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Managing Blood Sugars with Diabetes and ADHD: Tools and Strategies from a Neurodivergent Diabetic

"Don't forget to keep extra infusion sets on you!"

"Don't forget to bolus 15 minutes before your meal!"

"Do NOT forget to refill your insulin or you will straight up DIE."


I can barely remember to leave the house with my ID - how on earth am I expected to remember all THAT?


Living with diabetes is often about creating a stable routine. But when you also have ADHD, which disrupts that routine and consistency, things can get challenging. As a neurodivergent diabetic, I've journeyed through the complexities of managing my diabetes while navigating ADHD's unique challenges. Through a lot of trial and error (no really, like tons of error), I've found effective strategies and tools that help me maintain my blood sugar levels while fitting my cognitive style.


In this post, I’ll share my experiences, actionable tips, and tools that cater to those of us living with both diabetes and ADHD.


Understanding the Challenges


Executive dysfunction refers to difficulties with a set of cognitive processes that help a person regulate, control, and manage their thoughts and actions to achieve goals. These processes are collectively called executive functions and include skills like planning, organizing, focusing attention, remembering instructions, and managing time. When someone experiences executive dysfunction, they may struggle with tasks like starting or finishing projects, following through on plans, or controlling impulses.


Executive dysfunction is commonly associated with conditions like ADHD, autism, depression, anxiety, and brain injuries. However, it can also occur in other situations, such as during periods of high stress or fatigue (um, so like everyday with diabetes?)


My flavor of executive dysfunction looks like me opening the refrigerator because I'm hungry. I then proceed to look at all the ingredients and my brain tries to come up with something to eat. But it's not like how it SHOULD sound in my brain. It literally is multiple, non-stop conversations of what to do with the leftovers, whether I'm in the mood for that, I did have that yesterday, I don't think I have the energy for that, etc. Eventually, I close the refrigerator door and refuse to eat anything because I just couldn't start the task to begin with.




Lovely.


As you can imagine, this does not play nice with diabetes.


How are ADHD and Diabetes Related?

Research suggests a significant connection between ADHD and diabetes, particularly Type 1 diabetes (T1D). Individuals with T1D are more likely to be diagnosed with ADHD, with some studies indicating that about 35% of children with T1D also meet the criteria for ADHD.


Although ADHD is primarily a genetic condition, childhood hyperglycemia could potentially interfere with the development of certain brain regions involved in attention and impulse control.


In terms of risk factors, both ADHD and diabetes share some common ground. For instance, ADHD may increase impulsive eating and contribute to lifestyle factors that elevate the risk for Type 2 diabetes (T2D). Research also suggests that dopamine regulation, which plays a role in both ADHD symptoms and insulin sensitivity, may help explain the link between the two conditions.


Managing both ADHD and diabetes simultaneously can be particularly challenging because symptoms of one condition can exacerbate the other. For example, fluctuating blood sugar levels in people with diabetes can mimic or worsen ADHD symptoms, such as inattention or irritability, complicating diagnosis and treatment. Effective management requires a multidisciplinary approach, with healthcare providers coordinating care across specialties to address both conditions simultaneously.


Create Micro-Routines


Creating micro-routines has been a game-changer. Instead of trying to stick to a daunting daily plan, I break my day into smaller tasks.


For example, instead of setting a reminder to check my blood sugar at 8 AM, I remind myself to “check blood sugar before breakfast.” By connecting the action to a specific event, it feels less like a chore. This flexibility is crucial for anyone managing ADHD.


Additionally, I set multiple short reminders throughout the day for medication and snacks, allowing for easy tracking.


A graphic with a dark teal background and the following text: "Rachel Halverson BSN, RN, CDCES, NC-BC" in small white text at the top left corner. The main title reads "Habit stack" in large, bold letters, with "Habit" in white and "stack" in pink. The text below says, "I know. You’ve got a lot of new habits you feel like you need to develop." Underneath is a white outlined box with three stacked sections labeled "Brew Coffee," "Take Insulin" (in pink), and "Breakfast!" The final text at the bottom reads, "Don’t panic! Try associating new habits with old ones you already do consistently." The "Give Me Some Sugar" Diabetes logo is in the top right corner of the image.


Simplify, Simplify, and Simplify Again

Nothing turns off a neurodivergent brain more than complexity. The less steps there are in a task, the better. I'm like 90% sure this is why the majority of us re-use lancets.


If you are having trouble with...


checking your blood sugar

  • Consider using a CGM

    • There are over the counter versions now, like the Stelo, for those who are not able to access them via insurance

  • Use a simplified meter like POGO

remembering to bolus

changing infusion sets

eating

  • This is QUITE a loaded issue and would take several posts to cover

  • If you forget to eat, setting alarms is going to be a must

  • If you struggle with initiating the task of cooking or meal prepping consider the following:

    • Have a variety of ready-made meals on hand like frozen meals or pantry items you can microwave (canned soup, packs of rice/pasta, etc)

    • Sandwiches can be fairly easy and unintimidating to assemble

    • Amanda's (my neurospicy diabetic BFF) Famous Microwave Quesadilla

movement


Visual Supports & Tools


Visual reminders play a significant role in day-to-day management. Out of sight, out of mind very much applies to people with ADHD. Here are some tools I use:


  • Keep it out: If you're MDI, keep insulin pens in each room and in the kitchen. My oral medications are in a gorgeous, rainbow pill container that I fill once a month and it sits in my kitchen where I remember it.


  • Visual Food Guides or Carb Counting Charts: Create or download carb-counting charts with images of common foods. Visual guides like these are especially helpful in quickly estimating carbs, and they can be posted in the kitchen or dining area for easy reference.


  • Visual Calendars: I integrate diabetes tasks into my calendar using symbols, which helps me remember appointments, refills, and check-ups.


  • "Low Blood Sugar" Supply Stations with Visual Labels: For treating lows, set up “Low Blood Sugar Stations” with clearly labeled boxes or containers that have pre-measured, fast-acting carbs. Use pictures or color-coded labels on each container to make it quick and easy to grab what you need in a low.


  • Routine Charts or Visual Schedules: Create a visual schedule with icons or pictures for morning, afternoon, and evening routines. It might include images for steps like "Check BG," "Take Insulin," and "Eat Meal." You can make these as fun as you want with custom stickers or personal photos.


These visual aids significantly reduce cognitive load, making tasks feel manageable.


A flat lay of office supplies arranged on a gray surface. Visible items include a white smartphone, a pink eraser with "For Big Mistakes" written on it, a few paper clips, two pencils (one striped blue and white, the other red and white), small envelopes, and a notepad. The notepad has the heading "On the Agenda" in blue text, with a section labeled "Ready Set Go!" in red. The scene is organized and visually appealing, suggesting a planning or organizing workspace.


Engage with Community Support


Connecting with others facing similar challenges creates a supportive network. Engaging in online forums or support groups fosters a shared understanding.


I've learned sooooo many strategies from ADHD subreddit, Instagram, TikTok, and the like. Seeing how other people manage tasks can inspire you when it comes to managing your diabetes with ADHD.


Navigating Your Journey


Managing diabetes alongside ADHD can be complex, but it’s essential to develop strategies that work for you. By creating micro-routines, using technology, employing visual supports, practicing mindfulness, engaging with the community, planning nutritious snacks, and celebrating small wins, you can cultivate a rhythm that fits your lifestyle.


As I continue to navigate my journey, I hope these tools and experiences resonate with others. If you’re a neurodivergent diabetic seeking balance, I encourage you to explore these strategies and be kind to yourself along the way. You're not alone in this journey.


If you feel like it would be helpful to have someone to coach you along the way, apply to work with me.

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