Blood Sugar Highs + Lows: Hitting the Mindset Reset Button

This content originally appeared on Beyond Type 1. Republished with permission.

By David Bernstein

As people with type 1 diabetes, we undergo the daily frustrations of high and low blood sugars. We battle every day. The struggle seems relentless, and frustration sometimes sets in. What can we do about it?

Dosing Insulin for Food Is Complicated

Here’s an all too familiar and typical scene: We go out for dinner to celebrate a nice event—a birthday or anniversary or achievement. Since we’re celebrating, we go all out and order the full dinner. The main course is chicken, steak, or fish. We consider these blood-sugar-friendly proteins. No big deal there. But the main course comes with mashed potatoes…yum! And don’t forget the creamed spinach! For dessert, we just have to order the chocolate pie! Oh, wait—didn’t we also have those bakery-fresh rolls before dinner?

No need to enumerate the potential result: crazy high numbers in spite of the insulin we took thinking we would cover the carbohydrates. Then we dose the inevitable additional insulin units to “chase” the glucose high. Then more insulin as the midnight hour approaches and we need to go to sleep. Then the crazy lows in the middle of the night that make us run for apple juice or grapes or whatever we use when we hit bottoms. (And perhaps eating everything in sight.)

The next morning, we ask ourselves, “Why was I so ‘bad’?”

Don’t Beat Yourself Up

We control what we eat. To many of us, sugar just tastes good—and it’s not “bad” to include sugar or other “carby” choices as part of your sustainable, balanced diet! So, let’s not be too tough on ourselves.

You’re trying to manage something your body is supposed to manage on its own in response to a slurry of different variables—including fat, protein, and of course, carbohydrates. It is perfectly understandable that we get annoyed by stubborn highs and take too much insulin to bring them down. Yes, I sometimes exhibit insulin rage!

Creatures of Habit

Each of us has a way of managing the highs and lows. No two individuals with diabetes handle sugar fluctuations the same way. We each take a different approach. We are often set in that way.

Have you asked yourself: is your approach working well for you?

We have developed a strategy—a routine—for fixing the highs and lows. We have been doing this for so long we just keep doing it even if it isn’t effective.


As we take a step back from our diabetes and consider the human condition, what is one thing we all have in common?

Answer: We get into ruts.

What is a rut? I checked the dictionary for a good definition and the simplest and best was this: “….to not have changed what you do or how you do it for a very long time.”

Nothing new about this concept. We humans are simply creatures of habit. We start doing something and continue to do it. We continue along the same path even if the results are not always what we want.

Diabetes and the Importance of Change

Many of us have been dealing with type 1 for so long that we simply do the same things over and over again.

The pattern is fine when it works. But what happens when it doesn’t? When we have had enough negative results, we need to take a second look at the things we do by habit.

One author called this realization “a whack on the side of the head.” I am referring to the best-selling book by that title published in the early 80s.

Have you had a WHACK on the side of the head concerning how you deal with type 1? Have you had a wake-up call? I have, and it made me think that maybe it’s time to hit the reset button.

Hitting the Reset Button

When we finally figure out that what we do is not working, we need to go back and create what philosophers call “tabula rasa.” We have to imagine that we are starting over, knowing nothing, and no longer accepting the assumptions we’ve made.

Why is this an important thing to do? Because we change every day, week, month, and year as we deal with type 1 diabetes. What might have worked once does not work now. (Or perhaps it was never working?)

Perhaps the old ratios no longer apply. Perhaps our relationship with food is a daily struggle? Perhaps the insulin we take for meals needs to be 20 minutes earlier or 10 minutes later. Perhaps our reactions to highs and lows need to be tempered.

Most of all, perhaps it is time for CHANGE.

Am I Set In My Ways?

Each of us will have a different answer to the question. I admit to being a creature of habit. I rely on my past approaches to diabetes—even when they don’t serve me well.

Unfortunately, I am not alone. A friend of mine once said, “No one is going to tell me how to manage my diabetes.” Has a person with diabetes said this to you? Do you sometimes think this way?

If I am honest, I am quite set in a pattern in much of my life. I enjoy the security of knowing that there is a reliable structure in everything I do. I feel the most comfort in repetitive behaviors: waking at the same time, eating mostly the same thing, doing what I do every day, befriending who I befriend, and so on.

So why should handling my diabetes be any different?

The Will to Learn

All too often, we folks with type 1 diabetes are not open to new learning.

All learning begins with humility: it requires us to be less arrogant, less sure that we are doing the right thing, less certain that what we have done in the past is good for the future.

If you are reading this, you might be open to seeking new answers, new habits, and new approaches.. I want to be open to new learning so I can better manage diabetes.

It may be time to break out of the rut. It may be time to question our assumptions about how we deal with diabetes. In doing so, we can wake up fresh one morning and say, “Today is the first day of the rest of my new life with diabetes.”

Best of luck to all my fellow folks living with type 1 on resetting the clock.

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