T1D & Ostomy Hike: Mistakes Were Made
Mistakes are a given in diabetes care. Medical professionals provide the best advice possible based on their experience, however patients and immediate caregivers are the true experts. They know how to incorporate technology and the latest advancements in insulin to meet our unique experience with the disease.
I work hard to not beat myself up for making mistakes and learn as much as possible from each experience. Like so many, I experience self-doubt and can be my harshest critic; I have come a long way learning how to manage those emotions.
This hike was a great example of making mistakes and adjusting. I’ve written about my latest insulin approach for longer adventures, and this hike qualified as I would be on the trail for more than four hours.
Things started out fine, as I remained in control IQ sleep mode until arriving at the trailhead. At that point I stopped control IQ and set a temp basal of 20% and headed out on our hike.
My blood sugar remained between 120-135 for the first hour; I felt strong and stuck to drinking fluids and did not feel like I wanted or needed to eat too much. At the 1.5 hour mark I started to trend higher, finally reaching 220 with two up arrows at the two hour mark.
Decision time.
I was frustrated and really looking forward to the hike. Rather than going back to control IQ sleep mode or raising my temp basal to 50%, I decided to go back to control IQ activity mode.
Control IQ activity mode uses smaller increments of a bolus for corrections during activity. For me, it’s far too aggressive for any activity that lasts an hour or more. However, my stubbornness got the best of me and I decided to use this approach.
Within 30 minutes I started dropping. I felt it before my dexcom alerted me so I stopped for a snack and suspended my pump for 15 minutes. Thankfully, I made the adjustment quickly and avoided a major low. Once my blood sugar settled to around 115, I went back to a temp basal of 20% for the remainder of the day and had a great time.
I did not stick to my usual long-duration activity plan and it could have been a lot worse. Thankfully, I recognized my mistake and had enough time and experience to adjust, recover, and enjoy the rest of the trail.
Summary:
Total time: 4 hours and 22 minutes with 3,800’ of climbing
Insulin: Temp basal of 20% and then a failed use of control IQ
Ostomy: one bag empty
Food/Hydration: Two PB&J sandwiches (70 carbs) and 3L of electrolyte infused water
