April 15, 2009
Jennifer A.

I feel that I am a fairly educated person. I feel like I understand blood sugar management and deal with it frequently with my pregnant patients… I find it easier to predict the blood sugar trends during the pregnancy as I can anticipate the different changes of insulin resistance based on how far along the pregnancy is. However, I find that it is sometimes not as easy when dealing with my own blood sugars, especially after different activities. I have to admit, I try to control my blood sugars fairly tight, which also means on the low side, at times. I think this is due to the fact that I have my patients managed very tightly during the pregnancy as this is what is important for a healthy outcome. As a result of this, I sometimes deal with hypoglycemic unawareness.

Now that we are doing our Phase Two Endurance training, I find that my blood sugars have been frustratingly difficult to control… with many highs and lows. This hopefully will improve with trials of altering the basal rates better and experimenting with my nutritional supplements during my activities. But, it makes it hard to do a good work-out when you are dealing with lows. For instance, I planned on doing a long ride on the bike (luckily it was indoors on the computrainer). I had had some low blood sugars the night before and overcorrected as I was high in the morning. I gave half of the bolus for breakfast and correction and lowered my basal rate before my ride. During the ride, I noticed that my cadence was slowing and I felt it was harder to pedal. I checked my blood sugar and it was extremely low. I ate some fruit and glucose tabs. I rechecked and it only came up a little. I refueled some more and continued riding. I checked several times more through the ride and it only raised minimally. Very frustrating! The bike coach I was working was concerned and questioned how I was planning on keeping my blood sugars up for 5-6 hrs during my ½ ironman. I replied, “That’s why I need to practice and work on blood sugar repletion.”

I thought my blood sugar management would be a little easier to deal with after I got my real-time sensors (which are now happily covered by my insurance company). Granted, I realize that these sensors are best to follow the trends. But, I get so annoyed when the calibration is off. This is sometimes even by 100 points. I feel I check my blood sugars even more so when wearing the sensor. I still wear the sensor as I feel it helps with my trends and just try not to pay attention to the number as much, which is hard to do at time… especially in the middle of the night when it alarms when it’s reading a high or low value (when it’s within a good range).

OK… enough griping. Can you tell I am writing this while on call in the hospital? Anyhow, I will end with a lighter note. I just started reading the new edition of the book, Diabetic Athlete’s Handbook by Sheri Colberg, which has a forward by Matt (good job by the way). This is actually the inspiration to my blogging rant. It has so many great points and suggestions on planning your activities. It has tables on how much carbs to take prior to the activity based on what your starting blood sugars is, duration, and intensity of activity. It also has a table on how to adjust your insulin. I’m in the middle of reading the section on “Dealing with Exercise-Induced Hypoglycemia.” I know some of this is a review on what was described at DTC… but it’s good to have it as a written guideline (as I am much more of a visual learner). So, if you want a good reference book… this is it!