It seems to be that time of year where it is in the air. No, I’m not talking about fall or pumpkin spice…it seems to be the season for diabetes burn out. Recently, many of my fellow bloggers have been describing their experience with diabetes burn out (check out Mindy’s post and Frank’s post). Because of school, stress, anxiety, blood sugar roller coasters, and dealing with diabetes in general, I have been feeling burnt out too.
Let’s start with the good news first: I FINALLY started my senior year! Yay! Now the not so good news…unfortunately, the stress and anxiety of school has made my diabetes management much more difficult and my blood sugar has been all over the place.
One day the other week, I ate lunch (my blood sugar was in the 120s before eating) and went to class. While sitting in class, my blood sugar spiked into the 300s. I honestly don’t even really remember much of what happened or was said in class that day. I know the topic was endocrine that day, so at least I understand the diabetes portion well enough!
After class that day, I had a panic attack in my car. I received a phone call from my endocrinologist office telling me that my insurance company won’t cover my Humalog and that I will need to switch to Novolog. This has happened in the past, but after sending in a prior authorization request, I was still able to receive Humalog. Apparently, this time is different, and the insurance company is forcing me to switch to Novolog at least to see if there are issues in how my blood sugar is affected. But for now they will only prescribe me the Flexpens, which administer whole units. While I am trialing Novolog, I won’t be able to administer my insulin in half units. This may not seem like a big deal, but my body is sensitive enough to the insulin that half units actually make a big difference in my blood sugar control. Thanks insurance company for putting me through much more unnecessary stress, emotional upset, and crazy blood sugar roller coasters! Perfect timing while I try to juggle all the commitments I have with school!
This past week I had more blood sugar issues. Monday night after eating my snack I spiked into the 300s. I had planned to go to bed around 1 am and get a good amount of sleep, but diabetes had other plans of course. I saw my blood sugar trending upward on my Dexcom (continuous glucose monitor) and knew that as soon as I climbed into bed, I would hit 300 and have to get back up. So what did I do from 1:30-2:30 in the morning when all I really wanted to do was sleep? I walked on the treadmill for an hour. Needless to say, I didn’t feel that great and was exhausted Tuesday. Tuesday night I had the opposite issue; my blood sugar was low.
Last night/this morning I had more issues. I was borderline low (in the low 70s) but trending downward overnight so I treated with some orange juice. I woke up with a blood sugar of 287. Once I ate breakfast, I climbed into the 300s yet again.
I didn’t have the energy today to walk on the treadmill or do anything other than lay on the couch to sleep and wait for the insulin to begin bringing my blood sugar down. Usually I don’t like to sleep when my blood sugar is that high, but I have just been so frustrated, exhausted, and burnt out lately, I didn’t really care. I just wanted to sleep! For most of today, I have felt completely worn out and my head has felt like I am in a fog.
Diabetes Care, a journal published by the American Diabetes Association, had an interesting article about the effect of stress on blood sugar. This study found that in type 1 diabetics, the effects of acute psychological stress on glucose depends on whether the mental stress happened following food intake or while fasting. They found mental stress after eating caused increased glucose about 30 minutes after being exposed to the stressor and lasted about 2 hours. This would explain why my blood sugar spiked during class the other week; I ate, felt anxious/stressed right before and during class, and then my blood sugar went up.
The study also states that chronic psychological stress has been associated with higher A1C levels. According to my Dexcom reports, which show an estimated A1C, the past few weeks since I started school my A1C has creeped back up to 7.5%. At my last endocrinologist appointment in early August before classes started, my A1C was 6.6%.
I really hope that this season of diabetes burn out is a short one. I am so tired of feeling frustrated and exhausted and of diabetes interfering with my schoolwork. I hope that I can get my blood sugars in a more normal range soon!