Leafing It

As of yesterday, I am leafing it.  In the past 3 years, I have gained 40 pounds, mostly in the first year.  I attribute the massive weight gain to a combination of rapid A1C reduction, new birth control pills, a discovery of my love for cooking, and a new boyfriend with a ridiculous sweet tooth.  At the beginning of all of these things my A1C was over 9 (the lowest it had been for quite some time), I was single, and at my lowest weight since before puberty.  Currently my A1C is down to 6.1 (!), M and I have been together happily for over 2 years, and I am at my all-time high weight.  A year or so ago, when I really noticed the weight gain, I tried working out but with my new-found lower BG levels but I couldn’t work out for more than 10-15 minutes without going wicked low.  I tried all kinds of things to keep my blood sugar up, but was too overwhelmed and quickly stopped trying.  Truthfully, I have never been one to work out.  Actually, I hate it.  With a passion.

Anyway, back to that new leaf.  I started going to the Joslin Clinic, here is Boston, three months ago.  For the first time in my D-life I had an entire diabetes team, not just an Endo.  They quickly zeroed in on my problem areas and helped me to at least exist in Boston without going incredibly low every time I step outside.  After a session or two with my exercise pathologist, she recommended the Joslin Why WAIT? program.

I was reluctant at first – I’ve never dieted, and I certainly have never seen myself as fat.  (No daddy issues thus good self-esteem.)  But after some consideration and long conversations with M about the cost/benefit ratio, I decided to give it a try.  I couldn’t deny the extra weight any longer and figured this was going to be the best, if not only way, to really deal with it.

So, as of Wednesday, I am on a 1500 kcal diet, substituting breakfast and lunch for a Boost Glucose Control shake (lunch also comes with a salad), cooking the 600 kcal dinner entrees (600kcal is A LOT of food!) that have been provided for me, and spacing 400 kcal worth of snack throughout the day.  I’ve also started taking Symiln before all three meals, and exercising regularly.  I will do my best to keep the blog updated with my progress and any helpful tips that I pick up along the way.

I have high hopes that the program will solicit some positive changes.  After just one day of the new diet and the Symlin, my total daily dose of insulin has dropped from around 75u to 35!  And I wasn’t hungry at all throughout the day.  Although my numbers were trending a bit low for my liking, my Dex graph was nearly perfect for the last 24 hours and I didn’t take a single correction bolus.

So, the new leaf has turned, and I’m hopping for a happy outcome!

Diabetes is Annoying

Here are the the things that annoy me most about diabetes (in no particular order):

  • Ugly 15 day old  Dexcom sensors on my arm that prevent me from wearing short sleeves on the first warm day of the year.
  • Having to plan everything from eating to walking in advance in order to keep my BG from misbehaving.
  • Envying my friends who inadvertently flaunt their functioning pancreases (pancreii??) in front of me.
  • Sensitive infusion sites that hurt for no reason after only a day.
  • Having no money to go out and have fun because I just stocked up on pump supplies and sensors.
  • Having to find a job with benefits.
  • Lows whilst out for a walk.
  • Being placed on mailing lists meant for AARP members.
  • Needles.
  • Feeling guilty for wanting a brownie.
  • Having all of my pockets occupied all of the time with pumps, and Dex receivers.
  • Always needing to carry a purse to carry all of my D-stuff.
  • Lows at “bed” time.
  • Stubborn highs.
  • Talking to inanimate objects like a crazy person.
  • Lows in the middle of the night.
  • Showers burdened by infusion sites and sensors.
  • Treating M like crap because I’m having a low and he’s just trying to help.
  • Lows during exercise.
  • Dedicated shelf space for D-stuff.
  • Not being able to wear pants without pockets.
  • Having to explain.
  • etc.

Diabetes and Walking

Since moving to the city, I have been having a really hard time figuring out how to keep my blood sugars level while trekking around on foot.  It seems like the moment I walk out the door, my blood sugar plummets through the floor.  Being a car-bound Midwestern girl, who avoids most forms of exercise, I never really noticed just how big of an effect walking has on my blood sugar.

For instance, the other day I was going to meet M for lunch; he works 1.6 miles away, along a route that is not conducive to using public transportation.  I left the apartment with a blood sugar of 150 and a Dex arrow pointing east, and, about halfway to my destination, Dex began wailing.  I was down below 60.  I ate three glucose tabs and continued to walk – I didn’t want to miss my lunch date because of BG issues – ignoring Dex’s pleas for me to stop.  Upon arriving, I checked my BG…35.  35!  And it was a 35 that, Despite Dex buzzing at my side, caught me completely off guard.

So I ate my lunch, reduced my bolus to compensate for the low, and turned my basal down by 30% for the walk home.  Dex was reading a NE pointing 95 by the time M had to return to work, and I had no choice but to head back.  Nonetheless, I felt pretty good about the walk home.

However, I made it just about halfway back when Dex started buzzing again.  I reached into my pocket, thinking that I would need to correct a high (my high alarm is set at 140 so this seemed plausible) but Dex showed another below 60 warning.

I downed another handful of glucose tabs (finishing off the bottle that I had forgotten to top off that morning) and stopped at a bookstore  to wait for them to take effect.  After 20, maybe 30, minutes later, I left for home, with Dex showing a NE climbing 75.

To make a long story short, when I got home, Dex was reading about 61 but a quick check with my Ping remote showed me sitting more in the mid-forties.  I downed a few juice boxes and plopped myself down in font of the TV to recover.

I’ve gone on a few other long walks since then and I am developing a system that works 80% of the time:

  1. Reduce basal by 50% 30 minutes BEFORE leaving (return to normal 30 minutes before stopping or when I get there).
  2. If my BG is <130, eat 15g or so of carbs before heading out.
  3. If eating in the middle of the walk, reduce carb bolus by 1 or 2 units (depending on how much walking I plan to do after).

What do you do to keep BGs up during times of increased physical activity?