Thursday, February 27, 2014

Workin' on My Fitness

One of the silver linings of having Type 1 Diabetes is the ability to be in tune with your body. Since I was diagnosed at age 11, I really wasn’t formally exercising back then…but it seems like “normal” people focus on two main goals when implementing an exercise regime: (1) weight loss or gain and (2) general “feeling” improvement. But, as we all know, weight loss or gain is not necessarily indicative of “health” and a general feeling improvement is extremely qualitative. Luckily (maybe?), as a Type 1 Diabetic, I have a few more numbers to look at when reviewing my overall health or health improvement.

Just for matters of inclusion, I will mention the few small-ish changes I have made recently. Keep in mind, I don’t follow all of these bullets 100% of the time, but I’m at least trying!!!
  •  Be more conscious of total-day carbohydrate count
  • Breakfast is a Slim Fast shake totaling 30 g
  • Lunch is fruit + hard-boiled egg + raisins + “bag-o-carbs” (cereal or leftovers or a couple of girl scout cookies) – carb count around 40 – 55g
  •  Dinner is a wildcard, but whatever we eat I try to stick to no more than 55g
  • Try to walk/jog 3 times a week for 30+ minutes
  • Weights or non-cardio exercise about twice a week right now (might include weights, or just pushups, etc)
  •  Check CGM approximately every half hour
  •  Only weigh myself once or twice a week

Using my CGM I have found that no matter how hard I try to come up with the “perfect” bolus for a meal with 60+ carbs I can never maintain the blood sugar control I want. So, I have unofficially limited myself to only 50-ish carbs at one time. For those non-Diabetic readers out there, 50g of carbohydrates might sound like a ton, but keep in mind one large banana by itself can be over 50 carbs…and that’s just one banana!!! So, I try to stick to lean meats and lower carb veggies (i.e. not corn or potatoes) for dinner. Or, like last night, shredded chicken seasoned with enchilada sauce topped with homemade salsa…no tortilla.

Anyway, what does all this mean and how have I used numbers to recognize positive changes in my life?
The other day I decided to look at my daily insulin totals over the last few days. Before these small changes, I was averaging in the 50 – 60 units range per day. After these small changes I have significantly decreased my insulin requirements and see an average of between 30 – 45 units per day.  


The CGM has also allowed me to recognize patterns in between meals (this is probably the biggest benefit to the CGM technology, in my opinion). A few weeks ago I noticed that I was always setting a temporary basal rate of 0 units around 10 am until lunch time since my blood sugar would drop below 80 mg/dL. After experimenting with a few basal rate tweaks, I went ahead and adjusted my carbohydrate to insulin ratio for breakfast. Previously I needed 1 unit of insulin to cover 10 carbohydrates, but now I have adjusted the rate to 1 unit of insulin per 12 carbohydrates. All of this, decreased basal rates and increased carb-to-insulin ratios, equate to a decrease in total insulin usage. Which is a really good thing!

I love having these extra numbers to gauge my overall health level. If I implemented these small changes, but did not have Type 1, I might be discouraged, especially since my weight has not really changed. At this point I am building muscle and becoming stronger, so I don’t expect it to change dramatically, but I can tell small differences in how my clothes fit and feel. These numbers prove that exercising, even a little, can affect your health all day, not just during the exercise times.


I look forward to checking in every once in a while with these health updates! Working out is not the easiest activity for a Type 1, it takes a lot of planning (at least for me)…and I don’t always recognize blood sugar patterns right away, but I’m thankful for the technology that makes it a little less stressful!