“Are you alright?”
“What’s wrong?”
“You seem quiet today.”
I knew why my work mates were asking. Diabetes has been affecting me so much at work lately, to the extent that my feelings could be read off my face with ease.
“I’m fine. It’s nothing.”
It wasn’t nothing. But the last thing I felt like doing was talking about it.
Going to work with the insulin pump has really tested my patience. I’m on my feet and moving around for much of the day, which makes insulin a lot more sensitive than normal. My work day is a prolonged period of physical activity, and not simply an hour of exercise. I guess what makes the insulin sensitivity more of a big deal with the pump, is that my basal insulin is being delivered to me live and continuously as I’m working, unlike Lantus.
For a few days last week, the hypos were relentless. I recall having at least three on one day, in particular, last week. Three. Every time I crack open a fresh canister of skittles, I hear my diabetes educator’s voice ringing loud and clear in my head.
Minimise the lows. The first thing we need to do is to minimise the lows.
Hypo unawareness is my biggest fear. With every passing hypo, all I think about is was whether I can feel it or not. I think about how much longer I will be able to feel them. At the end of it, all I really want to do is succumb to the defeating exhaustion that follows.
I had talked over my work day with my diabetes educator in the beginning. On a scale of 1 to 5, I’d rated my level of physical activity at around a 3. We’d anticipated a reduction in basal insulin requirements while I was working. I just never anticipated that the taps would take so long to turn down. I’ve now reduced my basal rates to about one seventh of my normal rate, and it finally seems to be holding me steady through the mornings.
The other factor that I am also starting to consider is the insulin I take to cover my meals at work. I’ve been plummeting quite quickly after my lunchtime insulin dose, and I’m starting to think that I might need to reduce my bolus by a certain percentage.
I’m hardly a role model for physical activity. I’d never have guessed that it would be such a significant issue for me on the pump. Not in a million years did I expect to be here, writing about physical activity and diabetes!
But I’m close. I’m really close to nailing this.
I’m so sorry about the frequent hypos 🙁 I hope you work it all out soon. It does take time to nut it out and it sounds like you’re doing tremendously well.
Also maybe consider that your insulin to carb ratio might need tweaking during lunch to reduce that bolus, especially if you’re constantly active.
You got this Frank!
Ash x
Thanks Ash. I’m tempted to use my second Libre sensor!
I am also sorry about the frequent lows. I think as time goes we are more use to the idea of lows and that might not be the best thing.
I referred your blog to the TUDiabetes blog page for the week of June 6, 2016.
I have had more lows since going on pump and have never been able to fix it. I believe it is all the fast acting insulin going in. I don’t hardly ever go shopping any more. Pump is fine if you don’t move, but I do hate shots but thinking of going back to mdi.
Hi Frank and great work so far! Each step is a step closer.
I wonder if people are more sensitive to their insulin via pump because there is more consistency in the depth of the administration via the infusion needle. You aren’t changing it around all of the time and the depth isn’t changing. There are lots of people with T1 D with lumps and bumps from so many injections – maybe you are missing them with the infusion needle – less lumps and bumps occur too because you aren’t going into the skin so often.
I also love your picture of the skittles. Would you mind if I snip a copy of the picture to use in my education or on my website as a tip?
thinking about you and your bravery! I love that you are sharing this all with us. Lots to learn and think about. Thanks!
Dawn Phenomenon, Breakfast, Physical Activity and Diabetes - Type 1 Writes - Diabetes Blog
[…] couple of months ago, I wrote about the relentless hypos I was having at work. There have been days where my blood sugars have been bouncing up and down like a yoyo. The […]