OH MAN! - Diabetes Slip-ups

So anyways… I pretty much eat the same thing for breakfast every day during the week. You would think I have the insulin dose right by now. I usually give a pre-bolus of 3u for the carbs and then when I actually start to eat I give an extended bolus for the protein/fat. I generally see a pretty flattish line from breakfast to lunch with the occasional weirdness thrown in.

This morning was a bit noisy and chaotic in my house but I went about my morning routine. The kids were running around and I kept getting asked questions as I was getting breakfast ready. I usually give my boluses in the kitchen, which is a noisy and busy place but it is how I have always done it. I entered the pre-bolus in the pump, entered the insulin dose on my cell phone in xDrip and went about the routine. There was a conversion thrown in there about perhaps lowering my son’s basal rate and my wife joked about “blaming” his low blood sugars on some random thing so I pulled the phone an out played “Blame it on the Boogie” on youtube which had 75% of my children dancing and cheered up my youngest son who was crying about something at the time.

When I got to work, I suddenly remembered that I forgot to take the protein/fat bolus, so I did an extended bolus with a little bit up front (because I was late to give it) and went back to working.

About 1/2 hour later I noticed on my watch that my BG was rising and the CGM arrow was starting to point up at an angle (which is abnormal for me at this time of day). I thought that is weird and kept working. Then my CGM alarm went off at 8.0 (144) and I started the - “what the &^$%% is going on routine” and gave myself 2u in sugar surfing fashion. (2u is my normal dose to hit the weirdness with and I use 4U for extreme arrows up weirdness).

Then I went through the list of what could be causing the problem:
-Did I forget to bolus? No - and if I did I probably would have seen an earlier BG rise.
-Was it the coffee? No - usually caffeine did not raise my blood sugars.
-Was it breakfast? No - it is what I always have without issue.
-Am I sick? I hope not - but possibly.
-Have I been getting enough exercise lately? - Well maybe not enough but really…
-Do I need to raise my basal rates in the morning like I did a few months ago? - well maybe.

And finally for some strange reason which I cannot explain… I picked-up up my Omnipod PDM and reviewed the boluses for the day. And the 3u breakfast bolus was not there in the history. It was completely missing. Which kind of explains everything. But I was 100% sure I gave that bolus. I remember inputting that 15g for carbs into the pod. I remember my son screaming about something that I was trying to ignore until I completed the bolus. And then there was that Jackson 5 song and the dancing.

And then it hit me… I am wearing my pod on the left side of back right now and sometimes I get communication failures since I hold the PDM in my right hand. Usually I just move the PDM closer to the pod and it communicates. BUT it would have been so noisy in the kitchen this morning that I did not hear the beeps from the controller that the communications had not worked.

So I sheepishly gave the missing 1u from the breakfast carb bolus and reminded myself that sometimes the reason for the highs are pretty simple.

Anything silly you folks have done lately?

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I’ve done that, @AE13 - lucky it was a relatively small bolus… I did it with much higher-carb meal sometime back. Yikes!

Recently (Ok, three days ago :slight_smile:) , I did a set change. Was in a hurry, and decided to do JUST a site change, since there was still 100U left in my pump - enough to get me thru to the next set change on weekdays… Got the site change done, then primed the canuila and headed on my way…

Problem is, I sorta forgot to MOVE THE TUBING to the new site (or remove the old one…) Fortunately, the half-unit didn’t do too much damage…

Oh heck, what haven’t I done? My favorite? I had delivered and threw away 10 vials of insulin mail order. Yeah, i thought I took it out. OOps.

As a matter of fact, I had a diabetes slip up this morning, too. I had to see two doctors today in the afternoon. I ate a noon breakfast on the way to my doctor’s appointment. I normally pre-bolus up to 60 minutes before my morning meal.

I use the do-it-yourself artificial pancreas, Loop, and I delivered a bolus well in advance of arriving at the restaurant. When I noticed a slightly rising moderately high number, I checked my bolus history and none there. Radio communication must have failed with my earlier bolus and I usually catch when that happens.

So there I was, psyched to eat with no IOB. So, I took some Afrezza instead. It did a really good job of holding my post-meal line in the low 80s. But then I had to eat a glucose-tab during the doctor’s visit. Following the doctor appointment and still cruising sideways at 63, I decided to treat myself to an ice cream sandwich. I ate that and just delivered a small token bolus.

Next thing I know I’m topping out in the 160s, telling myself I know better than to treat a low with SWAG food!

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That’s one thing I like about eating low-carb; mistakes make you rise to 12 mmol/L instead of 25 mmol/L. Before I got my CGM I would sometimes forget to bolus and wouldn’t realize until four hours later when I’d go, “Geez, I feel kind of high!” and test to find that I was something ridiculous like 23 mmol/L. Most of my screw-ups more recently relate to caving in and eating high-carb foods or else letting blood sugar changes ride to see what will happen before doing anything aggressive to correct them because sometimes I drop low after a correction while I still have a ton of insulin on board while other times highs persist for hours even with multiple corrections…I never quite know what kind of high I’ll get.

This past week I’ve been eating breakfast on the way to school or after getting to class, and for the past two days my CGM has alarmed with a straight up arrow even thought I hadn’t yet eaten. It doesn’t happen as soon as I get out of bed as I’ve heard some describe, but happens more than two hours after I’ve been up and about. The day before yesterday I rose from 4.8 to 12.8, and today I rose from 5.3 to 7.8 where I hovered for several hours before dropping back down (this morning I immediately bolused 2 units when the rising alert went off, yesterday I waited until I was around 10 to bolus).

Then this evening I stupidly decided to eat some tortilla chips after dinner because I am craving those and have not yet found any good low-carb ones that I can eat. I bolused like 18 units for my dinner plus the chips, but still rose to about 13.5 for three hours, and am still at 8.4 almost six hours after eating those. I am not sure why I do it, yet I still fall into the trap of eating carbs at least once a week or so.

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If there’s anything I’ve learned from 24 years of this idsease, it’s to cut myself some slack once in a while. If the occasional treat helps you feel satisfied, you’ll stick with it better the rest of the time.

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I eat low carb too, and the biggest problem is getting sufficient crunch! in my diet. As we all know, it’s an essential food group. This is why God gave us chips. I do pretty well substituting nuts–almonds and pecans (ah, pecans!)–to make up for this very necessary nutritional element, but every once in a while (usually at a party) the urge for the real thing can be overwhelming. And I long ago found that for me at least corn chips are way worse than potato chips, glycemia-wise. Right up there with pizza and Chinese restaurant food for stuff I always seem to underestimate when I decide to indulge.

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A couple of nights ago I treated a BG that was slowly trending down with pringles :slight_smile: that someone brought into the house. It is amazing how few pringles I got to eat. I need to have a bigger low :). Of course I just had a few more to be sure the low wouldn’t happen and then ended up correcting.

I also sometimes “treat” low BGs with ice cream sandwiches. (Not emergency lows but trending down BG that would result in a low) and either just eat 1/2 or do a token bolus.

@Terry4 - My family doctor / GP loves that I can see my BG on my watch and always asks to look at it when I go for an appointment. I always make 110% sure that I have a really good BG when I go in - something to do with irrational pride.

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Yeah, I’ve been doing this for almost 26 years and I agree. I just wish it wasn’t quite so often. But after indulging I was actually up most of night feeling really unwell (I think I may be developing an allergy to corn!), so that will stop me from doing it again anytime soon.

I buy low carb tortillas which I really like for lunch. I wonder what would happen if I baked or deep fried them - could this turn into low carb nachos?

I am inspired to try.

I agree. I like eating chips with delicious dairy-free chipolte-flavoured sauce. The sauce itself has no carbohydrates, but it’s the chips that are the problem. It just seems gross to dip nuts in sauce. I’ve been trying to make low-carb chips with almond and other flours without success so far (they never turn out crunchy without burning). Today I will try some with chickpea flour; not quite as low-carb, but at least better than corn. (Especially since the past few times I’ve had corn chips or popcorn I’ve ended up with very unpleasant symptoms for hours afterwards and am nervous I’m developing a new allergy.)

True, true. And yet… it can be done! Pecans better than almonds in this respect: more surface area. Also: napkins.

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I usually eat macadamias as my crunchy thing. Sometimes there are some extra crunchy ones in the bag and those are the best. For straight junk food I love Epic pork cracklings maple bacon flavor if I can find them. The carbs are only 1 gram per serving so if I don’t eat the whole bag my BG’s are fine

My most recent slip-up that I can remember was several months ago. I was sitting in a friends office and there were snacks everywhere! I ended up eating mindlessly (I wasn’t even hungry) for probably half an hour without taking any insulin or checking my BG’s and awhile later my BG was in the 500’s. I got it back down pretty quickly but I’ve been more mindful about snacking ever since.

A flavored water. Oh yeah it was bad.

I still eat some tortilla chips and limit to 15-20 carbs, so low carb chips, one serving. Also nuts, also some organic corn chips, 15-20 carbs,

Also occasional small portion of ice cream, paleo brownies, paleo poppyseed muffins, whatever I eat, I am trying to stay at 20 carbs per meal, sometimes I go to 30…have to have some slips that give some variety and satisfy the cravings!