Q has been taking one or two dance classes every week since she turned two. This didn’t stop after diagnosis. Her diagnosis was literally one week before that year’s recital week began, and we all know “the show must go on.”
While we were on MDI we had dinner at 6:00 pm each and every night. Once we began pumping, we had a little more flexibility, but we tried to keep to about the same schedule.
It is inevitable that dance class spans 6:00 pm forcing dinner to be really early or really late.
Typically before a class like dance (or ice skating which she took last winter and fell in love with), we give her an extra 10-15 gram carb snack before the class.
She was signed up for four weeks of swim lessons this summer. I couldn’t decide whether to schedule them at 5:45 and mess with dinner or at 6:45 and push back bedtime. Turns out that 5:45 is not such a good idea because by the time you get home and eat it’s 7:30 and the kids need a bath and everything is thrown off. Next year maybe we’ll try 6:45.
So as we do for dance and other physical activity, she had a 10-15 gram carb snack on the way to swim. And then when I checked her BG right after she finished her 45 minute lessons that first week her BG’s were in the 300’s and 400’s!
At our endo appointment I asked what was going on with this. Last year at swim she would often go low, why was she going crazy high this year?
The endo had two suggestions:
- Eat dinner early and back off on the insulin bolus.
- Give a 20 gram carb snack and half a unit of insulin.
We couldn’t do the early dinner because it would have meant eating at 4:45 pm.
I didn’t understand what the larger snack plus insulin would do. The doctor said something about large muscle groups, her body not using the snack right away causing her to go high, and that this little bit of insulin would get the sugar moving through her body so that her large muscles would actually use it.
To tell the truth it was toward the end of a long, trying appointment (Q was upset because when she asked the doc a question that she had written out, the doc wrote the answer on Q’s paper which “ruined” it. Ugh!). I couldn’t quite comprehend the reasoning, but I thought I would give it a try.
Skeptical as I was, the next week I gave 20 grams of carbs and 0.5 u of insulin. And guess what? It worked. Her numbers after swim were mostly in range, but never crazy high.
So the moral of the story? Systems that seem to be working in one scenario may not work in a similar scenario. And of course, diabetes is always a guessing game!
Please read the disclaimer. Of course none of this constitutes medical advice and you should consult your physician or CDE if you have questions.