“Our bodies are always evolving and our strategies are rarely static.”
That was one of the key messages I provided to a group of active people with type-1 diabetes in a presentation I did a few weeks ago for the Connected in Motion Virtual Slipstream.
That same message rang so loud in my ears my last couple of rides.
For me, cycling season started about a month and a half ago. Although I’d been training with the Peloton app through the winter months, my Saturdays were dedicated to running. But when my foot developed an injury at the same time as the days grew longer and the mornings brighter, I switched back to cycling Saturdays.
I kept the same strategy for long rides that I had last year, figuring they worked for me well then, surely they should continue to work for me just fine now.
Bodies change, my friends, we are not robots, and our strategies have to change with them.
Which is frustrating as heck for this seriously impatient T1D chick.
My strategy last year involved waking up at least 3 hours before the start of my ride, eating my normal oatmeal breakfast (36g carbs) with a bolus reduction of 14% (odd number, I know, but it worked for me). I would reduce my basal by about 60% generally around 30 minutes before, although I had started to reduce it about an hour before to further minimize a pre-ride drop in blood sugars. If my BG was less than 7.0, I’d dose up 15-20 grams carbs before clipping in.
My goal was to start my rides between 6.5-10 mmol/L, minimize my circulating insulin during the ride, and minimize my risk for hypoglycemia.
Hypoglycemia has always been my struggle.
But these days, the struggle has totally flipped.
For three consecutive Saturday rides, my blood sugars have been perfectly okay on the way out the door, perfectly okay at about 40 minutes into the ride, but after that, holy gozingas they shoot straight up to the moon and no amount of exercise is bringing them back down.
I’m out there with my BG upwards of 14-15 mmol/L.
And it is stubborn.
I’ve turned my basal back on full stop. I’ve even succumbed to dosing small amounts of insulin, which I do not like to do. And still, one of the rides, they didn’t start dropping until I was back home again.
I’m out there for 3-5 hours; that’s plenty of time to plow through the BG stubborns. But sometimes, this disease is a total jerk face that doesn’t do what it’s supposed to do.
Not cool, Dear Diabetes, not cool at all.
If it was just one ride with wonky numbers, I might chock it up to some kind of outside abnormality (stress, menstrual period, impaired sleep, some other unknown diabetes wonkiness, etc.) but because I’ve had three consecutive rides showing similar patterns, it’s time I alter my strategy.
It’s time I go back to the T1D trial and error drawing board.
How do I do that?
I write EVERYTHING down.
- Time I wake up
- Breakfast BG
- Time I take my breakfast bolus
- Breakfast bolus reduction
- The contents of my breakfast, specifically the number of carbohydrates
- Pre-ride temporary basal and the time it was set
- Pre-ride BG
- Any changes to basal during the ride
- Carbohydrates consumed on the ride
- Times carbs were consumed
- BG before consuming carbs
- Post-ride BG
- Post-ride temporary basal
- Post-ride nutrition
- BG readings for the remainder of the day
From there, I wait until I see an appropriate pattern to build a suitable strategy. It may take three rides to develop the strategy, it may take six rides, it may take 10 rides. Because I’ve already got a strategy developed from before, I may only need to change one or two things, but I still need to document it all to see what change sticks.
Patience, they tell me, is a virtue 😜
Once I have a strategy in place, I’m not that diligent with recording my diabetes; in fact, I’m not diligent at all. But if anything changes, I’ve got a documented strategy that I can go and tweak as needed.
Like I am now.
My last strategy served me awesome for well over a year. Here’s hoping this next one will have longevity too.,