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Jun 26 / Caro

‘More’ Does Not Mean ‘Faster’

More insulin will not make blood glucose levels go down faster, just further. In exactly the same way, more carbs taken to treat a low blood sugar will not make it rise any quicker, just further.

I know this.

So why do I persist in over-bolusing and repeat bolusing until my insulin doses are stacked as high as the sky, just because I’ve not seen a downward movement quick enough? When I know that I have enough insulin on board to treat the blood sugar level I’m at, why do I get impatient and add more? Sometimes as little as twenty minutes after taking the first bolus, I’m adding another unit, because the number hasn’t changed. My pump history is littered with random boluses delivered, in almost Pavlovian fashion, in response to the High Alert tone from the CGM.

But all it does is initiate a roller coaster ride. A crashing low follows, which leaves me drained and sweaty, with a pounding heart and an irrepressible urge to eat the entire contents of the kitchen. One (appropriately sized) gulp of Lucozade becomes two. Then three. And four, because I still feel rubbish. Before I know it the bottle is empty and I’ve consumed the better part of 90 grams of carbohydrate. It won’t get me up any faster though….

It’s a vicious cycle and it’s all anxiety led.

I’m so fearful of highs these days, and the damage that they may be doing to my unborn child. Once I see a sharp upward trend, or a high number, I become obsessed with reversing it. The anxiety about that number overtakes all rational thought about stacking boluses and bringing the number down safely. And once I’m low, the familiar anxiety about passing out or harming myself and others wraps itself around me. The adrenaline surge that comes with the low blood sugar territory sets me on edge, and rational thought is dulled by the fog that descends when my brain is lacking in glucose to fuel it. All I want to do is eat, until the feeling goes away.

Some days I feel like I’m pogoing from low to high and back again. That in itself is an enormous frustration and causes yet more fear – of what those variations are doing to my A1c and my baby. Surely all this bouncing about can’t be good for him or her?

But I’m the only person who can stop this particular roller coaster. I know that I need to step away from the carbs when I’m low, and back off the bolus button when I’m high. I know that I need to learn patience and remember that ‘more’ will get me there at exactly the same speed. It just means I won’t stop when I’m where I want to be.

It’s just so much easier said than done.

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