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For the past few years, I've gotten into the bad diabetes habit of skipping boluses. Not food boluses. But blood sugar boluses. I have the habit of foregoing boluses when my blood sugar is 160 and under. I'll see a 140 or 155 and skip the bolus instead of bringing it down to 100. But above 160, I'm good about bolusing to bring the number down (something about those 180s and 200s scare me into submission).

I know that this extremely bad habit leaves my averages a little higher than they should be. And I'm not sure exactly why I do this...maybe over the years, a 150 doesn't seem so bad. Maybe I just get tired of so many injections a day so I leave off the "unnecessary" ones. Maybe it's some habit that I started in my childhood.

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After several days of using relatively unused abdominal real estate for my infusion sites, I've determined that I had most likely worn out the prime spots, which resulted in some pretty horrendous blood sugar spikes. I guess I should have known it would happen.

I have tried in the past to move my sites around. I've gradually moved toward my love handles, I've moved north before, I've even tried a thigh site with less than desirable results. In fact, the results were terrible. Terrible enough that I either yanked the sites after just a few hours or went back to the tried and true spots.

Perhaps I should have been more patient. (Story of my life, right?)

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I hit "ESC" on Toohey to double check when my last bolus was. Yep, right on time. I suspect I'll be slightly high since I changed my site this morning and had a fast-food breakfast. But when I see 304 I'm shocked. I squeezed out another glob of blood and checked again. This time 302. Son of a f*%#ing b*&%h!

I had taken 9.5 units to correct for a hideous fasting (which is why I changed my site a day early; I'd been running high since I put that site in on Sunday morning) and for the excessive amount of carbs I was eating for breakfast. I had even logged on to the restaurant's web site for nutrition information before bolusing.

I'm so livid now that I can't finish doing what I was doing. I can't think. What the hell is wrong? Two things came to mind: 

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Back in March, I wrote a post about my top five diabetes habits that needed to be changed. I'm curious to see how I've progressed in the last four months. I haven't made a conscious effort to truly change, but I have kept these things in the back of my mind. So here goes:

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I have no idea why it didn't hit me until yesterday afternoon. I know what stress does to my blood sugars: it lowers them. They get pesky and no amount of carbs will bring them up. So as I was contemplating this weekends' low annoyances, it hit me. Stress.

Last week, my stress level definitely went up. The first round of tests started for the semester. I had group meetings and papers due. Plus I've been dealing with the medical stress that comes with changing treatments and making important decisions. All that added up to leave me with averages like 84 and 69 (over six hours of riding in the 60's).

So Saturday morning, I dropped the Lantus back to my original dose (14 units in the morning and 15 units in the evening). I'm still having a few lows (more than the week of highs), but I'm also seeing a mix of highs in there. Sadly, those highs are my own doing.

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Is that why my A1C jumped the way it did? Is that why I’m not more aggressive with my bolusing? Is that why I sometimes look at a 186 and decide not to correct?
 

Don’t get me wrong, I’m not the perfect eater and that certainly has had an effect on my A1C, but do you remember how utterly shocked I was at my last endo appointment when Dr. R said 7.5? Well, I do! I could barely focus on anything she said after that because I was so dumbfounded. I even thought about asking her to repeat the test because it just couldn’t be true.
 

Since that time I’ve made an effort to be more proactive with my bolusing and to bolus prior to eating instead of after. It’s a little unnerving and out of my new comfort zone. It’s hard to get back into the habit of bolusing first.
 

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