Lows and taking care of infants/toddlers

Hello! It’s me again. I’m starting on a frustrating low roller coaster again. I seem to do okay on my insulin regimen when I don’t have activity which makes me happy. However, I have two adorable nieces who are right around 15 pounds. Any time I spend any extended period with them (a few days or even a day) I start noticing a lot of lows. My endo told me not to count it as exercise and wasn’t sure that it would cause lows, but I’m wondering if I should count it as exercise? I mean picking up and setting down and walking around with 15 extra pounds is physical activity in my opinion. And if I’m being completely honest, since covid hit my steps are way lower than they would be so I feel like I’m nowhere near as active when I’m not with them. I’m trying to lower my basal tomorrow to see if that helps. I’m just curious if anyone out there has small kids in their life too where they notice their blood sugars are impacted. I ate pasta tonight for example and went to 52 within an hour. I ate 6 gluc tabs which spiked me to about 110 and an hour and a half later had a glass of milk when I started dropping again. Right now I’m hanging out around 120 even without insulin for the milk. Any suggestions are welcome- I’m trying to take my basal from 1.6 overnight to 1.55 and then 1.65 during the day instead of 1.6. Let me know if you have any other suggestions!

You know you’re body best, and if taking care of the tiny tots (well maybe not so tiny but I’m going for alliteration here😊) is driving you down then making a change to your basal sounds like a wise course of action. Exercise is typically something we do intentionally for fitness or weight - but some of the things we naturally do count as well. I’m attaching a link of you’re interested. I would inevitably drop during my Target run(ssss) from all the walking I did. 5 Everyday Activities You're Already Doing That Count as Exercise | Planet Fitness
So I would say if lifting your neices is dropping you, it sounds like you’re doing the right thing. I would suggest doing a separate profile that you can activate as needed. Have fun with the kiddos!

I used to call my kids my “progressive weight workout,” since they kept getting bigger, and I kept picking them up.
And the constant motion! Oh, yes. There is no doubt at all that chasing after littles counts as exercise, at least the way it sounds like you’re doing it.

I’m sure some people just passively watch toddlers, and I guess for them, that’s not exercise. But if you’re picking them up and putting them down, giving piggyback rides and playing tag, and swooping across the room to grab the permanent marker out of their hand before they can reach the linens, then, yeah, that counts.

You’re not crazy. You are more active on days you’re with them; dose accordingly.

And on behalf of every parent who wishes they had a you in their lives, thank you, thank you, thank you!

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Hi Taylor @Tee25 , I’ll get into the “little kids thing” in a minute, but first … About 15 years ago, during the study of Joslin Medalists [all have had diabetes for more than 50 years], the researchers were surprised to find that a number of the people who provided their living body for study were found to occasionally resume making their own insulin - your body may now be producing some insulin. The amount of insulin was not sufficient to stop all supplemental [injection/infusion] insulin and was only for brief time periods. You may be now producing “some” insulin on your own.

Now as @srozelle said, kids are a progressive workout. I don’t know on what basis on which the endo made the assumption that kids would not add to your activity level; my personal experience, both 50 years ago with my own kids, and again 20+ years ago when I moved from Massachusetts to Florida to help care for a 22 week premi granddaughter tell me that children at any age added to my activity. And my need for less insulin, and my guess is that your nieces are significantly adding to your body “burning” more glucose.

Another thought, for me, certain types of pasta release glucose much slower than others - when I eat these types. I do not include the total carbs listed on the label in my initial bolus knowing that the insulin required will send me low - I put a significant part of the bolus into dual, or sometimes wait two hours to take a second bolus.

I don’t know how many units of insulin you take on an ordinary day, bot reducing your overnight basal by 0.05 for 6 hours reduces your total basal by “only” 0.3 units. Out of curiosity, what percentage of your daily insulin dose is made up of basal insulin? For many years, my basal dose has been 30% or less of my daily insulin dose.

This is not related to diabetes but a friend of mine returned to working with toddlers after a year or so or of the classroom - in very short order she discovered muscles she had forgotten existed😊! Enjoy your “weight training.”

Interesting! So if I am making my own insulin how long does this last according to the study?

And my basal is actually right now a significant part of my day. I’d say probably 50-60% some days which does seem like too much to me

Taylor @Tee25 , I’d need to go back and read the repo, but if my memory can be trusted, the resumed insulin production was for brief periods.

You should be able to read on your pump the exact percentage of basal and bolus on my tandem, in the pump history section. Some literature says that basal and bolus should be split 50 50, other literature says different. When I got to 35 65, at endocrinologist suggestion, I got into hypo difficulty.

Okay thanks! I’m wondering if that’s the problem for me too.

If you think I may be Taylor @Tee25 , you could try skipping a meal and watch your BGL and see what happens. If you drop too low and you need to eat, I will be telling you your basal is set too high. Try doing this fasting over an extended period, like eating supper and not eating again until the following noon. A couple of days later, eat breakfast and skip lunch. Write down BG every couple of hours and note changes.

If you are using BIQ or CIQ, you will need to turn these off. Keep your CGM alerts turned on, and be careful. This has been my my method for validation of basal rates.

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Also Dennis, I’m curious which pastas you do differently? The first I tried was tortellini and I happened to have home style Mac and cheese earlier today that did the same thing. I’ve never had this with pasta at all before so so weird its
happening now. Tonight’s may have been because I stacked my insulin slightly with a correction and my dinner time bolus, although I did subtract the insulin on board from my bolus too. Still dropped pretty quickly within an hour of eating though.

Taylor @Tee25 , I look at the color of pasta, and to a lesser degree, the thickness of the different kinds. For instance, the “whiter” the pasta - indicating more highly refined flour - will cause my BGL to rise faster and higher than the less refined. Our chef - my wife for more than a half century - usually cooks hole-grain, brown color pasta such as rotini which has a longer absorption time that allows me to avoid glucose spikes.

Keep in mind, that the IOB estimation made by your your pump is ONLY for prior bolus, it doesn’t take into account the hours of basal infusion. Another thing to look at, and maybe adjust is ISF [insulin sensitivity or correction factor]; if this number is set too low, your pump wizard MAY be providing too much correction insulin.

Yeah funny that you say that I actually mentioned that to my endo today too as we make adjustments. She’ll email me back about what to try for correction factor now. I’m losing weight on purpose but it’s kind of amazing what an increase in activity and losing a little weight does to your insulin sensitivity

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