Whether you are newly diagnosed with cystic fibrosis-related diabetes (CFRD) or have been dealing with it for years, this post is for you! Learning to juggle checking blood sugars throughout the day, giving insulin injections and eating just the right amount of carbohydrates can be time consuming and exhausting. Below are some quick and easy tips for making your CFRD more manageable and less stressful!
Keep a list of your daily medications, vitamins, medical supplies, snacks, etc. in a place that’s easy to see. Tape a piece of paper to your bathroom or bedroom mirror that lists everything you will need in your bag before leaving the house. This simple note will mentally lighten the load you carry and keep you from forgetting essential items.
Place a small bag of fruit snacks, dried fruit, glucose tablets, juice, candy, etc. in various places throughout your home, car and place of employment. This will ensure that you always have something nearby if your blood glucose gets too low. My current go-to is Black Forest Juicy Burst snacks from Aldi. Some of my favorite dried fruits are Kirkland Signature Organic Dried Mangoes from Cosco and Turkish figs from Nuts.com. You may also want to keep a packet of sugar or a glucagon pen with you in the case of an emergency.
Check your blood sugar before and after meals. This is obviously an individual preference. However, I’ve learned that if I want to keep my blood glucose numbers within range throughout the day, it’s helpful to test before and after meals.
Rotate the fingers you prick for checking blood glucose. I’m currently using an insulin pump and a continuous glucose monitoring system, but when I was only using my meter to check glucose levels, my fingers would get so sore! I learned that pricking only one finger per day gave the other nine a little break!
Write down your injection sites. If you’re on a basal and a fast-acting (mealtime) insulin, it’s often difficult to remember from day-to-day where you’ve given injections. Make yourself a little chart and keep it next to your “list of medications, medical supplies, etc.” paper. Write down the days of the week and then make a note of where you’re going to give injections each day.
For example:
MONDAY: Basal insulin- right thigh, Mealtime insulin- right side of stomach.
TUESDAY: Basal insulin- left thigh, Mealtime insulin- top area of stomach.
This gives you a guide so you don’t have to do the mental work of remembering to rotate to a different area of your body each day.
If you’re on an insulin pump that’s connected to a continuous glucose monitoring system, an easy way to remember when to rotate is to keep your insulin pump insertion sites on the same side of your body as your CGM, then rotate whenever you change out your CGM.
Pack healthy snacks. In addition to having some high carbohydrate snacks on hand for when your blood glucose levels start to dip, it’s also helpful to bring a snack with you when you go out. I often feel tired and weak if I haven’t eaten anything in several hours, even if my blood sugar isn’t low. For this reason, I’ll bring something to eat that has a combination of protein, fat and carbs. Some quick and easy snack ideas are trail mix, granola bars, crackers and peanut butter, fruit and olives or nuts, or some guacamole and veggie sticks or crackers.
Write down what time you can start eating. Get a whiteboard or chalkboard for your kitchen and jot down the time you can begin eating. You could also set a timer on your phone. Sometimes a 5 to 10 minute window of either eating too early or not eating soon enough can throw off blood glucose levels by quite a bit.
Use a continuous glucose monitoring system (CGM) and an insulin pump. A CGM will drastically reduce the number of times you will need to check your blood glucose levels using your meter. It’s a small device that’s inserted on your body (generally your abdomen or arm) and gives you an updated reading of your blood sugar about every 5 minutes. An insulin pump takes the place of your daily insulin injections. It’s connected to your body and dispenses a small amount of your basal insulin throughout the day. You also administer your mealtime insulin by using the pump.
Cystic fibrosis-related diabetes can be very challenging, especially because it’s an added stressor to the daily work of managing cystic fibrosis. When you begin implementing steps to take off some of the mental load you carry on a daily basis, things begin to get easier. And if you struggle with digestive-related issues (don’t most of us with CF?!), check out my blog post, Help! My body won’t digest food!, for helpful advice on maintaining a healthy gut.
