Life on Insulin: Lots of Planning, Little Success

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Normal people do normal things without planning.  Eat.  Sleep.  Run.  Anytime.  Anywhere.  When you live on insulin, though, it’s a totally different story.  Spontaneity tends to lead to disaster.  So, I plan.  This should mean I’m safe, right?  But for the last few months I’ve felt like no matter how much I test, plan and measure, I am unable to manage my diabetes correctly.  Take the past 12 hours as an example:

Last night after a relatively early dinner of chicken and vegetables (the only carb was carrots and I bolused generously for them), my blood sugar at 164 at bedtime.  I corrected and set an alarm to wake me for a check 90 minutes later.  At that time, my BG was still 160 and I had insulin on board.  I was worried about hypoglycemia, but I was also exhausted and fell back asleep, without correcting 

My alarm went off again at 4:30 a.m. and I got up to run.  My BG was 197.  WTF?

I went out tired, basically feeling like crap, and I forgot to lower my basal rate.

But one mile into the run and three miles into the run, it seemed like my BG was on the way down (184,153) and so I set my temporary basal rate to 30% and continued to run.

I ran 8 miles and when I was done I tested my blood sugar again, expecting a relatively low result. I hadn’t eaten anything, after all, not even a gel.  Why, then, was my BG 176?  I mean really – no food and lots of exercise + insulin should mean low BG, not high.  Somebody please explain why my BG was going up.  And it gets worse.  I went home, showered and tested:  216!

I could use advice now. Any kind of possible explanation would help because on Thursday morning I will be participating in my first Mountain to Valley 135 mile (215K) off road relay race.

I signed up for this race a while ago, when I thought I would be running the Tel Aviv Marathon that was supposed to take place three weeks before the Milano Marathon. So, I thought I would be well rested, five weeks after my marathon and the idea of running as part of an eight-person team that will be running along side another eight-person team, seemed like a lot of fun. But now when my body is still tired from Milan, the logistics of the race are becoming clear, and my blood sugar is defying all the rules, I’m not all that sure it’s a good idea.

The race is very different from anything I’ve done before.  Each runner runs three different parts, each 5-7 miles long, one or two of which are at night. In between the running we rest, eat and drive each other to the next stop. Some of the parts are very difficult.

We are bringing sleeping bags so we can catch a few hours sleep here and there, but won’t get more than three hours at a time. I don’t know how that will affect my blood sugar levels.  I may need to change my nighttime basal rate, which is higher than my daytime rate.  But will anything help?  At this point I feel like it’s going to be a mess no matter what I do. Somehow I will drag myself through it.  But it’s supposed to be fun.  It’s not supposed to be something I stress about and I don’t want to go through life anticipating BG disasters.  I want to be in charge. 

Food is going to be the biggest issue in the race. This morning I overheard some of the guys I’ll be running with talking about different food options. Someone said sandwiches, then someone else suggested pizza.

What will I do? I’m going as part of a running team, but I’m actually totally on my own.  I’ll have to plan my meals and bring them with me.  I can’t just wait to see what happens and go with the flow because while I may not understand what’s happening with my BG levels right now, I do know one thing for sure: If I eat pizza I won’t be running or driving.  I’ll be sleeping. 

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Kory

You might be coming down with an illness?  The few times that I’ve had numbers climb like that have preceded coming down with a fever 1 or 2 days later.  

I’m with you in this frustration – similar endurance lifestyle – similarly feel a bit isolated, but lighten up it’s only food, right? 

kathy

We use numbers to guide the treatment of our disease, because that’s the best thing we have.  But, you can’t use them to judge your success or knowledge of this dynamic disease because it doesn’t play fair or use the same linear strategy.

You’re doing just great.  You can train for and experience marathon runs. You will eventually win this race. 

Scott K. Johnson

I wish I had some wise words for you, Michael. Sometimes diabetes just doesn’t cooperate with our plans. That is often the most frustrating thing about it.

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