The term “pivot” is often used in business when they need to make changes to the way they operate in order to survive a downfall.
In diabetes, it pretty much means the exact same thing.
My husband has informed me that Vancouver is not currently experiencing a heat wave; you need consecutive days of extreme heat to be considered a heat wave, he says.
I’m choosing to ignore that ridiculous definition.
When you live in a loft with 17-foot windows that faces the afternoon sun, like we do, pretty much it’s a cooker for days after just one day of extreme heat.
It’s a friggin’ heat wave in here folks.
My insulin is cooked.
My blood sugars are ridiculously unpredictable, and for the past 4 days I’ve been waking up in the morning with unexplainable highs, despite going to bed in optimal range, and no crashes in the night.
It’s the heat.
It does it to me every single time.
And currently, it’s on the verge of messing with my cycling goals.
Not cool, heat, not cool at all.
If you’ve been following me for a while, you know that I like to wake up with my blood sugars between 5-7 mmol/L prior to a morning ride.
I have a strategy in place to accommodate my Saturday morning rides, when I have a bit more prep time, and another strategy to accommodate my morning bike commutes where time is limited – all are heavily reliant on optimal wake up blood sugars.
So what do I do when those morning blood sugars aren’t optimal?
Do I let them mess with my cycling goals?
Do I cancel the ride and take transit instead?
Or, do I pivot?
I totally pivot 😀
Tuesday morning my wake-up blood sugars were 10.8, arrowed angle up. Given my history the previous 2 days, where my blood sugars just kept going up and up and up throughout the morning, I opted to give a correction, which I normally wouldn’t do when I’m set to start riding 1.5 hours out. I also gave my full breakfast bolus and didn’t reduce my basal until I was just about to start, and only reduced it to -40%.
At about 30 minutes into the ride, my BG was 7.8, straight arrow down. They were dropping fast, so again I pivoted.
I sucked back an applesauce pouch (14 grams of carbs) and adjusted my basal to -75%.
I finished the ride with my blood sugars at 5.6, no arrows, and plugged a post-ride temporary basal of +95% for 1 hour and inputted a 10-gram carb bolus to partially accommodate that applesauce pouch I had earlier – both to reduce risk of post-ride highs.
How does that differ from my usual bike commuting T1D strategy?
Normally, I give -50% of my breakfast bolus, and plug in -75% basal about 20 minutes prior to starting, and always a increased basal of 95% for 30-60 minutes post ride. Sometimes I need to eat in the middle of the ride, but often, I don’t.
That’s a strategy that usually works for me, 80-90% of the time, but this is T1D we’re talking about – sometimes you’ve just got to pivot!
And when the pivot works, we all walk/run/ride away smiling 😀