I started long acting Insulin in 2014 under pressure from both my endocrinologist and GP. Up until that point, I tried my hardest to avoid insulin because I saw it as the enemy. I can remember being on a 10-day trial of the Medtronic CGM to see what was happening with my levels and sitting in a room with other people who were also on the trial. The conversation turned to the number of shots we were on a day. The guy next to me was on three. Back then I thought I was pre-diabetic and considered myself lucky to be shot free. I didn’t realise that the source of my higher blood sugar levels was autoimmune or that I had LADA (Latent Autoimmune Diabetes in Adults) which is essentially type 1 diabetes.
Starting insulin was terrifying. I had no idea how my body would respond and didn’t believe my endo when he assured me that I’d have so much energy that I wouldn’t recognise myself. Now that I’m on a regime of both basal and bolus insulin I feel embarrassed that I didn’t believe him. Insulin has given me back my joie de vivre and made me feel like a kid again.
In my last post I talked about the challenges of getting a minuscule dose into a syringe and the feeling of fear around getting the dose just right. Just a few weeks later I’ve learned that practice makes perfect and a bit of peer support goes a long way.
I no longer worry about whipping out my syringe at dinner and dialing up my dose after hanging out with my friend Sarah MacLeod from What Sarah Said.
She showed me how to inject in the back of my arm by scrunching it up against a chair and mentioned how important it is to normalize injecting in public. I had always felt a little shy about lifting up my shirt and perhaps disrupting conversation to inject. She mentioned it didn’t make sense to go to the restroom, “who wants to go to a dirty smelly bathroom right?” It’s much cleaner at the table. I’d always worried that the insulin would get everywhere, on the food or other people. So far so good except last night was a little awkward in the Italian restaurant. The waiters were clearing the table just as I was priming my syringe. I persisted and although I probably overbolused a smidgen a ½ glucose tab in the movie theatre sorted me out.
When diabuddy, Christel Oerum from Diabetes Strong and I caught up for a walk in Malibu we discussed the predictability of dosing.
When you know how your body responds to carbs, insulin and exercise its easy to see how much you’ll go up or down with a meal, a walk or a yoga practice. Like me, Christel, likes to take the guesswork out and counts every carb. She’s just written a really cool blog on how yoga impacts her blood sugars and her new Fit with Diabetes e-book is an essential read. More on her new book from me in an upcoming blog post.
I think my biggest challenge was to work out corrections (injecting insulin after a spike to keep blood glucose levels in range) It felt overwhelming and scary. What if I overcorrected, at what stage would I take a correction, and what if I wanted to eat, or exercise? To tackle this one, I had the support of Karen Rose Tank from Rose Health Coaching, she’s a certified health coach, yogini and type 1 diabetic and go-getter like me.
I did my first correction at her house. She shared with me that you can use a correction to get yourself back in range and it’s a matter of keeping an eye on your levels after the correction.
Gary Scheiner, my diabetes coach from the mySugr bundle, explained that a good way to determine how far one unit will lower your blood sugar is to take a correction and then fast for the 4-hour duration that the insulin is in your system. It was magic to watch my level of 173 mg/dl (9.6 mmol) come down to 128 mg/dl (7.1 mmol) in 4 hours.
Even cooler was to see how just 2 gms of a glucose tab would raise my level by 45 mg/dl. Big thanks to Mona Morstein from the Low Carb Diabetes Association and her new book Mastering Diabetes for giving me the info I needed to understand how to raise blood sugars safely. I was drinking apple juice to bring up my levels and could never figure out how much of a sip was 4 gms worth of carbs. I’ve learned that I only need half a glucose tab to stabilise my levels, no more eating the entire fridge at 11pm. It’s been neat to note that taking an injection at meals hasn’t impacted my daily yoga practice either. I can inject at breakfast, head to my mat an hour later and see little change in levels before and after practice.
All these milestones in the last two months have built my confidence and tackled my fears head-on. It reminds me of the time my husband dared me to jump in the freezing ocean in South Africa. At first, I crossed my arms, shivered and refused to go in. Then, as I watched my husband dive under the waves I felt silly for being such a chicken. Slowly I waded in up to my ankles trying to get used to that numb icy cold feeling. Eventually, I dove in too and came up for air smiling from ear to ear shouting, “ That was awesome! and so refreshing!”
I can’t exactly say that living with diabetes is awesome or refreshing, but learning to ride the waves has a sweetness of its own.
with great respect…