A Couple of Things

So last night I posted on having to treat an upcoming low right after dinner and being so full I thought I would explode... Well I woke up this morning at 310. What the hell! I did play basketball over lunchtime for a couple hours, and I'm just not used to dealing with that particular exercise/duration/intensity yet.

There are a couple of possible scenarios I thought of for that high this morning:

1. I still went low last night and the high in the morning was a rebound
2. I overtreated that upcoming low last night

I am lucky enough to work with a group of RN's that specialize in diabetes. One of the nurses said that if you wake up high in the morning and it is because of a rebound from a low during the night, you will have ketones in your urine. I will keep that in mind for the next time I suspect that. The problem with that is my morning habitual routine. First stop in the morning is the bathroom, then downstairs to test & eat breakfast (usually). By the time I know I'm high and suspect anything, I've got nothing left to, uh, deposit on the ketone test strip. Although I suspect that there would still be ketones present the next time I need to go - you can't flush them all out in a single void (I don't think so anyways).

Another thing that one of the nurses recommended is a formula regarding temporary basal rates before & after exercise. This topic is varies so much for every person, and of course the exercise can vary quite a bit (sometimes I play basketball and am very aggressive, other times I lack off a bit... depends on "stuff" you know?). So, with that being said, YMMV (Your Mileage May Vary). The formula was basically for every 30 minutes of good intensive work, run a 50% basal rate for 4 hours afterwards. So, for 2 hours of basketball I'd want to run my basal rates at 50% of normal for about 16 hours afterwards.

That may have really helped me yesterday because I think I was crashing at dinner because of that good exercise earlier in the day. What happened was that a while after dinner I started feeling kind of "funny". I did a test and I was running in the low 100's (101, 110, something like that). This was immediately recognized as a problem because I still had over 8 units of insulin on board from the recent bolus at dinner! So, I had to scramble to avoid crashing in the near future.

Maybe if I had continued to run a temp rate reduction that afternoon I would not have been crashing at dinner.

It gets complicated though when you start to think about such intensive exercise, burning alternate fuel sources, creating ketones causing insulin resistance driving blood sugars higher.

I'm a master at overcomplicating issues. It really is complex though, the way the bodies metabolism works and having to try to figure it all out (and get it right) while exercising.

Stay tuned...