Wake up, get out of bed, drag my pump across my bed… that’s not quite the day in the life that Paul McCartney sang about in the Beatles’ Day in the Life but it might’ve been had he been a Type 1 Diabetic.
I spent a week carefully documenting the amount of time diabetes took out of my day. Setting a timer to record the amount of time it would take for a hypo (low blood glucose) to rise or how long it’d take out of my afternoon to change my pump set. Type 1 Diabetes doesn’t stop me from living my life to the fullest as I hike, exercise, work, or try new foods but some days more than others, I lose hours because of diabetes.
Would I be more punctual without Type 1? Possibly. Would I rush less and have more leisure time without it? Probably. Would my hair look better on the regular? For sure. I don’t want to dwell on that though because there isn’t much I can do to gain back the 1-2 hours I lose a day by being my own pancreas- I just have to work around that and adjust my life a bit. But that’s what Type 1 is about anyways; a lifestyle change in the way we eat and drink, as well as in the way in which I’m highlighting in this post; the way I maneuver through my day.
This post isn't a record of every single day with T1D, but more of an accumulation of a weeks worth of diabetes interference into one to paint a better picture. Although, I will say that I’ve had days just like this, sometimes with less time taken out of my day and sometimes with more.
If you’re thinking, “Wow this chick wakes up EARLY,” you’re half right. Yes, I wake up at this time frequently but not by choice. My alarm is set for 7:30 A.M but my Dexcom™ (the CGM I’m using) app on my phone has other plans to when and how my day is going to start. I have to sleep with my phone as close to my head as possible incase I don’t wake up to the heinous alarm, I could at least feel the buzzing. On the rare occasion, the alarm wakes my mom (who shares my Dexcom™ data) and then results in her calling or just arriving at my door with a glass of juice. Who doesn’t love starting their day with a large glass of sugar or a mouthful of chalky glucose tabs?
Unfortunately, drinking the juice doesn’t mean I can go back to sleep. The glucose will take about 15-20 minutes to hit my system then maybe a few extra minutes for the CGM to catch up. Depending on how severe the low- this takes about 30 minutes out of my sleep and morning.
-Time elapsed: 30 minutes-
Finally time to wake up, but here’s the buzzword of this day with Type 1 Diabetes: GROGGY. I’m already not a morning person (I’m more of a 10am-3pm kind of person) so after my interruption in the earlier hours- I am one unhappy Ciara. But that’s alright. I’m lucky that my BG hasn’t spiked*.
*It’s very common to spike HIGH after a low because our bodies are telling us to eat eat eat- making it difficult to only have the amount of glucose we actually need to correct the hypo. This has been a goal of mine for awhile - to monitor the amount of glucose I’m having and work on being patient with my lows. A spike feels worse than the waking up at 4:30 A.M to alarms and several missed calls from mom.
I like to workout in the morning, I know it’s cliche but it really is the best way to start my day. If I don’t workout in the morning, I feel lethargic the rest of the day and usually opt out of an evening workout. This is all dependent on the day though. I love barre and bootcamp classes which are two completely different workouts. These different workouts have completely different effects on my blood glucose levels and although I do barre 2-3 times a week and bootcamp, twice a week- I still don’t know how my BG will behave.
I take time in the morning leading up deciding how much I need to eat, how much I need to bolus for and what percentage of my basal rate I need to reduce. I typically do a 75% basal rate for barre and 50% basal rate for the bootcamp (as it includes more cardio).
Not too often, but often enough to include here, do my BG levels drop and prevent me from finishing the workout. On those “low” mornings when I’ve had trouble keeping my BG up, sometimes just being near a treadmill makes the numbers plummet. I’ve had to leave classes half-way through or take a 5 to suck down a juice box. This makes it feel like a waste of an hour, since I wasn’t able to get my full 60 minutes in.
-Time elapsed: 15 minutes-
Post-workout is my favorite part of the day because this means breakfast. Read about my favorite bolus friendly breakfasts here. My breakfasts are heavily influenced by how my BG levels are post-workout. If they’re trending higher, eggs and avocado are fantastic but my favorite is when they’re trending lower and I can throw in some toast and fruit. Either way, Type 1 Diabetes can remove choices from my daily life. Yes, even with high BG could I have some carbs but I just would have a harder time bringing the numbers down and would spend longer feeling….blegh (definition of blegh: how one feels with high blood sugar).
When carbohydrates are involved, a pre-bolus is what I aim to do. This means, giving myself a bolus of insulin for the carbohydrates I’m planning on eating about 15 minutes before they’re actually consumed. I end up twiddling my thumbs waiting for a downward sloping arrow to hit my Dexcom™ app so I can chow down.
-Time elapsed: 15 minutes-
Belly full, shower done and I am READY for the day. Did my breakfast from earlier raise me up too much? Did I bolus too much? Checking on the sugars the hours after a workout is really important because usually they trend lower but in the world of Type 1 Diabetes “usually” doesn’t mean much. The levels could go either way. It’s usually in this spare time before heading to work that I’ll change my pump site, draw a new reservoir, and possibly switch out my CGM. My pump site and reservoir are changed every three days and the CGM is changed every 10 days. Rarely do all 3 of these tasks align on the same day BUT sometimes they do.
Pump site change, 5 minutes. Remove old site, clean it. Figure out which of the many places I want to put the new site, clean that. Work up courage to put on said site. Ta-da.*
Reservoir change, 5 minutes or more. This can be slightly time consuming because when drawing insulin from the vial we get bubbles. Bubbles are a big no no because they take up space in the reservoir where insulin could be and thus resulting in your body getting less insulin than the pump thinks. Also, nobody wants bubbles under the skin.
CGM change, 5 minutes. Before I switched to Dexcom™, this task would have taken a lot longer. I used the Medtronic Guardian Link, and it would almost always hurt so therefore I would take longer to muster up the courage to insert it. This CGM was also not guaranteed to work. It would bleed and then after the two hour warm-up tell me that it just wasn’t going to work. But the Dexcom™ is so painless and quick! I could never go back.
*Not a daily event but every now and again following a new site change, I find out that the cannula (the little subcutaneous straw delivering the insulin) isn’t working and high, like really high, blood glucose levels may occur. This results in another 5 minutes out of my day.
-Time elapsed: 15 minutes-
There are a few scenarios that happen at this time: work or school, maybe the occasional day off. But work is where Type 1 Diabetes presents the most challenges, as my classes are all online.
I work as a bartender in a small beer and wine bar- quite fun and quite relaxed. But busy. I’m lucky to have freedom in my job to test my sugar when needed, even change the occasional faulty pump site. Adjusting to this job was when Type 1 Diabetes would get in the way, the long hours on my feet, finding the right time to eat and remembering to do so. So I’ll sum up the “horror” stories of diabetic interference.
I’ve had blood glucose levels drop in the middle of a rush, having me feel like my head is on the ceiling spinning like a fan and feet are heavy in the ground. I’ll have to sit down for 20 minutes at times to wait for the juice or glucose tabs to hit. I’ve also ran out of juice before and a coworker had to run to the convenience store for me to restock. That sucked.
-Time elapsed: 30 minutes- 1 hour-
On the way to my deep slumbers can be daunting. I make sure my blood glucose levels are above 150 mg/dL (my daytime target is 100 mg/dL), so if I’m below that target that means I have to snack a bit to bring the sugar levels up. Sitting at the edge of my bed just waiting, hoping I didn’t overcorrect with glucose so I’ll go too high above that 150 mg/dL target.
Time elapsed: 15 minutes
Total time: 2 hours and 30 minutes
So there ya have it. I'm a normal gal. I have hobbies, I adventure, I love to socialize. Type 1 Diabetes interferes with all of it. But doesn't stop me. I work around it, because it's worth it to enjoy the things I love. I hope by learning about my most simple of days with Type 1 Diabetes, you can understand its' implications on the more eventful days.
Thank you to my dear friend, Carolyn, for this idea to document how many minutes I spend a day catering to my Type 1 Diabetes. I spend a lot of my free time with Carolyn and Type 1 Diabetes is always there during our movie nights and beach days. Thanks babe.