Diabetes Self-Management Blog

Oh, what a dream! I was in the midst of reading a book involving time travel when I checked my e-mail to find that Andy Stuckey had sent a link to his and Murray’s “If I Were Jack Bauer” music video at www.dotcomedy.com. After I watched the video, I must have drifted off to sleep with the image of Jack Bauer as a pizza delivery boy swirling through my brain.

In my dream, Stuckey lived in the future, while I was still in the present, but there was an elevator that took us between the centuries. While you couldn’t get off the elevator to live in the other time, you could learn about what was to come—or revisit the “good ol’ days,” depending on your perspective.

Diabetes still existed in that future. That’s right: No cure yet. But there was one major improvement: Eating pizza didn’t send your blood glucose soaring. At least not Jack Bauer pizza. I know this because Stuckey delivered some to me and my blood glucose was only 92 mg/dl when I checked upon awakening. I don’t know if it had something to do with how the pizza was made or a new and improved diabetes medicine of some sort, but it was a welcome innovation.

Too bad it was only a dream.

If we can’t have a cure, I have only one wish: to have an easy, fail-proof way to control blood glucose levels. I use a meter. I use a continuous glucose monitor. I take Symlin (pramlintide) to help smooth out the spikes. I know food well enough to “guesstimate” carbs and fat pretty well even for unfamiliar dishes. When I travel, I check out recipes for native dishes before I go so I’ll have a better idea of what’s in the food.

It’s still a crapshoot. There are just too many variables with diabetes. Take my visit to New York City a couple of weeks ago, for example. I tagged along with a friend who was attending the American Diabetes Association’s Advanced Postgraduate Course. In addition to my accumulated knowledge, Sandy is an R.N., dietitian, and C.D.E., so I also had somebody to help me troubleshoot.

On the first day, we kind of got lost going to a restaurant. OK, I’ll confess: I got us lost. We were going from 45th Street and 7th Avenue to 44th Street and 8th Avenue. Except that I got turned around, and we trekked off uptown instead of downtown. After meandering around off course for a few blocks, we managed to find the restaurant.

My face was numb. Sandy said that my eyes were glazed over. Oops! Little too much exercise there, but a swig of soda took care of my hypoglycemia. We shared a roasted vegetable appetizer and a very thin-crust pizza with no sauce, very little cheese, and plenty of veggies. My blood glucose came up very nicely. In fact, it kept going up and up and up…and stayed there.

It was still high that evening when we met fellow bloggers Andy Stuckey and Tara Dairman and former blogger Katharine Davis for dinner at Katz’s Deli, where I split a pastrami sandwich and a potato knish with Sandy. I took insulin, injected Symlin, and drank plenty of fluids. We took the subway back to the hotel, which involved lots of stairs and more walking (and walking… and walking…).

In terms of crust and ingredients, I’ve had worse pizza and handled it. Pastrami and potato knishes are not new foods for me, and I’ve handled those OK in the past, too. With all of the walking and climbing up and down steps, you can’t say I wasn’t getting any exercise.

So why wasn’t my blood glucose coming down? Even if I’d grossly miscalculated my insulin doses for the food, why weren’t my correction boluses working? Was it the fumes from all the vehicles in the city? Was all that neon in Times Square having an effect? Had the planets realigned themselves? Should I have worn red instead of blue?

What Sandy and I finally decided, after some rest the next day saw my blood glucose coming back down, was that all of the walking had further inflamed my already arthritic knees. Once I learned to pace myself a bit better, the rest of the trip was uneventful—at least as far as my blood glucose went. I even ate a plate of fettuccine with pesto that, I swear, kept growing faster than I could down it and didn’t have any problems with soaring blood glucose.

Yep, variables. It’s not enough to control portion sizes and know the nutrition content of your food and balance that with meds and exercise; you have to account for physical and emotional stress, hormone changes, the temperature, and your sleep schedule (not to mention the alignment of the planets…and avoid wearing blue on Wednesdays).

As far as anybody doing anything about it—well, I can dream, can’t I?


  1. 25 years ago, AIDs was a public headline; a death sentence. Today, AIDs is not eliminated, but managed. It took over 100ys for Diabetes to reach a similar milestone. Diabetes is a pervasive disease in the US and maybe world wide. So, why don’t we have a better return on the millions of dollars of targeted research funding?

    Why are we using stone age artifacts to manage this disease? Well how stupid of me. The reason is …

    Posted by Robert Ference |
  2. What a helpful article. I sighed with relief - I’m not the only one this happens to, right? Thanks

    Posted by radm2 |
  3. Jan, as you said, some days you can eat just about anything other days water will send your BS through the roof.

    Thank you for letting me dream with you. Pizza is not my thing but Sea Food Fettuccine or mashed potatoes & gravy, now that is a totally different matter.

    Posted by Norleen |
  4. Jan, what a great blog post! Why? -because it was so very true. I have had D for 45 years. In the beginning you are taught the supreme importance of food, exercise and insulin. Yes, these three factors ARE very important for determining our blood glucose values, but OTHER things also influence our bg values. If one carefully logs all bg values, insulin, food and exercise one begins to see that SOMETHING ELSE beyond these three primary factors also MESSES everything up, makes all our calculations go down the drain! We must still work with the insulin, food and exercise components but NEVERTHELESS accept that we often fail to achieve good bg values and that is not our fault! Today we do not know enough about ALL the factors influencing our final bg values. We know about stress - but how do you correctly put it into the calculation? I write about living with D in my blog at http://chrissieinbelgium.blogspot.com . I am very healthy but D is a constant challenge.

    Posted by Chrissie in Belgium |
  5. You hit the nail on the head, Jan. If we could solve the blood-glucose control problem, we wouldn’t have to worry about curing diabetes–or, at least, curing diabetes right now–since we diabetics would collectively have lower rates of developing complications (not to mention much easier lives).

    My favorite BG variable is stress–it always makes my BG go up, but when I’m stressed out I’m less likely to have/take the time and energy to figure out how to optimally adjust my insulin dosages, by definition. Talk about a catch-22. :)

    Posted by clopsal |
  6. I am a D-nubie, diagnosed last September. Still trying to find easy ways to stabilize my BG (Yeah, I know - nothing’s easy but….). I received an ad in the mail about a new snack for diabetics called ExtendBar (www.extendbar.com) that contained only 1-3 “net carbs”. “SWEET” says I and placed an order or on line for a 15 bar sampler box for $15.99 (one only per household). Then I read the fine print - 20g to 31g carbs - and a bunch a mumbo jumbo about how this product would “stabilize my blood sugar for 9 hours”. Did I waste my money or is this legitimate?

    Posted by Jon Shinabarger |
  7. Hi Jon,
    Your comment raises a few issues. The Extend bars do work for some people, particularly those who experience hypoglycemia (low blood glucose) overnight. These bars contain uncooked cornstarch, which is more slowly digested and absorbed than other carbs, thus helping to even out glucose levels. You still need to count the carbs in the bar, though (don’t go by “net carbs”, either). Also, eating a snack that has some carb, protein, and fat (e.g., crackers and peanut butter) can prevent hypoglycemia overnight, too. However, the larger issue is that, since you’re newly diagnosed (not sure if you’re on insulin or not), you need to address the bigger picture, which is focusing on getting your medicine (pills or insulin), meal planning, and activity levels sorted out. If you’re having too many low blood glucose levels, for example, you may need less medicine, rather than more food. Work with your physician and dietitian to fine-tune your diabetes treatment plan.

    Posted by acampbell |
  8. Dear Jan,

    I loved the idea of the “Jack Bauer pizza”. Maybe some day?
    Thank you so much for your New York story.
    I thought I was the only person whose blood glucose went up and up andup and didn’t go down no matter what corrective measures I tried.
    I have days where no matter what, the carbs, the exercise, the injections nothing seems to even out and sometimes just won’t won’t , go down or won’t go UP.

    Thank you for your list at the bottom.

    Posted by jaime |
  9. I’m so glad I found this site…Keep up the good work

    Posted by Bill Bartmann |

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