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One evening this week I made pizza scima, a flatbread from Abruzzo.

Baking bread became a pandemic hobby for me. I love it, but the process takes time. Time to knead and time to rise. Time to punch down before the second rise. It’s a slow and calming practice that I have learned to appreciate. Baking bread became abeautiful way to mark the hours of a lockdown afternoon and I delighted in stopping in between work calls to take a peek under the cloth that was covering the dough, as it was snuggled – and getting ever more snuggly – in a bowl by the heater (in winter) or sunny window (in warmer weather). The oven would heat up the kitchen and as we sat down to dinner, a golden, crunchy loaf would emerge, ready to accompany whatever was being served up.
But days are returning to somewhat (new) normal here and there is less time. No lockdown means a different pace during the day, because I now inevitably rush out during lunch hours to run errands or stop off for a quick visit to the fruit and veg market before work gets started. Or I’m slowly venturing back into the office for a day here or there. All this means that those minutes that lent themselves to slow food activities now run into each other again: time is not as leisurely as it was, and suddenly it’s dinner time without time to make a loaf of bread.
But on this day, I wanted bread; fresh, homemade, just out of the oven, bread.
And so, I made pizza scima! It’s a five-minute process where all the ingredients: 00 flour, olive oil, salt, bicarb soda and white wine get tossed into a bowl, mixed together and then flattened on a tray. The dough is scored, and the oven does the rest. No kneading, no proofing, no resting, no rising.
Half an hour later, a stunning crispy on the outside, chewy on the inside flatbread emerged and honestly, it is the best bread hack there is to know. (Plus, the recipe calls for only a little wine in the dough meaning you have something to drink with dinner!) Viva gl’Abruzzesi!
There’s nothing like adding a sneaky little shortcut to your repertoire – whatever that may be. I think that often people with diabetes become super smart at finding these sorts of little techniques that become a snappy solution to a diabetes problem.
Yesterday, I learnt a new diabetes hack thanks to Kelly Kunik, DOC old-timer who writes at Diabetesaliciousness. Here is what she shared via a collaboration with Ascenisa*:
This reminded me of one of the topics for Diabetes Blog Week. For newer folks to the DOC, DBlogWeek was an initiative of Karen Graffeo who used to write at Bitter~Sweet Diabetes (seriously, check out all these people and their blogs). Each year, Karen would coordinate this monster effort, coming up with different writing prompts and then setting up a platform for them to all be collated in one space.
Back in 2014, one of the topics was diabetes hacks and ninety-five diabetes bloggers all wrote posts sharing tips and tricks they have discovered that goes towards making their diabetes a little easier. Here’s what I wrote. I’m so pleased to find that all the other contributions are still all together on this link, and I’ve just spent a delightful hour scrolling through and re-reading some of them, getting a refresher on some super ideas from super people!
Call them hacks, call it inspired improvisation, but MacGyvering the fuck out of diabetes is a talent worth cultivating, because you never know when a diabetes moment will call for it.
DISCLAIMER
I am on the Editorial Board for Ascensia Diabetes. I am paid for the pieces I write that appear on their blog. Kelly is also on the Ed Board. Sharing this for no other reason than it blew my mind!
There is so much about diabetes that can’t be simply explained or managed. And even if we understand the mechanism behind why something happens, we can’t necessarily fix it!
The intersection between diabetes and anxiety is certainly one of those things. When I am anxious, I go high. That’s the way it is. If I am extremely anxious and have a panic attack, the adrenalin rush sends me to insanely high glucose levels that I know I can’t treat by just bolusing insulin, because there will a swift, aggressive crash at some point and any excess insulin will make it worse. Much worse, because nausea often accompanies how I am feeling in the moment, so the thought of an ‘eat-the-kitchen’ hypo is not great at all.
I was feeling pretty anxious yesterday. It was a medium level hum that at times swelled to a loud banging noise, and I could sense that there was a topple on effect with my glucose levels. Except there wasn’t. At least not one that could be detected on my CGM graph, which was chugging along in range, albeit at the slightly higher end of that range.
But Loop was working hard to keep it that way. Micro changes to basal insulin showed a Loop graph of constantly changing dosing throughout the morning – at the same time I was feeling loud-banging-noise-anxious. At the moment there was a surge in anxiety levels – and I can pinpoint that moment – there was an accompanying surge in my insulin dose, but only for a little while. Because as my anxiety ebbed and flowed, so did my insulin dosing. All with me doing nothing.
Living with anxiety is one of the things that makes diabetes super difficult. I mean, there are so many things, but anxiety is a next level issue because the very idea of thinking about dealing with diabetes while dealing with an intense moment of anxiety is, quite simply, impossible. But even if I could, there is no way that I would be able to predict just how my glucose levels would respond, or the timing of that response, to act effectively.
As ever when writing and thinking about automated insulin delivery it comes with a very honest understanding, and acknowledgement of my privilege and knowing that I am extraordinarily fortunate to have at my disposal the technology that can help me in this way. I’ve written and spoken about this a number of times, and I am always acutely aware of the advantage of having a system that takes away so much of the brain power needed to manage such a complex health condition. I say this not as an afterthought – it is an ever-present thought.
But also ever-present is the gratitude that there is something with me that is providing such incredible insight into just how my diabetes behaves, operates and reacts to different situations. That is, of course, what CGM does. But it’s Loop gives an extra layer of insight – it shows me what my body would have been doing if my beta cells hadn’t gone on a permanent ‘tools down’ almost twenty-three years ago. And gives me an appreciation, and a reminder, of just how difficult diabetes is, and how incredibly challenging it is to attempt to perform the function of a highly sophisticated and evolved body organ!
Anxiety is unpleasant. What it does to diabetes is unpleasant. But having the tools to help manage its impacts on diabetes does help. It’s one less thing to worry about at a moment when it feels that I am being engulfed in a whole world of darkness and worry which is how I felt yesterday.
Now if someone could just magic up a DIY tool to stop the anxiety happening in the first place, that would be just dandy!
I found myself in A&E in the early hours of Saturday morning, and for the first time in more than two decades, that visit was not because of diabetes. I make it sound as though I am a frequent guest at local emergency departments, but that is not the case. I can’t remember the last time I was there, but I do know it was thanks to the unholy trio of diabetes, gastro and ketones. That would be the only reason I’ve visited in the last two decades.
But before that – back in my pre-diabetes days – the reason was something different. I used to have seizures in my sleep. And at 2am on Saturday morning, I woke up realising I’d just had a seizure.
The first thing I did as I was coming to was check my CGM trace. A neat line that had barely wavered between 4.2mmol/L and 5.6mmol/L. This wasn’t diabetes related.
The last time I’d had a seizure in my sleep was 16 years ago when I was pregnant with my daughter. But that one was because I was low. I knew what to do, I knew why it had happened, I knew that it was just one of those things, I knew it was a pregnancy low that I had read about.
This one had nothing to do with diabetes and that left me in a very confused space. I wasn’t sure what to do. Did I need to go to the hospital? That’s what used to happen. But was that still the drill? We made a few calls and we decided that it would be best for me to go into A&E and take it from there.
There is no good time to need to go to A&E. There are just bad times and worse times. Turns out this was a worse time. I arrived at 2.30am, exactly two hours and 31 minutes after Melbourne went into lockdown after a COVID-19 outbreak. Aaron wasn’t allowed to come in with me because new restrictions were in place, so he left me at the door. The waiting room was filed with people who appeared a little worse for wear after their last hurrah before lockdown went askew.
The triage nurse saw me straight away and I explained why I was there. She looked up after asking me if I had any other conditions and I said ‘Yes, I have type 1 diabetes.’ I waited for her next question, jumping in after it didn’t come for a couple of beats. ‘I wasn’t hypo. My glucose levels were steady and between 4 and 6 the whole night. I wear a CGM. It wasn’t from hypoglycaemia.’ She typed that into her computer and then told me to take a seat and someone would be with me. She smiled at me, ‘It’s foul tonight. You’ll be here for a while.’
This is where things diverged from my last A&E visits. I was sent back to sit down and wait. And wait, and wait. There are few upsides to living with diabetes, but one of them is that when it’s the reason for a visit to an emergency department, you are given the VIP treatment and seen straight away. At least, that’s been my experience. Ketones are not to be messed with and as soon as I’ve ever mentioned the word, I have been whisked away behind the locked door and seen straight away.
But not this time. This time I was with the ketone-typical people, and sat quietly until, about two hours later, it was my turn. Blood was drawn, a CT scan was ordered and done, a consult with a neurology registrar happened. I was asked by everyone I saw if I was having a hypo when I had the seizure, but other than that, no one paid any attention to my diabetes. Which was just fine, because Loop was taking care of that for me and I didn’t really feel like having to do a DIYAPS tutorial to explain why I didn’t want anyone managing my diabetes for me while I was there.
After a couple of hours of outstanding care and attention, I was able to leave the hospital and go home with instructions of what to do next, an appointment for an MRI and EEG scheduled for the next couple of weeks, and a subsequent consult with a neurologist. And with a slightly fuzzy head … and a heavy sense of dread forming in my chest.
It’s a couple of days later, and I’m feeling less fuzzy. The only physical remnants I have are achy ribs from the actual seizing. Emotionally I’m more than a little wrecked, and in a state of uncertainty which is never good. I’m terrified of going low and checking my CGM trace every 23 seconds, stupidly jumping at anything that hints that I could be heading into hypo territory – even though Loop is more than capable of taking care of it.
I’m scared that this is not a one off, and instead the start of something else that is chronic and going to take up energy. I’m worried that my usual scatterbrain and forgetting words is actually something more sinister. These are the thoughts that have been going through my head from the moment I woke after the seizure.
On Saturday morning I walked out of the hospital to meet Aaron, the sun was rising, and Melbourne was starting to wake up. I climbed into the car feeling grateful to be going home. And sad. I thought about how over the last three years I’ve managed to get my diabetes to a place that requires little effort and with that managed to claw back so much mental effort that I’d needed to dedicate to my broken body. Was that all about to be redirected to something else? Was I going to have to learn a whole new language for a whole new part of the health system that I am already sick of having to use? Was this my broken body reminding me that I don’t get to feel comfortable in it? That while I may have thought I’d found the magic key to putting diabetes in its place, other things could and would pop up. Not diabetes. But there could always be something else…














