Living With Type 1 Diabetes: One Step Back to Take Two Forward
There are so many ways to think of or say this expression, but overall it means you have to be willing to take a hit in order to make progress in the right direction.
Life with diabetes brings a lot of potential hits, but if we think of them as a starting point to progress it can make a difference in our mindset. You are thinking, yeah, right – how is it progress when my post-meal BG is high, you always have a low BG around exercise, or can’t seem to get what is going on around your monthly cycle, etc. That is a major hit in the wrong direction, right? But, consider if you start to evaluate these hits as information when you think of where you want to be? Then the hit becomes something you step forward from with a strategy and ability to avoid.
I thought of this more recently when I was working with someone wary about adding more than a 5-minute pre-bolus to typical meals. “But my BG is going to drop fast if I take my insulin sooner before I start to eat” is the statement I heard. It isn’t uncommon unfortunately. Fear of insulin and its ability to change BG is profound based on what we’ve been told since starting to use insulin. However, our rapid acting insulin today really isn’t that rapid (or we wouldn’t have insulin like Fiasp or Afrezza on the market, or companies working to make fasting acting insulin). It takes time for it to get working – usually about 15-20 min at the minimum. If you have the experience of rises after meals that you don’t want, then “taking a hit” by pre-bolusing longer than usual may be the step that moves you forward in containing the rise. OR, you might find that you waited too long and a drop starts to happen sooner than you want during the meal. In both cases, being willing to experiment and potentially get a response you didn’t want in order to learn more and adjust better next time is a step in the right direction.
I took a lot of hits when I started running long distance and doing triathlons years ago. I had a lot of adjustment I had to work through and a lot of times when it didn’t go the way I wanted with BG. Either too much adjustment up front with temp basals and food and high BG, or too little adjustment or poor timing of adjustment, and not quite the right timing of fuel during with lower BGs that had me walking or taking a break to stabilize and bring BG up. In the end, my ability to adjust more on the fly now is so much better. I know if BG is going up a certain way, how and when to adjust or when to add fuel for performance that also keeps my BG in target.
Life with Diabetes is an eternal experiment.
At times it can feel like a new petri dish daily in which you are supposed to be growing green dots and they suddenly turn orange with blue fuzz. Sometimes you have it all figured out for a while – could be months, could be a few years or depending on the time of life you are in, it could be a few weeks (pregnancy, kids during growing years, stress, illness….).
Know that if you take some time to evaluate by being willing to take a step back and “see what happens” – if you just add a bit more insulin, or time before a meal, or food before a workout or temp basal for illness you can get ahead eventually and learn more for next time. Steps forward feel so good, even if it means a few steps back to do it.
If you’d like to take less steps back and make more progress, as always, Integrated Diabetes Services has a great team of clinicians all with diabetes to help you on this journey. Give us a call and let us know how we can help!!
Jenny, you have helped me overcome my fear of experimenting with pre-bolus times and using the temp basel mode on my pump for fats and proteins.
I found Integrated Diabetes Services via a webcast; working with you over the past 3 years (?) has truly made a difference in my management. Blessings!