Routine. Or, more accurately, the lack of it. My diabetes (of course, your diabetes may vary) is calmest when most of what is going on is the same as always. When I get about the same amount of sleep, exercise, food (amount/type), I can have wonderfully stable graphs on the CGM. Start to mess with one or more of the variables though and no matter how much I try, it seems like I can’t find a happy medium.
The trip to Indianapolis was great. Got time to myself, tried some local food & places, saw some local art, saw colleagues I’ve known for a long time and met some new ones, and learned useful stuff at the conference. Somehow that happened even when I stayed at a bg of 50 for a few hours at a time. I was paying very close attention, but once my bg did go low (which was nowhere near as often as some trips I’ve been on… the BHE has been a super good influence) it took a lot to bring it back up. I went through almost 1 full jar of glucose tablets from Tuesday to Saturday on top of regular meals.
There was a lot of extra walking of course – other than the two travel days (SO much sitting!!) I didn’t have a day of under 8,000 steps when a normal work day will likely be around 6,000 – and yesterday I clocked 20,784 steps on the FitBit. All that walking over the whole day means that I’m battling the extended lows while I’m still burning up glucose to create new ones. Temp basals are my best friend sometimes. I used -95%, -75%, and -50% a lot this week. [As opposed to my flight out here when I was on either +75% or +50%*]
Eating out at different places is one of my favorite parts of traveling – this trip I went to a Brazilian steakhouse (yes, I’m a pescetarian, but was with others and the “salad” bar was unbelievable), 2 local breweries, the city market (crepes made to order!!), a wine bar, and an Italian restaurant. When I eat out at home, about 95% of the time it is somewhere that we go to often, with meals that I know very well. It’s just harder to carb count in unfamiliar places. My inclination is to overestimate carbs when I’m guessing (this is NOT medical advice, but don’t do that), but I really was trying to be careful so I had a couple of meals that turned out pretty well and a couple that gave me that scary-looking spiked graph on the dexcom. At least the walking and those temp basals were helpful and bringing that back down more quickly than otherwise. Successes: didn’t have one correction or bolus that seemed to result in a low bg.
I always think that I should be able to apply experience from one trip to the next one, but I’m not sure how well that works. I do need to remember to use my temp basals early and often, but the same levels at the same times might not work the next time I’m traveling for a few days.
People who are much more widely traveled than I am have offered tons of great advice on the #DOC about traveling with T1 diabetes so I recommend you do a couple of searches for travel + T1 Diabetes + blog to get information that might help you think about what you’ll do on your next trip. What I can say is that you aren’t alone if you get frustrated that your normally decent management goes crazy on a trip no matter what you do. Pay extra attention, pack extra test strips, and carry glucose. Leave your goals of perfection at home with the stable bgs.
*Last time I flew I did temp basals of +75% or higher and still had high bgs the whole time. This time I started at +75%, realized I was running steadily at 70 and backed off to +50% but still ended up making the whole section of the plane smell like grape chalk with the glucose tablets I ended up eating. I need to remember to start off small & tweak from there.