Today’s ride is what I call the Ride of Resistance – insulin resistance that is.
Once upon a time, no one really talked about how the hormonal changes of menstruation, perimenopause, or menopause affected blood sugars. We knew that puberty could wreak havoc on blood sugars. But for many years these stages of menstruation, perimenopause, and menopause remained largely taboo topics in the T1D world.
Today, I’m talking about them. (As are many women with T1D – thank goodness!)
Cycling with type-1 diabetes while on your period can be a blood sugar beast.
Why?
Depending on where you are in your menstrual cycle, those hormones can make our bodies more insulin resistant.
Hormones had other plans
For today’s post, I had intended to discuss something completely different. I had planned to go into this ride with a lightbulb moment that I was sure would reduce the risk of auto corrections and thereby also reduce the risk for lows. But then, my period hit like a bloody hurricane, and, like all things T1D, I had to pivot.
I woke up with blood sugars at 6.8. I gave my typical breakfast dose of 33% less bolus about 1.5 hours prior to starting the ride, and activity mode was started at the same time. About an hour after breakfast I gave a micro dose of 0.05 units to mitigate the system from implementing an auto correction.
This was the lightbulb moment I had – a micro bolus every hour prevents the Tandem from giving auto corrections, no matter if blood sugars are rising or not. For me, those auto corrections on a ride are not so great. Extra insulin combined with exercise increases my risk for lows.
Sadly, the micro dose experiment will have to wait for another day. By the start of my ride, I was already in the 10s and rising fast. I did not use the weaker basal profile I have for exercise, but rather kept it on the profile I call “The Jerk” which was initially created for those times of menstruation.
My blood sugars kept rising.
I kept giving varying levels of boluses for the first 1.5 hours of the ride – 0.1, 0.3, 0.5 units at a time.
When we arrived at Sanctuary Cafe – a cycling-focused cafe, that had a beauty of a Bianchi on the bike rack (sigh, I still love me a Bianchi!) – my blood sugars were 7.4 with a straight down arrow.
I got a breakfast cookie, dosed 50% less insulin than what it called for, and switched to the activity profile on my pump. By this point, I had quite a bit of insulin on board, but after nearly two hours of riding I figured the exercise had finally tipped my body toward insulin sensitivity. I was hopeful this strategy would keep me from going low.
It did 🙂
A well-oiled pivot
I rode with a great cycling friend today. And due to the Canada-South Africa soccer game set for noon, we were on a time crunch for getting back. Because of that, we opted to head out for a condensed Steveston ride (no Iona Beach this week). The wind was fierce (my diabetes wasn’t the only thing giving me resistance today), but the road was flat.
Today’s T1D Ride Stats
Because of my body’s heightened insulin resistance due to that pesky period, I ended up dosing for 25 grams of “ghost carbs” – bolusing as though I were eating carbohydrates without actually eating any. This was a good strategy. Within minutes of ending the ride, my blood sugars were in the high 8s. That dose kept them from going much higher, and brought them back down to the 6s before I had lunch an hour later.
For those of us with T1D, the art of pivoting is essential. This condition is ever changing and loves being unpredictable at the best of times. Even though my blood sugars got up into the 13s before coming down, I don’t think I would make any significant changes from what I did prior to starting the ride, or during the first half of the ride. It’s hard to predict how Dear Diabetes is going to behave. While I often become more insulin resistant during my period, I’ve also had cycles where I experience little or no resistance at all. That’s the unpredictability of this condition.
Today’s ride was a reminder that diabetes doesn’t exist in isolation. For this ride, my menstrual hormones had already changed the rules before I even clipped into my pedals, and instead of fighting that reality, I had to adapt to it. That’s what managing type-1 diabetes often looks like – not finding the perfect strategy, but recognizing when today’s body isn’t yesterday’s body.
We do the best we can when we can 🙂
