February Quantified, Compared, Explained,Tweaked...

What are the chances of this kind of sensor-meter harmony?

30 Day Sensor average 132
14 Day Sensor average 122

My sensor data says that I'm staying in range 92% of the time, 5% above, 3% below.
I'll have to check what those limits are, because, while it seems like what I want, I don't think it indicates that I'm staying in the tight range that I consider my "target range" (70-110) so much of the time. Working on it, though.

I feel like things have gotten better since January. For the last 2 months I have shown roughly a 10 mg/dl point drop in the average each month. I have been getting especially consistent results over the last 2 weeks, in particular. I think the improvement relates to more sleep, better hydration and regular exercise. I hate to admit that simple things like that were always available and ignored, but it's what I've come up with. Either way, I'm watching my sensor info like a hawk and am happy that lately it's barely been budging from the 90-100 spot. I've done some studying of my data and tweaked my basal a bit.

For a while there, I was manually switching between my basal patterns all day long. I have 3 different basal delivery levels that kicked out 30, 22, and 19 units. Depending on what I saw going on I was switching to a different basal to address a trend. It worked, but it required TOO MUCH tweaking, and I was losing track of what was working when. Eventually, I found that I was getting lows even when I was using my lowest basal, so I decided that I needed to sort it out better. I looked for the spots where I was regularly seeing a rise or a drop and I adjusted the basal about 2 hours ahead of it. It worked. Today was smooth, and I didn't mess with the basal options all day. Just boluses.

Last month I said my goal was to reach an average of 126 mg/dl. I am not there yet, but it definitely seems within reach. Then I'll shoot for 100 mg/dl. 

I like info-graphics... good one from Greatist.

I have to say, I'm only barely interested in Cavemen, but, determining what whole foods seem to be the most beneficial and functional for diabetics is pretty important for me. Whatever you want to call this idea, it works for me.

More Health and Fitness News & Tips at Greatist.

Research and whatnot...

Well, yes... I have been away from diabetes blogging for a bit... I'm going to say I've been busy with some research. And, it's true.

Since 2003 I've been working in waves to achieve better results with glucose control. After tackling nutrition, it seemed like exercise was a variable that was hard to master. I had heard that it could make your glucose go both down AND up. Different times of day gave different results... I exercised and hoped for a safe outcome, or I skipped it...

Anyway, around the time I reported my January numbers I was starting a fitness routine (which consists of sprinting, lifting heavy things, play, and rambling walks) and ran into some interesting stuff.

Lifting Heavy Things: I thought that since my experiments with the elliptical trainer were giving me greater insulin sensitivity (because of extra muscle activity), doing some weight training would create the same effect to a greater degree. Well, I was wrong. I did my first workout session I had a crazy fast rise in my glucose. It was after a meal, but the rise was even faster than a meal. I found myself at 300 mg/dl. I was sort of annoyed. I emailed Ginger Vieira, because she lifts heavy things, is a Type 1 diabetic, and she's a health coach. I figured she might know something about it. She told me that it's pretty normal for this to happen. She referenced chapter 9 in her book. I bought her book and read it, quickly.

Yep, anabolic exercise requires insulin, and then later, glucose... Hmmm. There's more to it than that, but it answered my question.


Rambling walks...: I have experimented with taking some walks and it definitely does the same thing as the elliptical, and it's more interesting. My insulin sensitivity goes up and sometimes I even have to lower my basal rate, eat a glucose tablet, or I get away with eating more carbs in the following meal than usual.

Sprinting: Part of my weekly routine includes some sprinting. I'm not a runner, but it's kind of fun to get out and run as fast as I can for short distances. I'm doing it with Simon (age 11), and we are having a good time on Saturdays. We go out for about 15 minutes, warm-up and then give it our all for about 50 yards, rest. Do it again. Maybe 8 times.
Effect: some soreness the next day, higher insulin sensitivity for the next 4 hours
It's shocking that 15 minutes of intense work can have a dramatic metabolic effect. At that short interval, it's nothing but fun, with a good pay off. We are only doing it once a week, according to our routine, but it's pretty fun. I'm thinking of making my cycling more about slow, leisurely pedaling or sprinting in the future. It seems like that's where the greatest benefits are for insulin sensitivity. That hour long cardio stuff wasn't as fun, took a long time, and didn't seem to help as much.

I mentioned Ginger Vieira's book earlier. It's called Your Diabetes Science Experiment. A good portion of it is about exercise. I think it's good and I really enjoyed it. She has really done her homework and gives us the tools to figure out all the odd things we experience as diabetics.

Overall, it's been fun to try to figure stuff out. Of course, there's often more mysteries than breakthroughs, but it's all progress to me.

January numbers & health summary

I had said that I'd report my numbers here at the beginning of each month. I love having the CGMS and am in a habit of keeping it going all the time because of the great data I can get from it.

At the end of 2011 I noted that I had had a rough couple of months with illness, and my average BG had risen to 150 mg/dl.

This month my sensor average is showing 141 mg/dl, with:

• 12% above my high limits
• 87% within my normal limits
• 1% readings under my low limits

My goal is 126 mg/dl for an average, so this is a bit closer.

Translated to A1C, I would be at about 6.6 right now. (and then there's the other 2 months before... I did an at home A1C test and it said 6.8, okay with me, but no change...)

More importantly, I'm feeling pretty healthy lately. I'm trying to work on the quality and quantity of my sleep. I think I succeeded in getting rid of the sinus or dental infection that was giving me chronic headaches and unpredictable glucose control. I'm using small doses of exercise to increase my insulin sensitivity. I am enjoying less caffeine, and fewer pints of cider. Lately, I've had a couple "perfect" days when my glucose level stayed solidly in range and it felt like I had a handle on it. :)

Things that I need to keep an eye on: during a period of less sleep in late-January I started to have more heart arrhythmia episodes. I'm hoping that it's just a flare up and not a new reality.

What do you make of this? What do you call Low?

I've been listening to Robb Wolf's podcasts about eating Paleo diet and solving health problems. One reader asked about non-diabetic people testing their blood sugars and what he considered "normal". He said that with the non-diabetic athletes he works with it is very common for them to maintain blood glucose values of 60-70 mg/dl, all the time. These are insulin-sensitive, low-carb, ketogenic atheletes. I was fairly incredulous (almost mad?) because I have always considered those numbers to be uncomfortable low blood sugar numbers. Also, I have found Dr. Bernstein's standard of 85 mg/dl to be difficult to achieve, but this  60-70 mg/dl business just sounds uncomfortable!

I guess, if I had no chance of actually going hypo because of all the checks and balances (glucagon, etc) of a normal body working perfectly, I wouldn't be too freaked out to just walk around in the 70s all day. However, I do feel some minor hypo symptoms at that level and always correct to get my level back to 90-110 mg/dl.

So, that has me questioning my bias towards high-ish "normal" numbers, and also had me wondering if Robb was fudging numbers downward to make a point. When it comes to blood glucose numbers, we Type 1s are very aware of what is normal and what's not, so we don't go for exaggeration in the place where we live.

Then I saw this guy's graphs and read about him sleeping and waking up regularly with his glucose in the 60-70s. I just wondered, why would you do that? He says he felt better that way. Is that possible? So many questions... (just corrected my fasting 108 mg/dl down a smidge.)

looks like the slide into athleticism is inevitable

I've been finding very positive results with surges of exercise "turning on" my insulin.

 For instance, today... after a rough night with a heart arrhythmia episode, a hypo and over-treating it with ice cream... I woke up with my glucose in the 200s. After a week of fairly great control, it was pretty bleak. Plus, I was headed into a high-adrenaline day, the first day of a new semester, with very little sleep. Sounds like a bad blood sugar day, right?

Yep, all day I just hung out at 200 or so, and boluses did nothing. I was too busy to really care.

 I came home with tons of work to do, but felt lousy from poor sleep and being high all day. I took a nap, more insulin, everything stayed the same. As I was sitting down to put in my evening of work I decided that it would be a worthwhile experiment to put in 15 min. on the elliptical and see if it would budge my stuck glucose level. Immediate change. In 30 minutes I went from 208 to 78. I have never seen anything like it. It's like my insulin is just sitting there in my tissues waiting for me to give it the green light.

 Then I read this article about a Type 1 ironman who greatly improved his control by exercise and eating Paleo. I'm already eating that way, now I just need to figure out how little I can exercise and get the full benefit. I'd like to keep it to 30 min. a day, and be in the comfort of my warm home.

exercise experiment

Based on my recent breakthrough with physical activity upping my insulin sensitivity so much... I tried something after dinner tonight. After I eating, I was watching my sensor and saw that my glucose was already to 140 mg/dl, 30 minutes post meal. Considering that I took my meal bolus about 20 minutes before dinner and  I don't eat fast acting carbohydrate, it seemed like I was headed in the wrong direction. I decided that I'd get on the elliptical after dinner and go for 20 minutes, to see if I could correct the rise. It worked. I went from 140 to 89 within 40 minutes, with a meal in the works.

Now I just need to see if I can get an elliptical in the office at work. Not really, my trickiest readings all day are after dinner and into the night. Digesting dinner just seems to be a wild card.

This is good information. If my insulin worked faster I'd be fine, but it seems like it's always really slow. I'm almost never afraid it will work too quickly. This exercise deal is speeding it up for me. I'm all about it.