Hi all, new here! I’m a T1 I apologize in advance, this will be a bit long as there is kind of a lot I think I have to explain.
I’m working on losing weight, which means eating less and exercising more. I read labels and count carbs and calories. I use a nutrient tracker and try to eat balanced, 1500-1800 kcals/day. I use an “intensive” (4+ times/day) monitoring regimen, on Lantus and Novolog with a correction formula and an I:C ratio. In other words I’m pretty hands-on and well-informed.
I’ve already noticed I can get by on smaller boluses now that I’m more active (and I do have a formula to adjust my insulin for exercise also). But suddenly I’m starting to have a lot of lows again, which is unsettling and also screws up my weight loss because I have to keep eating more! I prefer being proactive with my insulin rather than adding in extra snacks, but I’m kind of stumped what to do.
So here’s the pattern I’ve been seeing, and I just wanted some second opinions on this. I know I need to consult my dr. as well but it will take me a while to get an appointment.
Monday and Tuesday, I changed my exercise time from just before lunch to just after breakfast, and ended up going low overnight Monday and Tuesday night. Wednesday I switched back to just before lunch, but still had a low. Thursday (yesterday) I took the day off, didn’t go low but had a HUGE drop between bedtime and morning.
I have already had issues with exercise in the past, and done a little digging about glycogen response, and after thinking about it more, I suspect what happened Monday and Tuesday was that since I had a long wait between exercise and eating, my blood sugar got robbed for glycogen replenishment later that night. Wednesday I’m guessing it’s because I was still within that 48-hour period of Tuesday’s workout. But on Thursday? I’m stumped.
My first instinct was to change my Lantus dose, but I’ve had some bad experiences with that in the past. And these drops are sooo big I’m not sure Lantus could be doing it (when I am less active I generally do well on my current dosing of both insulins, so I don’t think I’m having underlying problems that way - it’s related to the activity increase). Like I have seen it go from 10, 12, or even 15mmol/L at bedtime - which I know is really too high - to 2 or 3 by 2 a.m. without my taking any correction insulin. Supper insulin is long gone at that point…the only thing still working is the Lantus. Can Lantus do that much??
The other thing that’s happening, that ties into this, is that I’m having some decent after-meal spikes. This is normal for me in that it happens no matter how active I am. I know I don’t spike as bad if I wait 15 minutes between injection and meal so I can moderate that somewhat. Ordinarily I would want to adjust my I:C ratios, but what I keep seeing is that I will spike up at my 2h post-meal, but then by the next meal I will be low or almost low again!
As an example: Woke up at 8mmol/L this morning. Did my workout, it went up to 9. I’m not too worried about that - one my blood sugars are in flux right now with all the changes in routine and two I just finished a workout that included resistance work. Took my adjusted insulin for breakfast. Two hours later, 16 (!). But by lunchtime, down to 3. When I am less active I don’t go quite so high or so low but I will still see a spike and then a really big drop long after my bolus insulin should be on its way out.
There will be times that I “feel low” but my reading is still normal…but a half hour later it’s low for real. I think I can feel it not just when it’s low but when it’s starting to drop so fast. At least I still have good sensitivity, thank god!
I am so confused and frustrated and tired of this roller coaster. I have been exercising every weekday for the past month or so and have not been this unstable until now, so I feel like it has a lot to do with my changing the timing of my workout (last time this happened it was because I was going for long walks after supper so I think timing is really important for me). But it feels like every time I try to tighten down my blood sugars or be more active this happens. I know the body is not a petri dish but it’s like banging my head on the wall!
So what do I do? Do you think I just unbalanced myself with the schedule change and it will settle out after a weekend off exercising? Should I be looking at decreasing my basal and increasing my bolus? Have any of you experienced anything like this - what worked for you? I just want to understand what’s happening in my body (as much as possible that is) so that I can adjust whatever I need to adjust.