Going to extremes Part II: Dealing with high blood sugars.
When we first think of high blood sugars, our mind instantly thinks of that post-meal spike.
That moment you that thought you calculated just right........ but then 2 hours later your meter magically reveals: 251 [insert indifferent face here].
We have all experienced this as Type 1’s. #ifeelyourpain
Apart from the obvious calculating (and miscalculating), are you aware of the two HUGE things working against us?
Insulin timing and amylin.
You and your friend just ordered some delicious cupcake’s from your favorite bakery.
You both sit down. She instantly bites into her gooey red velvet cupcake, and you guesstimate the 51 carbs, dose, and then indulge in your peanut butter chocolate cupcake.
Her body immediately releases insulin & amylin—both helping to keep blood sugars stable and minimize any spike.
As a Type 1 diabetic, you have neither of these hormones.
You are 100% dependent on your insulin dose and the perfect timing of when to dose -- It can take 15 minutes to start working, 60-90 minutes to peak, and 3-5 hours to finish working.
While insulin is the obvious (major) hormone we lack as Type 1’s, amylin may be something you are unaware of.
In reality, we can (and clearly do) live without amylin, but not having amylin is a huge factor on why our levels rise so quickly post-meal and why it’s extra important to take our doses at least 10 to 15 minutes before.
So what exactly is it?
“At the base of the pancreas is a cluster of cells called the islets of Langerhans and contained within those cells are the cells that constantly measure blood glucose levels and produce insulin as needed to keep blood sugar within a normal range. Along with insulin, beta cells secrete amylin, a hormone that, among other things, regulates the rate at which food digests.” (Gary Sheiner).
—Amylin’s primary purpose is to prevent blood sugar levels from spiking too high after a meal.
—It slows down the rate at which your stomach starts emptying digested food into the small intestine
—It decreases appetite by promoting a feeling of fullness, thereby reducing your food intake!
Personally, I feel like it takes SUPER long for me to actually feel full/satisfied when eating sometimes so this totally makes sense. Do you feel the same?
While it’s very frustrating not to have BOTH of these hormones most other’s have, we learn to adapt and dose accordingly.
Don’t feel defeated!
So, why are extreme high blood sugars a problem?
Faltered brain function.
Physical and Athletic abilities become diminished.
Retinopathy (eye problems).
Spike Control—Strategies to reduce the spike.
Timing—boluses given too late to match the entry of the sugars into the bloodstream will lead to hyperglycemia. Wait about 15-20 minutes before eating.
Bolus for the Basal—Reduce your basal to have more insulin working right after eating and less working several hours later.
Injectable Hormones—Symlin mimics amylin by blunting the post meal spike and reducing appetite.
Lower GI— Glycemic index refers to the speed in which food raises the blood sugar level. The lower the GI, the less likely you will spike!
Add some acidity— Acidity directly affects the rate of digestion (slows it down). “Research has shown that adding acidity in the form of vinegar can reduce one-hour post meal blood sugar rise by as much as 50%!” That’s crazy.
Split your Meal—Have a bit now, have a bit a few hours later.
Get moving— Avoid sitting for extending periods of time after eating. Go for a walk, do some chores. Try to schedule your active tasks for after meals!
The other extreme: Ketoacidosis (lack of working insulin).
Ketoacidosis is a serious condition that will make you violently ill and can kill you. Fully understanding the steps needed to address DKA is vital. If ketones are present, refer to page 246-249 in the book or visit HERE for helpful steps.
Some Possible Causes & Prevention:
Illness/Infection—trigger stress hormones making you more insulin resistant.
Dehydration—increase water intake when blood sugars are running high.
Lack of carbohydrates—extreme fasting or restricted carb intake.
Spoiled Insulin—exposing insulin to extreme heat or frozen insulin breaks down the molecules making them ineffective.
Poor Absorption—rotate sites to avoid breakdown or inflammation of fat tissue.
If you have unexplained, high blood sugars, checking for ketones may be needed.
“DKA causes more than 80% of hospital admissions for people with insulin dependent diabetes.”
Practicing preventative care, seeking out helpful information, and growing your knowledge in diabetes management is so so important—especially when it comes to getting better control of your blood sugars and living a healthier, happier life!