Stress, blood sugars and eye exams

Sometimes I wonder: Just how much does stress affect my blood sugar? I know there are a LOT of factors that can contribute to a rise or a fall, but this past Monday was a classic example of blood sugar madness at its best.  

I woke up with a respectable 5.8. YAY! That’s four days in a row that I was under 6 first thing in the morning. I had recently adjusted my basal levels because according to my Dexcom, I was experiencing night time highs. 

Wow, i’m good! I thought, patting myself on my back and congratulating myself for figuring out this whole diabetes thing. It’s only been 26 years but …. 

HAH! 

After getting dressed, I headed into the kitchen for breakfast. Glanced at my Dexcom app on my iPhone. What the heck? I muttered. An 8.8??????   It’s been five minutes…

Well, I guess that kind of made sense given what was happening this morning…

It was time for my semi-annual eye doctor’s appointment, and if you’re like me (or I think probably most people with diabetes), that’s one of the most stressful days on my calendar. 

I’ve had a series of weird eye things, including two retinal bleeds a few years ago, that apparently weren’t related to diabetes but to my aging eyeballs and a lifetime of short-sightedness. I have two cataracts, that are threatening to “bloom/blossom” maybe soon, probably not. I’ve had these now for about 8 years and every time I go to the opthalmologist, I assume he’s going to tell me that surgery is imminent. Or worse. 

By the time I get off the bus and arrive at the hospital, I have an alert on my iPhone telling me that my blood sugar is 15 and rising. Hmmm. I do a correction bolus. 

On Instagram last week, I posted a picture of my usual breakfast: two rice cakes, peanut butter and almond butter, fresh berries, half a banana, an almond milk latte. It’s the exact same thing, almost every day. I even travel with those rice cakes and packages of peanut butter when possible.  It’s 40g of carbs. 

And yet, as I noted, this breakfast (or maybe diabetes itself) should come with a warning that “results may vary”, because depending on the day, my mood, my mood, how I slept, the traffic driving in, or just about anything, my blood sugars mid-morning aren’t always the same.

Now, I know that probably part of the issue is that I can see my blood sugar every minute, every second of the day. In the old days, before I wore a CGM, I’d test my blood sugar when I woke up, do my bolus for breakfast, and move on. 

There’d be a test before lunch, a test mid-afternoon if I was working out or felt I needed to test, and then a test before dinner and before bedtime. Five — maybe six — maybe seven tests a day. But there were often several hour-long gaps between readings. 

In the old days, I wouldn’t actually know that my blood sugar was rising on the way to my doctor’s appointment, or during a particularly stressful day at work. 

But I also wouldn’t know that my blood sugar was plummeting while exercising or in the middle of the night, or…

So, do I miss those pre-CGM days? Not really. I think my CGM is the one diabetes “technology” that I couldn’t live without even if lately, I find I’m not actually looking at my CGM app every minute of the day. I sometimes (what???) forget to look at it for several hours. I consider this progress, and a sense that I’m trusting the technology to actually alarm me if needed.

But I do love knowing my blood sugar at a glance. I also know that some days, seeing the upward arrow and that level depicted as a golden orb, makes me more stressful. Ten minutes later, with drops in my eyes waiting for the exam, I squint at my iPhone and see a 16.2.

I force myself not to “rage bolus” (giving myself unit after unit until I see a downward arrow. Not a great idea, I remind myself. It never ends well since it’s followed by a plunging low. But let’s save that topic for another day, shall we?) 

As for the eye doctor appointment? I read the numbers on the chart. I peered into the nifty high-tech machine as air was spritzed into my eyeballs, to test the pressure. I stared at the bright light of the exam “wand” as it pierced my vision. I tried not to blink, as instructed. 

“So?” I asked, quietly. Nervously. 

“Your cataracts are mild; they’re not ready to go yet. Other than that, you’re all good.” 

“Really?” 

“Yes, really. See you in six months.” 

I walked the short jaunt back to my office. My blood sugar, when I arrived at my desk, was right back in range. 

(Please remember, I’m not a doctor or an educator. Just a person who has had type 1 diabetes for the past 26 years. Please follow me on instagram at @grownupdiabetes.) 

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