I’ve spoken before of my beloved RPM classes (Spin by another name) which I partake in two to three times a week, normally at ungodly times of the morning (starting at 6am, meaning I normally get up at 5:20am to get there and get set up on time).
I genuinely enjoy these adrenalin-filled episodes in my life – however unlike my non-diabetic counterparts they require a lot more planning. First of all I get up at 5:20 and stumble down to the kitchen to check my glucose. Two times out of three I need to either bolster it up a bit with a few carbs, or give myself a bolus to bring it down. Then I drive to class. When I get to class, I check it again before I start. If it was questionable at all, I’ll check halfway through the class. Then, once I’ve finished cycling 25km to some thumping beats with my fellow sweaty bettys in the class, I’ll check once more to see what’s going on post exercise.
Following on from that, I hit the showers. After a high adrenaline class like that, my BGs tend to rise for the next few hours, so I set my pump to 140% basal rates until around 11am. After that (when my body is trying to replace the glycogen) I am liable to suddenly and quite drastically hypo, so I set my pump to deliver a 50% bolus until about 3pm, after which BAU (business as usual) resumes.
Gah – a bit more effort than your ‘normal person’ heading the gym innit?
Then – there are days like today, where I do exactly the same thing as I always do and get absolutely blindingly different results. I tested at 5:20 – 14.8 (nice, was 6.2 when I went to bed). So gave my usual pre-gym correction and jumped in the car. By the time 6am came (only 40mins later, let me stress) my BG had plummeted 10 points to 4.8. What the? How the….? I grabbed three glucose tablets and quickly ate them, then tried to cycle the first track. Tested again – 3.1. Aborted class and took another three glucose. Hit the showers, tested again, still only 3.6. Three more glucose tablets.
I’m now sitting pretty at 7.3 (it’s an hour 45mins later), but instead of burning calories, have been consuming them! How very frustrating.
Posted in Exercise, Hypos & Hypers
Tagged as Exercise
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Aaron wrote
I’m going to give you a virtual pat on the back Nic cos you know what, you are doing better than me because I’ve been on a pump almost the same amount of time and I’ve not even attempted to walk that gauntlet yet! And, a lot of people would just avoid it altogether I reckon so from my point of view you get massive brownie points for trying in the first place.
It is annoying though and I can empathise with that feeling of trying so hard and still not feeling like you get the results. I had a similar experience of sorts last night in with a meal out and it isn’t the first time this has happened either. It even made me think that I wouldn’t go out but it was my birthday and friends invited me so I took the plunge.
I was 14.8 beforehand so had a correction (have NO idea why I was that high in the first place either), counted the CHO and had 3 x boluses over the course of my dinner to cover it and wadda ya know – 17.9 when I get home. Joy. 1 1/2 hours later I’m still 16.9 but there is enough insulin in my system to take me to 7.0 so I don’t have a correction. Then I wake at 3am to test and…you guessed it! Still 16.9! Gah.
I suppose sometimes we just can’t get it right but it makes me wonder how much leeway should we give ourselves and how often is it OK to be really high (or low for that matter?
Anyone got any thoughts?
Nic wrote
Thanks Aaron…. sorry to hear about your story from your birthday as well, how ANNOYING! We as diabetics should definitely at least get our birthdays off
.
As for your question on leeway – I was speaking to a type one the other day and he also was saying the HbA1c test seems a little bit arbitrary because it all comes down to averages (and you can have shocking lows and highs and still get a good HbA1c). He suggested a better measure of how good your control has been would be to measure the variance from the 4-8 range over a three month period. The less the variance, the better your control. This sounds a whole lot more sensible to me.
Brendon wrote
Hi all – long time watcjer first time poster
Without geting into my long winded story in detail I’m in a position where my HBA1C i completely unreliable. Promarily because my kidneys have failed and they dont produce the hormone that tells the body to release red blood cells from the bone marrow (this is EPO – the stuff that cheating cyclists take).
Subsequently its not a good measure at all as I take artificial EPO to stimulate red cell production which means I dont get a steady stream of cells produced over the three months which means that the A1C is mostly meaningless – 4.9 one month, 8.5 the next
My endo has always preferred to look at the data from my meter and the spread of values outsode the 4-8 range and in particular when in the day these are happenning.
I’ve been meaning to invest in the software that does this for my Optium Exceed but havent quite got around to it yet.
Just thought you all might be interested.
Nic wrote
Hi Brendon, thanks for your comment (I too tend to read blogs and hardly ever comment). Your point makes me think even more that the HbA1c test is not a viable one – I’m going to start looking at my meter to see what my last month’s averages etc were. This will obviously get even better when CGMS’s become the standard because it won’t rely on how many tests we do etc.