I’ve lived alone for 28 years of my 33-year duration of diabetes. For the last two weeks I’ve been part of an extended family vacation with 10 other people. This trip makes me realize the large impact that social distraction plays with me managing my diabetes.
While at home alone, I rarely miss my intended pre-bolus time. As hard as a tried to keep to my pre-bolus habit while on vacation, it seems that some conversation would inevitably interrupt my mindset and I often ended up eating before I preferred or delaying my food until after everyone else has eaten. This has frustrated me as I enjoy extraordinarily good glucose levels while at home alone. I’m used to executing my diabetes plans well and it frustrates me to constantly miss delivering on my intentions.
Social distraction has also contributed to me missing my infusion site and continuous glucose monitor sensor changes. I’m not blaming my temporarily enriched social life but it’s given me an insight into what others here who live as part of a family must live with every day!
My question to people who live with family is this. How do you cope with the competing diabetes and family demands? I realize that my long years of living alone has embedded in me a “living alone” skill set. I have not been able to develop tactics and habits that permit successful diabetes living as part of a family unit.
One thought I’ve had about coping with social distractions is to use my phone alarm strategically to remind me of my bolus schedule. Working against that tactic is the ever changing mealtimes of a group on vacation.
I’d be interested in reading what others do to enlist the help of the family to enable meeting diabetes goals. Do you have any other ideas to help?
Great question. I’ll be interested, too…Since I was dx T2 at almost 60. The family was scattered. As I adjusted and made all the necessary life changes, my scattered family was very supportive. My husband found he enjoyed moderating his carbs, as did my sister…
When I read this post i had to chuckle a bit.
It is kinda reassuring to me that even our dear Terry struggles with that
But yeah, i think diatraction is what most of us deal with daily, as the majority of T1s have jobs, family and friends all potentially distracting us (not suggesting you dont have family and friends). I remember a while back when i asked in a post about how to remember prebolusing and i didnt feel that some of you guys quite understood what i meant: THIS!!!
I guess you develop strategies on how to deal with it, but it is a handicap
Phone alarms help me with my tresiba shot, can help with set and dexcom changes, and if you eat regularly it can help with prebolusing. But eating regularly is easier said than done
I think on the prebolusing part i have just come to terms that i prebolus when i remember, and dont when i forget.
Its more dangerous if you bolus too much, as happened at a dinner 2months ago when we were at dinner with my uncle, cousin and her baby, and it was all a mess --> terrible low the following night🙈
I hope i did not offend you in any way🙊
I think for you the cool part is that apparently this is a passing phase where you can get back to your routine in a short time.
For the rest of us, i am still looking for the ideal way to deal with it
Hugs, SC
I just manage it all myself and have to sometimes get nasty for people to leave me be when I need to do things etc. When I eat I say do not start asking me to do anything until I’m done eating etc. It’s hard to do anything with other things going on even with the devices alerting. I was teaching and Dex said 170 I delayed a stick even though I didn’t feel well because I was in the middle of something. When I did test it was 230! I did an injection and now I plan to always stop what I’m doing and test because Dex is as usual not reliable. It is very hard to follow this plan though because there is no way to live a normal life this way.
My family eats a bunch of crap and gluten. That’s hard because I have to sterilize all the dishes and gluten is everywhere. Living alone or living with somone gluten free etc would be easier because there’d be no gluten. But I also would have no help for lows or highs if I need it.
While I do have family and friends, my usual social life is much less hectic than someone who lives with others every day. I am quite happy with my own company, reading and writing on my computer, and visiting with people on the phone. My hermit tendencies are very compatible with my diabetes habits.
While I did deal with the distractions of a full-time job when I worked, I’m now retired and my life’s rhythms are much slower than the typical working family, especially those with children. I have a new respect for people with diabetes who participate in a full and active family life. I see their life’s balance as geometrically more demanding than what I experience as a single man living with a dog!
I am permanently distracted. By everything and anything. Let’s just call it attention deficit (not a disorder, I am highly productive!!).
I do live alone, but spend considerable time with others at work and play. Today at lunch in town with my parents I couldn’t even focus long enough to bolus on my pump, let alone prebolus. It took 4 attempts to see the process through. The pump kept timing out.
I was busy discussing the best way of stretching a leather strip into a bagpipe bag shape while folding it, with my father. He is also incredibly distractable. We are aged almost 45 and 74. Not growing up any time soon, I suspect. I can’t believe my mother survived 17 years with both of us under one roof…
I don’t need anyone else around to become distracted though. Shiny things, ideas, projects that I need to start immediately, facebook, youtube, a good book.
For example, 2 days ago I felt the (urgent) need to learn to make a leather bagpipe bag for my brand new smallpipes (they came with a giant bag). I briskly researched, had an energetic chat with a nice chap in a leather shop and purchased things, made the bag and had it airtight within a day (had to leave the glue to dry thoroughly before seasoning), and have been showing off to family and friends since. This is my life.
Prebolusing and any sort of regular patterns of life just don’t happen. Tomorrow I fly 2000km to work, and will have to pretend to be a focused professional for 8 days. Sigh.
This post has been simmering in the background of my mind for the last few days. I woke up this morning with some new thoughts about it. There are many events in our daily life that demand and receive appointed times. Many people live with a defined schedule for work. For many years I worked from 3 p.m. to 11:30 p.m. People with children deal with a fixed schedule for their children’s school day and extra-currilcular activities. Religious services occur on a certain day and time.
We accept these hard deadlines and do our best to comply with them. I realize meeting these deadlines creates its own stress but we accept them because we value what they offer.
We also live with variable appointment times, like our doctors’ appointments. Some people worked a different schedule each day based on the needs of the job. They may start each workday with a client meeting that could start at 7 a.m. one day and 10 a.m. the next.
My point here is that most of us live with a schedule of daily activities that we comply with since we value what these appointment times give us in return. Why do we then only give passing thought to the timing of our meals and the necessary medicine schedule it implies?
I know many gluco-normals can shoe-horn in their meals at the last minute, on the fly, but that style is not compatible with a reasonable pre-bolus time. A little forethought may be all that’s needed to give you a meal target time along with a time to dose insulin. Set a phone alarm and the system should be able to deliver some better results.
When I was growing up as part of a large family, my mother insisted on a fixed dinner time. We usually ate a 5 p.m. Of course there were exceptions to this pattern as inevitably one of us had conflict with this appointed time. But, as a family, we deliberately dealt with these exceptions.
What I’m trying to say is that we people with diabetes would be better served if we sought to institute a fixed meal schedule or one that was scheduled each day to accommodate other requirements. Giving thought each evening to the next day’s schedule is something many people do. Why not also give thought to your meal times, too?
Meal time is a big deal to those of us who need to dose insulin in a healthy way. Why not give it the priority we accord to many other activities that we consider important?
I am always so impressed how focused and diligent you are with your diabetes management. And when I found out you were retired, I realized that makes it so much easier. And I do believe if I was, I could focus on it much more than I do now. But life is complicated and gets in the way.
When you work varied schedules. When you have work that can ebb and flow. When you have family members get ill or move or graduate or get married or any of a million other things.
When I had my first child, I always put her first. But when I had that first low with no one but her with me, I realized my diabetes needs to take a front and center approach in the family dynamics. So while, I still focus on family first, than job, than diabetes, I have learned that sometimes the diabetes must be first.
And I have learned that if I don’t get that pre bolus right, I can fix it later. And if I do eat something that might not be the best choice, I can fix it later. I have realized anything is fixable. And I see my extended family so infrequently that a few diabetes missteps is ok.
Again, I think it’s how much time and effort one can give their diabetes. We are all in different places in our life and have different priorities. What works for me will not work for the next person. That’s life! And you have to enjoy it everyday.
I know this is true. Like any person with diabetes I need to fix things when my initial attempt doesn’t work. Even a well-timed pre-bolus doesn’t always work due to many other factors.
I prefer to make my best bolus attempt with any meal but realize I need to accept whatever happens and sometimes clean up the mess when things go awry.
Your structured lifestyle obviously facilitates your admirably tight control. Personally, I wouldn’t say that I “only give passing thought” to the D-stuff surrounding meals. I’m very much aware of what I need to do. It would be a luxury to say “dinner is served at 6 p.m. every night.” But people get delayed at work; they get delayed on the way home by errands or traffic (I’m not going to do a 45-minute prebolus only to have my partner call right afterwards and say he’s still downtown waiting for a streetcar); different meals require different amounts of prep time and very different degrees of attention (while I’m simultaneously keeping an eye on a broiling piece of fish and whisking a hollandaise, I can’t turn away to do a test and all the carb and insulin calculations); a dish isn’t necessarily done when the recipe says it should be (I bolused 30 minutes ago and it’s still raw!!); I may not even know until I’m actually plating, how much of a meal I’m going to eat (so I can’t measure and carb count and bolus ahead). Etc., etc.
Recently, because of laziness and exhaustion, we had frozen dinners two nights in a row. It was great! Carb counts were right there on the box, prebolus, put it in the oven, put your feet up for 22 minutes, and dinner’s ready! But while that’s terrific from a diabetes-care standpoint, neither of us particularly cared for the food, and it’s not how we choose to eat.
I’ve learned to just roll with it. Like @Sally7 says, I can correct a “mistake” later. There’s no point getting all flustered and frustrated and angry at myself right before I sit down to what is meant to be a nice meal.
I guess some of this is how up to speed ones family members are. When I was a little one and living with my parents, everyone knew what was what. My parents, my siblings and even my grandparents, aunts & uncles and cousins. But after moving away, and becoming much more high tech, they have lost that knowledge. There is really no need for the, to understand my pump or Dexcom or the fact that while my blood sugar is low, I am taking insulin for the food I am going to eat. Back in the old days, one would never do that. When I visit with extended family now, I think they get that I know what i’m Doing and they just let me do it. If I need something to eat, I can do whatever I need to. If I don’t want to eat, no one says anything. Part of this is probably due to the fact, that i’ve Been doing it for so long but they know to not push. Questions are great to help educate but no one pushes. Again that is my family and not everyone has that kind of family dynamics. But I think I would do the same with family that I do with strangers who question what i’m doing, I know what i’ Doing and have been doing it well for many years, thanks for the advice. I and my medical team have it.
But we are all heading into the holidays with lots of family interaction, and wow, the fun begins for many of us. So, Happy Holidays to all and good luck riding the family waves!
Your comment reminds me of an insulin dosing tactic that I could use more often. When a mealtime is uncertain, you can make your best guess as to its time and then prebolus only half of the usual dose and take the other half over time when using a pump or in a second injection bolus at the actual mealtime when it arrives.
If using a pump, for instance, and you want to take 10 units for the meal, take 5 units as a prebolus and then 5 units over say, three hours, for the balance of the bolus. If you get to mealtime and still have 3 units pending with the extended bolus, you have the option of killing the extended bolus and delivering those 3 units immediately.
This scenario could work nicely for your example of a meal that takes a little longer to prepare or a partner’s delayed arrival home due to a public transit delay.
That’s one of the things I like about pumps. If you’ve started an extended bolus, you may kill it before it’s finished. It’s like taking back a bolus, something you can’t do with an injection.
I have found this most challenging when riding behind on Harley. I have no control when he is going to stop to eat. When going out to eat. Normally, I give any correction bolus needed before heading to restaurant, but using pump on back of Harley is not possible. When riding, I keep Dexcom in bra to feel vibration (hearing sound not possible). If three vibrations, two shoulder taps on rider’s should mean ‘please pull over soon’, if four vibrations, three vibrations mean " STOP NOW’.
Actually, the best way to handle Dexcom issues is to just give no boluses before ride.
While family members can lead to distraction, they also can do just the opposite and HELP a person stay on schedule and keep in control. When my children were young, they learned about my diabetes as a matter of “life” in our family, and they knew what I needed and when. More than once, I heard a little voice say, “Get something to eat, mama.” They are now grown, but my ever patient, wonderful husband has done an exceptional job of learning what he needs to know to live with a T1 diabetic, and we have simply adjusted our schedule to accommodate the condition. In fact, HE seems to be more concerned than I am, many times. He is the one, though, that always asks, “Did you suspend?” before I do a labor-intensive task or when we are about to go on a walk. Our accommodations are not intrusive to our lifestyle; they simply comprise a part of our lifestyle. No big deal. We all do what we need to do to get by, and our accommodations actually have lead, in many cases, to a healthier lifestyle for both of us. Your initial question of controlling your diabetes with extended family who do not know about T1 is a different situation. They do not know you our your schedule in detail, and that is OK. You just need to be your own advocate by setting alarms or by delegating ONE reminder task to each person with whom you vacation, if you can trust them. “Cousin Joe, can you make sure I take a pre-bolus about 4:30 each day?” “Uncle Ralph, can we work together to make sure that we eat each day at 5:30 p.m.?” Family love to help one another if they know what to do.
@SherryAnn – Thanks for pointing out an advantage that families can provide in helping its members with diabetes. Your experience is a good model for appropriate and helpful family interactions with diabetes.
@Suzan – I like the system of shoulder taps you use to convey your needs when riding on the back of a Harley. It’s really all about good communication, no matter the system used!
This is one of the major challenges of diabetes, balancing diabetes care with the rest of life. I work full-time and attend evening classes (until recently was doing graduate school part-time), and social events. I don’t necessarily have a fixed schedule each day. And it’s very easy to get wrapped up in all the other things that need doing and put diabetes second.
I mitigate it by trying to put diabetes first. I find pre-bolusing very challenging when eating with others, so I don’t always do it. Instead, I’ve adopted a very low-carb way of eating (about 25-30 grams of carbs per day). Since I often need a bolus time of 30-60 minutes if I eat any higher-carb meal, I find eating this way gives me much better control (though not perfect control—I still go out of range daily).
I’m also not shy about pulling out my pump or CGM while carrying on a conversation with people, and this is even with having to hold these devices right up to my eyes to see them (so no being discreet). So if I do want to pre-bolus for a meal that’s not at a set time, I just do it when I feel the meal is getting close to being ready (but this has become much more rare since using Fiasp and eating very low carb). My family, friends, and colleagues all know that diabetes is important to me. Sometimes they’ll ask questions about what I’m doing, which is a good chance for education. Other times, we’ll just continue on the conversation.
I also utilize the touch bolus feature on my pump a lot. I’d say I bolus with that 90% of the time. It allows me to administer a bolus while talking, in a meeting, in class, while teaching, while on the bus, while walking, or in bed without removing the pump from my pocket. I love it. Between that and the little GoTubb of glucose tablets I carry, I often make a diabetes-related decision every hour throughout the day without anyone knowing.
As for remembering, I haven’t found that to be a problem. Diabetes is always at the back of my mind. But maybe this is because I’m used to managing diabetes while also engaged in interactions with other people all day.
that might not eat everything.