Food issues, bubbles in your pump tubing — it's all par for the course when you're living with diabetes.  But sometimes you just need some...




We're here for you at Ask D'Mine. Errr, that is, our diabetes advice columnist Wil Dubois serves up answers with a healthy side of snark. He's a veteran type 1, diabetes author and community educator.

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Toby from Washington, type 2, writes: I get so darn hungry in the evening! I have been cutting back in the day, and around bedtime I feel this overwhelming sense of fear like I am not going to get to eat again and I get really hungry and panicky. This has to be some mental connection to food. That is the worse time to eat a lot. Any suggestions?

Wil@Ask D'Mine answers: Hey, Toby, we've got a PG-13 rating here at D'Mine on the weekends, so it's OK to say "I get so DAMN hungry in the evening!"

Go ahead and try it. I bet it'll make you feel better. I want you to get up right now, go to your window, open it, stick your head out and yell "I get so DAMN hungry in the evening and I'm not gonna take it anymore!"

Of course, you'll still be hungry, but you'll feel better about it.

Our relationship with food is a complicated one. Food is more than just sustenance. Food is comfort. And joy. And recreation. And socialization. And communication. Food serves many, many, many social, cultural, and psychological needs for us. Is there a mental connection to food? Oh yeah, your bet your frickin' mac-and-cheese there is.

But recognizing the problem doesn't solve it.

There're any number of solutions. If we want to open the medicine cabinet, depending on what meds you're on for your diabetes, and how well controlled your diabetes is or isn't, you could talk to your doc about Byetta or Victoza. Both are outstanding diabetes meds, at least in their ability to lower blood sugar, and both have the side effect of dampening hunger quite a bit.

Or maybe you need something for that anxiety. It could be a pill. But it could just as easily be as something as simple as an occasional daiquiri, or aroma therapy candles.

Now, so you're trying to cut back on your food. My guess is that means either you or someone else thinks you need to lose weight. (Probable suspects = your doctor or your wife, or God forbid, both.) Your brain, however, isn't really totally on board with this plan. And the brain is like a five-year-old. A selfish little ball of all-about-me! Yeah, we can medicate your brain, but most likely you're already doing your part to support America's pharmaceutical industry as it is. So I think the easiest way to handle this is to find a safe way to feed the monster.

By that I mean, give in to your hunger but not to your panic. And do it in a careful and controlled way. Allow yourself to eat a bedtime snack, but force yourself to eat something, dare I say it? Healthy. If weight loss is the target then allow yourself a snack. A low calorie snack.

What that might look like is hard to say. Depends on what you like, I guess.

Exhibit one: the sweet craving. When I have a sweet craving at night I'll brew up a cup of Keurig no-muss-no-fuss decaf with a very generous splash of heavy cream and a couple of packets of Splenda. Mmmmmmmm.... Warm, sweet, inviting. Just thinking about it makes me want to go to bed right now.

Oh, but wait, maybe you're a salty snacker.

Exhibit two: nuts in small quantities. Hey, try pumpkin seeds. My spies tell me that you could scarf down a quarter cup of those bad-boys and still be under 100 calories. On the other hand, one of my colleagues swears by popcorn, and she's a pretty smart lady.

Oh, but wait, maybe it's not quite sweet or not quite salty you're craving.

Exhibit three: can I introduce you to baby carrots and ranch dip?

The bottom line is that there are plenty of healthy low cal options to let you feed your internal monster rather than suffer. If you can control your quantities you'll be happier and you'll be more likely to stay on target, and lower the risk of falling off the wagon altogether. The little ball of all-about-me in your brain knows it will be a snack, it will relax, you will relax, so everyone wins.

One last thought: try to time your snack so that you eat before the panic sets in, otherwise you are likely to over-eat. Then the monster will rule the night.



Sean from Massachusetts, type 1, writes: I have a question about infusion sets: whenever I put my pump on suspend and disconnect it for whatever reason, and then go to reconnect it again, I notice small bubbles have appeared near the very end of the tube, close to the end of the needle where the insulin comes out... What's the best way to get these bubbles out, without having to do a whole set change?


Wil@Ask D'Mine answers: Part of it depends on the brand and model of your pump, but the easiest way to drive the bubbles out on most pumps is to take a "faux bolus" before you hook back up. This simply means giving your pump a command to deliver a quarter or half unit of insulin before you hook back up to move the bubbles out of the line.

And you're right to want those bubbles out 'a there. They aren't dangerous, per se, but they can mess up your control.

I'm sure everyone has heard the alligator-in-the-sewer type tales of medical mistakes in hospitals, or of heroin addicts accidentally injecting air into their veins, resulting in death by embolism. OK yeah, that can happen, but it takes quite a bit of air. And it also takes air injected directly into your blood stream. Your pump, on the other hand, delivers insulin and air bubbles into your body fat. Air bubbles in your body fat won't do you any biological harm, but if you have a bunch of bubbles in your tubing they displace insulin, causing your pump to deliver less joy juice than you think it is. And that can cause you to go high.

The only down side of taking a faux bolus is that it might mess with your insulin on board (also called active insulin) tracking. I say that because not all pumps are created equal in this regard. Some pumps pay no attention whatsoever to how much insulin is still in play in your body. Some pumps only pay attention to correction insulin and ignore meal boli. Some pumps pay attention to all insulin.

If your pump tracks insulin for meals, after a faux bolus the pump will assume the missing insulin is in your body rather than on the bathroom floor.

But all things being equal, I think this is the lesser of evils, and based on the location of the bubbles you are getting, I doubt it would take much of a faux bolus to get them out.

So drive the bubbles out, hook up, and head out. Thanks for writing.




This is not a medical advice column. We are PWDs freely and openly sharing the wisdom of our collected experiences — our been-there-done-that knowledge from the trenches. But we are not MDs, RNs, NPs, PAs, CDEs, or partridges in pear trees. Bottom line: we are only a small part of your total prescription. You still need the professional advice, treatment, and care of a licensed medical professional.



Disclaimer: Content created by the Diabetes Mine team. For more details click here.


This content is created for Diabetes Mine, a consumer health blog focused on the diabetes community. The content is not medically reviewed and doesn't adhere to Healthline's editorial guidelines. For more information about Healthline's partnership with Diabetes Mine, please click here.