Thursday, September 11, 2014

The ?!? Factor

The other day someone posted a link to an article that talked about some of the factors that can affect blood sugar. None of these factors were new to me. I have either already been told about them by medical professionals or I’ve experienced them firsthand enough times to reach my own conclusions.

The list included the usual suspects:

- Carbs make it go up
- Stress makes it go up
- Hormones make it go up, except for all the times when they make it go down
- Exercise makes it go up or down depending on the type of exercise, time of day, length of time spent doing it and how long it's been since you did it
- Alcohol makes it go down unless you’re having sugary drinks in which case it sorta makes it go up and down at the same time

And so on and so forth.

I read this article while sitting on the couch. I had just returned from my first CoreFit class (more on that tomorrow), was sipping red wine and enjoying two chocolate chip oatmeal cookies. I had had kinda stressful work day. I had already run that morning.

That paragraph alone shows that there were at least five different factors at play at the same time. All of them pulling my blood sugar in one direction or another. All of them making my best laid plans seem laughable. How much should I bolus for those cookies? When I think about all the things pulling me up and down the answer is to take my best scientific wild ass guess at it.

So of course, after reading the article, I spent the next day playing a game with myself. How many variables are at play at any given time when I am making insulin-dosing decision?


I didn’t swim because, well let’s be honest here, I was too sore from the CoreFit class (more on that tomorrow). So no early morning workout means extra breakfast insulin and slightly higher blood sugars all day. But I did have the CoreFit class the night before which was a) hard, b) an unknown exercise as in I have no idea what it will do to my blood sugar over 24 hours and c) it was my first evening workout in a while which means all the stuff I do for morning workouts probably won’t work. So I took 0.20 more units that I normally do and crossed my fingers.


I bring my own lunch to work 99.9% of the time because a) I know what’s in it and b) it’s much less expensive and c) it is usually much healthier. Yesterday, a group at work that I’ve been meeting with for five years decided to bring in Chinese food to celebrate our half decade anniversary. So the lunch variables were a) I hadn’t exercised that morning and b) I was eating unknown food( for the record I tried to compensate a bit by ordering a veggie dish with no rice to at least keep the carbs to a minimum). On top of that I had a massage booked two hours after lunch which typically lowers my blood sugar. Typically. Except when it hurts a lot and then it brings it up instead. And since my muscles really hurt from CoreFit (more on that tomorrow), I was expecting pain. On top of that I was meeting Doug for golf right after the massage which usually drops my blood sugar. 

So four more variables to consider. 

Keep in mind we're not even talking about the internal things going on (hormones, stress, fatigue and other fun things that are harder to identify and account for).

I didn't take much insulin at lunch and was holding steady at 7.0 before my massage. I panicked a bit and ate four candies en route because I was afraid of going low. I spiked up to 14 before the first half hour was done so I bolused two units to tackle that mistake. I was 11.0 when I left the massage and 9.0 by the time I got home. I ate 20 carbs en route to the golf course only to learn that we weren't going to be able to play since there was a huge rain storm coming. We hit balls for 15 minutes and then had to head home. My pre-golf snack had been unnecessary and I was now climbing back up to 11 as a result.

By that point in the day I had completely lost track of how many factors I had to keep in my head and we haven’t even reached dinner yet.
So I stopped counting. It's just easier to manage it all without actually thinking too hard about all the things I have to manage. 

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