Ah, food… Never has there been something that elicits such a delicate balance of love and hate. Required for our continued survival, food plays an integral role by providing us with the fuel and nutrition we need to get through the day. It’s also somewhat responsible for weight gain and a variety of health issues if consumed improperly or in large amounts. The other side of the coin is that food can bring a significant amount of enjoyment to those who choose to experience their food as opposed to simply eating it.
For someone with Type-1 Diabetes, the consumption of food is a delicate dance of counting carbs, eating in appropriate portions an ensuring the appropriate amount of insulin is taken in proportion to what’s being eaten. It isn’t always easy and it’s made all the more difficult by the fact that every person is different their bodies may react to foods in different ways. For example, I know some people who can easily and quickly treat a low with a small glass of juice. If I tried that shit, I’d die long before the juice took effect.
For me, it’s a handful of jellybeans. Believe it or not, those bring my blood up far faster despite the fact that fluid will be absorbed quicker by the body. But some foods will be problematic, in general. Take chocolate as an example… I know a lot of people who will turn to chocolate in order to treat a low. The problem with that is that chocolate, in essence, is a solid block of fat mixed with sugar. When consuming chocolate, the body will usually break down the fat before getting to the carbohydrates. this can mean a significant delay in getting one’s blood sugars up, using chocolate. It’ll still get you there, it’ll just take forever doing it.
The same can be said of certain foods we consume at mealtime. For me, the guilty culprit is pizza. Anyone who knows me will tell you that gourmet burgers are my kryptonite and they would be right. But I definitely have a soft spot for stuffed-crust pizza. Especially on Friday nights when one can purchase a chicken Caesar stuff-crust pizza for only $10 online. It makes for a great end-of-week treat for the entire family and in fact, my son Nathan will only ever eat pizza from one specific restaurant. I recently tried to convince him to have a stuffed-crust pizza from the grocery store. It didn’t end well. But I digress…
Pizza poses a significant problem for me because it’s one of those foods without a happy medium. The contents of a pizza are unfortunately as such that i face the same conundrum as chocolate. The heavy amounts of cheese and fatty ingredients make it so that the pizza is processed differently than other foods. If I take an appropriate amount of insulin for the amount of carbs I’m eating, I’ll almost certainly bottom out within the hour. Why? Because those high-fat ingredients will get processed first and the insulin will continue to work BEFORE carbohydrates are introduced.
My insulin pump has an interesting function called “dual wave” and “square wave” bolusing. The former involves providing a specific amount of insulin up front with the remainder being dosed out over a period of time. The latter involves the entire amount being dosed out over a period of time. Why is this important? Because it allows for the appropriate dosing of insulin for the amount of carbohydrate I’m consuming while still giving the body time to process the other food aspects, such as fat, without causing me to go into hypoglycemia.
As wonderful as this sounds, the odd thing is that those wave functions aren’t available when using SmartGuard in conjunction with a CGM. This seems like a design flaw to me and I’m not clear as to why the puppy manufacturer would have done it this way. I didn’t build the thing, so maybe there’s a reason behind why it’s not permitted with SmartGuard but it rather feels like driving a car with heated seats that won’t work if you’re wearing specific pants.
It kinda sucks because it leaves me in a position where I either have to forego eating pizza altogether or I’m back to the good ol’ days of “guess-timating” how to bolus… The usual practice right now is that I’ll put off taking any insulin until I’ve actually completed eating my slice and even then, I’ll only bolus for half of the required dose at a time. This effectively mimics the square bolus effect as much as possible without disabling the extremely effective SmartGuard system that I’ve come to love.
I’ve always said that having Diabetes shouldn’t prevent a person from enjoying anything that a non-Diabetic would. After all, it’s 2022, we’ve put people on the moon, for light’s sake! Given all the advancements in medicine in the past decades, enjoying a pizza with my family on Friday night shouldn’t be such a convoluted ordeal. But it is. It usually ends up that no matter what preventative measures I take or how I adjust my bolusing, I either spend the evening trying to bring my blood sugars back up or I spend the night slowly trying to bolus to bring myself back down.
So there you have it… I know I often bring up how I’m aware that I complain about Diabetes a lot, but this is an example of how even having pizza on Friday night can be complicated. Which sucks. A lot. But such is the burden carried on the shoulders of anyone living with T1D. It can be tedious and exhausting but there are always ways to work through it. Food for thought (pun intended) Great, now I want pizza…☯️