I went on vacation to the East Coast for a week during the first few days of August and came back home last week. It was a wonderful vacation where we got to spend time with my husband’s family at a lake cabin they rented out for a week. My days were filled with sunshine, long walks, swimming, kayaking, and with all that activity (plus irregularity in my mealtime schedules) came a pile of lows. Agggh! Diabetes, unfortunately, doesn’t go on vacation.
It seems my body became extremely sensitive to the insulin due to these changes in activity and schedule. During my vacation, I had a lot of lows in the 60-69 mg/dL range but there were two nights where I had some severe ones where I would correct the 60-69 mg/dL blood sugar, check 20 minutes later, and I would be even lower in the 40-45mg/dL range. One of those days, after correcting a second time and waiting for my blood sugar to go up, I got so low that my Dexcom just read “LOW”. I think I must have been in the 30-39mg/dL range at that time as it seems the lowest the Dexcom can read is 40mg/dL. I was feeling like I was going to pass out. I was still mentally alert and didn’t need assistance, which was good, but still, it was quite frightening and the 20 minutes I had to wait for my blood glucose to go up felt eternal. This was the first time I had experienced such severe lows since I started on insulin. My lows had always been pretty mild for the most part and easily corrected with a piece of bread or something like that. I was very glad to have my Dexcom to warn me that I was shooting down quite rapidly. I think I probably would have caught the lows much later on my own.
Given this series of lows during my trip, I decided that I needed to write an appeal to my insurance company for the Omnipod insulin pump. My application got denied because my last A1C was too good and because I haven’t been on injections for long enough (they want me to be on injections for at least 6 months). I think an insulin pump would be beneficial for me so I can do smaller dosages and set temporary basals on days that I am more active. It would also benefit me during travel, when I know I may not be able to eat the meals I usually have or stick to my usual mealtime schedule (as happened during this vacation). We will see what they say. I am crossing my fingers hoping that it gets approved this time. I was already in the process of writing up an appeal letter before I went on vacation and it seems this pile of lows was the last push I needed to get it done.
In the meantime, I did ask my doctor for a NovoPen Echo so I can have more options to adjust my insulin dosages. The beauty of this insulin pen is that it can do half units, which the regular Novolog pen cannot do. I think that having the ability to reduce my insulin my half a unit on days when I am more active would be extremely helpful to avoid the lows that sometimes come after exercising. There are other times when I have gone out to eat where I know that a whole extra unit would have been too much for my meal, but a half unit would have made a world of difference. My post-meal numbers when going out to eat have never been bad though as I am extremely careful with what I eat, they’re just sometimes slightly higher than I like.
I still have to go to the pharmacy to pick up the cartridges for my NovoPen Echo before I start using it. As opposed to the regular pen, which you throw away when done, with this one you just replace the cartridge and keep the pen. I am looking forward to trying out this pen and seeing how much of a difference a half unit adjustment will make.
Although I had wacky blood glucose levels and many lows during this vacation, I do feel that it was a massive improvement over my last vacation. During my last vacation, I wasn’t on insulin yet, so I was managing my diabetes by eating extremely low carb and a pile of exercise. My blood glucose levels ended up spiking after a day (when I wasn’t able to do my usual exercise because I was sitting on a plane all day) and I spent the rest of the vacation pretty miserable trying to bring my blood glucose levels back down as I didn’t have insulin to do it. You can read about my whole vacation odyssey here. That’s when I decided I really needed to start on insulin treatment because it just wasn’t safe for me to be running around without treatment anymore. Although I still have some rough days trying to manage my meals and insulin, I do feel that starting on insulin has made a huge improvement in my life so far. It has taken a bit of the fear away from eating. I know that it’ll be a while before I overcome my fear of eating, but I feel I am slowly making progress.