Don't Worry, Be Spiky

Sharing blood glucose graphs, A1c results, time in range and general day to day T1D information has been the subject of debate for a little while, now. Perhaps since CGMs and Flash Glucose Monitors began to be more widely used in the social media communities. I'm fine with that, as I've mentioned several times before. I think it's great to see the shared information and, to some extent, the info published by others has helped my Diabetes management.

I understand that some information can worry or even trigger others into feeling inadequate or guilty. It might even bring about feelings of envy or that you're not doing enough. I use technology to monitor my blood glucose but I also use insulin pens to inject my basals and boluses. Sometimes, I'm envious about others who talk about their pump and how it has reduced their burden and improved their management. Furthermore, I sometimes feel envious of others who mention Looping alongside the obligatory #WeAreNotWaiting hashtag. A little voice in my head chirps away for a few seconds; "I'd like to try that"  But getting access to a pump, learning to Loop, etc is not as simple as sending an email or demanding it from my consultant. Could I do more? am I damaging myself by not kicking up a stink and manipulating my HCPs to prescribe the latest in pump tech to me. 

Why others, not me? 

That's why I understand the negative feelings of some when they see shared information. I also understand that I cannot stop others from sharing their own information on their own social media accounts. So, for me, it's a question of skipping on by the tweets or posts which might cause me to feel negatively and moving to the next ones. I recommend that course of action if you struggle with the shared information of others.

And on we go to the main course of this blog. Firstly, let me just confirm that I have full permission to share the graphs you'll see below. Secondly, as you may have already guessed, I'm about to share some blood glucose graphs. If you're uncomfortable with that then thanks for reading until this point, please drop by again soon to read another blog post.

Before you see any graphs, allow me to explain why I'm sharing them and who they're from.

They're not mine. I'd love it if they were! They're from somebody who is learning about T1D and how blood glucose reacts, an HCP who does not have Diabetes. Their sensors were not destined for NHS patients or anybody living with Diabetes. I'm sharing these graphs because I think that I'm sometimes guilty of over-worrying about my own blood glucose. I suspect we all are at some point. In addition, I think some people "live on the edge" when it comes to blood glucose and have frequent hypos because of the fear of "going high". Whatever "high" might be! It's a personal thing from Diabetic to Diabetic.

Comfortable? Then let us begin.

Remember, this is a graph from a person who does not have Diabetes. It looks like lunch increased their BG from 6 to 9mmol/l before a steady decline over the next hour or two. Later on, look at that rocket ship! That was caused by a milkshake and it looks very similar to how my BG reacts to something sweet and carby, my Type 1 Diabetes BG. That number and that arrow might cause me to worry that I've miscalculated my bolus. I'm heading into double figures, rapidly and need to react. Usually, I will and the inevitable hypo appears on the horizon because I didn't need to do that.

The Non-D blood glucose eventually dropped and, assuming my bolus was correct, so would mine. Insulin, home-made or otherwise, does usually work. 

It seems clear to me that we're not designed to have a flat-line blood glucose. It doesn't need to be between 4 and 5 mmol/l, 24hrs a day. As a Type 1 Diabetic, it seems to me that being in that zone frequently is asking for many, many hypos. It's right on the cusp of the hypo zone. One small miscalculation, 5 minutes more physical exertion, forgetfulness, etc and you're treating a low. We're told to avoid high blood glucose because it increases the chances of complications but what about frequent lows? The brain needs glucose to function properly. If you're tip-toeing on the hypo line a lot then are you increasing your chances of complications of a different kind?

I'm curious as to the answer but I'd rather not discover that personally.

How about another one?

I'm getting graph envy... Anyway! A steady 6 mmol/l again with little spikes following breakfast and lunch. Totally normal stuff. No flat line at 5mmol/l because this person eats, works, exercises and lives a busy life, as most of us do.

I've got more.

Would that graph worry you? It's the same person. You might describe that as "Spiky" or "Yo-Yoing". Yet they're just sleeping, waking up, eating, working. All the while their lovely organic insulin is working away, keeping things as steady as possible. Just as we do with T1D. 

Last one

I'm not sure what is happening here only that this person's BG is trying to draw a cat. Or a bunny!? But there is proof that a person who does not have T1D can sometimes spike outside of the preferred range, briefly.

Let me be clear, I'm not advocating for complacency when it comes to managing blood glucose spikes. Keeping things in the Happy Zone is important but what I have learned from seeing these graphs is that it's normal to see your BG increase sometimes, particularly after a sugary meal or snack. I've learned that I don't always need to react immediately to a jump up in numbers if I have insulin on board. Finally, living on the edge of a hypo is not living and might possibly be damaging to my health.

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