The return to insulin pumping continues to be mostly smooth sailing. As I’ve shared in other outlets, I am running ‘exercise mode’ on the t:slim a majority of the time during this transition phase. Simply stated, exercise mode creates a larger blood sugar buffer zone, in theory to minimize hypoglycemia risk while working out.

Emotionally, this option is helpful when taking the initial leap of faith with these fancy pumps in that there is room granted for fine-tuning. My doctors and I also decided to err on the side of exercise mode due to physical safety reasons. In layman’s terms, ‘early worsening’ is a phenomenon in which rapid decrease in Hemoglobin A1c can induce too much stress on the blood vessels, aggravating or causing complications of diabetes. Because the pump was most likely going to stabilize my blood glucose range more so than injections had been, we expected an A1c drop. Utilizing exercise mode constantly, for now, mitigates some of this effect by gradually reducing average blood sugar levels while (hopefully) preventing damage to the body.

‘Early worsening’ is one of the cruelest aspects of diabetes. Society yells at us our entire lives to, “Just stay in control of your diabetes!” – as if our health was not affected by a gazillion different variables each day. When folks finally start feeling physically better in an acute stage of lowering blood sugars, the risk of long-term damage can arise, possibly unbeknownst to the individual with diabetes if not made aware of this counterintuitive concept.

Talk to your own healthcare providers before changing your diabetes management. This is simply an idea that has worked for me thus far, and I believe the topic should be on our collective radar more often. As time goes on, I will likely tweak my style again to a different mode of pumping with a tighter blood glucose range. For now, though, I am still hopeful for the ideal mode one day in our futures: cured! (Accessibly, affordably, and equitably, of course!)