There is Always a Reason

I had 4 low blood sugars, yesterday.

Or more specifically, I had 2 VERY low blood sugars yesterday; the kind where you have the type of snack that normally would swing you back to normal land but this time was merely like pumping the brakes on the sliding BG and required twice the amount of sugar to bring me back to the magic 100.

The first one was late afternoon. The CGM alerted me about 5 minutes after I knew it was coming on. I had a pack of peanut butter cups (probably my favorite "diabetes doesn't have to suck" treat), but 15 minutes later, I knew that I was still falling, so I doubled down with somewhat healthier and almost as yummy Clif Mojo Bar. 43g of carbs later, I was 115 and level.

And then just before bed, the same thing; a low that I just knew wouldn't be averted by a simple pack of fruit snacks. So I doubled down with a Kashi bar and some delicious chocolate babka. Again: twice the amount of carbs to bring me back to normal. The same snack that on a regular day would sore me to 200 or beyond without insulin.

But there's always a reason.

I refuse to give in to the mystery of the disease and say it can't be figured out. It's really just carbs and insulin in and energy out, so what was the difference yesterday? Here are 2 possibilities:

1.) I've been nursing a small knee problem and hadn't been able to work out for 3 days in a row for about 3 weeks. Until yesterday. Like all injuries, this one healed and I've had 3 straight days of training. The metabolism has been jumpstarted and the result is more burn. As my body returns to a normal training load, my metabolism won't remain this high (much as I might wish it would!).

2.) For many Type 1 diabetics - including me - it's a misnomer to say that our bodies no longer produce the beta cells that make insulin. The reality is that for many of us, we still make those beta cells and they actually kind of do their job for a very short time until the body turns on them and kills them, usually within a day or 2. It's one of the reasons why diabetes can at times be forgiving... you eat more than you think you should've but don't soar to the moon or look at your CGM and see a glorious straight line. I've long believed that my good fortune with the disease is somewhat due to the fact that while I've never had it measured, I'm certain I still make those beta cells. Yesterday could've easily been one of those days.

The challenge, of course, is not to over-react when you have days like yesterday. Don't change basal rates. Don't suddenly think that it's going to take 40g to cover a low. Because though yesterday was somewhat unique, it wasn't special or magic or anything, other than another day of managing the 'betes.

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  2. Hey Marcus

    I can certainly identify with both reasons. I've just had a few weeks off injured and since getting back running I've seen that changing from one training pattern (lots->none->light->lots) causes step changes in BG behavior - thanks to my meter s/w I've graphs to prove it!

    Also, I'm sure that the beta cells are still there to some extent or other. Like you I see this as the reason why I don't seem to have as many issues as some people do in managing the condition. I have no other way to explain how I can sometimes eat 70g of porridge oats with zero bolus before a bike ride and only have my BG go to 8.6 (158), while other days it will send me far higher. At my next clinic check-up they're do a blood test to confirm whether there is still beta cells activity so that should clarify things!

    But as you said the trick is to try and understand why things happen, and roll with it best you can.

    Btw - check us out at http://t1sportireland.blogspot.ie/

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