How to Treat Type 1 Diabetes

Introduction

    There are many variables when it comes to management of type 1 diabetes.  Through this article, my aim is to teach a general method of how to treat or manage type 1 diabetes.  Over the years of treating my diabetes, I have learned many tips and tricks that work for me in having better control over my blood sugar.

First Off...

    I wanted to clarify that the methods that work for me may not work for everyone.  Everyone has a different reaction to different things.  The best advice I can give is everything is trial and error until you get it figured out for what works for you.  Also, this goes beyond this post specifically and across all other methods that have worked for others.  Basically, don't get your hopes up until you try it, and it works for you.

Fatty, Carbs, and Extended Release

    The main items of food that mess up my blood sugar is foods that have a mix of fat and carbs.  Foods like pizza (fat from the cheese and carbs from the crust) and fried foods (fat from the grease and food itself and carbs from the breading) tend to raise my blood sugar later and keep them high.  My only guess for this is that the fat and carb combo makes the digestion time take longer so the carbs don't affect the blood sugar until later.
    My solution I found for combating this is to use the "extended bolus" feature on the T:Slim insulin pump by Tandem.  In an extended bolus, you can choose the percentage of the total insulin you get up-front and later.  For example, when eating pizza, I tend to give 30 percent of the insulin right away and the other 70 percent is given evenly over a 2 hour period (this time can be changed to adjust for what works best for you).  


    The main benefit from this is that if I were to get all of the insulin up front, my blood sugar would bottom out because, like I said earlier, pizza takes a long time to affect my blood sugar.  With the extended bolus, you are able to give some insulin right away, and the remaining is spread out over a period of time to avoid dropping fast.  This also better controls the slow digesting food from spiking blood sugar later.  There is a steady rate of insulin being given which would mimic the body's natural release of insulin.

Exercise and Delayed Lows

    For me, when I do anything that involves exercise (going to the gym, running, sports, working outside, etc.), I get lows that are delayed by several hours.  A quick disclaimer: this only happens when I really strain myself, for example working outside for the day or being at the gym for a couple hours.  Anyway, this can obviously be a problem.  If I go to the gym at night, my delayed low would be in the middle of the night while I'm sleeping.  A way I have found to combat this is to eat carbs without giving insulin for it.  
    Now let's take a step back.  First, I went over foods that take a long time to digest (in simple terms, delayed highs).  Next, I went over activity that takes a long time to make me go low (in simple terms, delayed lows).  If we put these two together, where do you think that leaves my blood sugar?  If I combine these two, I get a blood sugar that ends up being steady and I don't spike high from the food or spike low from the activity.  It is my yin and yang, or the perfect balance.  


    Figuring this out took way longer than I would like to admit.  But it is more complicated than I am making it seem.  Many things need to be considered such as the amount of activity, what activity, and how many carbs will offset this.  Because if I don't eat enough carbs to offset this activity, I will still go low.  But, if I eat too many carbs, I will still go high from the food.  This was a very long trial and error system that I still don't have figured out in its entirety.  I mainly use this method for activities that I do multiple times a week such as going to the gym.  I have a general idea of how many carbs to use based on how tired I am afterwards or by how hard I know I tried while working out.

Last But Not Least

    Another trick I have learned about treating my type 1 diabetes is to assume the worst.  There have been many times where my pump site goes bad, and I end up with a blood sugar of 300+.  I always used to tell myself that I would give more insulin and see if I come down, so I don't waste the site if it is good.  I would get so caught up on saving the site that I didn't save my blood sugar.  This would lead me to going to 400+ going up so I have to put on a new site and play catch up.  If you have had this happen before, you know that these highs last a long time, and it takes a while to get back to the normal range.
    My point is, assume the worst (in this case it would be assume that the pump site is bad).  Along with this, another piece of advice I have to offer is to trust your gut.  If something feels off, it probably is.  An example of this is in the past, I have bumped my pump site on the edge of a table.  I knew I hit the table hard right on my pump site and should've taken action based on this.  But I ended up leaving the site on and I went high.  Sure enough, I took the pump site off and the cannula (the plastic piece that inserts under the skin) was bent.  This doesn't allow the insulin to flow properly which caused my high blood sugar.  If I had acted right away and changed my site, I wouldn't have gone high.

If you have any questions or want more information about my experience, feel free to contact me!  This is done by clicking the "Contact" link at the top of the page and filling out the form. Or you can always leave a comment below!

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