The Unexplainable

Today’s story is more a pondering, rather than an account of a daily happenings. But it is based on my life with T1D over the last 24 hours.

I stress before I go on that of course the endocrinologists know more than I do about managing T1D, but unless they are T1 themselves, I know more than them about living with T1D.

If we were to follow to the letter, the rules of healthy living with T1D, we would be testing 5, 6, 7 or more times per day, then injecting 4, 5, 6 maybe times per day in an attempt to keep our BGL between “acceptable” limits. This is the modern approach which has been enabled by the vastly improved technology that we now have.

As you now know, I don’t do that. I take an “executive summary” approach to that, following the basic rules but allowing myself some freedom along the way.

Yesterday my levels were running on the high side of normal, for no explicable reason except these things happen. And that is really the crux of what this note is about.

My test before dinner was high’ish …. let’s call it 10 (180 in the USofA). So I compensated, as I do, by having slightly less for dinner. As I said above, I take an “executive summary” to the modern rules and instead of having more insulin, I cut down my carbs. Then surprisingly my evening, before bed, test was still above 10.

Now taking everything into account that could have brought this about, which includes –

  • my exercise / rest over the last 24 hours
  • my general state of health at the moment
  • the type and amount of food I have eaten in the last 24 hours
  • my level of stress at work
  • my level of stress at home with normal domestic requirements
  •  the season and weather conditions

…. this should not have happened. There was nothing in the 24 to 36 hours that could sensibly explain why my level was over 10 last night.

Further to this, but without going in to too much detail, I can assure you that the reading was correct. There are certain indicators that occur naturally that tell you when the BGL is above where it should be. Midnight trips to the toilet might give you a hint. And last night I was getting clear and concise natural warning that my BGL was high.

So, why was this happening? I’ll pre-empt by telling you that there’s not a person on the planet who can tell you. But here is a list, from my 46 years of experience, that together could help to explain it. Do you notice that I’ve been careful not to be too precise or definitive? That’s because as I said earlier there’s not a person – not a doctor, not a scientist and not a know-it-all internet blogger who actually knows the answer.

  •  Maybe in the last 12 hours I’ve unknowingly eaten something that had a higher level of carbohydrate
  •  Maybe in the last 12 hours I’ve unknowingly caught a bug that is affecting me but hasn’t shown any symptoms yet
  •  Maybe there’s something not right with either of the 2 pens I use for my injections
  •  Maybe my insulin has gone past its use-by date (it hasn’t)
  •  Maybe the changing weather has affected my BGL
  •  Maybe, and this is the one I’m putting my money on, one of my injections in the last 24 hours went into a hard spot under the skin that is no longer allowing the insulin to enter my system as it should

That last one is the most likely in my experience. After somewhere between 50,000 and 65,000 injections, the body starts to be physically affected. Over the decades I have used different areas to inject in to, some of which are no longer useable. The doctors know that the relentless injections, be it because of the insulin itself, or the physical intrusion of the needle, eventually cause the layer of fat under the skin to go hard. And once that happens, one of the affects is that the insulin is no longer absorbed if it is injected in to that spot.

My current injection sites have been used now for – I can’t remember – maybe 15 or 20 years. But now it appears I’m going to have to move them again.

I’ll keep my focus on how things progress over the next weeks / months / years (hopefully). I don’t want to change my sites but will have to if the BGL continues to act up unexplainably. Where I’ll move to is a conundrum. I’m running out of places I can reach.

That is T1D as I have lived it ….. today.

Marathon des Sables – A Type 1 Diabetes Adventure

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