Well, it officially happened. I’ve officially had a diabetes scare.
This happened a few weeks ago and I’m totally fine now, but in the moment it was pretty alarming— I had given myself the wrong insulin. Luckily I had my Eagle Scout husband to take care of me!
I thought this might be a good time to explain different types of insulin. So what do I mean by “wrong” type of insulin? For normal (read: non-diabetic) people, their pancreases almost continuously produce very small amounts of insulin in response to changing blood sugar levels, which will fluctuate in response to food intake as well as a variety of other factors like stress, hormones, activity, and more. (No wonder its so hard for a diabetic to act as their own pancreas!)
For diabetics taking insulin using needles or pens, these small frequent amounts are basically impossible to mimic— this is one reason artificial pancreases, or closed loop systems, are so exciting, because they mirror the way the pancreas senses glucose levels and give a small dose of insulin in response, without much or any user input. However, these kinds of devices are far from being universal, so most people have to rely on their own judgment and monitored glucose levels to decide how much insulin to take.
Often diabetics will take a range of different types of insulin, which, when used together, can better adapt to daily fluctuations in blood sugar. For me, this mean two kinds of insulin— a long-acting version called Lantus, and a short-acting version called Humalog. The long-acting version is what I started on when I was first diagnosed. Since my pancreas still probably makes a little bit of insulin (something called the honeymoon phase), I’m on a relatively low dose: 9 units (1 milliliter = 100 units). I take this amount at the same time every night, because it slowly works over 24 hours to release a “basal” amount of insulin that is supposed to simulate what a normal pancreas would do in between meals.
A short acting insulin, on the other hand, is used to control the relatively quick spike in blood sugar that occurs after eating, especially if the meal is high in carbs. Because of the way a normal pancreas can react to an increase in digested sugar, most people don’t spike above 180 mg/dL after eating (milligrams of glucose per deciliter of blood). Short acting insulin works within 15 minutes and peaks around 30-90 minutes after its taken, which is about the same amount of time eaten sugar takes to get absorbed into the bloodstream and spike blood glucose levels. If I don’t take my long-acting insulin, my average glucose levels will rise over time; if I don’t take my short-acting, my blood sugar with spike after I eat, sometimes to the 300-400 mg/dL range (twice what it should). Again, since my pancreas still makes a little insulin, and because my insulin sensitivity is most likely still pretty high, I take a relatively small dose of short-acting insulin per grams of carbs eaten: about 1 unit for 40 grams of carbs. The most I’ve ever taken after a meal was 3 units, and most times even this amount is too much.
The scare happened one night when I accidentally took 9 units of my short-acting insulin right before going to bed. As we turned off the light, my life-saving continuous glucose monitor beeped to tell me my blood sugar was out of range—it measures my blood sugar automatically every 5 minutes, rather than me having to prick a finger a few times a day to measure. How I lucky I was that I have a CGM! Without it, I most likely would have gone to sleep as my blood sugar quickly dipped lower and lower. Since the alarm went off, though, I was able to figure out that I had taken the wrong insulin and not only was it a huge dose of it, but it was dropping me very quickly. If you (a nondiabetic) have ever felt like your blood sugar was low and you needed a snack to pick you up, or you felt a little tired or light-headed from not eating for a while, your blood sugar was probably around 70, which is the lower end of a normal range. Mine was around 40, and my CGM told me it was decreasing quickly.
I have always had a really big sweet tooth, and so when I was first diagnosed we joked that diabetes was the perfect disease for me, because when your blood sugar is low all you can do is eat a ton of sugar. That night, I ate about 350 grams of sugar in about 20 minutes, which is the equivalent of about 7 cans of soda or a cup and a half of white icing, and I don’t think I ever want to have either of those things again. I did learn a few really important things from that night though. First, I’m incredibly lucky to not only have access to the insulin I need at a reasonable price thanks to insurance, but I also am able to wear a CGM that honestly probably saved my life that night. So many people in the world don’t have access to (reasonably priced) insulin and other diabetes supplies, which for a diabetic are quite literally life-saving. If you want to help fix this, you can donate to the American Diabetes Association or JDRF, both of which fund research and advocate for those with diabetes. At the very least, you can sign the ADA petition for affordable insulin at https://makeinsulinaffordable.org .
Second, these mistakes are bound to happen and all I can do is to be prepared when it does happen. If you know a diabetic, it never hurts to carry some hard candies or juice boxes in your purse or backpack in case of emergency, or to know where they keep their emergency stash of sugary foods when they’re low. (By the way, don’t try to feed them chocolate if you can help it. There’s too much fat in chocolate to raise blood sugar quickly enough.) Sometimes when someone’s blood sugar dips too low, their brain gets greedy and basically takes all of it to continue functioning. The lack of sugar in the rest of the body means that they may lose control of their fingers or even arms, so they may need help simply getting to a sugar source or feeding themself until their blood sugar comes back up. I’m also very lucky to have my husband, who jumped into action by calling my doctor, bringing me a myriad of sugary options, and staying up with me until we were sure my blood sugar was back in range.
As a result of this scare, I was very happy to eat unsweetened or natural sweet carbohydrates for a while, and this dish is a perfect breakfast that is neither a sickly sweet Americanized breakfast or a savory breakfast of eggs which, frankly, I can get quite tired of. (Didn’t see that segue coming did you?)
Matthew and I first found this recipe when we did Whole30 a few months ago, and since then it’s become a staple breakfast for us when we need something quick on weekday mornings. It also happens to feature ingredients that you probably already have in your house, so it doesn’t require a grocery trip! The recipe is also fairly forgiving, so feel free to omit an ingredient you don’t like or change it for one you like better.
Apple Sweet Potato Breakfast Bake
Serves 6
Ingredients
1 pound or 2 medium sweet potatoes, chopped
1 large or 2 small apples, chopped
2 tablespoons of coconut oil, butter, ghee, olive oil, or a mix (we like coconut oil and butter mixed 1:1)
1/3 cup pecans or walnuts
2/3 cup raisins
1 cup milk (we use almond milk or coconut— full fat will make a creamier dish!)
5-6 large eggs
2 teaspoons cinnamon
1 teaspoon nutmeg
1/2 teaspoon cloves
1/2 teaspoon salt
1 teaspoon vanilla extract
Instructions
Preheat the oven to 325 degrees Fahrenheit.
In a large oven-safe sauté pan on medium high heat, add chopped sweet potato. Add about 1/2 inch water (usually about 1/3 cup) and cover. Let simmer until sweet potato has absorbed all the water, about 5-10 minutes. If the sweet potato chunks are still not soft, repeat until tender.
Add oil to the pan and reduce heat to medium. Add apple and cook until sweet potato is caramelized and apple is cooked, about 5 minutes. Add raisins and nuts to the pan and stir to combine.
In a bowl, mix the remaining ingredients, making sure to break up the egg yolks and fully mix them into the milk with a whisk. Add to the pan and stir until all ingredients are combined.
if desired, add a few more nuts and a sprinkle of cinnamon on top. Place in oven and cook for 20 minutes or until set. A knife should come out clean. We’ve found that often the middle will puff up and deflate once you take it out of the oven. Also, sometimes the oil or butter will pool a little bit on top and make the dish look undercooked, so be careful not to overcook.
Let rest for a few minutes to cool, and enjoy! I also like this cold straight from the fridge, and it is easy to reheat in the microwave. It will keep for about a week.
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