Flexibility

I have probably rambled on about this before but I think its pretty important for everyone but especially for those of us living with Type 1 diabetes. Having a flexible approach to managing life’s pathways and diabetes in particular is key to having some sort of “success”.

I say “success” loosely because it seems that no matter what we do to manage the disease we never really achieve what we want and to be honest that is probably due to the fact we are unrealistic about what we want to achieve.

Those of you out there and me included who have had any exposure to managing Type 1 diabetes will know that there is no one standard approach to achieving success with blood sugars, there are of course many different approaches which have some level of success for some people.

As we have just seen with Neil McLagan from “Crossing for a cause”, he just completed his 20 day journey across Australia on a road bicycle, covering ~3900km and his approach to managing the disease was being flexible with nutrition and changing his insulin regime often to meet the various changing factors he encountered along the way.

Massive congratulations Neil!

I am no different, the last few months I have been using the openAPS system, whilst this has been great at keeping me under control during normal everyday activities, I have not yet got it where I want with regards to endurance exercise and with the upcoming off-road triathlon on the 22nd of April (X-Adventure) my Diabetes management has to be flexible, for me this means turning off the openAPS brain and pump, returning to manual injections with totally different insulin.

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My available management options

If its the one thing I can take away from my experience with Type 1 Diabetes over the last 18 years, its that you have constantly change your approach, for me this means on a daily and sometimes hourly basis;

  • Changing insulin sensitivity factor (ISF): taking into account food, exercise, sleep, stress, work activities and weather. (ISF = how many units of insulin it takes to reduce your blood sugar by 1 mmol)
  • Carb / Protein ratio: taking into account the above but also how intense the exercise was and how long ago I did the exercise.

To give you an example, when I mountain bike I become super sensitive to insulin for 24 hours post ride meaning I can drop really quickly if I give even a smidgen too much insulin but then on the opposite side with swimming I go the other way and need to give more for 24 hours post swim – both cardio but both with different effects.

Basically what my rambling is trying to say is, don’t be afraid to take the management into your own hands and make ongoing small adjustments to make the strategy work for you – sometimes it will work and other times it won’t but that’s life, we learn and grow.

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Post ride earlier this year – strategy didn’t work!

Now I am going to keep my options open for the Munda-betes epic adventure in August, both for nutrition and my insulin regime, I will be changing back and forth and experimenting with various strategies because training will be mixed, on one hand my training will be for the cross country racing season and on the other hand endurance riding, I just need to be flexible until its at a point where I am comfortable, it wont be perfect but it doesn’t need to be.

On another note, keep an eye on this space as I have some very exciting upcoming news regarding the ‘Munda-betes epic adventure’!!