I’m ashamed that I spent so much of my life ignorantly thinking that diabetes was some nuisance like heartburn where you moderate what you eat and maybe take some medication, rather than the endless grind of counting units and risking your life every time you need to eat, or exercise, or sleep.
I can’t imagine living like that, and I’m so, so sorry to you and to everyone else that has no choice. A cure for cancer is often held up as the holy grail of medicine, but even cancer patients don’t have to be perfect every day just to keep living.
The scary part is potentially getting caught out somewhere entirely alone and without an emergency snack.
So she had a low in the middle of the night, in the middle of nowhere. She was still verbal, but barely, and sent me to get her some snacks out of the bear canisters. However I didn't know where she'd hid them. After looking in the dark for a while I had to go back to the tent and try to get enough of an explanation out of her to find the hidden canisters. Fortunately she was abele to give me enough context that I was able to find the canisters and get her something to eat.
After that, I kept my own hidden stash of snacks in the tent and make sure she told me where the canisters were.
First thing I do every morning is A) put on pants B) put my keys and a tube of glucose tablets in my front pants pocket.
You can probably guess the expensive way that became ritual.
I’m a Type 1 diabetic (diagnosed in my 30s) and have been living with it for about a decade now. This really isn’t a “what if” situation. I know what will happen. I will die or hopefully just become incredibly ill.
It’s not really scary at all.
It’s just something I live with and prepare for as best I can. The one thing that I’ve learned from living with Type 1 is that all you can do is make the best decision you can in any given moment. My favorite doctor told me that diabetes is a disease that is all about making decisions. So is life, I guess.
"Identifying most people with T1D continue to secrete varying amounts of insulin and C-peptides for decades after initial diagnosis:
https://www.healthline.com/diabetesmine/dr-faustmans-controv...
See below for my deeper response on these and other issues:
It takes a genetic predisposition and a trigger - perhaps a virus? - for your immune system to start eating your pancreas' insulin-producing cells.
The old labels of "juvenile diabetes" etc. are as unhelpful as the notion it's caused by obesity.
I guess this is somewhat similar. Especially in places where your health insurance isn't a given.
I did, got him some OJ, and moved his car out of traffic. He went from incoherent and “drunk” to “seemed pretty OK” in just a couple of minutes before the medics even arrived. (He still took the ride, but it was none of my business at that point.)
I once walked home from work and apperantly didn't notice it, walked a few busy intersections and finally sat down somewhere where someone noticed me and called an ambulance who game me a glucose iv and everything was back to normal in a few minutes. So everything was still somewhat working and the "go home" signal was set but everything else was broken. Not everyone responds the same though and concerning cars I have at least some dextrose with me at all times and some in the car as well, as well as hidden at work and at home and in all my coats and backpacks and everywhere... OJ works quite well since it is readily available.
They did teach my parents one thing when handeling people with hypoglycemia: never try to stop them from consuming your entire fridge. Motor control is lacking and a young adult can easilly hurt you badly if you try to intervene.
The glass half-empty is...
I'd be much happier if I actually had an information device that I wore on my wrist that gave me all the data I need to manage T1D at a glance without igniting arguably the worst alert fatigue ever seen in healthcare when I have a smartphone, a pump, a CGM, and a watch which all go off in a discordant concert with one another with no clue that the other is alerting or any mechanism for stopping the noise save for turning off the device. In short, my wish is that the companies making these devices would give more care to the _design_ of the ecosystem around them, not just their individual device. I know, this is an emergent problem, but one that I've dealt with nightly at 3 AM when the devices go awry, not my diabetes, which is actually quite stable. The vast majority of my disease control and management issues arise from technology. Like insulin, it's the exogenous nature of the device that indicates there will be side effects, whether we design for them and manage them, or not. Unfortunately, patients pay with their user experience, all day, every day. There is no greater use case for the design of a killer app for the smart watch, i.e. wrist-worn information device, because I don't actually care what time it is. Rather, I'd be happy if the device actually made BG and related information the primary data currency of the device, not time. Time is actually secondary to the primacy of BG in this particular use case. I wear two watches to account for the fact that I need BG at a glance and the sensors for tracking exercise and metabolic impact. I've not seen a single device or interface that gives me what I want on one device at a glance without a byzantine UI.
https://i.imgur.com/Iv6V3ap.jpg
Date, time, glucose graph, steps, pulse, time from last value, last glucose value, delta from previous value, current pump basal rate and units of insulin from the base.
More than enough to understand your current situation. Battery life after few years of use about three days.
- mis-calibrate (first day's readings are garbage after new sensor insert)
- UI on the app will sometimes mis-render by 10-15 minutes. On several occasions I have been watching the graph while dosing, didn't see any change whatsoever after 30/45 minutes, and gave more insulin because of that information. 5 seconds later the screen changes and displays 15 minutes of BG going steeply down as I would expect, but now I have 2x the dose in me -_-
While I'm swimming in sensor readings the actual impact on my treatment quality has been close to nil, but it does make the people around me feel better. I feel as if my ability to sense my own levels has worsened because I default to trusting the graph over how I feel.
If my body wouldn't dislike those I would agree. But my experience is after about a day the results get so mixed up and unreliable that it's pretty much worthless. Hopefully they get better over time.
A bizarre phenomenon: feeling stuffed because you ate a huge meal, but having a hypo anyway. You don't want to eat anything because you're not hungry, but feel an overwhelming urge to stuff your face with sweets anyway.
I've been told that it can come on more suddenly and acutely for cyclists. As a marathoner I find that I feel it coming for several miles, which is tens of minutes. The activities are somewhat different so it's not impossible that they manifest differently.
But the basic idea is similar. You've got so much readily available glycogen in the body, and when it runs out, you have to shift to a different metabolic pathway -- and your body starts sending up warnings that you are rapidly running out of reserves and must stop now.
It's as much mental as physical at that point.
Unmanaged heartburn can lead to esophageal cancer, you shouldn't take it too lightly.
Frankly, I think depending on other people is a liability. I can't count on my hands how many times I've had to explain to people that you don't give an unconsious diabetic insulin, you call an ambulance and follow the instructions you're given. I just don't trust the average person enough to burden them with the responsibility.
The only people I would trust to look after my unconsious body during a severe hypo are medical professionals - and there are medical professionals that I still wouldn't trust!
Yes, the maths is unavoidable. Diabetes burnout is real. But if you've it had for nearly 3 decades, like I have, then you learn coping strategies. My advice is to spend some time finding a specialist who listens and answers questions. Use the devices available to you and learn them well. Don't make changes to your insulin regimen when you're angry or hypo. Most importantly, don't strive for unattainable perfection.
Here's the instruction to the people I know I will be spending longer stretches of time with: When I look very tired, disoriented, or talk incoherently: fetch orange juice or some other sugary drink. Make sure I drink it. When you find me unconscious: roll me on the side, call an ambulance. You can put sugar under my tongue but do keep watching me. If you feel confident, apply the syringe from the orange box in the fridge.
Thankfully, none of this has played out so far. Except that I had to rely on friends a few times when my sugar ran out. That's already plenty scary.
Sure I bounced back and got a CGM, but only because I could afford one. I was terrified of going to sleep at night without a handful of alarms set to wake me.
Isn't that the case even if you have someone sleeping beside you? I suppose it mitigate some risk on the off chance that your partner wakes up and notices you're sweating or whatever, but what if they're sound asleep? Does someone who's high/low on blood sugar exhibit symptoms that are easily picked up by a sleeping person?
Most diabetics have CGMs these days, though, and somebody like that should be setting hypo / hyper alarms so that either them or their partner wakes up.
(The problem there becomes false alarms and the subsequent alarm fatigue that results in you turning them all off.)
CGMs are available over-the-counter, just like finger stick machines, in a variety of countries like Canada and Ireland. But in the United States a prescription is required for any CGM even if insurance doesn't pay for it and insurance generally only pays for it once you are actively on full-time insulin treatment, so type-2 diabetics can't avail of insurance to reduce the cost of potentially not needing to go on recurring insulin by getting a handle on being pre-diabetic. (Plus many doctors won't write a CGM Rx for someone who isn't type-1 or very symptomatic type-2. This has resulted in nutritionist businesses springing up whose purpose is to turn a credit card charge into a prescription for a CGM.)
But of course different countries have different regulatory systems, we all know that. This is to say that even when you find a system and method that has worked for others in your online community, that method might not be available to you, and it causes even more stress to have the idea, right or wrong, that a useful tool is just out of your grasp. And carbohydrates help you if you dare move between countries.
Here in Europe we can simply get them from Abbot/Dexcom an ship them.
I can't make any promises, but I'm positive that I'll be able to develop a product that takes care of finding the correct insulin doses when giving activity and CGM data + meal information withing the next year's.
Only for under 21s, and only recently. Once you hit 21, the rug is pulled out from under you.
https://www.cbc.ca/news/canada/edmonton/glucose-monitoring-d...
Granted this was 4 years ago, so I'm unsure how things have changed. The CGM is a game changer. I wish I had had it earlier. Would have kept me (hopefully) from a lot of issues and putting my friends and family through unnecessary pain.
My wife has a Tandem T:Slim and Dexcom G6 and she can't turn off the urgent low alarm. The alarms drive her totally crazy.
Though I'm happy to know at least the system will disable her basal rate if she's heading low.
Wow. There is no need to dismiss the plight of cancer patients in relation to that of diabetes patients.
As a diabetic, if you go through the (granted, horrible) grind, you can be fairly certain you'll live for quite some time.
If you are a cancer patient, even if you are currently in remission or even 'cured', you don't know if the cancer will come back. And if it will respond to the same treatment and if not if there is an alternative. Your survival timeline basically becomes one giant question mark.
What I read in that comment about "being perfect every day" -- and what I notice about having T1D compared to the awful experiences of family w/ cancer -- is the distinction b/w experiencing suffering caused by some terrible external force (cancer) vs experiencing suffering that can be interpreted as caused by yourself. Or suffering for which it's always easy to partially judge yourself.
The reason this post (notice even the 'defensiveness' in its title) resonates so much w/ those w/ T1D is because this condition presents one with non-stop, 24/7 complicated problems to solve w/ serious consequences...and yet, any time something goes wrong, it still feels like it's kinda your fault. Like you made a mistake.
That is a non-stop mental grind that is unique to T1D and a small set of diseases. The uniqueness certainly does not make cancer less awful.
I had cancer, it was shit, and yes, there's always a chance its not done with me, but at least the cause of death won't be "finally forgot a snack".
> what if I start to go low during this meeting? should I pop some carbs and run high for this interview, so I don't risk a hypo partway through?
Love this part. Had to do it literally yesterday to prep for interviewing a job applicant. Imagine the stress of an upcoming meeting, but also your brain might stop functioning half an hour into it! Ha ha! Good times.
> Love this part. Had to do it literally yesterday to prep for interviewing a job applicant. Imagine the stress of an upcoming meeting, but also your brain might stop functioning half an hour into it! Ha ha! Good times.
Haha, yeah, this is one of those things that every T1D has had to do at some point, that non diabetics would probably be shocked by. There are just times when you can't risk going low. Going high ain't great, but it at least doesn't involve the immediate danger that a hypo at just the wrong moment does...
On that note, feel free to send me an email if you want. Or not, no pressure. (I would've sent you one, but your profile is empty :) )
If it helps (?), I also broke down crying reading this, because I have MS and it is so true to my experience. I've never been able to communicate well how exhausting the constant mental load is, and I imagine it's even worse for people with T1 diabetes since blood glucose can get out of whack a lot more quickly than my immune system can make more holes in my nervous system.
You nailed it on the head exactly with the constant balancing.
"Okay, so I didn't sleep for crap last night due to symptoms. Do I have some caffeine and spend the rest of the day in pain due to the increased muscle spasticity? Maybe if I have 3 cups of coffee instead of 1 and also take some of my muscle spasticity medication, I'll be able to stay awake but not be in too much pain. Except if I dip into what are supposed to be nighttime pain meds too often, I might run out of Tizanidine. When will my insurance refill? How much will it cost out of pocket when I have a bad pain month?"
And then I get stressed out about the MS, and we're supposed to avoid stress, so then I stress about my stress. Fantastic.
And all until the day we die.
Try new and improved META-stress: all the worrying and none of those pesky resolutions or good things!
If anyone reading this struggles with gastroparesis I'd love to chat about diet choices that have worked for me. Contact info in my profile.
1) https://www.mayoclinic.org/diseases-conditions/gastroparesis....
To be honest, i don't do the math. I choose the amount of units to inject by feel. I mean, i know by eating a banana, i get something like 20g of carbohydrates, and i should take 3u. But if i feel, that the correct dose is 6 units, then i take that.
I cant really explain it. But i kind of feel the state, where i am going, and can adjust instinctively. Works more often than not. I have never passed out.
Edit:
I measure blood sugar A LOT, though.
Most important things are what i think as the Morning Gate, and the Night Gate.
For Night, must have blood sugar under 10mmol/l. Preferably without pending effects such as food or recent injection. If i get that right, the night blood sugar is steady.
In the morning, must account for the morning blood sugar raise phenomenon.
You eventually gain an instinct for it. Doesn't always work, but for me it works better than the formulas...
That is the most important part, you can really live a good life if you have that. I hope we get more powerfull and cheap way to do that continously. At the momemnt it's at least 300 USD a month for a CGM device that can measure every five minutes. It's abit like monitoring traffic load and adding more servers as you go, except too many servers kill you.
That with knowing how you react to changes in life works wonders, e.g. exercise, eating fat foods, sitting all day.
About devices.. The first Glucose-test-device (what are they even called in english) took 5min to process the results. Current one is 5sec. A massive improvement in both speed and accuracy in these things.
I hope a good non-invasive device is developed, though i'm not sure it is essential, for me anyways.
Not even just that, but with fairly primitive monitoring tools. The built-in stuff for Dexcom can only alert on highs or lows, not on things like the rate of change, which would be much more useful IMHO.
(When looking at the app, there are "trend arrows," also, but they unfortunately are misleading in some situations. Often looking at the data points can give you a sense of your situation, though.)
The official one from Dexcom is not very good.
Even with import taxes/tariffs applied, I could imagine a vacation to Europe being massively subsidized by just bringing back one or two years of GCM supplies (obviously Vimes theory of socioeconomic unfairness[1] applies).
[1] https://www.goodreads.com/quotes/72745-the-reason-that-the-r...
Dexcom is the only one accurate enough to use with SMB looping. And the only one in germany that sends the glucose numbers to your phone with BLE. Libre 2 can be hacked to do the same though.
However, I was under the impression that the GP [emj] was "only" considering good monitoring to improve their decision about insulin application. Not a closed loop system. But yeah, if they meant a closed loop and if the Dexcom is the cheapest option here, then the 300 US$/month is actually cheaper than the 380 US$/month you outlined.
Also 30 years here. I have exactly the same thing as you describe though when I switch insulin I do start calculating again to be sure it matches with my assumptions. Blood glucose measuring is required though as you mention. I'm one of the lucky ones with very lineair and predictable response to every unit more or less of insulin. Not everyone is that lucky though.
The picture of you and your son in that hospital bed broke me. You're doing great.
T1 here too. The weird part about this, is that it happens while you are aware of it.
My brain: "hey, you're doing it again. stop it. You know it'll end bad". my hand: "nope. here's more cookies".
It's the real life experience of this Frog and Toad meme: https://i.imgur.com/YdSSscE.png
Of course being able to even afford this in the US requires a certain level of privilege. Supplies are very expensive.
(causes your liver to release its glucose)
It’s sort of in a testing phase…
I used to think that if you control all the parameters, then you can control diabetes. Thinking in this way is incorrect, and my lack of understanding caused a bunch of arguments between me and my sister. I wanted her blood sugars to be better, and assumed her bad blood sugar days were caused by poor control. They weren't, and quite honestly, only God knows the real cause.
I was pretty ignorant about what I didn't know. My sister is 32 now, and I feel like she's got a very good handle on her condition in the last decade or so. It is a continual struggle, but I'm proud of the fact that she now has mostly good days, with the occasional bad day here and there.
https://www.clinicaltrialsarena.com/analysis/vertex-stem-cel...
It's a stem cell therapy, in human trials (not the usual "in mice" crap).
A single patient already had their diabetes disappear: https://www.fiercebiotech.com/biotech/vertex-diabetes-cell-t...
The downside of stemcell therapy is that it is essentially an organ transplant, aka requires immunosuppressants, for life.
That being said, every decade has seen life-changing therapies introduced. The introduction of long-lasting insulins. At home testing for glucose and ketones in urine. Mixing insulin formulations together to reduce the number of injections at a time. Thinner needles greatly reduced pain from injections (this one happened almost every year.) Moving from urine tests to blood glucose tests! Introducing shorter-acting insulins that reduce onset time. GLUCOMETERS! Moving from needles to pens allowed crazy-simple and virtually painless injections. Moving from pork formulations to human formulations of insulin. Carb counting: previously we used fixed diet - eat the same thing at the same time every freaking day. INSULIN PUMPS!!! Crazy fast-acting insulin formulations cutting onset down to 15 minutes. CONTINUOUS GLUCOSE MONITORING!!! Tracking and alerting for low glucose, overnight and remote. CUSTOM-BUILT CLOSED LOOPING!!! Reliable/medical grade CGM. Approved closed looping systems.
Many folks have worked very hard to make my life more livable, and I thank them for it. Today is, without a doubt, the best time to be a diabetic.
That being said, I still wouldn't recommend it;)
So think disruptive tech. A new player comes into the market with something that obsoletes the old tech, and maybe destroys a whole market. But that new player makes their own money off it.
So yeah, maybe Tandem, Dexcom and Medtronic don't have a big incentive. But someone else can make some real money if they can find a cure or novel treatment that obsoletes all those others things.
Edit: On the 42 factors, during-sleep BG is either stable or up. For me it's either side or down (but occasionally up).
I do have the 'pre-sleep' BG that usually goes down, right after brushing my teeth (is it post-brushing then?), which is a well-known factor on Reddit. Basically, doesn't matter if I'm going to sleep at 10pm or 1am. I check my BG, it's 8, arrow straight or even up (CGM indicates the trend). Brush my teeth and check again, 7 with arrow straight down to the floor :/
The primary problem with those types of treatments is you have to be on immunosuppressants, or the immune system just kills the cells again. That type of treatment is typically not recommended unless the patient is already on immunosuppressants, or has extreme hypoglycemia unawareness, or extreme needle phobia. Immunosuppressants are typically considered a worse outcome than properly treating T1D with insulin + CGM.
For the same reason, sometimes T1D's will get a pancreas transplant if they are also getting another required transplant that will require immunosuppressants.
I think the best hope in the next 50-100 years or so is continued development and improvement of closed loop systems. Eventually we should get to a point where highly sophisticated closed loop artificial pancreases can automate much of the process away. This will improve treatment and long term health outcomes, but will still require a fairly significant level of maintenance and oversight on the part of the patient (or their parent). There's a lot of really promising work being done there.
If you have the knowledge, I can highly recommend doing some research and try looping. I've been doing it now for three years. Time in range is about 92%, A1c always 5.8-6.0%. 80% of the stress is gone. Life is better.
But, it's not accepted therapy and you have to do lots of research to learn how to use the systems. For me it has worked like nothing else. I got my life back after 21 years of suffering with T1D.
I thought pump implants already did that, what's missing?
Closed loop artificial pancreases are the future, but they will still require a large amount of attention and management by the patient.
My friend got a new high-end closed loop system, and it's so much better than the previous pump. There's still a long way to go before it's truly an artificial pancreas, but my friend already has much higher quality of life, and the tech is still improving.
You should get most of your calories from olive oil and nuts.
Protein intake should be just as much as you need. Excess protein causes blood glucose instability.
Carbohydrate intake should be as low as possible.
Here is a sketch of a ketogenic diet that works long-term:
- 2 eggs over medium with 4 tablespoons of olive oil
- walnuts/almonds/pecans with a little cheese
- hazelnuts, peanuts, macadamias for hunger
- a little chia seed (2 tablespoons)
- salad with avocado (14g of fat) and 9 tablespoons of olive oil, with vinegar
Get a lot of salt. Take a multivitamin and fish oil capsules.
Once a week, eat a burger with no bun. Cheese and meat. This should be eaten after hard exercise (e.g., a hike). You might eat other cheat foods (e.g., seafood, steak) but avoid carbohydrates.
Tell us, how long have you been diabetic?
Anecdotally, I have maintained a HbA1c below 5 for more than 20 years using small variations on the ketogenic diet described above. I need just 6 units of Humalog (short-acting) and 16 units of Lantus (long-acting) per day. It makes diabetes very, very easy to manage.
If anyone reading this is tired of struggling with diabetes, please consider adopting a ketogenic diet.
Consult with a physician!
Even if keto "isn't for everybody" (and KetoType1 should have put a disclaimer), I'd certainly much rather take advice from someone with skin in the game.
I've posted a pretty good link below from a respected source if you don't believe what I wrote and whether or not I have diabetes type 1 is not relevant.
I personally have friends who manage Type 1 & 2 diabetes with little-to-no insulin on Keto, and I'd hate to see people being turned away from at least researching a lifestyle that could significantly benefit them because a well-respected member of the community said it was "dangerous" (and often, deferring to doctors can be not helpful for reasons mentioned above - I wish people would at least research for themselves).
Telling people to research a lifestyle is completely different than providing ready made recipes paired with unqualified statements based on a sample of '1'.
At the same time, I do encourage people to take charge of their own health, and to make calculated and appropriate risks. My primary concern was people only reading your name, the word "dangerous", and being put off from further research about keto in general because of that. Some physicians used to recommend rice- and grain-heavy diets for diabetes, so some healthy skepticism (EDIT: in the "trust, but verify" sense) is warranted, even towards one's doctor.
That's fair, but for all you know OP is making stuff up, has been misdiagnosed and 50 other things that could be true that would make their well intentioned unqualified advice utterly irrelevant and dangerous to boot.
Just like you shouldn't take legal advice from ACs on the internet you shouldn't take medical advice from them either, especially when they're novelty accounts promoting diets that have been used to 'cure' everything from cancer to epilepsy, Alzheimers and TBC. Extreme skepticism is warranted there. As for your doctor: assuming they're a diabetes specialist: you should put your faith in them, and if you don't trust them then you should go find yourself another doctor, not start taking randos advice.
Obviously it isn't a one size fits all approach, and the above poster could have been a bit more diplomatic, but IMHO it is worth discussing treatments that have been demonstrated to work.
This is an overstatement, to put it mildly, at best you can say that it works for you and for those for whom it also worked after they have put it to the test. But it does not work for everybody and you shouldn't make unqualified statements like that.
Here is a much better (and much better qualified) picture:
https://www.healthline.com/nutrition/keto-diet-diabetes-type...
One important thing to point out is that you can't reverse T1D with keto, like some people are able to with T2D. It can greatly reduce your insulin requirements, but not to zero. Your pancreas will not return to normal function.
It's actually pretty easy to get used to a keto diet. Initially you might crave a lot of food items that you were used to eating, but eventually you stop missing them. I don't feel like I'm missing out on anything when I'm having some aged cheese and roasted nuts as a snack (which replaced eating cookies or chips for me). It is a little bit more expensive though.
As for drinks, eliminating fruit juices and opting for the 'light' or 'zero' variant as a drop-in replacement if you want something sweet is pretty easy.
https://www.tandemdiabetes.com/products/t-slim-x2-insulin-pu...
The pump delivers insulin and gets blood glucose readings from a CGM (continuous glucose monitor) over bluetooth. Then the pump can make decisions such as stopping insulin delivery if you're going to go low, doing small correction boluses, and adjusting basal rate.
However it's far from perfect and still needs a lot of management. My wife has T1D and was recently pregnant, which really raises the bar on how tightly you need to control your diabetes. She ended up mostly micromanaging it all herself rather than trusting Control IQ to do the right thing.
The other issue is CGMs are not that accurate, so these systems are making decisions based on not great data.
https://www.diabetes.org.uk/guide-to-diabetes/diabetes-techn...
"Diet" might even be the wrong word, more like a lifestyle.
Skip carbs altogether?
Not really. The majority of diabetics get used to those things quickly (of course there are some of course that deal with a major major needle phobia that can make it even harder). The hard part is that it never ends. Almost every moment of every day, your brain has a background process running that's evaluating every decision in context of your diabetes. There are no breaks. Your prefrontal cortex now has to take the place of a previously complex and automatic bodily process. It's the last thing you think about when you go to bed and it's the first thing you think about when you wake up. It's what you think about when you want to go on a walk, are about to enter a meeting, go into an interview, get on a plane, take a shower.
It's usually little things: "okay, where am I at now? which direction is it going? when did I last eat? do I have snacks ready? do I have enough insulin for the day? what if I start to go low during this meeting? should I pop some carbs and run high for this interview, so I don't risk a hypo partway through? why am I going low right now when I took the same dose I took yesterday for the same meal? why am I now skyrocketing for no discernible reason, I didn't even eat anything? shoot, I'm starting to hypo out of nowhere in the middle of this great conversation, which I now have to interrupt to eat a snack and recover for 15 minutes. I fell asleep with a perfect BG, but now I'm awake at 2AM half delirious because my BG fell all the way down to 50, and I'm in the kitchen shoving cookies down my throat because hypoglycemia activates a survival instinct to EAT EVERYTHING that's extremely hard to control, and I know that I'm gonna shoot all the way up to 250 shortly, which I'll have to treat with insulin, and I'm basically not going to get any sleep tonight".
And then the math often doesn't make any sense. There are so many factors that effect it. One day the same number of carbs + insulin may make you go high, and the next low, because of other environmental factors. (See the "42 factors that effect blood glucose" chart in the post.) You're constantly having to adjust.
I'm literally crying while writing this post, because it's so exhausting and it never ends.