From Abby: Absolutely Not Medical Advice.
This is NOT medical advice. Not even close. But Abby has some opinions that are influenced by her years with type 1 diabetes, her nursing degree, and all the stuff she hears people saying about diabetes, and she wants to share those opinions here.
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Diabetes is confusing. Sometimes you think you have it figured out, and then - BAM - you do the same thing that worked the last five days but today it doesn't work. I believe that 90% of the time, there is a reason for these disturbances. I've decided to take my educated little brain and put some myths to rest, and spread some pearls of wisdom. I am a Registered Nurse, but I am still learning about diabetes, and everything that comes along with it, every day. So this is not medical advice. This isn't written to influence how you take care of yourself or how you should take care of yourself. Talk to your doctor before you make any changes to your healthcare. Seriously.
Welcome to Absolutely Not Medical Advice: Diabetes Hearsay.
Myth #1: Insulin Makes Me Fat, So I Need To Use Less, Goshdarnit.
Here's the science (it's an abridged regular-people version): Insulin helps you metabolize your food, so that your body can use it (carbohydrates to glucose, specifically). The problem comes in when you eat TOO MUCH of these foods, and your body doesn't need so much of them. Where does it get stored? As FAT! We store excess glucose as fat. We can thank our ancestors for this skill. When they lived in times when food was sparse, they needed to store it in their bodies for later use. So, okay sure, you take more insulin, you gain weight - I can see why you'd think the insulin is the culprit. But really it is all those carbohydrates and, ahem, CALORIES, you're consuming that makes you gain weight. You gain weight when your CALORIE INTAKE EXCEEDS your calorie USE. It really is that simple. I dare you to take a look at calories in your food while you're looking at carbs/protein/fiber whatever else you're looking at. I bet you'll be surprised at what's actually in there.
Myth #2: If I'm going for a run right now I should turn off my basal. RIGHT NOW.
No. Please, no. If you can promise me anything today, it's that you will not do this. Here's the skinny: short acting insulin (Humalog (lispro), Novlog (aspart), and Apidra (glulisine)) lasts approximately four hours in your body. This kind of insulin doesn't even start working for about 15 minutes, and there is also a ginormous peak around 30-60 minutes after administering it. So, it stands to reason that, unless you're going for a four-hour run/hike/bike ride/swim/whatever, changing your insulin now will not help, and could make you high later. What you should do, if you are wary of lows, is make a change to your basal 30-60 minutes before you work out. (This gets really complicated based on food, type of exercise, recent boluses, time of day, how often you exercise, what color shirt you're wearing, etc - talk to your doctor about making ANY and ALL changes to your medication regimen.) In general, however, stopping your pump or skipping a meal bolus right before you work out will not ... ahem ... work out well. [Editor's note: This doesn't even begin to tap into ketones and how important it is to have insulin on tap at all times, so talk to your doc before disconnecting your pump for exercise!]
Please feel free to email me (abby at sixuntilme dot com) with questions or diabetes myths you'd like to see discussed, or if there is something you have a desire to know more about. I'd love to research and answer any questions. I love to learn, and I am on track towards becoming a CDE, so this is really helping me do my future job better. No question is too random, or issue too insignificant, because trust me - someone else out there has the same question or struggle.
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