The exercise roller coaster

Most of the time, my blood sugars don’t bother me on any real level. I have inconveniences because of lows and figuring out the cycling thing took a while, but as a whole, I don’t feel like my blood sugars impact my life. I stay in range most days, and in exception for being sick, I don’t see a ton of spikes. Much of that is because I’ve been doing this for nearly 19 years, and part of it centers around my recent dietary changes. (Less carbs and processed foods mean less spikes). When I do see spikes, they’re often explainable as I know what caused them and exactly where they came from.

This week, however, has been anything but standard. I’ve been on a roller coaster for four days and I want off the ride. The chaos started Tuesday. I knew I was riding for an hour after work, so before leaving the office, I ate some chocolate covered almonds and expresso beans. Shortly before that, I’d changed my pump site to an angled site in preparation for the ride. When I got on the bike at 5:30 p.m. I was 300 mg/dL with an arrow slanted upward.* Knowing I was only going to out for an hour, I went ahead and gave small correction. I kept my decreased basal rates in place though. I ended up only riding 45 minutes, but I rode hard, shaving 15 minutes of my 10-mile time. When I returned home, my CGM said “high” with another arrow slanted upward. Thinking it was a mistake, I tested and found a 426 mg/dL staring back at me.

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I corrected for the 400+ recognizing I’d already given a small correction an hour earlier and had just completed my ride. I fully anticipated a low in a few hours. But instead, I kept seeing a 400-something staring back at me. As I racked my brain to figure out what was happening, I remembered the site was new. After being so high for more than four hours, I didn’t want to try for a solution. I immediately changed my site and gave another correction. Within 30 minutes, I had a downward slanted arrow on my CGM and a 367 mg/dL on my meter screen. By bedtime, I was 166, which made me much happier to see.

I woke up at 2:30 a.m. with a 44 mg/dL and a blaring CGM on my nightstand. I over-corrected with seven glucose tablets and went back to sleep.** I woke up at 4:45 a.m. to drag myself to Adventure Boot Camp fully expecting to be high. I was 144 mg/dL. Hmm, I must have been lower than I originally thought. I ate two gluten-free pancakes with blueberry preserves and headed out the door to day one of boot camp. When I arrived, I was 124. For the hour of camp, from 5:30-6:30 a.m., I stayed between 120-150 mg/dL. Sweet, I thought. I’ve mastered this and class is going to be super easy.

As I returned home and readied for work, I paid no attention to my CGM. On my way out the front door, I grabbed a bottle of water and felt the urge to pee. I felt higher than normal so I grabbed my meter and checked, expecting to see a 215ish staring back at me. Instead, I saw a 419 mg/dL. What the crap? How is that even possible? I’d lowered my basal rate the hour before boot camp, and I gave less than half the dose for my pancakes knowing I was headed to rigorous exercise. I was dumbfounded. I corrected and came down to 112 mg/dL by lunchtime.

I didn’t ride Wednesday afternoon, and instead went grocery shopping. I had a low while roaming around Publix (you would’ve thought it was Target) so I opened a bottle of glucose tabs and started eating them in the store. (Don’t you love when that happens?) I went to bed with a 138 mg/dL and no sign of highs or lows. I had trouble waking up Thursday morning because I was low. Again. I heard my beeping CGM from the nightstand and fumbled to find it. When I pushed the OK button, I saw “LOW” and a flatline for past three hours. I struggled to get myself out of bed and find my glucose tablets. I downed five of them and struggled to get moving.

One of my roommates is familiar with diabetes and even noticed the oddities in my numbers. When she asked what was going on, I explained the exercise roller coaster phenomenon. I’ve been riding for a while, and I’ve just about figured out what works for me in terms of avoiding highs and lows. But of course, I still have moments. But adding in things like boot camp and yoga make for an interesting mix of temporary basal rates and after-exercise spike maintenance. While it’s frustrating, I know in time I’ll figure it out. While annoying, it’s just part of it. I can handle the lows, but the highs really drive me crazy.***

Anyone else ever experience the exercising roller coaster?

*Your diabetes may vary. While I purposefully spike before I ride, 200 is my preference. This particular number is higher than I’d prefer.
**Your diabetes may vary. Please don’t correct and return to sleep. Instead, you should test, treat, wait 15, test, repeat if needed. In other words, do as I say not as I do. YDMV
***When I’m above 250 mg/dL, I have this image of my organs writhing in pain and gasping for air. In some cases, my image includes them shriveling up like raisins while desperately trying to work properly. I have no idea where this image comes from. Actually, I do, but that’s another post for another day. 

Victoria is riding 105 miles in October as part of the JDRF Ride to Cure Diabetes fundraiser. She’s been training since January and is currently up to 50 miles. She’s raising funds for her ride which will go to research and research-related education about type 1 diabetes. To support her, click here. Regardless of your ability to donate, she’d love to have your prayers for her training and the Ride in October.