2013-05-13

Assorted Diabetes Miscellany

Here are a few type 1 diabetes observations, culled from recent personal experience:

First, travelling is almost always disruptive to blood sugar control, even when one proceeds with the best intentions and the highest regard to BG control. There is something about being pulled away from one's regular maintenance regime that seems to make the body react differently to the same set of stimuli if the underlying surroundings are slightly different. I can only really chalk this up to the complexity of the endocrine system itself. Perhaps different levels of cortisol, serotonin  etc. change the way insulin is absorbed. Who knows, though?

Next, exercise always helps, but sometimes it helps a lot and sometimes it only helps a little bit. I can engage in the same 45 minute-run, at a near-identical pace, along the same geographic course two days in a row, and my blood-glucose response will be radically different on both days. Some days, my BG increases in response; some days it decreases substantially; some days it hardly budges. Such a wide array of responses to the same stimuli can be confusing. They are also, frankly, discouraging. It is extremely disappointing to engage in an activity that both theoretically and historically reduces my BG only to watch my BG rise. How does one develop a theory about something that behaves differently every day?

Making drastic changes to one's exercise regimen appears to be more effective at reducing BG and increasing overall BG control than simply maintaining a regular exercise regimen. I have no theories about this. It merely seems true in my experience.

More broadly, there seems to be an issue with adaptation. The human body apparently can adapt to higher levels of exercise, to the point that previous levels no longer offer the same benefits in terms of BG control. In a sense, I almost feel as though a well-trained diabetic body can develop a resistence to the benefits of exercise. (What follows is a big, psychological "why bother?") But it isn't just exercise. The body also builds a resistence to insulin (e.g. type 2 diabetes).

Another example is the case of dietary changes. Dietary improvements that previously aided in BG control can no longer be counted as improvements two years after the fact. All the benefits associated with foregoing pizza, for example, are gone as soon as you stop eating pizza. Two years later, you are not eating pizza and you are also not benefitting from not-eating pizza. To experience further benefits, you will have to forego something else. I think this is how Dr. Bernstein's diet gradually developed. He must have slowly given up all the foods that caused any sort of rise in his BG, until he paused and found that he had given up food that caused any significant rise in BG at all. At this rate, I am on that path, but I must say that I have already long since reached the point of diminishing returns as far as dietary changes go.

In the end, I think my principle problem is stress. There is no question that stressful situations cause my blood sugar to rise. It is probably not too far a stretch to suggest that small stressors increase my blood sugar to lower degrees. Over the next few weeks, I am going to test this theory by cultivating a calmer, more meditative approach to stressful situations.

Worth a try, anyway. Nothing else seems to be working well anymore.

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Note: Now may a good time to peruse my Lexicon to review some of the basic diabetes terminology employed here on the blog. While you're at it, take a gander at some of the other terms I often use around here.