Shooting the Moon

Using multiple daily injections (MDI) for my treatment plan is not my favorite thing in the world.  I'm doing it now because it is financially necessary, but it comes with some problems.  So today, I'd like to suggest a new entry for the Diabetes Terms of Endearment: Shooting the Moon.

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But first, a disclaimer: I have not cleared this practice with a CDE or any medical professional.  I don't recommend it for others.  It's what I've been doing since my willpower when it comes to wonderful food is WEAK.

Shooting the Moon: when someone on MDI is in a difficult food situation, unaware of what exactly might be served or consumed, loads up on insulin, always with bread or glucose tabs at the ready.  See also: S.W.A.G. Bolusing

Let me give you some examples.  There are three recent ones that come to mind.

Situation 1: Going to the amazing Mesob for Ethiopian food with four friends.
Have you ever eaten Ethiopian food?  First, it's amazing.  Second, it's very difficult to know exactly how much and what will be eaten.  At Mesob, our favorite place for it in Rome, we usually go with friends and they serve it all on a giant platter with a variety of side dishes which are difficult to predict.  Plus, you eat each bite with a small piece of delicious injera bread.

The issue: What exactly will be set down in front of us?  How much will I be able to wrestle away from my friends?  When will I get full?  Or, do I carb count every.single.bite?

Solution: Shoot the Moon.  Dose up big time knowing that you want to eat as much of this delicious food as possible.

Situation 2: A site-unseen tasting menu at one of the best restaurants in Rome

We made a reservation for Restaurant Week at Metamorfosi.  We were expecting 3 courses.

Just how deep is that dish of risotto?

The issue: There were more than three courses, the risotto dish was deeper than I expected, the homemade bread was too good to pass up, and there were little sweet surprises along the way.

Solution: Shoot the Moon.  Don't look back, just eat as much as you can at one of the best meals of your life.

Situation 3: The issue of having dinner with very important colleagues when pulling up your shirt to give a shot is really not the best idea.

This is me tonight.  I'm having dinner with at least 20 other people.  I have no idea if it's a buffet, a served meal, or what it might be.

The issue: I really don't want to give myself a shot in front of some of the most important scholars in my field. I am not embarrassed or ashamed of my diabetes, but there are certain first impressions that you don't want to make.  Also, what exactly will I be eating?

Solution: Shoot the Moon.  Assume that the meal will be similar to a normal Italian meal with pasta and some other carby things along the way.  There will likely be dessert.  Test before leaving my office, give myself a decent dose, and hope for the best.

So far, my Shooting the Moon strategy has not backfired.  If anything, I rarely give myself enough, ending up a bit or a lot higher than I'd like.  But, I'm always prepared for the worst case scenario too.

Wish me luck!  And don't try this at home.