A lot of people out there, those with diabetes of any stripe and those without, seem to think that because T1D is treatable that it is also predictable.
Ask anyone that's lived with it long enough and you'll get this approximate response:
It's predictable within certain bounds. I know that 1 unit of insulin will generally drop me 50 mg/dl or 3.0 mmol/l. Generally.
Unless I'm exercising. But only cardio or walking. Sometimes push ups and mountain climbers.
Unless I'm sick and then it doesn't do squat.
Unless I'm ovulating or menstruating.
Unless I'm stressed out.
Unless the weather is hot. Or humid. Or both. Or neither.
Unless... You get the idea. It's a capricious fucking disease.
This was my day today after doing pretty much the exact same thing as yesterday. Except this morning I woke up north of 200 mg/dl. I corrected for that, ate the same food as yesterday, exercised at the same time, and due to some random bullshittery I ended up down around 39 mg/dl before the jelly beans and lunch kicked in.
Let me interject here and also say 'thank everything for Dexcom' because I didn't feel the hypo at all before I got the 'hey, you're going low' alarm. Even when the urgent low alarm kicked in, I was still feeling okay. Tired because I'd just done exercise, but generally okay. Feeling okay at 48 mg/dl (2.6 mmol/l) is not the greatest thing. I've lost my hypo awareness and I don't know how it happened because I do not have a history of excessive hypos, severe hypos, or hypos occurring on a regular basis.
Right, so... Watching the Dexcom monitor what's going on, as soon as I hit over 100 mg/dl with a straight up arrow, I bolused for half my lunch carbs.
I'm pretty sure my old DSN would yell at me for that. Why did I do that, though? Two reasons.
1) Thanks to the app I use to track blood glucose levels and dosing (MySugr), I had an approximation of IOB (insulin on board) to keep myself from going hypo again. I also have my carb ratios down pretty solid.
2) The rollercoaster of hypo to hyper wrecks me. I'm pretty much worthless for 18-24 hours after a day with two or more hypers with a hypo in between.
Also, even though I'm only 867 days into this Type 1 Diabetes lark, I've learned what works for me most of the time. I know that if it's a mealtime and I've gone hypo just before and it's not due entirely to external insulin that I can do about half my usual dose and come out okay. I also know that I can't do this when my meal is greater than 60 grams of carbs.
It's a skillset that most people never need to know. For those of us with Type 1, it's a great advanced skill for our toolkit.
** How it works for you will be different than how it works for me. If you are going to experiment with this, err on the side of caution. **
There will always be something that interferes with the elusive 'perfect control'. What we've got is data. What we do with it is what matters. All anyone can ask of someone with T1D is that we do our best. Some days we can do everything. Some days, life gets in the way.
But you're not alone in this. Every day that we wake up and live despite having to act like a tiny sliver of an organ that most people never think about, we're doing our best. And that's all anyone can ask.
(Happy to report that I'm currently chilling at 130 mg/dl with a flat arrow an hour and a half after the hypo.)
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