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August 17, 2007

NPH to the Rescue

This summer I am teaching swimming lessons and two weeks ago I started what is going to be a month of teaching 9am-12pm and then 2:30pm-6:30pm. During the lessons I am in the pool and therefore detached from my pump. It took me a couple of days of horrible fastings to figure out what was happening.
I was testing between each lesson and my sugars were fine throughout the morning (85, 120, 107 etc) so I wouldn't take any insulin because the BG was staying down from moving around in the water. Pre lunch would be 150 or so and I'd eat lunch and cover normally. Then I would test after lunch and it would be high so I'd correct before the next set of lessons. The correction always worked and I'd test between the next set of lessons sometimes giving a bolus to keep it down. Then post dinner would be bad and I'd be high throughout the night and my fasting as well (the pre bedtime corrections seemingly not working.)
This happened multiple days in a row. So I tried taking some insulin between classes (even though my sugar seemed perfect) because I knew I was needing insulin on board. (This didn't fix the high nights and fastings.) My workouts for the week went horribly. I was finishing workouts that were supposed to be fast and intense at 8:00min pace or slower with a heart rate of 186 or 192! Definitely glycogen starved.
I was hestiant to take NPH because I didn't want to risk being low at work or low if I decided to work out in the evening after work because of any lingering NPH. But I needed some legitimate basal rate going.
So this past Monday I took just over 50% of my daily basal from 9-6:30pm as NPH and it worked so well. I left my pump off during work except for boluses. Just having that basal insulin there made all the difference.
I was frusterated after Tuesday's turbo workout was still no better despite a fasting of 124 (still not low enough, but not 330...) but after another two days of good fastings Thursdays track seemed to be a big improvement, and so hopefully I am 'back in the game.'

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