5 Things I’ve Learned about Exercising with Diabetes

It’s November 26th which means it’s day 26 of the Happy Diabetic Challenge! Today’s prompt is about diabetes and exercise. There’s so much I could say on the subject, so I decided to settle for a bit of a round-up post that explains what I’ve learned about exercising with diabetes over the years…

I exercise on a daily basis.

This statement is not a faux-humble brag, nor is it an exaggeration. Unless I’m sick, I work out in some form or fashion every single day. My workouts will vary in their intensity, but one thing is consistent: My diabetes plays a major role in how long, when, and what type of exercise I choose to do.

Since I grew up playing sports, I’ve had just about my entire lifetime with diabetes to figure out how to make it peacefully coexist – or, at least, merely coexist – with whatever exercise routine I’m completing. As a result, I’ve learned quite a few lessons along the way, and I’ve come to recognize several patterns that my diabetes follows when I exercise:

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My diabetes is practically BFFs with exercise.

1. My diabetes is happiest if I work out first thing in the morning. I never thought I’d be the type of person who works out before eating breakfast, but trial and error has taught me that this is the way to go in order to better manage my blood sugars during a workout. Fasting exercise has worked wonders on my blood sugars: I never have to worry about dealing with an insulin-on-board-inducing low blood sugar, nor do I have to be concerned about what the food I ate prior to my workout will do to my blood sugars while I’m exercising.

2. Different types of exercise affect me (and my blood sugars) in different ways. Many people probably relate to me when I say that weightlifting and high-intensity interval training (HIIT) often yield stable blood sugars during workouts but then trigger the need for more insulin hours later, whereas cardio (such as dancing, running, or circuit training) usually causes sudden drops in blood sugar levels. Of course, it depends on the timing, duration, and intensity of the workout, but it’s interesting to see how different types will require me to react in different ways in terms of my diabetes care.

3. Sometimes I need to suspend my insulin, sometimes I don’t. Again, whether or not I suspend my insulin – or even run a temp basal – depends heavily on when and how I exercise. If I’m doing my morning routine (which happens 75% of the time), then I don’t really do anything with my basal rates: I just keep them running normally. But if I’m taking a midday walk or decide to exercise in the evening, I often have to do something about my basal rate to avoid crashes or spikes. Insulin suspensions or temp basals are wait-and-see situations in those cases.

4. The hardest part about exercise and diabetes is that I can do the exact same routine every day and get different results. If I worked out at precisely the same time, for the same amount of time, and with the same sequence of movements every single day, then…my diabetes wouldn’t give a damn. Every day of life with diabetes is different because of the variables that inevitably cross my path. Things like mood, that time o’ the month, stress, diet, illness, and more can cause major changes in my blood sugar levels. It’s my job to react accordingly to those changes, but that doesn’t mean I always hit the mark on the first try. So with that in mind, it can sometimes be hard to accurately predict how my blood sugar will fare after every single exercise routine. Just thinking about it can be more exhausting than the workout itself.

5. My diabetes is my biggest motivator/fuels my desire to exercise. At the end of the day, I work out because of my diabetes, not because I’m trying to sculpt washboard abs (though I wouldn’t complain if that actually happened). My diabetes loves exercise: It results in an increase in insulin sensitivity and it helps tame my blood sugar levels overall. How could I not be motivated to work out every day with outcomes so tangible?

My Diabetes Hates Weddings

So basically everyone in my life right now is engaged, or on the fast-track to getting engaged.

And that’s awesome! No, seriously, it’s an exciting time for a lot of my family and friends. And I’m happy to be part of it all because I like going to weddings. Who doesn’t love to celebrate love?

Well, I can tell you what doesn’t love to celebrate love…MY DIABETES.

My diabetes effing hates weddings.

My diabetes hates weddings SO much that I’ve yet to go to one where it doesn’t act up in some way.

My New PDM (1)

I was naive enough to think that it would actually be a good diabetes day during the last wedding I attended. And it was, for the most part: I woke up, had a Dunkin Donuts sandwich for breakfast, got dressed and made-up. I showed up for the ceremony with a slightly low blood sugar that was swiftly corrected with a mini box of raisins (oh, if only I knew how many more I’d consume that night…).

I was fine, right through the cocktail hour and the start of dinner. But that’s where the troubles began. You see, there weren’t many passed hors d’oeuvres during the cocktail hour, and I could’ve really used some because I hadn’t eaten anything besides the sandwich and the raisins all day long. By the time dinner started, I was ravenous and basically shoved anything within arm’s reach into my mouth. This included a lot of cheese, meats, and pieces of flatbread.

If I’d actually been thinking about how my blood sugars usually respond to slow-acting carbs in things like flatbread, I might’ve actually wound up okay. But over the course of the next several hours, as wedding guests were whooping it up on the dance floor, my blood sugar was making a slow and steady climb up into the 300s! When I finally realized this, I started taking correction boluses that, apparently, were far too aggressive…because when I finally ended the night in my hotel room around 1:30 A.M., I was in the 70s. And dropping.

My lowest blood sugar was 43 that night. I ate multiple packs of raisins, 5 or 6 glucose tablets, a FiberOne bar, and half a pack of peanut butter crackers. All between the hours of 1:30 and 4 in the morning. It was exhausting. I was tearful and sweating so badly at one point that it looked like I had just come out of the shower. I even wound up sending my sleepy boyfriend down to the lobby at one point to buy me an orange juice, because I was running out of low blood sugar remedies. I drank half of it and was relieved to see my CGM showing, at long last, a diagonal up arrow. I couldn’t believe that I’d just spent the last few hours hovering below my “low” threshold on my CGM, but I didn’t waste any more time thinking about it – I was extraordinarily tired and happy to finally go to sleep.

But now that I’ve had time to think about it, I’ve realized that I need a new strategy for myself and my diabetes when it comes to weddings. I’m going to be my cousin’s maid of honor next month, for goodness’ sake, so I want to do everything I can to ensure “decent” (i.e, blood sugars under 200 but over 80) for the special day.

A key to success, I think, will be regularly scheduled meals and making sure that I avoid an empty stomach at all costs.

A1c: Keep it a Secret or Share it with the World?

This post originally appeared on ASweetLife.org on May 12, 2015. I felt very strongly about keeping my A1c to myself four years ago. I’m still not too keen on sharing it with the world for the reasons I explain in this post, but I have been known to celebrate A1c victories on social media by posting particularly exciting results. Where do you stand on the spectrum? Keep it a secret, share it with others, or somewhere in between?

Over time, I’ve grown more comfortable with the concept of sharing as much of my diabetes story as possible. I’m open to the idea of answering questions that others may have for me, but there’s a key piece of information that I don’t think I will ever willingly share online: my hemoglobin A1c.

Some might make the assumption that this is because I feel ashamed or defeated by that number. I won’t lie, there are times in which I do get disheartened by my current A1c – particularly when I expected to hear a more favorable report from my endocrinologist.

Rather, I think the real embarrassment stems from the comparisons I make between my own A1c and the numbers reported by others. When I began blogging for ASweetLife just over two years ago, that marked the start of me exploring the world of T1D blogs. It was awesome to connect with others virtually by reading about their own personal experiences with diabetes. I admired the courage that many demonstrated by revealing some of their greatest challenges and obstacles they had overcome in their journeys. It seemed that improved A1c numbers were a common theme for nearly all of them.

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What do you do with your A1c information?

At that point, I started to compulsively compare my number to everyone else’s numbers. I seriously questioned myself and my ability to obtain a better A1c reading. I mentally berated myself for having a less-than-perfect number. The rational part of me knew that it was not wise to measure myself against others, but I just couldn’t seem to help it.

After a while, it dawned on me that the road to better A1cs had not been smooth for any of these individuals. It was marked by divots, twists, and turns along the way. As such, I wasn’t being fair to myself as I sought to see a better A1c. I know that it’s hard work and that I just need to focus on my own overall health and well-being (as opposed to that of other people) as I continue to strive for that 6.

Regardless, don’t expect to see me posting my A1c to my blog any time soon. I don’t really think I need a daily reminder out there for all to see of what my A1c was at a given moment in time. Instead, I think it’s important that I focus on what’s happening now and what I can do to help my current state of being. So for now, I’m content with keeping my A1c to myself.

I Dos and Don’ts: My Tips for Attending a Wedding with T1D

I can always count on diabetes to make life’s most joyous occasions just a bit more challenging…so I shouldn’t have been surprised when my diabetes threw several curve balls at me on my cousin’s wedding weekend.

There was the moment at the rehearsal dinner when I stood up to get something and hit my leg against a chair, literally knocking my pod off my thigh. (But I didn’t even realize it for another 20 minutes.)

There was the moment later that night, after the rehearsal dinner, that I discovered my blood sugar was high and that my mealtime dinner bolus probably was never delivered.

There was the moment the next morning that I realized my breakfast options were limited to a giant, carb-y bagel or a massive, sugary blueberry muffin.

There was the moment when I was with the bridal party – applying makeup, styling hair, and trying to calm the bride down – that it hit me that I had no idea what to do with my backpack (a.k.a., my diabetes bag) during the ceremony, as I had to be standing up there with the other bridesmaids during the vows.

There was the moment I psyched myself out big time by wondering what the hell would happen if I passed out in the middle of the ceremony in front of all of the esteemed guests.

There was the moment I went a little too overboard on drinking Prosecco at the reception…and a few more cocktails at the after party.

There was the moment I woke up the next day with a high blood sugar and hangover from hell.

Needless to say, there were quite a few diabetes “moments” over the course of an otherwise beautiful weekend. As a result of them, I’ve decided to document some wedding dos and don’ts for myself, as this won’t be the first time this year that I’m a bridesmaid in someone’s wedding. Here’s my unofficial roundup.

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Showing off my decked-out pod at the wedding reception.

Do have plenty of back-up supplies. I got lucky this time around because my parents were a phone call and short car ride away from me when my pod fell off. I should’ve been carrying insulin and a spare pod on me, but at least it was within my mother’s reach at the hotel room.

Don’t sweat the small stuff. Things happen, and I’ve got to learn to accept them more quickly so I can better adapt to a situation. It took me awhile to forgive myself for the pod snafu at the rehearsal dinner, and if I hadn’t snapped out of it, then it could’ve ruined the night for me.

Do try to plan meals when possible. I knew that I should avoid a high-carb breakfast on such a busy morning, but I can’t resist a blueberry muffin, especially when it’s one of two breakfast options I had. I wish I’d thought to bring food that had accurate carb counts on it so I could’ve had more predictable blood sugars throughout the day, but I did come back down from the sugar-induced high relatively promptly.

Don’t forget that family and friends are willing to help. My “problem” with my backpack was solved by handing it off to my boyfriend about 30 minutes before the ceremony started. I didn’t miss any photo opps with the bride and bridesmaid during the hand off and I felt better knowing it was in good care.

Do remember that time flies. I had to keep myself in context; after all, I was standing up in front of the guests for less than 30 minutes. I knew there was relatively little insulin in my system and that I was starting to level out somewhere in the 100s by the time the ceremony started. The odds of me passing out were slim, and I needed to give myself that reality check.

Don’t forget to drink plenty of water. Duh, that’s drinking rule #1! I’m embarrassed to admit that I maybe had two glasses of water during the entire reception and after party. It’s not like there wasn’t water available, so I don’t know what I was thinking. But I do know that I was incredibly lucky to hold onto stable blood sugars well into the night, despite my lack of hydration.

Do have a plan for hangovers. Sometimes, they happen, and they’ve got to be dealt with swiftly. After some consultation with my mother, I set a temp basal to fight against my high blood sugar and downed glass after glass of water. By early afternoon, I was feeling much better. And even though I had a bellyache, I didn’t yak, so I suppose that’s a silver lining.

And one extra “do”…do have fun with diabetes devices! I decked out my pod in a Pump Peelz sticker that had an image of the lighthouse we were near on it. Sure, it wasn’t visible to anyone but me (and a few people I couldn’t resist showing), but it still made me feel extra special and coordinated with the wedding venue. Sometimes, its the little things in life.

So besides taking several valuable dos and don’ts away with me from this weekend, I’m also walking away with a wonderful first experience as a bridesmaid to a cousin who’s always felt more like a sister to me. When it comes down to it, my irritation with diabetes doesn’t matter – it’s the love and celebrations I felt all weekend long that do matter.

Brunching with ‘Betes

Confession: I’m a brunch lovin’ millennial who also really hates brunch.

The reason I hate brunch (besides waiting all morning long to eat my first meal, I get hangry) is that it annihilates my blood sugars.

Breakfast Alley
It’s not uncommon for me to spend several hours after brunch trying to correct a high blood sugar.

It probably has a lot to do with the aforementioned fact that the timing of a typical brunch is typically not favorable when it comes to my basal rates and insulin-to-carb ratios. On a normal weekday, I’m used to eating breakfast within an hour of waking up. My body and my blood sugars are very much so accustomed to this pattern, so when it’s interrupted, it shouldn’t be any wonder why they don’t respond well.

It’s not that I don’t try. I do everything I can to offset the lateness of a brunch meal by running a temp basal and ordering as low carb as I can. And it seems to work well, up until I get up to leave the table and head home. Often, I find myself correcting two or maybe even three times after brunch, and it’s extremely annoying.

Maybe I could help curb spiking blood sugar by ordering just one mimosa, as opposed to two or even three (or just skip drinking them altogether, but seriously, I’ve had enough mimosas in my life to know how to properly bolus for them). Maybe I could insist to my friends that brunch plans should be earlier and force all of us to wake up early on a weekend morning. Maybe I could skip brunch plans altogether.

But that would be accepting defeat. Just like I refuse to let diabetes ruin any aspect of my life, I won’t let it stop me from enjoying brunch with whomever I please. I’ll figure out how to avoid post-brunch highs, I just know it. It’ll just take a little more time and patience…and several more brunch outings. Yum.

Testing for Accuracy, in Addition to Blood Glucose

This post originally appeared on Hugging the Cactus on March 21, 2018. I’m republishing it now because of a recent experience I had with my meter reporting inaccurate and inconsistent blood sugar levels. Has this ever happened to you? Drop a comment and let me know.

Blood glucose meters serve the sole purpose of checking current levels of glucose in the blood. Pretty self-explanatory, right? And it’s equally obvious that it’s crucial for all meters to generate accurate results so PWD can make the right treatment decisions based on those numbers.

Unfortunately, though, accuracy isn’t always what I get.

The other day, I was running low before bedtime. I corrected with an organic rice crispy treat (honestly, it was a million times better than the brand name kind). I waited nearly an hour for my blood sugar to come up. When my CGM wasn’t showing any progress, I tested: I was 47. It’s rare for me to be that low, so I tested again. 52. I believed it, especially since I was experiencing several hypoglycemic symptoms.

B. J. Palmer

I chugged a glass of orange juice and plopped down on the couch to wait for signs of improvement. Before long, I was freezing cold – a sure sign I was coming up, because I had been sweating 20 minutes prior. But I didn’t feel comfortable going to bed yet. I wanted to see if my CGM would show an up arrow. When it finally did, I made my way upstairs to brush my teeth and wash my face. In the middle of my routine, though, I decided to glance at my CGM again – and saw the dreaded ??? screen.

I decided then that the Dexcom should be out of commission, a.k.a. not trusted at all, for the remainder of the evening.

I ripped it out and inserted a fresh one, not really caring that it would wake me up in two hours to be calibrated. I would need to set at least two alarms for the middle of the night, anyways, if I decided to go to bed disconnected from my Dex. So it just made sense.

Once that was done, I tested again. I was pretty tired at this point and really didn’t want to have to eat something else, so I did it as quickly as I could. In my haste, I jostled my meter just so – enough that I saw the test strip, already marked with my blood, move slightly as it brushed against my PDM and was placed next to it.

113 mg/dL flashed upon the screen. Normally, I’d be thrilled! But I furrowed my brow. Something just felt…off about that reading. So I tested again.

206.

What?!

I tested a third time – 203. Okay, something was definitely wrong. Either that 113 was wrong (likely) or my meter had just produced two wildly inaccurate blood sugars in a row (less likely).

This is one of the many times that it’s convenient to live with another PWD. I asked my mom if I could borrow her test kit and see what result it generated. Seconds later…a twin 203 popped up on the screen, reassuring me that the 113 was a fluke on my meter.

Relief with the reality and irritation with the technology washed over me simultaneously as I went to correct the high with a bolus. I was glad I wasn’t heading down again, but irked that my meter had failed me. True, it was a bit of human error there, but aren’t we at a point in technological advancements where this sort of thing just shouldn’t happen? I put my life into the “hands” of my meter, Dexcom, and OmniPod. They should produce results that are undoubtedly accurate.

I guess we aren’t quite there yet.

How Working From Home Affects my Diabetes

Diabetes is a creature of habit. It rarely appreciates disruptions in its expected routine…so when they happen, it likes to make its displeasure known.

This probably explains why I’ve dealt with a number of diabetes curve balls since I started working from home (as opposed to an office) full-time.

I’ve been working remotely, 40 hours per week, for just about a month now. This was a choice I made as I prepared to move from Massachusetts to Virginia. I like most things about my job, from the people I work with to the skills it has helped me develop. But I don’t particularly love that my job forces me to be a self-described “cubicle rat”. When I work in the office, I’m parked at my cubicle for a solid portion of the day. As a semi-fidgety person, this was a tough reality for me to swallow nearly five years ago when I started my job. However, I was able to adapt to the old ball-and-chain that is my desk, and learned to break free from it every once in awhile. Before long, I discovered that getting up every 60-90 minutes to either wander into the kitchen for a drink, walk up the stairs to another floor in the building, or in nice weather, stroll around the building in laps, were all excellent ways to cope with my desire to move as well as keep my blood sugars at bay.

So that’s close to five years of having a very specific routine that my diabetes and I were used to…no wonder it was pissed off when I changed things up.

You are a rare gem.

Working from home affects my diabetes in ways that I expected and others that caught me off guard. First, the things that didn’t surprise me: I knew that I would likely be even more sedentary at home than in an office. I’m not walking across a parking lot, up a set of stairs, and down a long hallway just to set up my desk each day. All I’m doing is walking five feet into the living room in order to power on my laptop. So there’s a lot less daily movement, and I’ve had to work hard to incorporate as much of it as possible because my diabetes responds incredibly well to exercise.

I also knew that my relationship with food would change a bit. Since I was living with my parents before the move, I was lucky enough to have 99% of my food preparations done for me by them (thank you for feeding me, Mom and Dad). Not only would I need to take care of cooking my own food in this new situation, but I would also need to become responsible for making smart choices and stocking the pantries with healthful things…because when you work from home, ALL the food is available to you. And since there aren’t any coworkers nearby me to chat with and take my mind off snack time, it’s much easier for me to just traipse through the kitchen whenever the heck I want and eat a gratuitous number of chips, crackers, cheese, and any other sort of goodies I can find. I don’t like admitting it, but I don’t always bolus for said snacks…making it that much more of a struggle for my blood sugars.

But what I didn’t know about working from home and how it might impact my diabetes is that there’s an emotional side to it that almost certainly comes into play. The first few weeks of my move were absolutely draining. I was homesick and trying to adjust to this strange, new place at the same time, and honestly, I think it was all a little too much for my diabetes to deal with at once. There were three straight days in which I had to fight hard to get my blood sugars to come down from stubborn highs, and there was another string of days in which I felt like I had to eat everything in the kitchen just to keep my numbers up. Between the numbers that my blood sugars represented and my emotions, each day felt like a seesaw and I wasn’t sure what to expect next.

What took me by surprise the most, though, about my new work arrangement was how quickly I acclimated to it. By the end of week two of working remotely, I had a routine – with a few fluctuations here and there – that I’ve since tried to stick with: waking up around 6:30, exercising, showering, getting dressed, eating breakfast, logging onto work, working for 4 hours, eating lunch, taking a break to do household chores/errands, working for another 4 hours, then logging off for the day. So far, I’ve found that following this pattern helps me move around as much as I did when I worked in the office, and it establishes a flow that my blood sugars and diabetes can follow. I’ve also, for the most part, remained mindful of the foods I eat during the working hours, after making mistakes with a bag of pretzels and banana chips in the first couple of weeks.

Even though my diabetes wasn’t happy with remote work in the beginning, I think I’ve arrived at a place in which it’s coming to terms with it…and, I daresay, warming up to the concept.