BAD Blood Glucose On A Remote Island - Why, And What The Hell Happened?

I have been on holiday, and after a few days of good behavior, my blood glucose decided to rebel (or insulin to go on strike).

For the last two days of my stay, my blood glucose has fluctuated between 220 and 260, despite my best offorts to adopt all the counter-measures I could to square my “diabetes formula”. My beloved >90% TIR was gone, and I accepted that (everything can’t always be perfect). What I struggled to accept was that I had no idea of why this was happening.

For context, I spent a week in a remote island in Indonesia with some less usual, challenging conditions for a T1:

• Limited food availability (we mostly ate white rice, tofu, fruits and vegs and some other fried or oil rich foods served by the local people)

• No internet and no electricity for more than half of the day (electric current only worked during the night, and there was no wifi or digital facility)

• No scaler for the foods, as everything was prepared in bulk and consumed together with the other few people (we were 8 total on the island)

• Lots of heat and humidity, which I have reasons to suspect spoiled my insulin a bit.

Keeping the above in mind, let me try to unpack what was going on and try to figure out a reason for my absurd blood sugar levels:

• The lack of internet made it difficult to understand the content of my meals because I could not log it into the apps I am used to use. Additionally, and without a scaler I could only guestimate my portions, so each meal was a guessing game. Everything was shared and I did not eat that much so the portions were not anyway - and I could kind of get a fair amount of bolus in most cases.

• I was not able to keep track of diabetes on my journal with my usual consistency, mostly because I could not count my macros and draw an accurate picture of my ratios, but also because the days were so intense that finding moments to sit down and do the math was difficult. [This really sounds like an excuse, as we ALWAYS have to make time for the important stuff]

• The type of food is a bit different than usual, but nothing drastic. I am used to consume 600+ grams a day of (whole and unprocessed) carbs, but here I am getting more white rice, often with oil, both of which are processed. I avoided the deep fried and oily stuff to the best of my abilities, but that food definitely upped my insulin resistance.

• It was hot and humid, but I was used to it by all the running in the extreme heat of the Italian summer, so I don’t consider this a huge factor.

• I was also swimming A LOT every day (~3 KM), so I can’t say I was not moving and not trying to keep that insulin sensitivity up.

• I was very NOT stressed, or that’s what I think at least - I was on a remote island with nothing but palm trees, lizards and the best sea I’ve ever seen. The only noise was that of the waves on the shore, how can that be stressful?

• I was drinking tons of water (4+ liters a day, as usual) and sleeping like a baby for 8+ hours every night, so all the “insulin sensitivity basics” were covered.

I think that not keeping track on the journal was the biggest problem, and that white rice and oily stuff was probably not the best carb to consume.

But I couldn't make sense of why, despite “nailing the basics” (hydration, sleep, exercise and stress), I had to inject THRICE as much insulin as usual for half of the amount of carbs I usually eat, and still my BG was above 200.

I started to believe that my insulin was not as effective, because it had been traveling with me for two weeks in and out of bags and refrigerators…but that sounds like a weird explanation to me, and much like an excuse.

However, after a bit of struggling and negative self-talk, I fully accepted the situation and just went on with my holiday (still trying to do my best but also shrugging my shoulders if the results weren’t coming). And as soon as I stopped caring, my blood sugars came back to normal and in the usual steady, beautiful flat line I like to see on my CGM.

I am not sure what this means. Probably, merely thinking about this entire situation did stress me after all, and the stress, the negative self talk and the mounting sense of despair did play some role in all of this.

I don’t know what happened. I just know that the power of “letting go” of stress changed everything for the better.

And I have the feeling that with a slight more of preparation I would have nailed it. For sure, T1 did not limit me nor ruined my holiday, and I would do it all all over again!

T1 Diabetes is still my best friend, we just need to understand each other a bit better as we grow together!

Do you have any similar experience?

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