“If you’ve had a good time playing the game, you’re a winner even if you lose.” – Malcolm Forbes
It’s Saturday afternoon. The house is clean, errands done. The sky is blue, the sun is warm and inviting. It’s time to give my body and mind some love and go for a bike ride.
This is not a leisurely bike ride. My intention is to make my heart pump fast and hard. I am looking for an adrenaline rush. I want my muscles to burn while I push my peddles and ache afterwards in thanks for making them work hard.
I hate to bring fanny packs or extra baggage to carry my emergency supplies in case of a low blood sugar. Instead I have a favourite pair of Lulu Lemon capris that work perfect. Two pockets on the outside of each leg. One pocket for lifesavers, house key and money. One pocket for my iPhone for music and to record my time, distance and route on MapMyWalk or Run or Bike. In the pocket in the back of the waist is room for my Burt’s Bees lip chap. I NEVER go anywhere without my trusted Burt’s Bees!
These items I describe are not the only ones I carry with me. I am attached to my Continuous Glucose Monitor transmitter and sensor on my outer, left thigh. Clipped to the right strap of my tank top is my insulin pump. I keep it there when I work out so I can check my CGM graph to keep my sugars in check. I check this on my ride based on how I feel.
Today’s work out starts out on a positive note. My blood sugar is 7 mmol/L (126 mg/dl). Based on this, I decide to eat 1/3 cup of Prana Organic Maple Almonds. I don’t want my sugar to spike up quickly with a rapid acting carb but I don’t want my sugar to drop fast mid workout. I figure the almonds are the perfect match for today.
As I walk in the door of our home, I look at my pump again. It is a beautiful thing! I end with a BG of 6.2 mmol/L (94 mg/dl) with one arrow going down which is not bad but I’m a little worried I will go low.
AND this is where it turns into another huge learning curve. Even after living with Type 1 diabetes celebrating 40 years this Fall. I am always playing the game. I am forever learning. Because the rules are never the same. They are always changing. There is no formula. I need to stay on top and adapt to these changes.
Looking at the screen of the CGM on my pump, I have to make a decision. Do I take a chance and ride it out? Risk having a low blood sugar? OR do I set a temporary rate on my pump to slow down the flow of insulin? AND/OR do I take less insulin for my post work out snack?
This is what I decide to do:
1. I set a temporary rate for 50% for one hour. So, for one hour I will ask my pump to give me 1/2 the amount of insulin I need to sustain me in a fasting state.
2. I measure out 1 cup of lactose free chocolate milk my post work out snack at 22 grams of carbs and decide to only take insulin for 12 grams.
AND that is when my evening from hell begins.
I spend a better part of 4 hours trying to get my sugar from a stable 13.5 mmol/L (243 mg/dl) back down to target. My head is fuzzy. I feel angry at myself. AND the extra sugar in my brain is not helping.
I evaluate what I could do better next time. What rules in this game am I going to change for next time?
1. I always need a post exercise snack. I don’t think milk is the answer. I think it is too high in the Glycemic Index. It spiked my sugar almost like juice does. I will choose something that is solid food with a combo of complex carbs and protein.
2. I will take the full amount of insulin for the snack.
3. I will not panic with one arrow going down and I will confirm the sugar on my pump/CGM with my blood glucose meter.
4. I will wait to set a temporary rate on my pump until bedtime instead of immediately after exercise. I do believe that part of the spike involved a glycogen response from my liver as I rode hard and my stomach told me I performed in an anaerobic state for the last part of my ride. My stomach felt heavy and I lost my stamina as my muscles failed.
“Many times what we perceive as an error or failure is actually a gift. And eventually we find that lessons learned from that discouraging experience prove to be of great worth.”
― Richelle E. Goodrich, Smile Anyway: Quotes, Verse, & Grumblings for Every Day of the Year