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  • Writer's pictureSheri Colberg, PhD

My Diabetes Vacation?

You know what the hardest thing about having any type of diabetes is? You never get to take a vacation from it. (The same is true about most chronic health conditions.) Diabetes is unique, though, in that it generally impacts every aspect of living, from eating to exercising to sleeping and aging well.

I’m not complaining—just commenting about my life with type 1 diabetes for well over 50 years. In the early years, I did not have the capacity to check my blood glucose and could only guess at what it was doing. For that reason, I had to become very aware of my body’s responses to every morsel that I ate and any activity that I did (or didn’t) do, which to this day still helps me better predict how my body will respond. Ignorance was not bliss, though, and it was honestly a relief to be able to check my blood glucose when I finally started being able to.

When I first got a blood glucose meter back in the 1980s (after 18 years without one), I checked often and religiously tracked what I ate, drank, and did for more than a decade, which helped with understanding how my body responds and what to expect. Documenting its impact around the clock for decades, though, never allowed me to take a vacation from diabetes.

Nowadays, some people may feel like they can get more of a vacation by having a continuous glucose monitoring (CGM) device that gives them a reading every five minutes. I wish that a CGM would let me take a mental vacation, but I personally end up getting more frustrated by the inaccuracies of my CGM, its frequent and nighttime alarms (that I can’t turn off), the time lag between CGM glucose values and actual blood glucose (a 6- to 20-minute delay), and feeling pushed to achieve perfect blood glucose values—which is hard to do with a chronic disease that affects metabolism and is impacted by hormones, stress levels, sleep quality, illnesses, and so much more.

Some people swear by insulin pumps but, again, I personally have been frustrated with using them due to infusion site issues (not delivering any insulin at times, leading my blood glucose to shoot up for hours), cost of pump supplies, insulin waste (as they hold way more than I could ever use before they need to be changed), and constantly having to wear something on my body. For these reasons, I’m not that excited about the hybrid closed-loop systems comprised of a pump and CGM that deliver basal insulin via programming and algorithms handled by a separate device. With such systems, you still have to decide how much insulin to give for meals and override the system’s settings to be able to exercise without going low, which is one of the biggest hurdles to having them fully automated. I also don’t trust CGMs to guide insulin delivery choices with how often mine has been off target.

So, for me, a true diabetes vacation is likely not coming anytime soon. The closest I get to one is going old school for a while with no CGM and no insulin pump. Don’t let anyone tell you that you absolutely have to have these devices to manage your blood glucose levels—I have the same very respectable A1C values without them as I can achieve with them—but also don’t abandon your blood glucose meter!

Sometimes my idea of a vacation from diabetes is just checking my blood glucose is 10 times a day instead of 288 (every five minutes)! Do whatever you need to do for your own peace of mind with diabetes and call it a vacation until an actual diabetes cure comes along.

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