Except When It Doesn't
Dealing with doing everything right and still experiencing low blood sugars
November 2013 — I've developed a pretty solid routine for days that I plan to play basketball. I've been playing at the same YMCA since about 2005, and always around the same time of day. Much has changed in my life over the years, but I'm still enjoying that lunchtime basketball as often as I can.
Developing that routine has taken a lot of time, a lot of testing, a lot of record keeping, and a lot of experimenting. Thankfully I enjoy basketball enough to make all of the work worth it. I want to do whatever I need to do in order to keep my diabetes out of the way while I'm playing. I also play better when my blood sugar is in range.
I know I have to eat a good breakfast to fuel my body for exercise. I know I have to eat that breakfast around 8:00am or 8:30am to give my breakfast bolus time to get out of my system before playing. I know I have to start a temp basal rate at 10:30 am adjusting my background insulin down because I don't need as much while I'm exercising. And I know that I need to test a few times while playing to make sure things are going as planned.
Most days I'm able to get right where I want to be and stay there. Not exactly, of course, but close enough that I'm not disrupted during my basketball by highs or lows. My routine works for me and gives me confidence in my blood sugars when I exercise.
Except when it doesn't.
Not long ago I started doing some light running before basketball. As I expected, adding this new variable into my exercise routine threw my blood sugar management way out of whack. For weeks I experimented with different approaches, trying different combinations of breakfasts, insulin doses, basal rate adjustments, and a snack (or no snack) in between the running and basketball.
After a while I found a combination of things that worked. I was able to get my running done without trouble and then enjoy my basketball without trouble, feeling good through both. This combination worked for seven or eight weeks straight — consistently. I could almost predict where I would end up after exercising.
Then one week it just didn't… and I was so confused. I couldn't identify anything I had done differently, even for the past couple of days! Besides being confused, I was very frustrated. I had done everything I was supposed to do in order to enjoy my exercise, and there I was sitting on the sideline sucking down juice, glucose tabs, and granola bars while my friends were playing basketball.
But there was something so disturbing to me about the situation because I couldn't wrap my brain around why I was low. I had done everything I knew to do, and yet I was still low. And at the core of my being I knew this… this… unexplainable blood sugar behavior is a thing that just sometimes happens with diabetes. It was something that I had to just accept, deal with, and move on.
I think our ability to cope with situations like these, ones where we've done our best, done everything we know to do, and still don't get the results we hoped for, make us so very strong.
We've all experienced something like this, yet we don't give up. We have our plans and our routines, and we count on them because they work for us.
Except when they don't, then we cope, regroup, and try again the next time. There's a lot to be said about that.
dLife's Viewpoints columnists are not all medical experts, but everyday people living with diabetes and sharing their personal experiences, most often at a set point in time. While their method of diabetes management may work for them, everyone is different. Please consult with your diabetes care team before acting on anything you read here to find out what will work best for you.
Chocolate Pudding Confetti Bean Salsa Pan Fried Jerk Salmon with Tangy Apricot Sauce Chickpea and Couscous Salad Pears with Creamy Cinnamon Dip Prosciutto and Asparagus Rolls Grilled Mahi Mahi with Tomato Vinaigrette Golden Split Pea Soup Turkey and Tomato Casserole Spicy Basil Salsa
As I mentioned in an earlier post, one of the benefits that made it cost-effective for me to go with the real healthcare (HSA) plan rather than the phony (HRA) plan is that my company is now covering "preventative" medicines at $0 copay. The formulary for these, as stated by CVS/Caremark (my pharmacy benefits provider), covers all test strips, lancets, and control solutions. I dutifully get my doctor to write up prescriptions for all of my testing needs, submit...