My second year of grad school is now in full swing and I'm now learning how stress messes with my BG levels. Last semester when I was diagnosed, I actually didn't deal with many stress-induced highs. My I:C ratio was too high and I was dealing more with frequent lows. Over the summer my management was great. Any highs were due to miscounted carbs or mistimed boluses and I got pretty good at preventing lows. I also exercised nearly every day.
Now that school is back in swing, managing my BG is much harder. I work part time teaching and I'm taking 9 credits, 3 of which are online. It's a very stressfull, busy schedule that doesn't leave much time for exercising and I'm dealing with frequent highs.
Anyone have any suggestions on managing BG levels during stressful times? I know I need to start slow and take one thing at a time, but I'm not sure where to start.
Are you highs literally caused by stress or hectic lifestyle (which makes it difficult to remember to take care of yourself)? I graduated from grad school last year and can understand the demanding schedules, odd eating patterns, etc. Sometimes I would forget to pump insulin, check my BG after meals, or eat late at night (while often underestimating insulin). It may help to consider being on the pump (if you're not already) and exercise is great for stress relief and blood sugars (but you know that!)
My job can be pretty stressful. Exercise is my main stress relief. It sort of works two ways, 1) in that it's a direct way to blow off some steam and 2) it forces me to spend time, like maybe 4-5 hours before "blasting off", getting my BG in order to work out. Not that much more or less in order than usual but just to make sure things are where they are supposed to be.
The old story of stress is FIGHT or FLIGHT. Do I stand and fight or do I run away? Either choice requires more strength, adrealine, glucose, etc. So when you get into those stressful situations, your body is going to automactically compensate and your blood glucose will rise. As a diabetic, I feel I have the best stress barometer in the world.
The other thing to remember is that worrying about and dealing with highs is stressful in itself. If you can control that, it is the place to begin.
Are you on a pump or MDI? I found my pump to be a good friend when I was in grad school and working full time. Also, can you see patterns? Do you chart/record your readings. If you can identify the occurences, you could change your dosages (temp basal on a pump) for those those times.
ARs exercise idea is fantastic, as it lets off steam and helps reduce your numbers. I would make this a priority. And, strange as it seems when you use them, the stress relieving activities (I am floating down a stream on a beautiful day and relaxing....) really do work. There are CDs, etc that you could try. I did a lot of those at bedtime. It helped me sleep instead of worrying all night.
I have my carb counts but I never figured out a reliable "stress" count which meant all I could do during stressful exams was bolus a *small* amount before the exam and fingerstick after. Stress is a funny thing because it is all about how you perceive it.
I was diagnosed in my second year of grad school and was totally overwhelmed by having to learn diabetes management while taking a full courseload and getting through a challenging internship. I am so sorry you're going through this!
My stress level was through the roof also, and I chose to put diabetes first- to the extent that I could and still fulfill the minimum requirements of my program. I hated having to lower my academic expectations of myself, but it helped me reduce the stress. It pissed me off that I wasn't able to be as engaged with the program as my peers, but I was so stressed about BG that nothing else seemed as important.
I recommend choosing your battles carefully- which I know is difficult when you're stretched really thin. Therapy can be really helpful for managing different sources of stress, and there are some who specialize in working with people with chronic illness. I wanted to go, but didn't have insurance, time, or money! Whatever options for stress relief you decide to try, I wish you the best!
Here's what I'd say if you were one of my doctoral students. Lay out all the hours of your week. Block out the time you can't change, then mark the potential study time blocks, not putting any of that past 10 pm. Now block out 1/2 of the study time and make it time on the treadmill. Your brain function will so improve you won't need so much "study" time. You'll get through the thinking process for your dissertation problem faster.
Put on an audio book while treadmilling.
Thanks for the suggestion. I think I'll find that helpful. I already have those "can't change" times blocked out, so all I would need to do is block in the study times/workout times.
I'm thinking it's some of both, Kathy. I'm on a pump now (it helps a great deal). I did injections last semester; I did just fine with them but couldn't get doses precise enough.
You've gotten lots of good advice regarding stress.
But also wondering if your honeymoon phase is also a factor, as your profile says you were diagnosed in Jan 2012. If your body had been producing some insulin, it may be dropping down now, and result in similar difficulty with highs that you didn't have before.
Are you noticing any patterns to your highs ? Have you tried basal rate or I:C changes ? Temporary basals might also be helpful as you try to see what adjustments may help.
Good point. I need to start actively looking for patterns. I log regularly using the WaveSense app (it's identical to the Sanofi iBGstar app) and it has a great trend chart feature. I need to force myself to spend some time looking over that chart and looking for trends.
I bumped up my basal one notch; it's helped some but I need to do more. My fasting BG is usually fine, although it is higher than it was over the summer. Over the summer, I was consistently in the 80s first thing. Now I'm usually right at 100 and sometimes a little above. I don't think overnight is the problem. I tend to be elevated throughout the day.
During tax season when I'm under stress, I tend to bump up my basals by about 20% and adjust my meal time basal a bit. You don't even have to change to I:C ratio on the pump, just add a couple of carbs to the calculation in the bolus wizard and see if the bump takes care of the problem.
I don't now how you're eating but if you're having trouble you might want to have the same meals over and over so that you're comparing apples to apples.
