Type-1 diabetes: Battling the BG uglies

Sometimes Dear Diabetes can be a near saint.

Sometimes Dear Diabetes can grant you the loveliest straight line of in-range blood sugars.

But other times, he’s just a nasty piece of work, a thorn in your side, an ingrown toenail, the best frienemy you wished you never had.

Sometimes he throws you hours of obtuse blood sugars that have you scrambling for corrections or rage bolusing; you can almost hear him cackling off to the side.

Sometimes, he’s the biggest jerk face ever to enter your life.

That was the Dear Diabetes I faced Saturday morning.

Snowmaggedon 2020 hit the West Coast last week, and given my history of falling on ice and breaking my pinky finger while running last year, I wasn’t super keen to run the icy roads this winter wonderland.

broken pinky 2019

Instead, of doing a long run, I set up the bike trainer and plopped myself in front of the Peloton app for a high intensity 45 minute session.

I didn’t change my Saturday morning T1D strategy, even though I changed the sport; they were both high cardio exercises after all.

So, just like several Saturdays prior, I set the alarm for 5:30 a.m. I like to wake up at least 2.5-3 hours before the start of my long-haul exercises in order to ensure most of my breakfast insulin will be gone by the start. I don’t like to exercise on an empty stomach. And I don’t like to do a whole lot of bolus reduction math, so for me, this is the best strategy.

I took my morning insulin the second I lifted myself out of bed, knocking off 14% from the usual dose. I don’t know how I came up with the 14% reduction; it’s just a number that’s worked for me for several months now for my Saturday morning runs/rides.

I had my usual breakfast of overnight Steel Cut oats with all the fixings.

I had a cup of matcha tea; it was freaking early after all.

I read, and then I read some more.

I checked my blood sugars an hour prior to my intended start time. They were trending down at 4.3 mmol/L.

Bloody freaking hell.

I dropped my basal by 75% and popped 2 Starburst in my mouth, which are usually super quick at bringing my BG up.

I waited 30 minutes and checked again; they were now down to 3.3.

Are you freaking kidding me?

I was getting close to the intended start time and I had a lot of things to do post ride; I didn’t have time to be battling the TID uglies.

I ate another 2 Starburst, which I was almost 90% sure I would regret as an overcorrection later, but I didn’t have time for this ridiculousness to slowly correct on its own.

Sure enough, within 30 minutes the arrows were trending up fast.

I put on my cycling garb, clipped in my shoes, did NOT input another basal reduction, and started pedaling my legs off.

About 30 minutes into the ride, I had my husband scan the Libre over my sensor; once again my BGs were dropping. They were at 4.6, neutral arrow, and I still had 15 minutes to go. I had started the ride at 6.1 with an angled up arrow.

I did not correct.

I figured with just 15 minutes left of the ride, and the slow decline that had occurred previously, I was good to continue without a low.

I was right.

My end BG was 4.6.

Normally I increase my basal post exercise when I’ve dropped it during exercise to ward off acute highs. I didn’t do that this time because I’d done the reduction prior to the ride, not during the ride, and I figured that it would all balance out with the normal basal used during the ride.

I figured wrong.

Remember those added Starbursts? They were kicking me in the teeth for a good 2 hours post ride.

Bloody freaking hell.

Next time, I’m increasing that post-exercise basal no matter what, and will likely give myself a half bolus for those added Starbursts if I see the arrows trending up within 15 minutes of completing the run/ride.

BG uglies
Not cool blood sugars, not cool at all!

You win some, you lose some in this never ending game of type-1 diabetes.

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