February 2008

How to Recover From "Highs"

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Just take insulin!

If the above advice is all you need to get back into equilibrium after a high blood sugar, then your body is much more obliging than mine. A "High", or "hyperglycemia" for the armchair endocrinologists out there, has less significant short-term effects than going low, but for me a high is harder to recover from. Doing the following when I go high helps me get back to my normal range while avoiding too many dose corrections and limiting my blood sugar's volatility.

Do a blood test as soon as you think your BGL might be high
Since going high usually isn't quite as obvious as being low, it is easy to ignore the warning signs and delay doing a test. (If you need a refresher of the warning signs, they include: excessive thirst, frequent urination, dry-mouth, a metallic taste in your mouth, and fatigue) I have found that if I catch a high early on, it is easier to correct and I have shorter, less severe side-effects.

Correct with an insulin dose ASAP
Sure, you most likely aren't going to have a major medical situation if you don't correct your BGL immediately. But the longer you are high, the greater the negative impact on your kidneys, circulation, and eyesight.

Drink a big glass of water
This is such a simple thing to do, and yet over the years I've noticed that it helps *a lot*. Hyperglycemia is exacerbated by dehydration, which in English translates into "drinking this water will help your blood sugar drop." Also, you're probably thirsty anyways, so enjoy.

Test an hour later, and correct again if you haven't reached your target
If you test before this point, your short-acting insulin may still be taking effect, and it is easy to over-correct. After an hour, test, and take more insulin if you're still above your desired BGL. Plus, this test will show your endocrinologist that not only are you back in range, but you are taking good control of your diabetes.

Taking these steps will help you get your blood sugar back to where you want it to be quickly, easily, and safely. You'll be feeling better sooner, your organs will sustain less long-term damage, and both you and your Endo can sleep easy.
One of the biggest challenges facing us in our lifetimes as diabetics is how we include our loved ones in our journey with this disease. Like it or not, the genetic anomaly that resulted in us developing this chronic condition had an indelible impact on not just our lives, but the lives of those we spend our time with. Coworkers, friends, and family all have to learn about and cope with our disease to a certain level, some obviously more than others; and chief among these people is the romantic partner who, for better or for worse, spends almost as much time with Diabetes as we do.

This is the first part in a series of articles, each one progressing into a deeper level of sharing and understanding. How much you share with your partner depends on many factors: how curious they are, how committed your relationship is, how comfortable you are exposing such personal information and experiences, and more. What "level" you feel you are with your boyfriend/girlfriend/husband/wife/fiancee doesn't reflect on the quality of your relationship, just how comfortable the two of you are talking about the disease.

Level One : Your First Discussion
This seems obvious, but at some point you are going to have to tell the other person that you are diabetic. How soon this happens is up to you, although some things can definitely force the issue. Personally, I am outspoken about my diabetes (as you can tell from the website you are reading) and I usually bring it up as soon as I am beyond the "flirting over a drink" stage. Since I wear an insulin pump, try to test frequently, order diet sodas, and always wear my medical bracelet, girls pick up on the hints pretty quickly and ask me about it.

The "Single Sentence Rule"
When I am explaining diabetes to someone for the first time, I use something I like to call the "Single Sentence Rule". I limit my explanation or response to just one sentence. For example, if someone asks, "Why did you order a Diet Coke?" or "What does your bracelet mean?" I simply respond, "I have Type 1 Diabetes," and then *stop*. This accomplishes a couple of things. Obviously, it answers their question. But more importantly, this prevents you from :
  1. Talking too much, and blathering on until you end up scaring away a possibly interesting person
  2. Responding to an innocent, casual question with something intimidating and somewhat of a "downer"
  3. Wasting your time explaining something important to someone who won't understand
This tactic is very useful. If the person was curious about your funky bracelet or just making idle chitchat, your first one-sentence response will satisfy them and you can move on with other conversation. If they say "Ew" or "Weird", then congratulations, you just saved yourself from wasting 10 minutes of your life talking to someone who doesn't deserve your company. If they are interested in you, and/or legitimately curious, they will follow up your response with another question, ranging from the embarrassingly abundant "So you can't eat sugar?", to the intelligent "What exactly does that mean?", to the bonus-points-earning "Do you give yourself shots or do you wear a pump?" Once again, you answer with a single sentence, and continue this pattern until their curiosity is sated, they agree to go out on a date with you, or you get sick of talking about your pancreas and change the subject.

While diabetes is obviously a serious condition and an integral aspect of our lives, the most important piece of advice I can give you is to keep this first discussion light. Explain the basics, make a few jokes, and be ready to dispel a few commonly-believed misconceptions. Odds are good that the cute guy or girl won't give it a second thought the rest of the night, and you can focus on the really important topics of discussion such as "Light Beer versus Dark Beer" and the relative merits of The Beatles and Fall Out Boy.

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