Just arrived here after being a T1D for 30 years and pumping for 20.
At this point I’m semi retired, so this is almost an afterthought at this point, but one of my 5 offspring was recently diagnosed as TD1, and in the ensuing dicussions, I realized how much knowledge I had gained over the years. I am most interested in hearing from people who perform hard labor as a way to make a living.
Early on after meeting with 3 different dietitians ( I would consult a dietitian before an Endo) it was discovered I was consuming 4 to 5000 calories a day.
It would initially seem an impossible task, but I’ve been managing tolerably well.
Working ( or more like arguing) with the same Endo for 15yrs, it was quite the adventure. It was made more difficult by the fact CGMs were sci-fi back in the day. When we parted ways he sat in front of me and shook my hand. He stated that if he saw my 8 point A1C average for the last 15 years on a piece of paper, he would guarantee retinal damage, neuropathy , and kidney damage.
None of the above.
He said I taught him something he may have never known.
I really almost punched him. After all those arguments we had, he never gave an inch. His only advise was to change careers.
A lot of days I would stop my basal and not bolus until after dinner, even then half the normal ratio.
This was not a daily occurrence, which may have been easier, but 6 finger sticks a day was all I had to go on.
The main takeaway to all this is that glucose (or chain-glucose) is stored next to your muscles, it’s there to feed your muscles as they work, so the bloodstream doesn’t have the burden of distributing glucose full-time as it’s needed.
What happens after loooong days is that there’s no glucose left ( or mostly depleted). What happens now?
The brain tells the bloodstream that the muscles need restocking.
Well, you don’t need insulin to stock glucose, so over the next 24 to 48 hrs the bloodstream does it’s best to replenish with whatever it can find.
I’ve found it’s never a staight line calculation, and sometimes the process starts and stops for reasons I’ve never been able to figure out.
My CGM is amusing to me , a great tool that grants me insite to things I could only guess at.
I came home from work one day and felt a little queasy so I did a fingerstick…twice in a row. I showed my daughter the meter, she stared for a second and said : how can you be standing? to which I replied: I have no idea whatsoever…
It was 23
Hi @Arlon welcome to Beyond Type 1. I do not do physical work every day but there are weeks when I am on an active construction site and do very physical activities and then there are weeks where I am sitting in front of a computer, not doing much other than thinking. I see both so I guess I can comment on both,
I learned to feel my blood sugar because when I was diagnosed, a home blood sugar meter was sci fy. So my choice was to either learned what a low felt like or die. Now 45 years after diagnosis, I sometimes don’t feel a low and I know that is dangerous and something to avoid. My CGM is pretty good about alarms even if I have them all shut off except if I drop to 55.
I can get my insulin to work 10x harder with exercise. I know my “rapid” insulin is still in there even after 12 hours. So if I am extremely active, 200 grams carbs and less than 2 units (sometimes zero) is all I need. If that activity keeps up I’ll run out of glycogen (stored sugar) and I’ll need huge amounts of sugar to replenish.
I think you’ll find a lot of us here with that experience. I’m glad you joined our group and hope you stay and share your experiences with this community.
Joe
Thanks Joe
That’s pretty much what I was hoping for. I haven’t run into anyone else with our set of challenges.
I have to be honest, I actually enjoy the challenge of going from breakneck speed to the admin side, then middle ground work, then back. When you get down to it we all have our own set of challenges, diabetic or not, so I’ve learned to take my mini failures in stride, almost happily.
I ran my own business( with only one employee)and helped raise 5 kids.
I’m glad I’ve found this group, I need some feedback at times, which hasn’t happened for me as far as being a diabetic goes.
Do you recall when your low sugar awareness started to fade?
Thanks
John
@Arlon well. For me, I was in the middle of one of those “very active” times. Like you, my bs must have dropped without me knowing and without the numb tongue, shakes, sweats, and the greenish lights I see when I close my eyes during a bad low. The thing is I was traveling for work and I went to my hotel room and in a matter of minutes I forgot who I was and what I was doing in that room. I think I had diabetes a little over 40 years st the time. Anyway a long story short I dumped my backpack while looking for a clue as to who I was and found a snickers bar and figured “I’ll eat this and try to figure it out” and in 15 minutes I was fine and I did figure it out. I got a CGM after that. Dexcom G6.
I’ve been lucky with lows, you can “re-calibrate” by targeting a higher blood sugar for a few weeks too. Anyway I feel 99% of my lows today and the CGM (G7) saves me from the rest. I like getting my blood sugar on my watch that’s a long way from urine testing
That makes me feel good, give or take I have 5 more years.
I don’t know if this is the venue for stories, but I was in Tanzania by myself and on the last day, I was treated to dinner along with excessive drinking, from there I went straight to the airport.
I took a seat in the lounge waiting for the flight. I felt the low, but in the state I was in, I couldn’t get it together enough to react intelligently. I emptied my bag desperately looking for my glucose, not remembering I had used them up during the last two weeks.
Luckily a waitress came over and smiled, saying “sugar?” in her best english. I relaxed instantly, shook my head in a yes, and it was over.
I decided not to drink so much after that.
@Arlon Welcome Arlon to the Community Forum!
When did I first notice hypo unawareness? During the winter of 1967 or 1968 after shoveling out my car from 20 inches of snow and waking up in a snowbank; I had passed out from my first real low. Since then I’ve trained myself to be more aware of the symptoms and take corrective action. Since then things have “mostly” been better, but occasionally [3 times] a hypo came on unexpectedly but others noticed and made me, forced me, take action. Nothing close to those days since I’ve had a useful CGM - thankfully.
Hard work, yes - I like outdoor labor. I was laid off from a life insurance company, Actuarial Research, in the 1975 depression and with unemployment rate in Bostom above 20% I couldn’t find work so I began my own company doing everything I could find, panting houses, roofing, building repairs, carpentry [obtained a Massachusetts builder’s license]. My lunchbox was crammed with food, and doctors at Joslin recommended a 4,500 calorie intake per day; now in my mid-80s and retired I continue to eat 230 grams of carb most days.
I closed my business after 10 years and took a sit-down position for the next 25 years; this work required occasional week-long travel where I’d be on my own; but by this time the digital BGM were available and I’d schedule myself to do a finger-stick even if I didn’t think one necessary. To complicate matters, I was clinically diagnosed “Brittle Diabetes” when I was involved in the glycosylated hemoglobin study; the study in 1974 that yielded the HgA1c / HbA1c test - my blood tests fell outside the margin of error.
Up until the pandemic lockdown, I’d spend weekends working with my SIL on their gentleman’s farm, shoveling, mending fences, pouring concrete - heavy labor then for a guy pushing past 80. Only twice in those years did someone need to tell my I was acting “low”; my SIL once and the other a big guard dog who kept pushing me to the shed where we had refrigerated juices.
I’ve been lucky.
Wow, I’d call that some kind of record. Impressive credentials.
I live next to one of your kind, he’s 85, owns and runs his own excavation business, and works 7 days a week, except he doesn’t carry the extra burden of being a T1D.
I’ve handled all my lows to date without passing out or the like. I attribute this to the fact my father was a 50 year T1D and I inherited some gene that makes my mind vigilant about recognizing lows, at least that’s my theory.
Well John @Arlon, I’m not in the same class as your neighbor, I’ve slowed down considerably in the last two years and even hired a guy to replace a couple of cage-top screen panels that blew out in the hurricane. Even stopped bike-riding and limit my daily walks to 6 miles.