Hey, we’re halfway through Diabetes Blog Week 2015! So far so good. I’ve been doing my best to write to the prompts this year, but I think I’ve taken a few liberties. Anyway, I think I stuck close today.
“Today let’s talk about changes, in one of two ways. Either tell us what you’d most like to see change about diabetes, in any way. This can be management tools, devices, medications, people’s perceptions, your own feelings – anything at all that you feel could use changing. OR reflect back on some changes you or your loved one has seen or been through since being diagnosed with diabetes. Were they expected or did they surprise you?”
I’ve been doing triathlon for five seasons now. Tri training is all about cycles. There are two big cycles that last many months: the training/racing season and the off-season. During the main training season from March to September, there are smaller cycles of 3-4 weeks. These build and then have a recovery week. And each week is a kind of cycle, too, with hard and easy days, peaking on the weekend. The “off-season” is really a misnomer, since I still do about 7-10 hours of exercise per week; it’s just unstructured and fun.
Each of these cycles requires a change in how I manage my diabetes. The harder I train, the more insulin-sensitive I become and less I have to dose. And the more I train, the more I eat, which means more insulin . . . but not too much, of course. Saturdays and Sundays are my long run and ride days, and I’m most insulin-sensitive on those days and Monday, too . . . even though it’s my rest day. On recovery weeks, the 25-30% reduction in my training volume really shows up in increased insulin needs.
Add to this another pair of cycles related to insulin. Every three days I change my infusion set and insulin reservoir. I’ve noticed that the insulin loses a bit of its potency by the last day. (I’ve heard various reasons: insulin starts to stick to the tubing; the tissue around the infusion set changes; the insulin in the reservoir gets a little warm and less potent; etc.) Insulin definitely works best when the vial is new, and sometimes it almost seems not to work very well at all by the time the bottle is empty.
Finally, I swear that my body has its own cycle with the occasional week when—all other things being equal—I’m extra insulin resistant. Maybe it’s the accumulation of training stress. Maybe it’s hormones. Maybe it’s just the psychological pendulum swing that happens when I have several bouts of low blood sugar, which leads me to be more conservative with my insulin, which leads to higher blood sugar and the need for a little more courage and insulin. Who can say?
Being an athlete with diabetes—just having diabetes, actually—definitely requires a lot of flexibility and adapting to changes.
For an explanation of this post’s title, see the animation on this page.