Diabetes, Weight and Exercise Update

Knowing that I wanted to try to get pregnant again, and knowing that my diabetes needs to be in great control prior to conception, I've been working with the diabetes educator at the high-risk clinic, who I worked with during Oscar's and Bella's pregnancy and Tittle's and Gus' pregnancy.

 At the end of my clinical trial in mid-November, by A1C was tested at 7.3. Not great, but not horrible, either. After our consult with the MFM, I began working with April again at the beginning of December 2012. I've been meeting with April monthly, and downloading my pump for her between appointments, so I'm getting pump adjustments every two weeks.

With all of that hard work, I am happy to report that my latest A1C, drawn on 2/27/13 was a 6.3!!!! While I am thrilled with this number, as my clinic recommends below 6.5 during preconception and below 6.0 during pregnancy, I've been have A LOT of lows.

These lows are really wreaking havoc on me trying to lose weight. I really only have 10-15lbs to lose, so I don't need to do anything too dramatic. I've met with a dietician to review my food choices and quantities, so I've added A LOT more veggies to my diet and am really trying to stay within the caloric recommendations I received. Staying within the calorie range is easy....except when I have lows. For each low, I need to have at least 4oz of juice and, once my BG is at a normal level, I need to have a snack of at least 15g carb and some protein. What does this mean? An extra  150-200 calories PER LOW. Now, let's think about how many lows I've been having each day. Sometimes up to THREE! That's an extra meal, on top of the meals I'm already eating, so I feel okay with the dietary changes I've made, we need to get rid of the lows so that I can stop consuming up to an extra 600 calories each day, but I need to add in EXERCISE.

We have an elliptical and recumbent bike in the basement. Jon has been doing a great job of riding his bike at least 40minutes per day. I'm supposed to get up with him at least twice per week to use the elliptical, but that really hasn't happened. This week I was going to get up Monday, Wednesday and Friday with him. Has that happened? No. Here is my main issue: timing.

If I want to exercise, there's a lot more thought that has to go into it than a non-diabetic has to think about. If I want to exercise after dinner: Do I bolus for everything that I eat or under-bolus so I don't go super low? What should I set my temporary basal at? When should I start my temp basal? I tend to drop really fast during and immediately after exercising, so what should I bring downstairs with me other than my water and music? Will exercising after dinner, with that dinner bolus, cause me to have a severe low overnight that could put me in the hospital because by blood sugar will be so low that I can't wake up on my own? If that happens, Jon might not notice I'm low until the alarm goes off in the morning, at which point it would be too late to do anything? If that happened, how would Jon handle me and Gus at the same time? How would Jon and Gus handle everything if I was in the hospital or, even worse, dead?

Yes, I know this all sounds very dramatic to the non-diabetic, but this is what we diabetics have to think about. So, after dinner exercise is not an option for me right now. The only other option for exercising, then, is before work. I already wake up at 5:15am to get in the shower on a typical day, so I would  need to start getting up at 4:30am in order to get that workout in. Exercising at this time would eliminate the worries of overnight lows, which is a good thing, but DAMN that's early. And lately, I've just been so tired, that I've been choosing sleep over exercise. Maybe after the initial few days I would have more energy from exercising (that's what I noticed on the days I did get up with Jon to exercise with him), but that's still so early.

But, if I want to lose this weight, keep the weight off and (more importantly) be more healthy, this is what I will have to do. So, my goal is that over the next three weeks I will get up three times per week to exercise before work. This will create a habit, from which I can then increase to 4 days per week, then 5 days per week.