For Want of a Cup of Coffee

I know what you're thinking. "Rob, you absolute paragon of diabetes control. You're like a divine presence come down from the Heavens to lift us up with your stylistic ramblings and fill our heads with important information about diabetes." Yup. Guaranteed, that's what you're thinking, word-for-word. 😉

Okay, so I'm not exactly a psychic. But I have the distinct feeling that some of the people reading this blog might think that I think I'm the patron saint of diabetics. 

Not even close. I'm a good diabetic most of the time. But some of my choices fall under the category of "Do as I say, not as I do."

My last post was about my diagnosis of cardiovascular disease. If you don't know, such a diagnosis comes with even more dietary changes. Reduced fat. Reduced salt. No caffeine. They might as well have told me I'm only permitted to drink water and eat nothing but cardboard. What's funny is that these restrictions are already built into a diabetic diet in hospitals. I found that out when I had to stay the night after the angiogram. They sent me a meal that was labeled "heart healthy," but with packets of sugar and a fruit cup loaded with fructose. So I called down to let them know that my meals should also be for a diabetic, and that's when I was told the diabetic menu was even more restrictive than the heart healthy one.

Reduced fat, reduced salt, no caffeine, and NO SUGAR! 

Now it's the water and cardboard diet, for sure.

During a follow-up appointment with my cardiologist, I credited him with bringing my blood sugars under tighter control. He initially rejected this idea until I explained that with my cardiovascular system no longer struggling as hard to function, the overall stress on my body has been reduced. Similar to the "fight or flight" reflex, my body was in near-perpetual "fight mode" just to function before the stent was placed. That meant naturally occurring steroids were constantly being released into my bloodstream, and steroids make a diabetic's glucose level go up, UP, UP! So once I'd shared my hypothesis with him, he agreed that he might very well be responsible for my blood sugars improving.

Mind you, it was a marginal improvement, but an improvement nonetheless.

For the record, I tried. I did. I bought decaffeinated coffee to get my day started. I'm not affected by caffeine for some bizarre reason. In terms of alertness, that is. If anything, I typically experience caffeine crashes after drinking a cup of coffee. After years of drinking regular coffee, decaf tasted... off. Only one brand ever got it right, and I can't find it for the life of me anymore. 

~ shakes fist impotently at the sky ~ Damn you, Maxwell House!

So I, ummm... I gave up. I have my ONE cup of java in the morning, and that's it. Just one. And one, is seems, is about all I can handle at this point. Because when I drink my singular cup of joe, things inside my aging body go absolutely goofy. 

Let me be clear. The only carbohydrates in my coffee come from my sugar free, French vanilla creamer. Somewhere between 8 to 10 grams of carbs total, which on a diabetic exchange diet isn't even the equivalent of one piece of bread. (15 grams = one bread.) The artificial sweetener I use adds zero carbs. 

I believe I've discussed it before, but I'll review how I decide how much insulin to take. I check to see what my glucose IS, calculate how many "breads" I'll be having with the coming meal, and then add enough for what I assume my glucose WILL BE. Because I'm insulin resistant, my doses are high. VERY high. In fact, when I tell hospital staff how much insulin I would normally take, they silently assume I'm trying to get them to kill me and go with their preset standards. They come in and tell me they're going to give me a "very high dose of 11 units," and I'll reply, "Oh, that is adorable." Later, when my blood sugar is checked and it comes back at 400 or more, they start taking me seriously. If my blood sugar is normal, between 80 and 110, I'll take 28 units of Humalog if there are three "breads" in my coming meal.

But in the morning, if my glucose is normal, (which is rare*), and I'm going to have my coffee, and ONLY my coffee - no other food of any kind - I take... Brace yourselves... 

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48 UNITS OF HUMALOG!

That's probably enough to kill a bear, if not an elephant. This is because the coffee puts a lot of stress on my cardiovascular system. Has this been confirmed medically? Nope. But I'm not eating anything else in the morning, my creamer is sugar free, (but still has carbs, which are accounted for), and I use artificial sweetener. So if someone else can come up with a better theory, I'm all ears. The closest thing to "proof" are my sparkling lunch readings, which DO come closer to that perfect range.

*About my fasting blood sugars rarely being normal... This is a whole different issue about balancing my insulin doses more carefully at night, which I'll try to get into in the near future.

I'm 55. I have no family. My friends are all distant. I'm both alone and lonely. So I'm going to break some of the rules every now and again, especially if breaking them means I get a little enjoyment out of life.

The proper summoning configuration

to get me out of bed in the morning.