Everything seems better in the summertime- the weather, the fresh food, the parties, and the festivals.  Everything, that is, except my blood sugar.  For some reason, I seem to have many more highs and lows during the summer months than any other time of the year.

From August through May, I wake up at the same time, eat lunch at the same time, workout at the same time, and go to bed at the same time.    My basal rates reflect the patterns of when I eat and exercise- lower throughout the morning, lowest before I work out and highest in the following six hours.   I have determined my carb ratios at different intervals, which are influenced by activity levels throughout the day; my boluses are (usually) the correct doses.  

However, I'm convinced that I struggle to keep my blood sugar in tight control during the summer because of one main reason: my schedule varies so much from day to day, as opposed to the regular routine that I live during the school year.  Some days, I wake up early and run before the heat.  Others, I sleep in and lift in the middle of the day, or run in the evening.  I swim any chance I get, morning or night, plus my friends and I love to go on long walks.  Some days I have brunch, some days I have a late lunch.  Two nights a week I eat dinner at six because of a class, yet I eat dinner closer to nine or ten if I am working. 

There's no easy way to approach this situation, and I'm definitely not going to cancel any sort of summer activities because it complicates my blood sugar.  Instead, I try to work my blood sugar around my schedule. Even though my pump has the "Patterns" feature, which would allow me to program in three different 24 hour basal rate patterns, I am not sure I could even isolate three different insulin schedules that I could use more than one day a week.  Each day is so different, in terms of when I wake up, when I eat, what I eat, when I work out, and how I work out; each day calls for a unique approach to blood sugar management. 

So, instead of programming a basal rate that corresponds to my schedule, I use a more generic basal rate, keeping the number of units per hour relatively consistent around the clock.  I then use extra boluses and the "Temporary Basal Rate" feature to lower or increase insulin when I need it.  For example, I take insulin for breakfast at either eight or eleven, depending on when I actually eat.  I always run a Temporary Basal rate of 150% for about an hour after exercising, whether that happens to be at noon or seven in the evening.   I make micro adjustments by testing often and bolusing- some days, I take up to twenty boluses. 

In the summertime, my schedule is flexible, and it makes sense that my insulin should be flexible too.  Having such a consistent schedule during the year allowed me to really fine tune my basal rate, and, as a result, it seemed that my basal rate did a lot of the "work" for me.  During the summer, however, that basal pattern doesn't work, because I do not eat or exercise at the same time.  Instead, I have to even out my basal rate and make lots of adjustments manually, including increasing my basal rate, decreasing my basal rate, suspending my pump, and taking extra boluses.  The key to making it all work is testing often and listening to my body.  Even though it feels like some extra work, having the flexibility to run, eat, sleep, and play when I want is completely worth it!