Everybody does it...or at least that's what I told myself.
I'd gotten away with doing it for several months: purposefully letting my blood sugars run high because I hate having lows. I'd developed this bad habit one year ago, during a summer where I was filling all of my free time with mile-long runs to the gym where I'd spend at least an hour weight lifting, taking yoga classes three times a week and jiu-jitsu classes twice a week.
That all sounds dandy for a healthy diabetic, but the problem was that I was trying so hard to never go low that I was far too often running a regular 200+ blood sugar.
We all know a low blood sugar in the middle of a run or a jiu-jitsu class basically puts a big RED LIGHT on the activity. My other issue was that jiu-jitsu classes were so intense that I was worried I wouldn't be able to feel the low blood sugar symptoms until it was too late, so I compensated in the most unhealthily way: a decent-sized bowl of cereal before class equals a guaranteed blood sugar above 150 after class (if not a lot higher).
I didn't want to take any chances with having a hypoglycemic seizure on the mats... so a "temporary" high blood sugar seemed like the safer way to go. Not to mention that I've never had a hypoglycemic seizure in the past eight years of being diabetic, and I'd really like to keep it that way.
Well, after a whopping A1C of 8.0 at the end of summer, I had to stop denying just how out of control my blood sugars had been. It was almost as if my body had gotten used to the feeling of being at 200 and it no longer felt unhealthy.
I was told to increase my long-acting insulin by several units (which terrified me) and to drastically increase the carbohydrate-insulin ratio I had been using. The problem was, I was so used to under-bolusing It was incredibly hard to change my attitude toward bolusing. I would remember that I was supposed to increase the bolus, but in the back of my mind I was still thinking: no, no, I don't need to, this is enough, anymore and I'll go low.
Three months later, my A1C was still 8.0. I clearly hadn't changed my faulty ways. My doctor tried to get me to explain why I was under-bolusing because she knows I wasn't running high out of neglect and that I take my diabetes very seriously. I gave her the same excuse: that I don't want to drop low during exercise (which obviously didn't happen very often) and so on.
The first thing that really helped me focus on lowering my levels was when she told me that the body can't make muscle properly when blood sugar is high.
WHAT!? You mean, I'm going to the gym and weightlifting and not getting the most out of it?!
Today, I've tried to maintain a careful balance. By eating foods lower in carbohydrates and higher in healthy proteins, fiber and carbs mainly from fruits, vegetables and oatmeal, it's been much easier to keep myself from going low. I don't usually bolus for the small meal I eat right after I work out in the morning because weightlifting has a major "after-effect" on your body's metabolism. In other words, while you do burn calories while you're physically lifting, you burn even more calories during the rest of the day when you muscles are rebuilding themselves.
There is definitely a way to workout rigorously and regularly without going high or low. Of course, there's really no magic bullet or recipe because our bodies all work so differently. The real trick is to figure out what works for you by testing before and after your workout (and then perhaps a few more hours after that) and paying close attention to how many carbs you're consuming and how many carbs you're bolusing for. And it's frustrating sometimes, sure, but I always try to remind myself that there's really no sense in all this exercise if my A1C is going to be over 8.0 while the rest of my organs are begging desperately for a little more insulin.
And of course, when you're out for a run or working out in the gym, don't forget to bring some glucose tabs along with you!