I want to get some feedback on a thing that I seem to deal with quite often.
There are really 2 scenarios that produce results/BG behaviors that I find confusing.
Some background: I’m a LADA type 1 and have been managing my BGs using a Medtronics 670G pump, continuous sensors and auto-mode for ~1 year. Before that I used a 530G pump without continuous sensors for 6 - 7 years. During this time period I’ve been able to keep my A1Cs in the low to mid 6 range most of the time with a few excursions into the low 7s.
I am very sensitive to insulin with an average daily usage of ~22 units with a carb intake in the 200 range.
I find I have to be careful about how much physical activity I engage in, especially after eating and the associated bolus of insulin, otherwise I risk a low that comes on very fast.
Now we come to what I’d like some feedback on:
My usual morning routine is a cup of coffee after taking my BG and calibrating the sensor. Usually the morning BG will be in the 120 - 130 range and coffee pushes it up into the 150 range. I usually don’t bolus for this but instead let the pump auto-mode deal with it.
This last Saturday I decided to move the remains of 2 trees we’d cut down off of our back yard. This took me ~1.5 hours of what I consider to be medium physical activity.
Before starting my BG, as reported by the sensor, was just below 160, during the activity I periodically checked the pump assuming my BG would drop and I’d be forced to stop and have some food to compensate. In reality the opposite happened and my BG rose to 170 by the time I was done moving all the wood.
I think key factors to keep in mind are I had not eaten any food or taken a bolus of insulin before the physical activity. I also did not set a temporary target or suspend insulin delivery, the pump had given me several micro boluses during the activity.
Later the same day I again engaged in some physical activity, this time what I consider to be light. I cleaned a number of (probably 20) pine cones off my lawn and dug a small hole around a sprinkler system pipe that needs repair.
This activity occurred ~1.5 hours after I’d eaten a lunch that contained 84 grams of carbs for which I bolused ~6.4 units of insulin.
I don’t remember the BG level reported by the pump this time (forgot to look) but based on past history it was probably in the 150 - 160 range.
This time my BGs crashed, I drank a box of apple juice after realizing my BGs had dropped to 70 and had a down arrow. Ultimately my BG hit 63 before rising to 130 due to the apple juice. Based on having eaten this exact same lunch and had the same bolus many times my BGs would’ve risen to ~190 - 200 and dropped to the 110 range by 5:00PM if I hadn’t engaged in the afternnon’s physical activity.
So, I’m wondering why the 2 significantly different reactions?
Did my BG not drop during my much heavier morning activity because I had very little insulin in my system?
** I did not check for ketones after this, I guess I probably should’ve.
Is there any link to the food I ate and the way my BGs reacted in the afternoon or was it simply because I now had insulin on board?
Is it possible my system is still making insulin and the food triggered it?
Is this a common behavior for a type 1 diabetic?