I’ve learned a fair bit about physical activity, and how to manage my diabetes around it in the past year. I guess having my job and my income depend on it, is a big motivation.
I am physically active at work every day, which means that I am more sensitive to insulin and more prone to going low through the day. Combine this with trying to offset dawn phenomenon when I wake up each morning, and you’re left with one very tricky equation.
One positive of combining work and exercise, is that every day is Groundhog Day. There is no shortage of opportunities to experiment. And when something does go wrong, I get to repeat it the following day in almost identical conditions. Not to mention that I don’t need to feel guilty about telling my doctor that I don’t go to the gym!
The negative is that at times, diabetes has felt very gruelling to manage while I am at work. The motivation to basal test, or to conduct experiments, isn’t always there. There have been days where I’ve literally been juggling highs and lows with insulin and food, respectively. There have been weeks where I felt like I haven’t gotten anywhere, and it’s often hard to pick myself back up and carry on.
Your diabetes, and the kind of physical activity that you undertake, will likely be different to mine. However, here are a few of the strategies that have worked for me while I have been physically active in recent months.
I would class my level of activity as mild – being on my feet, lots of walking around, some climbing up and down ladders and lifting. There are some days where it is more intense than usual – particularly if we are busy. But I find that most days, my level of activity is identical.
I find that for this mild level of physical activity, I need 30% less basal insulin compared to when I am vegging out at home. The 30% reduction in basal insulin needs a lead time of around half an hour before I start work. Most would suggest an hour’s lead time, however I don’t feel that my level of activity is at full speed until half an hour into my work day. I.e. I’m spending too much time chatting to people in the morning!
Mealtime boluses are still a work in progress. I’m currently sitting on 1 unit for every 8 grams of carbohydrate. At breakfast, my full insulin dose does its job, as I’m not on my feet for another hour and there’s probably some dawn phenomenon in play. I’ve tried reducing my insulin dose for meals during my work day with mixed results. At morning coffee time, I’m dosing insulin or snacking while I’m on my feet. Whereas at lunch time, I’m dosing insulin at the start of my break and not going back out to work for another hour. I’m working with a 30% bolus reduction with morning tea, and 15% with lunch.
I’m probably about two thirds of the way there. My overnight, and morning BGLs are looking fantastic. I just need to focus on getting some more green numbers into the afternoons, so that I’m not going home and snacking or eating dinner on higher numbers. It’s been an ongoing issue.
Work has been a gruelling journey, but I have finally began seeing results in recent months. Putting the hard work into fine tuning my basal rates and mealtime boluses has been invaluable towards a productive day, free from the stress of highs and lows.
I’m not so terrified of going to work without wearing a Libre sensor anymore, and I can comfortably go for two or three hours without needing to check my blood sugar. When I uploaded my meter data to Diasend on the weekend, I realised that I had only had three lows in the last fortnight. Freaking awesome. I finally feel a level of confidence in what I’m doing.
Another piece of advice that I never gave myself: give yourself a break. When I was on injections I would often come home with exhausting lows, crash on the couch and eat my way out of it with junk food. I failed. Constantly. The task of fine tuning insulin felt overwhelming, and the motivation was never there. After my pump start, I was under the illusion that I’d have everything down pat in a number of weeks. In hindsight that was such an unrealistic goal. Give yourself some room to breathe. Maybe basal test every second day. Or have a few days off from your experiments if they’re feeling overwhelming. Set small goals.
As with any element of managing diabetes, it takes a lot of time and patience. You won’t necessarily get it right the first time. Or even the tenth. Goal posts are always moving, because diabetes is always changing. You’re always learning, and putting two and two together.
But with time, you pick up these valuable little skills that will make fine tuning your next diabetes scenario a little easier.