself. My father and step-mother did their absolute best to support me, but back then unless there was a real observable physical or deep mental disturbance we were expected to cope and move forward.
The discovery of the physical practice of yoga gave me my first taste of true relaxation and surrender. I didn’t really understand why it worked. All I knew was that I wanted more. Yoga gave me a sense of peace and security and I loved its physicality. Little did I know that the yoga class was a transformational space and the yoga itself a transitional object.
In Stephen Cope’s book “Yoga and the Quest for the True Self” he explains that, a transformational space is a place where you can find refuge from the demands of everyday life. A place where you can let go and say, “it’s not up to me.” A place where you can find acceptance and support for who you are rather than what you have.  He also explains what a transformational space is not. It’s not a place where you are asked to trade one set of ideologies or beliefs for another. I.e. trading ideas about religion with ideas about yoga or spirituality. Or that you must do a practice in a certain way to gain the peace and freedom you crave.
It was easy in the early days of my yoga life to think that I had to be rigorous with myself and push myself into the forms and shapes of the physical practice. Even though I had all the necessary ingredients to transform and grow, trying to be like my teacher or like the person next to me on the mat only served to make me more anxious. If I couldn’t get it right, I’d try harder. It took years of looking in all the wrong places and a diagnosis of type 1 diabetes to recognize that a transformational space didn’t have to be external, it could be the purest form of acceptance. Acceptance of one’s self.
Living with diabetes carries with it it’s fair share of trauma, anxiety, stress and depression. It’s a very rare person that can escape unscathed. No matter how much information you are given via your health care providers or support team no one knows exactly what you must do to manage your condition. No body responds to medication, diet and exercise in the same way. The amount of energy that goes into daily management is exhausting. You are asked to think like a pancreas 24/7.
One of the biggest things that’s overlooked by our health care system is how traumatic it is to receive a diagnosis of type 1 diabetes. The initial shock and disbelief are overridden by the huge amount of information one needs to assimilate to immediately manage the condition. Without missing a beat, you are expected to self-medicate, learn how to use technology and treat any hazardous side effects. I.e. keep yourself alive!
Trauma occurs as a result of powerlessness in the face of an overwhelming force, and when the ordinary systems that give people a sense of control, meaning and connection are overridden
Trauma like anxiety is not an uncommon occurrence. According to studies in the US more than half the population (60.7% of men and 51.2% of women) reported exposure to at least one traumatic incident in their lifetime, including rape, molestation, physical attack, combat, shock, threat with a weapon, accidents, natural disasters, abuse, neglect or witnessing something traumatic. 
I find it interesting that being diagnosed with a chronic illness is not emphasized on the above list. Nearly half the global population are dealing with some sort of chronic disease, and one in three adults worldwide is living with multiple chronic conditions: cardiovascular disease alongside diabetes, depression as well as cancer, or a combination of three, four, or even five or six diseases at the same time. That’s half the population or more dealing with multiple traumas.
It’s astounding to me that more time and resources aren’t devoted to supporting the population to manage all the associated mental health challenges that come along with these chronic conditions.
It’s encouraging that yoga is now being seen as a viable adjunct alongside western psychological treatment. In studies on Yoga and Trauma In a randomized control trial (RCT) by Bessel Van der Kolk, David Emerson and colleagues, 64 women with chronic, treatment-resistant PTSD were assigned to either a trauma-informed yoga class or a supportive women’s health class. Students were taught physical yoga practices, breath work and meditation with an emphasis on inner sensing, taking note of how the postures felt internally as opposed to how they looked externally. The group was also encouraged to modify a pose or hold a pose longer or stop as they needed. Key phrases like, “notice, allow and when you are ready” were used in the instructor’s language. The key ingredient here was not to pressure the student. Rather inviting the student to follow what the body was telling them as they executed the poses.
The results of the study concluded that, yoga significantly reduces PTSD symptomatology, in a manner comparable to well-researched psychotherapeutic and psychopharmacological approaches, and that yogmay improve the functioning of individuals with PTSD by helping them to tolerate physical and sensory experiences associated with fear and helplessness and to increase emotional awareness and affect tolerance.
In my own experience, I have been able to find comfort and safety and a way through the traumatic shock of my own diagnosis and subsequent challenges with the use of what Stephen Cope calls “transitional objects.” A transitional object can be anything that is constant, reliable, and supports the student during this period of transformation. It could be the teacher, the room, a favourite book, a chant or a specific practice.
As I transitioned from healthy person to person living with a chronic illness and specifically diabetes I found the following ‘objects’ of immense support.
A guide – having someone to literally and symbolically hold my hand through the transition. Not only is the support of loved ones invaluable but having a guide who knows the pitfalls and goalposts can help ease the transition. For me that started with my first CDE who showed me how to inject and work out my insulin to carb ratios. She also gave me significant emotional support. Reminding me that a diagnosis of type 1 diabetes happens to anyone. There’s nothing I could have done differently.
Hearing this brought tears of relief. I had tried so hard to fight the inevetable and here was someone letting me know it wasn’t my fault. So often with a disease like diabetes we are told by the media and the medical establishment that we ate the wrong things, had the wrong kind of lifestyle. These ideas made me feel like somehow, I was wrong. Her kind and gentle words let me off the hook and helped me to relax.
A community – After my diagnosis I went online to see if there were any other people into yoga or healthy lifestyles living with type 1 diabetes. To my surprise I discovered a thriving community in online forums and Facebook groups. I tentatively sent out a question and immediately received 15 replies. Realizing I am not alone, that the problems I have living with this condition are shared, helped me come out of isolation. Whenever I have a question related to my diabetes management or my feelings about living with diabetes I can reach out and get immediate support. This has been especially potent when in the middle of the worst hypoglycemic event ever I reached out to a fellow type 1 on Instagram and received her advice on how to treat the event with glucose and post low insulin dosing.
A routine – Having a regular daily routine has been another potent tool. Knowing that I’ll be taking my insulin shots at the same time each day, eating at the same time, with roughly the same amounts of carbs. Going to bed at the same time each night and waking up at the same time each morning. Having a regular daily yoga practice and afternoon walk are all regimes that give me a sense of certainty and stability. I may not be able to control my pancreas, but I can control the parameters around how I respond to stress. Keeping things simple and rhythmic is a great way to stay stable and grounded throughout changing conditions.
A practice – Having a consistent yoga practice has been my number one transitional object. I’ll never forget the day of my diagnosis and how after returning from my GP I went straight to my yoga mat. As I settled into child’s pose to prepare for the practice I symbolically felt myself giving up and giving over to a higher power. Asking for support, healing and whatever else I could think of. I rededicated myself to yoga and all that it offers not only as a practitioner but a teacher. I recognized myself in the wounded healer and that I could only ever teach from my own experience. This shocking new normal would have to serve as the springboard for my journey into this next phase of life. Returning to my mat day after day, especially amongst the challenges of anxiety or re-traumatization from a severe hypoglycemic event. My yoga practice rebuilds my inner strength.
In yoga a transitional object is called an ‘Alamba’ the word means crutch. We may need the aid of a crutch in the beginning but eventually as we regain our inner strength and heal from a traumatic event we walk freely again.
Learning more about mental health and how to support someone living with a mental health challenge through the medium of yoga has been an inspiring and healing journey for me. Not only have I gained valuable tools in working with others but it has been exactly the kind of transformative space and transitional object I’ve needed in my own healing journey.
With great respect…
 Mental Health Foundation. (2016). Fundamental Facts About Mental Health 2016. London, UK: Mental Health Foundation.
 Cope, S. (2000). Yoga and the Quest for the True Self. New York, USA: Bantam Books.
 Herman, J. (1997). Trauma and Recovery. New York, US: Basic Books.
 Kessler, R.C., Hughes, M., Sonnega, S. and Nelson, C.B. (1995). Posttraumatic Stress Disorder in the National Comorbidity
Survey. Archives of General Psychiatry. 1995; 52(12): 1048-1060.
 Van der Kolk, B.A, Stone, L.,West, J., Rhodes, A. Emerson, D., Suvak, M., and Spinazzola, J. (2014). Yoga as an Adjunctive
Treatment for Posttraumatic Stress Disorder: A Randomized Controlled Trial. Journal of Clinical Psychiatry, 75(0), e1-7.
 Van der Kolk, B.A, Stone, L.,West, J., Rhodes, A. Emerson, D., Suvak, M., and Spinazzola, J. (2014). Yoga as an Adjunctive
Treatment for Posttraumatic Stress Disorder: A Randomized Controlled Trial. Journal of Clinical Psychiatry, 75(0), e1-7.
 Mental Health Aware Yoga Teacher Training Manual © Lauren Tober 2020
I’ve lived with diabetes for 13 years. For the first six years after my initial diagnosis, I still produced my own insulin, I could manage the whole thing with yoga, diet and herbs. I never imagined I’d need insulin. But then I did.
I started slow.
First there was the daily shot of basal insulin. I restricted my diet, ate under 30 carbs a day, exercised fanatically, dragged myself up and down hills and ate a ketogenic diet. I sported flat lines and felt safe and confident with my management. That went on for 4 years. It worked, until it didn’t.
10 years after my diagnosis I took the plunge and started meal time insulin. My motto was, a little goes a long way. I used 1/2-unit syringes and eked out the doses. Learning from the low carb diabetes community that the less insulin I used the less likelihood of lows. It felt safe and doable. I could relax. Or so I thought…
Last year I started needing more insulin because I made a radical change. I wanted to go vegan for ethical and emotional reasons. I’ve talked a lot about the ‘why’ here on the blog. Suffice it to say changing from a strict low carb diet to a high carb low fat one has been no picnic. I’m nearly a year and a half in and it’s tough.
Don’t get me wrong. I am over the moon being plant based. I feel healthier, I’m more resilient and I love being creative in the kitchen again, but to be honest I’ve struggled with my mindset.
Right now, I’m dealing with Diabetes Burnout.
I though diabetes burnout would look like giving up on my management or feeling like things were hopeless. But Diabetes burnout is subtle. Mine was triggered by a severe low. I wrote about that on the blog too.
Since my low I’ve lost confidence with dosing. Even after meeting with my diabetes coach and fine-tuning things, I’m still afraid. As a result, I’ve been taking less than I should, or over treating a low and then not correcting when I go high. I’ve let my blood sugars run high over night. Been afraid to adjust my basal rate and tweaked and adjusted my bolus ratios up and down like a yoyo. Looking at my meter day after day and watching the peaks and valleys, I feel defeated. I keep asking myself where did I go wrong? I have all the right education, I know what I need to do, but when it comes to doing it, I don’t.
In Tandem with going plant based, I’ve been studying Mental health Aware Yoga. This involves being able to tailor a class to students dealing with any kind of mental health challenges like anxiety, depression, trauma and stress. One of the first things I learned was how to create a safe container. How to make my students feel safe no matter what.
Feeling safe goes hand and hand with gaining confidence. And if I’m really honest with myself, right now I feel the opposite. Out of my depth and worried I’ll never regain ground.
So how can I create a safe container for my life with diabetes? I don’t want to wrap myself in cotton wool, but I do need to feel safe when making decisions that often make me feel like I am teetering on the edge. It’s heart thumping, stomach churning scary stuff. Who wants to jump of a cliff ever?
There’s a Zen story:
“An honor student, frustrated with his life and with school, worried about what tomorrow may bring, approached his teacher asking for some guidance.
“The story goes,” says the teacher in response to his students request for help, “That a Buddhist Monk was walking through the mountains one day. Then, out of nowhere, a tiger appears, chasing the monk towards the edge of a cliff. The monk, in his quest to escape the tiger, runs to the edge of the cliff and climbs over the side, where he sees five other tigers 15 feet below him, waiting to eat him.
So, the monk is just hanging there, holding on to a vine on the side of the cliff, waiting there for the little chance he has to escape or for his imminent demise. Then, as the monk hangs there, exploring his options, he turns to the left and sees a strawberry.
He smiles, “Wow what a magnificent strawberry!” he says to himself. So, he picks it and eats it.
The student waited for his teacher to continue but it was clear that the teacher was done with the story. “That’s it? That’s the story? The monk is about to be eaten by tigers so he reaches out to pick and eat a strawberry?” the student exclaimed.
“What’s the point?” he added.
The teacher replied, “The lesson is to know and embrace the experience of being alive. You must be alive every second you are alive.”
The student responded, “But teacher, everyone is alive when they are alive.”
“No,” said the teacher. “It’s the experience of being alive in each moment, in each experience, good and bad. We must be alive every second we are alive and not simply exist and live out our days.”
The student, confused, questioned his teacher, asking, “But everyone alive is alive, aren’t they?” he insisted.
“No. Look at you now,” explained the teacher. “You are running around being chased by tigers, consumed with your thoughts of how it could be better, how you could be better if only things were different. Yet, you have shared with me over the past year several difficult situations, in addition to the circumstances that I have observed, how you were about to be eaten by tigers and how you have been saved in each situation. You can’t be alive if you are living in fear and if you’re living in fear you can’t see and experience life; the magnificence of your life that is right in front of you in each moment.” – Keith Rosen
The story is a powerful reminder for anyone who grapples with challenging circumstances. To be fully alive means feeling the fear and doing it anyway.
And that’s what I intend to do. Starting today…
with great respect…
When I was little I was convinced a monster lived under my bed. Every night just after brushing my teeth and getting into my P.J’s I’d make a bee line for the bed and hide under the covers. Spending the night terrified that if I moved or breathed the monster would get me. Even though at night I was frightened for my life, I woke up every morning refreshed and unafraid. Somehow, I knew the monster could never survive the light of day.
After years of yoga, personal reflection, and trauma work I now know why I was so afraid. Having lost my mother suddenly at the age of 10, I projected the shock and fear into an external threat. As an adult and the author of my thoughts, I understand that I can only ever be the source of anything I project. The monster wasn’t separate to me, it was a part of my psyche supporting me to make sense of the incomprehensible. Mothers aren’t supposed to die and leave their 10 year old daughters.
Being with fear and uncertainty is something I deal with every day as someone who lives with type 1 diabetes. I spend my whole day managing risk. Most of the time I get it right. But every now and then I don’t.
To describe the onset of a mild low is easy. There’s the feeling of ants crawling around my middle. The rushing to the loo, the increased heart rate. A kind of hyper vigilance and anger all at the same time. But when the low is severe? With no warning? That’s something that defies words.
Last night was just like any other. We’d gone for our afternoon walk and I decided to water the plants. I’d kept my CGM in my coat pocket, so I could keep an eye on my levels. Often around sunset I dip low as my long acting insulin wears off. As my numbers were more than steady I decided to do some weed pulling. No more than 10 minutes, knowing that any kind of gardening induces a low. Still, after checking my blood sugar I was in the clear. A nice steady 5.0 mmol.
I came inside, prepared my dinner and then decided to have a shower. I took my long acting shot for the evening ( I split my dose), checked my level, it was 5.3 and hopped in the shower. I checked again when I got out and due to my CGM getting damp it read 5.6 with an upward arrow. Great, I thought to myself, I’ll check again in five minutes when the heat from the shower dissipates. On my mat, I started my evening practice. After a few poses I felt a strange tingling around my middle. Knowing that that is one of my ‘tells’ for a low, I checked my CGM, it said 5.4… I decided to cross check with my glucometer just in case.
Thank GOD I did! It said 2.9!
I freaked, checked another finger, while at the same time trying to wrack my brain as to where my glucose tabs were. Once the other finger came back with the same number I ran upstairs, realised they were downstairs and ran to them and shoved four tabs in my mouth at once. My heart rate was through the roof, I had no idea if 12 carbs was enough. Everything went into soft focus. All I could do was feel my heart rate pounding, the sweat running from every pore, the thoughts in my mind jumbling with no coherence. While John went upstairs to get his phone (in case he had to call the ambulance) I ate another glucose tab thinking 15 carbs would be better than 12. Then suggested we get the hypo kit out of the fridge, unused, not even looked at since purchase.
I tried to read the instructions to John. “What is this for? “He asks, “Just in case I pass out.” I am trying to read the instructions and stuck on number 2, which says, slowly inject the water into the vial. I’m thinking but where is the water? Do we have to get the water from the tap and put it in? John is saying there are pictures of what to do on the inside lid of the kit. I don’t understand the pictures, I don’t understand the instructions, I’m sweating profusely now. I check my CGM it’s a straight down arrow
NOT GOOD! I down another three glucose tabs so that’s 15 + 9= OMG don’t even know how much I took. Was it too much? Not enough? I can’t set my timer to make sure its been 15 minutes since I took the tabs. I can’t do anything but try and explain that we only need the hypo kit if I am unconscious. “Whatever you do John, don’t put the needle in the vial we cant waste the kit.”
We hang in the balance, check my blood sugar with the meter which is much more reliable than my CGM at this point and see it’s the same number as it was five minutes ago. Not going down. Phew, but not going up.
I start to really feel the low now. I feel faint, sick to my stomach, weird as F…ck.
And then inch by inch it creeps up. John puts away the hypo kit. I sit in a stupor. Even though my blood sugar is back up past 4mmol (that’s a normal range) my brain is not online. It’s worse than the feeling after a panic attack. I’m literally numb. All the while my only thought is why?
Why did I drop in 20 minutes from 5.4 to 2.9? I knew it had to be something to do with the long acting Insulin, somehow it had absorbed too quickly. Maybe the shower and the heat? But how much was absorbed and how long would it last. Was there a danger of going low again? This had happened just before dinner and I had to inject meal time insulin for that. Would they interact? Was eating and injecting going to endanger me again? And why didn’t I know more about this? Where are the formulas and strategies for this unexpected scenario? Why can’t our HCP help us to be prepared for these kinds of situations? They send us home with the basics. Eat, inject, treat a low with 15 carbs. That’s it? Talk about flying blind.
Once I could properly operate machinery again I sent a message to some of my allies in the DOC (diabetes online community). Their response was so immediate that I cried.
One friend mentioned that I should split my meal time dose just to be safe. Take a unit at the start of the meal and maybe another one two hours later. Another friend assured me that at 2.6 mmol 24 carbs worth of glucose tabs was the right amount to treat the low and my levels would soon stabilise. She also mentioned taking less insulin for the meal and watching every 30 minutes to see what happens. If I saw my levels spiking, then that was a sign to take more insulin. After a ton of messages back and forth, she admitted she couldn’t ‘tell’ me what to do and that I would have to trust my intuition and decide. Everybody reacts differently to every food. She reminded me that I have diabetes, it’s okay to have high levels, better to be high than low.
I decided to dose 15 minutes after the meal when I saw the upward trend and took ½ a unit less than normal. My blood sugar spiked. I survived.
It’s morning now and the sun is shining. The monster firmly back in its cage. I am in awe of the women I reached out to and their instant support. I know they have had soul crushing lows and impossible highs and just like me make it through. Without those who have gone before us, how would we know the path to tread? How would we tame the monsters under the bed?
If there is one lesson, this low has taught me it’s to reach out and keep reaching out. Ask for help. Know you are not alone. Yes, ultimately, we have to make our own decisions when it comes to how to manage our diabetes. But for every potential choice there is a person with lived experience out there willing to support you, you need only ask.
With great respect…
When I first travelled to Japan to teach I would walk into my yoga classes and see some of the students wearing masks. My translator explained that the mask was worn when someone was feeling unwell, living with a condition that required them to avoid colds and flu or as an ounce of prevention. I remember being in awe of their ability to
a. put themselves and their health first and
b. think of others
When I was diagnosed with diabetes I realised straight away how important it was not to get sick. Being sick meant uncontrollable blood sugars for a sustained period of time. Add to that the stress, trauma and tension of feeling doubly unwell.
My job as a global yoga teacher required lots of air travel so I donned a mask while flying and where it was acceptable, wore my mask in public places. When someone was sick I wouldn’t come over to visit and when my partner fell ill I would do my best to bolster my immune system and keep my distance.
When Covid hit, the directions from the government felt sensible. As there was no vaccine, no understanding of the disease and a variety of outcomes from no symptoms to loss of life, why not wear a mask to
a. protect myself and
b. help others.
I assumed that everyone felt the same way. Nine months later I have come to the realisation that people don’t.
I am living in South Africa right now. I have been here for a year. I am unable to return to Australia for many reasons. I look with envy at my friends enjoying maskless beach walks, parties with friends, their latest bookstore purchase or whatever.
I have not been shopping, partying or socialising for nine months. The few times I have gone out it’s been for doctors visits, a quick trip to an almost empty beach or a drive through the countryside where I don’t even leave the car.
People might think I’m paranoid, overreacting or have been brainwashed. I mean why not just give up and get it? Isn’t freedom and the enjoyment of life and all it has to offer more important than my personal fears? What comes to mind is that ‘people’ have never lived with Type 1 diabetes.
From the moment I was diagnosed I knew that freedom would have to be a compromise. 24 hours a day, 7 days a week tethered to medication that has no definitive outcome. Each injection could be a life or death sentence. Traumatic to say the least, living a ‘normal free’ life with diabetes is possible, but at the same time impossible.
Every outing requires careful planning, supplies, contingencies, every meal requires math skills, and a thought-out strategy. Every walk, yoga practice, garden foray requires something different. There is no room for error or spontaneity and yet you see people living with diabetes seamlessly. Why? Because they don’t talk to you about what it’s really like. And why would they? You will never understand.
Just like how you can’t understand why a person living with chronic illness might expect you to consider them when you make the choice to either maskup or be an avid antimasker.
I won’t go into details, but the details matter. When I come across a person on the path to the beach or in the forest without their mask, in a known hotspot, where I have been told the cases have risen 41% in one day… I can’t help thinking,” Wouldn’t it be smart for them to wear a mask? Or even turn around and walk away?”
Nope, guess not…instead they happily pass me by even waving and almost breathing on me, looking at me a little funny and perhaps thinking to themselves ‘brainwashed moron’. While I, the chronically compromised mask wearer, walks past in fear of my life. Not quite able to shrug off the incident because
a. I know people who’ve had Covid and
b. they’ve died!
I can rant and rave all I want, I’m still going to have people tell me, ” it’s a conspiracy, they’re denying us our freedoms, you can’t catch it in the open air. If I don’t wear a mask and you want to fine that’s your choice. Lockdowns don’t work.”
Duh? They do!
Look at Australia and New Zealand. Almost no cases, people enjoying backyard barbies, in person yoga classes, toilet paper available everywhere!
The next time you tell me it’s about freedom and my basic human rights, remember even YOU are conditioned to believe in an ‘idea’ called freedom.
Living with diabetes has taught me to let go of my ideas and instead I have learned to
a. accept what is and
b.protect this absolute precious life.
with great respect…