Reason #458 – Diabetes gets in the way of me doing what I want, when I want.
For the most part this isn’t true. For the most part it doesn’t get in the way at all. I test, I correct if necessary, and I go on doing what I want. But there are exceptions, and it’s these exceptions that are driving…me….NUTS!
My current problem is this: I can’t go for walks shortly after a meal.
Scott blogged about something similar to this a while ago – the idea of spontaneous exercise, which is even more difficult and frustrating, but I’m finding a bit of the same phenomenon to exist for me here, even when it is planned. Obviously, it’s definitely worse when I want to walk shortly after a meal and haven’t planned it so I have loads of insulin on board and those little insulin dudes are doing their little insulin thing with my recent meal at breakneck speed. But even when I do plan it, I can’t seem to get it right!
Here’s an example:
This morning I had breakfast at about 7:30 am. I always eat a low-GI, low(ish) carb breakfast (under 30g carbs), and my bloodsugar is typically very stable in the mornings. In fact, the mornings are usually my most stable time of day. My post-meal peak in the morning doesn’t usually get much above 7.5 mmol/l (135 mg/dl), and then usually I float down to a lovely pre-lunch number over the next couple of hours. Usually.
This morning I was home with my daughter (as I normally am on Fridays) and the weather was gorgeous, so I decided that the kid and the dog and I would go for a walk. The kid was going to need a nap around 10:00, so I wanted to be home by 9:30, but I wanted to walk for a full hour so that the dog and I could get some decent exercise. That meant leaving at 8:30. Now, because I’m an accountant and am good with numbers, I realized that 8:30 was only an hour after 7:30, which is when I had breakfast.
So…I planned accordingly and took a teenie bolus with breakfast. Teenie. Wee. Very small. At 8:30 we were ready to walk and I was feeling sluggish, so I checked my blood sugar and rang in at a whopping 14.8 mmol/l (266 mg/dl). Ick (ick). To not take a correction bolus at that level went against everything my body was telling me, but to take one would have gone against everything I knew from experience – post-meal walking experience, anyway.
So we went.
It was a lovely walk. It was nice out. We got our exercise. But….
…getting close to home I started to feel low. I (of course) had my dextrose tabs (which I greatly prefer over glucose tabs) along, and started popping them, glad that I could see my house coming up. We got home and got everybody in and I started having the familiar blotchy vision that comes with a low for me. (Not the I’m-going-to-pass-out vision, but the I-can’t-see-a-darn-thing-through-these-blotches vision.) I tested, and was 2.9 mmol/l (52 mg/dl)!!! (!!!)
I don’t know what I should have, or could have, done differently! Having a snack at 14.8 wasn’t a logical option, but neither was taking a smaller breakfast bolus to start me out even higher! If I did this every day (or even every few days) I might consider creating an alternate basal profile on my pump for it, but I don’t. Plus, I wouldn’t necessarily go at the same time every day. Tomorrow I might have breakfast at 9 am and go for a walk at 10 am!
I know some of you are thinking “suspend your basal, doorknob”. And while I resent being called a “doorknob’, I have to respectfully disagree, because I do this crazy thing called a superbolus at meals (maybe someday I’ll blog about it), which means that after a meal (even with a teenie, wee, bolus like today…which contradicts the idea of a “superbolus”, but we’re not talking about that now…) I’m on 0.05u/hr of basal after breakfast. Note the extra “0” after the decimal point. If I suspend that, it’s not going to do a whole hell of a lot…especially in comparison to what my meal bolus is doing.
The only remotely realistic option I can think of is to bring a snack along to eat after about 1/2 an hour of walking. I’ve tried this when I’ve started a walk with a lower bloodsugar (which is what I really prefer to do), but I always end up low (which is why I aimed for the higher starting level today). And, as we all know, stuffing our faces when we exercise kind of defeats at least part of the purpose.
I’m fed up. But I love walking. And I have to work around other schedules besides my diabetes’ schedule – e.g. my daughter’s!
So as much as diabetes doesn’t keep me from doing the things I want to…sometimes it really gets in the way of them!