My last post was in January. The main reason was that I am traveling and I was not so motivated to sit down and tell my story. I was not that motivated, as I thought, I did not manage my diabetes as I should. Of course, this is all in my mind, so hopefully, when I write it all down, I can convince myself, that I am doing well.
Mid February, my husband and I left for a trip on the South Island of New Zealand. This was all we knew, no time frame, no fixed destinations, just the freedom to do whatever we liked. I knew that managing my diabetes would be harder, so we would stay mainly in motels and self contained units (airbnb) with full kitchen facilities. I hoped that living this amazing life, as that is what it is, would help me to relax more about my diabetes management. Unfortunately, I have to say, after three months of traveling, it has not.
While we stayed in a lovely cottage in North Canterbury, I uploaded for the first time in six weeks, the information of my sensor. I was pretty sure that the average BGL over the last three months would be a lot higher as usual. Luckily I was wrong. The result was 7.7 mmol/l. In "normal" life, it was on average 7.6 mmol/l. So I should have been really happy and yes, I was not disappointed, but still, I hoped that this relaxing life style and the amount of walking we have done, would have given a better result.
The other thing I hoped was that during this trip, I would be less focused on the BGL numbers and that I would not look at my pump so often, as I do this quite a bit. Unfortunately this has proven to be impossible. Due to the more irregular way of living, the BGL's swung way more. Ups & Highs caused by different food or pump accessories. Downs & Lows caused by different food and exercise. I will explain this.
Ups & Downs because of different food is easy to explain. It is not always possible to know the exact amount if carbohydrates when, for example you go out of dinner. Also, as you know, I love "my coffee". I also love the nice baked goodies on display in the cafe we visited. The temptation just to have something nice was maybe a bit to high sometimes. So if this caused the BGL's to go high, I could at least blame myself. (But I should not blame myself)
What is/was very frustrating is when I see a rise in the BGL's and I cannot explain this. During this trip I have learned that during warm, sunny days, the insulin is not working as good as it should. When the insulin in the pump has got too warm, the basal (background) values are not correct anymore, so the BGL's are creeping up. Another increase of BGL's is caused by saturation of the infuse site, if the chosen spot has already some scar tissue, so the insulin can not be absorbed any more.
The Downs & Lows because of exercise I have "talked" about in other blogs. It is so difficult to avoid going to low when I go for a walk. I did a couple of longer walks in the past weeks. One was the last day of the Abel Tasman track. This was a total of 16 km and around 6 hours on the track. It went really well until after lunch. Approximately one hour after the lunch, I got a hypo. Reason, the insulin I gave myself for the food I ate was already "working" and together with my body burning the sugars because I was walking, the BGL's came down quicker than that my body could process the carbohydrates. Even with the basal rate on only 20%.
These fluctuations make me insecure and I feel out of control. This makes me look to often on my pump, as I like to be in control and to be sure that my BGLs are on average between 6 and 8. If I think that the BGL's are too high or creeping up too quick, I adjust my basal rates and/or I give an extra bolus. This overwriting of the pump can also lead to lows, as I don't trust the pump and of course too much insulin is actually the main course for going low.
Anyway, as I wrote in the beginning, the average of the BGLs has not gone up enormously, so I do something right. Will I ever be more relaxed about it all, I don't know, I hope so. For now, I will keep enjoying traveling through New Zealand and just keep on trying to be a bit more relaxed about it.
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