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December 2nd, 2008
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I've gotten into the habit lately of bolusing for a meal more toward the middle or the end instead of before. It depends on a number of factors, including what and when I ate last, what I'm getting ready to eat, and what my pre-meal blood sugar is. This mid-meal bolus stems from several instances when I've either gone low or started to go low before I even finish eating. It's pretty unnerving to feel a low so close to a meal.

 

Like today, for example. I tested at 130 not long before we headed downstairs to eat lunch. Since there are few tables for the amount of people who typically choose to eat lunch in the lobby, I went ahead of the microwave-users to secure a place for the five of us.

 

While I waited, I nibbled on some cojack cheese. Negligible carbs, so I didn't bother with a bolus yet. Next I pulled out my fave chips: cheddar-flavored Sun Chips. I felt fine, but decided to wait to bolus until I started eating my sandwich. My colleagues gradually joined me and somewhere between hitting the bottom of the Sun Chips and opening my PB&J, I entered 130 on Toohey and bolused aggressively.

 

It wasn't long before the potential low symptoms started to creep in. Am I shaking, I wondered. Man, my skin feels sensitive right now. Am I talking too loudly? Can I walk to the elevator? Can I walk to the cafe for a regular soda? Damnit why didn't I bring my meter down here? Would anyone at this table not overreact if I ask them to get me some fast sugar? Why don't I have any instant sugar with me?

 

The symptoms didn't get any worse and actually somewhat subsided. I felt like I could get upstairs without incident. I sat down in my cube not much more than 45 minutes after I started eating and tested. I was 103, which made me think that I was adjusting to being "that low" after several days of battling highs from Aunt Flo. I quickly decided

that this was more than a mere adjustment and grabbed a handful of Skittles instead of riding things out to see if it got any worse.

 

I hate diabetes.



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You need to talk to your diabetes educator if you have one. I suspect you are overdoing it on the insulin at meal times. You should check your sugars before meals, then determine how much insulin you need based on that number and the amount of exercise you've had recently. Guessing is not a good idea.

However, since I'm not your doctor or your counselor you should talk to them. Good luck. Low blood sugar is scary.


As a family practice doctor and a diabetic I would say that as long as you eat carbs you wil be bouncing all over the place with your sugars. You will need much less insulin overall, much smaller boluses, and have much more predictable responses to your food if they don't have starches and sugars. You will also save the few beta cells you have left and let them continue to help you smooth things out if they aren't trying to help during all the crazy blood sugar swings.
There are lots of wonderful flavors in the many kinds of proteins, vegetables and all the different sauces we can eat.
P.S. You'll feel lots better and be more fun to be around, too.


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Michelle Kowalski
Michelle Kowalski, a writer, editor and photography hobbiest living in Phoenix, was diagnosed with Type 2 diabetes in February 2005. In January 2008, as part of her quest to start on an insulin pump, Michelle learned that she actually has type 1 diabetes. (Read More)

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Rebecca Abma
What happens when a health writer develops a chronic illness? As Rebecca K. Abma can tell you, it turns into an obsession. Since being diagnosed with type 2 diabetes in December 2003, 90 percent of her non-work computer time is spent researching the disease and chatting with fellow diabetics. (Read More)

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