Emotional Diabetes

It occurred to me the other night as I was trying to return to sleep at 2 a.m., that I have, right at my fingertips, an opportunity to make numeric sense of my glucose response. It’s always good when a hunch turns into hard data, whether it’s good news or bad.

The Dexcom system includes a computer program called Clarity which logs my sensor’s activities over time. So as I lay there waiting for sleep to return, I wondered what would happen if I looked at my insulin use over the last while, and what would happen if I compared my insulin jabs to the amount of time I’m in the target zone. It could all be a depressing exercise or it could be a way of highlighting these mythical stress responses, those three-day periods where I seem to jab in insulin to little or no effect.

You may wonder, why don’t I just look at my glucose level over time? Well, it gets affected by the insulin I inject. And, while never really enough, the insulin amounts (which are up to me to determine) show when I’m trying to bring the body glucose down. It’s somewhat scientific, and I’m sure any professional researcher would laugh at my logic. Never mind. It’s worth a look.

At the same time, I vaguely remember there being a formula of body weight vs. daily insulin requirements. I think it’s something like body weight (in pounds) divided in half equals average daily insulin requirements (in units).

All I really want to know is how bad is my situation? Am I screwed? Is this shame I feel every time I inject a shit-load of insulin really warranted? How do I fit into the scale of insulin-dependant diabetics? How weird am I?

So I went into Clarity with a notebook at my side. I noted down the amount of my daily injections back to Aug. 1, then I determined the percentage of time those daily numbers had me in the target zone. Somewhere in there I got confused by the process (my chronic math anxiety), and thereafter just focused on the insulin injections, which is my attempt to bring down high glucose. Here’s what I found.

• The daily average for October so far is 26 units of Humalog.
• The daily average of September was 31.
• August was at 24.
• Fasting in over seven days August brought down insulin requirements by 75%.
• Binging on cheesecake elevates insulin requirements to the stratosphere. Best to avoid. Maybe a slice now and then.
• This last (failed) five-day fast did not bring down my glucose as usual. My insulin injections were reduced by only 25%, which reflected the lack of weight loss. My theory is I was experiencing a three-day stress response, a low-key, non-food-oriented anxiety event that affects my body’s glucose. The stress event may well have quashed the weight loss during the fast.

First off, the daily average over each month vary quite a bit. I’m not sure why, but it’s something to keep an eye on. Also, I have no real idea of when I’m experiencing stress events other than vague feelings of disconnection and forgetfulness. See the last post. And it’s entirely possible I decide to fast while feeling frustration over my glucose numbers which in turn are related to buried stress.

The other thing I found was a scientific paper that said diabetic people with high levels of insulin resistance use upwards of two units of insulin per kilogram of body weight, or 200 units a day. At my max stress response, I use 0.5 units of insulin per kilogram. That puts things into perspective.

It’s all making emotional diabetes a more plausible concept, and that’s both scary and comforting. One last thing to note is that while my linking things together may be just occurring now, the stress responses have been happening for all of my life. This explains why my pancreas has been overworked for so long and why it’s now flat and nearly lifeless.