Managing Life with Type 1 Diabetes - Christy Nichols

Disclaimer- I’m not a doctor. I’m speaking from my own personal experiences and journey through 17 years of type 1 diabetes, but I’m always happy to answer questions about what my life is like and share my experiences with this disease. Type 1 diabetes is an auto-immune disorder where the pancreas doesn’t produce the hormone insulin. Insulin is what the body uses to lower blood sugar levels. There is nothing that can currently be done to prevent type 1 diabetes and at this time it cannot be cured. Those with type 1 diabetes didn’t eat too much sugar and no amount of dieting or exercise will make it go away (Let’s bust those myths right now.). So there’s some basics. For more information please see the websites listed at the end of this blog!

Whenever I go to type 1 diabetes conferences or meet ups, we always start with the diagnosis story. So, hi. My name is Rae Christy Nichols and I was diagnosed with type 1 diabetes in August of 2002 at age 12. No, it’s not genetic and no one else in my family has type 1. I weighed 90 pounds when I went to Children’s Hospital and my blood sugar was over 600 (I try and keep my blood sugars between 70-120.). I showed the classic symptoms- excessive thirst and hunger and extreme weight loss. So let’s fast forward 17 years…..

 

  Sometimes I sweat so much my insulin port melts off and I have to take an injection after a workout

Sometimes I sweat so much my insulin port melts off and I have to take an injection after a workout

I’m walking into my endocrinologist’s office on February 1, 2018 at 7:30 A.M. I’m exhausted. I’m up earlier than I normally am for a week day and I’ve also been up all night fighting with constantly dropping  

blood sugars. I’m running on little sleep adding to my nerves. I’m always anxious walking into these appointments, even though she’s the best and doctor I’ve ever had, and my type 1 diabetes is in the best control it’s ever been. So, here I am walking in and waiting to hear what my A1C is going to read. My doctor has never put a ton of emphasis on this number and that’s one reason I keep going back to her, but in “diabetes world” this number means everything. So what is A1C? Hemoglobin A1C measures a person’s blood glucose as an average of the past 3 or so months based on a blood sample from one’s finger. While there are a lot of potential errors that can give an inaccurate read, this is the best test currently available to determine one’s diabetes control – a lot can ride on this 1 number like risk for future complications. It’s generally recognized that a type 1 diabetic should be around 7.0-7.5 or lower. This basically means one’s diabetes is in control. For someone healthy and without any form of diabetes it should be somewhere between 3.9 and 5.5. Keep in mind that these numbers can vary depending on who or what organization you reference- I’m just giving a general idea for those of you not familiar with hemoglobin A1C. At my last visit, 3 months ago, my A1C was 6.7. In theory, I’m doing really well, and now at my current appointment, my A1C is 6.5. Yes, I’m really happy about this number, but I’ve had some kinks to workout thanks to Crossfit.

Remember I said I was up all night fighting dropping blood sugars? Well, this is an experience I’m constantly fighting hours and hours after the day’s WOD. Exercise uses energy and glucose is one energy source exercise uses a lot of. Exercise typically drives blood sugar down. I try and keep my blood sugars in the range of 70-120. I have to carb up (carbs increase blood sugar levels) and reduce the insulin (insulin brings blood sugars levels down) I receive from my insulin pump before and after a workout to keep my blood sugar levels from going dangerously low. Here’s the catch- there’s no exact ratios on how much to carb up and how much insulin to reduce. A 6 minute AMRAP is going to be a different ratio than a 20 minute x amount of rounds for time. I’m probably going to need to reduce my insulin more for the 20 minute WOD and maybe have some more carbs compared to what I would need for the 6 minute AMRAP. Stress hormones drive blood sugars high and low as well. Did I have a crazy day at work? That throws a wrench into the mix. Am I anxious about an event I have coming up? That could cause a problem. The variables feel endless at times, but I’m constantly monitoring my blood sugar levels before, during and after the WOD (honestly, I’m monitoring all day every day) thanks to my insulin pump and Continuous Glucose Monitoring device (CGM) that tells me what my blood sugar is about every 5 minutes. This is all helping me to try and find the magic ratio of insulin reduction and carbing up. Sometimes I get it right and have very even blood sugar levels and sometimes I get it totally wrong and run really high or start dropping really low. Another issue to toss in as well- high intensity exercise releases adrenaline which shoots my blood sugar up high. Typically after a WOD I have really high spike that will start to slowly drop about 15-20 minutes post WOD. Don’t feel like you need to understand all of this information I just tossed at you. My point is that I’m in a constant state of calculations before, during and after the WOD. I’ve been playing this game for 17 years now so I don’t even realize I’m doing it most of the time.

     

  This shows my blood sugars dropping. You can see in the right picture that my sugar spiked to about 350 post WOD then started dropping and dropping. I ate over 100 grams of carbs that night- I stopped counting after 100 grams.

This shows my blood sugars dropping. You can see in the right picture that my sugar spiked to about 350 post WOD then started dropping and dropping. I ate over 100 grams of carbs that night- I stopped counting after 100 grams.

So back to my doctor’s office and I’m telling her about these lows I’m having that are keeping me up at night. This has been a serious battle for the past month or so. I’m cutting my insulin back a lot and I’m constantly drinking juices to try and correct and prevent the lows. Now I get kind of excited because I get to tell her my theory on why I think it’s happening. So I know the intense exercise is part of my low blood sugars, but there’s another reason I have to factor in now: the muscle I’ve gained and the fat I’ve lost has helped my body absorb and use insulin much more efficiently. Muscle is incredibly good at processing insulin whereas fat just isn’t. I now need to cut back my insulin in general (not just before or during a workout). I’m literally cutting the amount of insulin I need during the day and night because of the muscle I’ve developed and the way I’m now eating. To be clear though- I will always need insulin. That’s just an unfortunate fact of Type 1 Diabetes. Until a cure is found, my body will never produce insulin the same way or at all as non-type 1 diabetics will. I am always going to need it via pump or injection as that is the technology currently available on the market. There’s some really cool cure based stuff coming though that are currently in human trials!

When I first walked into Cornerstone, I weighed 165 lbs and had a body fat percentage of around 35%. I was a size 10 and hating that I’d let myself get to that point. I would also have to do all this Crossfit stuff with type 1 diabetes. I have to eat when my sugar is low and I have to eat sugar/carbs to get it back up in a safe range- I have no choice. This causes some major frustration when counting macros, but I‘ve learned to accept that sometimes I’m going to go over on my calories and carbs for the day. Through a lot of trial and error with my insulin and carb ratios, I’ve managed to keep my A1C around the 6.6 range since I started Crossfit and I’ve also dropped 15 lbs and am now a size 4 in jeans! My body fat percentage has dropped to 22% causing the muscles to process insulin much more efficiently. It’s important to note that high A1C levels (well over that 7.5 number) and high blood sugars in general can cause weight loss- very unsafe weight loss (remember, I was diagnosed weighing 90 lbs and a blood sugar level over 600). I’ve managed to lose weight and keep my numbers in a safe range the majority of the time. Needless to say, my doctor was impressed and happy with how my type 1 diabetes management is going while throwing Crossfit into the mix.

 

  Left to right- Jan. 2018, August 2017, and July 2017

Left to right- Jan. 2018, August 2017, and July 2017

     

There’s a lot more to the world of diabetes, but this is a small part of my life that has become very important to me. I’m impressed and proud of myself for diving into this new community and seeing what I’ve been able to accomplish ever since I attended my first class back in September 2017 and managing my type 1 diabetes is very much a big part of the accomplishments.  I also encourage everyone to know the signs and symptoms of type 1 diabetes. It can hit ANYONE at ANY age- not just children. Check out the links below and please feel free to ask me questions!

http://www.jdrf.org/t1d-resources/symptoms/type-1-diabetes/

 

https://beyondtype1.org/what-is-type-1-diabetes/

 

Seneca Seley