Step 3: Bolus more insulin. More than sixteen years after I started using insulin, it still freaks me out. There . . . I said it. It’s not the insulin itself but the potential for hypoglycemic events. They feel terrible, get in the way of my exercise plans, and can even be life-threatening. Despite trying almost everything last year during Ironman training, I saw a lot of episodes of massive blood sugar drops when exercising after work, often while riding my bike home. It was frustrating, and eventually I stopped giving as much insulin as I knew I needed at lunch. At the same time, my carbohydrate intake increased. When you put it all together, my blood sugars were higher than I would like, my tolerance for those values went up, and my desire to take full doses of insulin decreased.
So . . . This one is going to be hard work and has multiple facets. I need to take more insulin but not always. I need more insulin when I know that I won’t be exercising right away: with breakfast and dinner, for example, or overnight when my 6AM workouts are still hours away. I need to look at the recommendation from my bolus calculator which seems big—OMG! 12 units!—and start to feel confident that it’s actually the right amount if I’m not heading into exercise. But even before I feel confident, I need to JFDI and take the insulin. Fake it ’til you make it. (All this assumes that the carb inputs to the calculator are correct. See Step 2.)
It’s possible to make this step easier if I also add in some future steps, like eating fewer carbs and journaling more, but let’s talk about those later. Baby steps.