My own definition of insanity: doing the same thing, over and over, getting the same result, while simultaneously knowing the definition of insanity. Over the past two weeks, I’ve been on loop mode. I knew I was on loop mode, but history kept repeating itself. Until… a recent lunch with Amber and our friend Trish (and podcast 17 guest) said, “Ya know, you could just stop eating so many carbs in the mornings.” Let’s backtrack, mainly because I feel the need to justify why I needed to be told this essential truth in diabetes management after 18 years.
Here’s the truth: I love cereal. For real, like heart-racing, borderline-addict status love. Years have passed since I went multiple days without cereal. When do I visit the grocery store? When the cereal box is empty. Cereal is not a PC diabetes meal. It has more carbs in one bowl that some of my ketogenic friends eat in 6 months. Cereal goes better with fruit, which adds more carbs. Then you add in the dawn phenomenon, and yes, the evidence mounts against cereal. Even still, the vice has persisted through serious trial and error over many a morning, resulting in the ability to eat it most mornings without any blood sugar issues, especially over the last few years. I take the same amount of insulin everyday for roughly the same cereal and fruit. Bingo.
Until two weeks ago, when the morning schedule changed at the start of our third year of med school. Instead of a 6am alarm to go study, now the 3:30am alarm goes off to get to the hospital for our surgery clerkship. For the first time in my life, I’m beating the dawn phenomenon to the punch. The dawn phenomenon hits snooze a few times while I’m making coffee, showering, and making breakfast. Then, right when I’m about to eat breakfast at 5ish, boom goes the cortisol and growth hormone.
For the first two weeks of the new schedule, I’d wake up, have an alright blood sugar in 100s, retest before breakfast in the 200s, then several hours later be still in the 200s… or maybe even 300s. This is still the same bowl of cereal, at the same amount of insulin as always, but getting a much higher sugar each time. This went on until that lunch with Amber and Trish, which reminded me of the next rule:
Rule #5: Don’t eat when you’re high
Let’s preface that by saying that yes, there are times where one has to eat when high, but when given the choice and time, it just makes more sense to ride out the high before grubbing down. Surfing down the wave is easier. Is it tempting to do so? Yes, but in my experience, it usually takes more insulin to cover the food and correction than my ratios suggest.
So, where do my mornings stand now? Sadly, without cereal. Happily, with no more high blood sugars. Instead of eating a full breakfast right at 5PM, I opt for a lower carb approach like trail mix or the most energizing coffee concoction known to man. Luckily, the surgery rotation ends in 5 weeks, when the cereal life can begin anew, hopefully.