4 ms·

"You don’t have to curtail your physical activity to avoid hypoglycemia because glucose is portable and durable." Between this and your "humble-brag" on your o

"You don’t have to curtail your physical activity to avoid hypoglycemia because glucose is portable and durable." Between this and your "humble-brag" on your other post, what I'm led to believe is that you're pretty ignorant on how variable insulin sensitivity and blood sugar management is from individual to individual. I've maintained an A1C of less than 6.5 for more than a decade so I'm the picture of "perfect" control and I can tell you that physical activity is a pain in the ass. I'm hypersensitive to insulin during physical activity. When I go to the gym I want zero insulin on board because just 10 minutes on the treadmill could drop me from 160+ to 30. Just walking is enough to cause me to have low blood sugars, so I have to reduce or skip insulin with food accordingly. I'm required to elevate my blood sugar to 200 before I can scuba dive and then I can still only dive for a maximum of an hour because there is too much risk I will pass out and drown. And then you say, "I am dealing with an issue where I think some of my preferred injection sites are becoming less effective". Preferred injection site? WTF dude? Of course it is becoming less effective, that is why they tell you to constantly change the location. Preferred injection sites are a huge no-no.

1123581321 8y ago
Yes, I deal with all that besides Scuba diving (interesting!) These routines around everyday exercise are not constant worries as represented in the earlier post. After exercising a few dozen/hundred times you know what to expect and don’t need to think about what to do. I will say that inconsistently performed intense exercise can be challenging; a regular exercise schedule is less effort to manage for diabetics. I rotate injection spots but have favorites based on convenience, sensation, etc. like anyone else. The variation in effectiveness I’m seeing is small enough that I’m not sure what’s happening yet. It’s not really a big deal because my numbers are fine. It’s not a disease that varies so much from individual to individual that lessons can’t be learned and shared, and it’s a disservice to misrepresent the mental effort to new diabetics and people potentially lapsing into poor control.
pimeys 8y ago
I'm like you when I do any activity having insulin on board. I'm a T1 using a pump, and I really like the combination of a pump and CGM for staying away from surprises. I use AndroidAPS to monitor my glucose and insulin on board, taking a temporary basal setting of 0% if needed before any activity, so my insulin on board drops to the base level or a bit below. Soon the insurance replaces my pump to a Dana RS, which supports closed looping with AndroidAPS. Then it's just setting a temporary glucose target to a higher value and the system takes care of the basal rates to keep the glucose from dropping. The article here is kind of weird. How am I supposed to dose e.g. 0.3 units or 0.75 units of insulin with the pills? The ability for a very fine granularity and the possibility to automate my medication are much more interesting compared to the pills mentioned in the article.
- bigtunacan 8y ago
  You are spot on. The temporary reduction or even suspension of insulin depending on my activity are key in preventing lows for me. The closed loop pumps are the biggest improvement I've seen for living with T1. There's always lots of promises, but this is one of the few things that really improves my life on a day to day basis and it just keeps getting better.
  - pimeys 8y ago
    Right now it seems there is official support only to prevent hypos, but not to give you more insulin at night when you ate something too heavy and didn't guess the right TBR. Only the open source AndroidAPS for Android and Loop for iOS do this. And then you have a very limited set of pumps you can use.
    - bigtunacan 8y ago
      The Medtronic 670g is the only pump that currently will automatically correct highs, but it only works with the Medtronic CGM which is untrustworthy. The Tandem t slim x2 only has support for hypo prevention today, but it supports at home firmware/software updates and they are pretty far along with the FDA on getting approvals for their auto dosing for highs. They anticipate a release this summer. I wish that OmniPod was further along on this front. I would love to have a tubeless solution and the convenience of not needing to disconnect every time I'm going to get in the water, but the trade-off just isn't worth it IMHO.
      - pimeys 8y ago
        If you can to get the right pump, I highly recommend compiling one of these apps. Just wipes out all the competition from the commercial axis, truly life changing apps if you learn how to use them. https://github.com/MilosKozak/AndroidAPS/ https://github.com/MilosKozak/AndroidAPS/ https://github.com/LoopKit/Loop https://github.com/LoopKit/Loop
        8y ago

1123581321 8y ago

Yes, I deal with all that besides Scuba diving (interesting!) These routines around everyday exercise are not constant worries as represented in the earlier post. After exercising a few dozen/hundred times you know what to expect and don’t need to think about what to do. I will say that inconsistently performed intense exercise can be challenging; a regular exercise schedule is less effort to manage for diabetics. I rotate injection spots but have favorites based on convenience, sensation, etc. like anyone else. The variation in effectiveness I’m seeing is small enough that I’m not sure what’s happening yet. It’s not really a big deal because my numbers are fine. It’s not a disease that varies so much from individual to individual that lessons can’t be learned and shared, and it’s a disservice to misrepresent the mental effort to new diabetics and people potentially lapsing into poor control.

pimeys 8y ago

I'm like you when I do any activity having insulin on board. I'm a T1 using a pump, and I really like the combination of a pump and CGM for staying away from surprises. I use AndroidAPS to monitor my glucose and insulin on board, taking a temporary basal setting of 0% if needed before any activity, so my insulin on board drops to the base level or a bit below. Soon the insurance replaces my pump to a Dana RS, which supports closed looping with AndroidAPS. Then it's just setting a temporary glucose target to a higher value and the system takes care of the basal rates to keep the glucose from dropping. The article here is kind of weird. How am I supposed to dose e.g. 0.3 units or 0.75 units of insulin with the pills? The ability for a very fine granularity and the possibility to automate my medication are much more interesting compared to the pills mentioned in the article.

bigtunacan 8y ago
You are spot on. The temporary reduction or even suspension of insulin depending on my activity are key in preventing lows for me. The closed loop pumps are the biggest improvement I've seen for living with T1. There's always lots of promises, but this is one of the few things that really improves my life on a day to day basis and it just keeps getting better.
- pimeys 8y ago
  Right now it seems there is official support only to prevent hypos, but not to give you more insulin at night when you ate something too heavy and didn't guess the right TBR. Only the open source AndroidAPS for Android and Loop for iOS do this. And then you have a very limited set of pumps you can use.
  - bigtunacan 8y ago
    The Medtronic 670g is the only pump that currently will automatically correct highs, but it only works with the Medtronic CGM which is untrustworthy. The Tandem t slim x2 only has support for hypo prevention today, but it supports at home firmware/software updates and they are pretty far along with the FDA on getting approvals for their auto dosing for highs. They anticipate a release this summer. I wish that OmniPod was further along on this front. I would love to have a tubeless solution and the convenience of not needing to disconnect every time I'm going to get in the water, but the trade-off just isn't worth it IMHO.
    - pimeys 8y ago
      If you can to get the right pump, I highly recommend compiling one of these apps. Just wipes out all the competition from the commercial axis, truly life changing apps if you learn how to use them. https://github.com/MilosKozak/AndroidAPS/ https://github.com/MilosKozak/AndroidAPS/ https://github.com/LoopKit/Loop https://github.com/LoopKit/Loop
      - 8y ago