Q: My husband and I are very frustrated about his Type 1 diabetes. He uses a pump and CGM and is diligent about keeping track of everything. We live up in the Rockies and get lots of exercise. Still, his blood sugar is mostly high and spikes all the time. Twice this summer, we’ve vacationed at a lower altitude for several days. Both times, his BG stopped spiking and stayed close to normal. As soon as we got back home, the spikes and high readings resumed. Do we need to consider moving to a lower altitude?
A: As I read your description of the altitude change and concurrent changes in his blood sugar, one word really stood out: vacation. I see this frequently. Getting away from the stressors of daily life can lead to a marked reduction in a stress hormone called cortisol, and this produces better insulin performance. My guess, and this is only an educated guess, is that your husband might benefit from learning to apply some stress-management techniques.
That said, I love the fact that he is so detail-oriented. Tracking glucose levels frequently and matching insulin doses to food and activity can put a person in a great position to succeed. However, emotions play an important role as well. It would be worth sitting down with your husband and having a heart-to-heart talk about the stress in his life. If necessary, seek out the assistance of a professional mental health counselor.
Want to learn more about managing stress with diabetes? Read “Relaxation Techniques for Stressful Times,” “Stress: The Good, the Bad and the Ugly,”“Three Ways to Cope With Stress” and “Yoga for Diabetes.”