I never realize just how dependent I’ve become on my diabetes technology until I have to go without it. I have lived with diabetes for almost 24 years (as of next month.) And in those 24 years, to say the technology has changed/improved would be an understatement. When I was first diagnosed, I was immediately put on 4 shots a day. NPH in the morning (but don’t forget to roll it in your hands to mix it up, first!) and then Regular insulin that I would take precisely 30 minutes before each meal (which was super fun to time that one while eating out.) I also had to check my blood sugar first thing when I woke up in the morning, before every meal, 2 hours after every meal, and before bedtime. And I also had to have a snack before bed, to make sure I didn’t go low during the middle of the night.
Times have changed. Somewhat.
Fast forward 24 years and I now wear an insulin pump, which acts as an external pancreas that I program, and it gives me continuous insulin, based on pre-set formulas. Which is somewhat of a hit and miss game and can change with the wind. Or the time of month. Or with exercise. But I digress. I do still have to give myself insulin before a meal, but I just push buttons on my pump screen. And I “should” take it 15-20 min before I eat, but I don’t have to be as strict about it. There have been many times I’m still receiving the insulin as I’m eating my meal. And I don’t have to excuse myself to go to the bathroom to take my shot like I did for many years. And I only have to change out my pump site every 3-5 days. That’s a big improvement over taking 4-5 shots per day.
I also wear a cgm (continuous glucose monitor, for the newbies reading this.) I can look at my phone screen, or my Apple Watch and see my blood sugars 24/7. I find it to be very accurate, and I probably rely on it too often. I have been known to bolus off of that number (#likeyoudo) even though we are not supposed to. But as opposed to how it was in the early years, now my day looks like this – Check my blood sugar first thing in the morning so I can calibrate my cgm. Check my blood sugar before meals (in a perfect world). Look at my cgm graph 2 hours after my meal to see if I need to correct a high. Check my blood sugar before bed, just to make sure that the number is accurate and that I’m in a safe range for sleep.
And here’s where I realized how much I rely on this data. Last night when I went to bed cgm-free…. I had this odd feeling in my stomach and I literally said the words “I hope I wake up” out loud. Meaning if my blood sugar drops too low overnight, I was hoping that I would wake myself up. Not everyone can feel a low in their sleep. Historically I always have woken up in that drenched sweat and known to check my blood sugar. Or my husband has looked over and seen my drenched and woken me up. But I’ve noticed over the last year or so, I don’t wake up until my cgm alarm goes off. And either wakes ME up or my husbnad, or one of my friends that follow my cgm data. But I’ve gotten used to that alarm and last night it concerned me that I was going to sleep without the security of knowing I had that alarm to wake me up.
Most people can lay their head down at night and dream sweet dreams, or even stay awake worrying about their kids’ or about work problems. But most people don’t go to sleep at night wondering if they will wake up in the morning. That’s what those of us living with diabetes have to worry about – whether or not we are the one with the busted pancreas, or if it’s our kid(s), or our spouse, or any loved one. We have to be a mathematician, and a statistician, a doctor, a nutritionist, a pancreas, a parent, an employee, a child, the list could go on and on …..
Some days I think I need a device break. To go back on shots and no cgm for a little while, just to give myself a break. And I may still do that eventually. But not today.