Winter is coming

The past night we changed from summer time to winter time. While it is lovely to have your weekend extended by 1h – especially when you have attended a party (soccer season winding-up party) on Saturday night – and I am looking forward to be able to go to work in daylight, at least for a couple of weeks, it is getting darker and colder outside. Winter is coming. The weather forecast for the week to come had sleet in it. Like the roads and bike tracks aren’t slippery enough as they are now with all the wet, fallen leaves lying around!

I don’t know about you, but for me there has always been a good correlation between required insulin doses and season of the year. I tend to need more insulin during the winter months, probably because I am not as active as in summer. I still ride my bike to work every day during the winter, and this year I have also, besides the weekly indoor soccer practise, resumed swimming again, so it is not like I am totally inactive. Still, compared to the summer, where I usually have two soccer practises, 1 game, and extra bike rides “for fun” on the program, winter does not entail as much physical activity. When on MDI I would usually have to increase my Actrapid (Regular) doses by a couple of units with each meal, the Lantus dose in general staying the same.

The past night we changed from summer time to winter time. While it is lovely to have your weekend extended by 1h – especially when you have attended a party (soccer season winding-up party) on Saturday night – and I am looking forward to be able to go to work in daylight, at least for a couple of weeks, it is getting darker and colder outside. Winter is coming. The weather forecast for the week to come had sleet in it. Like the roads and bike tracks aren’t slippery enough as they are now with all the wet, fallen leaves lying around!

I don’t know about you, but for me there has always been a good correlation between required insulin doses and season of the year. I tend to need more insulin during the winter months, probably because I am not as active as in summer. I still ride my bike to work every day during the winter, and this year I have also, besides the weekly indoor soccer practise, resumed swimming again, so it is not like I am totally inactive. Still, compared to the summer, where I usually have two soccer practises, 1 game, and extra bike rides “for fun” on the program, winter does not entail as much physical activity. When on MDI I would usually have to increase my Actrapid (Regular) doses by a couple of units with each meal, the Lantus dose in general staying the same.

Approaching the first winter with the pump, I am looking forward to see, whether the tendencies noticed on MDI do also apply to CSII, or if that is just another set of experiences that I can forget all about in relation to diabetes management. Starting on the pump was like starting from base once again. Of course, some of the experiences that I had build through 16+ years of diabetes would still apply, but the vast majority of them had to be modified.

Resuming swimming has been a challenge. I have about 18 years of swimming experience, 12 of these with diabetes, but the last 3 or 4 years I haven’t really made it to the swimming facilities. This winter I have decided to give it another try, though. I work on the University, and students as well as staff are allowed to use its swimming facilities for free at hours when no teaching takes place there. For the staff, Mon-Fri from 7:00-8:00 AM and Fridays between 12:00 and 1:00 PM are available. The morning hours are a no-go for me. When it is dark outside, I cannot get myself out of bed before absolutely necessary, and as I have a 30 minutes bike ride to reach the University, I would have leave home at 6:30 AM or something like that to take advantage of the morning swimming hours. The hour on Friday noon is not ideal either, but I am working at getting into a routine that allows it. So far (3 attempts) I haven’t had too much success. I thought I could use the same strategy that I used for soccer practise in the spring: I would have a small snack, accompanied by a small bolus (<>r at 12:35). Hmm, another indication that I was low. I did not expect to see the number I did on the meter, though. Sure I felt the weakness you do when you are low, but other than that I didn’t feel too impeded by it. Until I saw the number, that is! 1.6 (29)! Damn, grab glucose tabs and M&M’s in my back and start chewing. Slowly made the 700 m walk back to my office, cursing and wondering whether I should make a stop at the canteen. I decided not to stop at the canteen - my hypoglycaemic brain couldn’t handle that challenge - and headed straight to my office and my lunch box and sugary cola. It took me a good 45 minutes to get back to my normal self. Why does it have to be so difficult to succeed? With 3 failed attempts, I am now considering not to do the extra snack-bolus thing before swimming. My guess is that it may prevent me from going low, but is also likely to leave my above 11 (200) when I finish, and that is really not in my interest either, as by that time I am usually hungry because I will normally have lunch around 12:00-12:30 PM. Maybe this is just another one of the choices between cholera and the plague that diabetes offers you?