I am a 19-year-old athlete with T1D. How do I manage?

Question

Hello doctor,

I am a 19-year-old female who was recently diagnosed with type 1 diabetes. This week, my blood sugar levels have been really erratic, even though I have been following my insulin schedule. This morning, my blood sugar was 280 milligrams/deciliter, even though I had not eaten anything since last night.

Could this be the dawn phenomenon?
Should I adjust my overnight insulin dose?
I have also noticed some small bruises at my injection sites. Is this normal, or am I doing something wrong with my injection technique?
I am planning to join the college soccer team. What precautions should I take during practice in terms of insulin timing and blood sugar monitoring?

Kindly help.

Thank you.

Answer 1

Hello,

Welcome to icliniq.com

I understand your concern.

Your situation is understandable, as managing type 1 diabetes can be challenging, especially in the early stages. Here are some insights into each of your concerns:

Dawn phenomenon:

High blood sugar in the morning, even without eating, can indeed be caused by the Dawn phenomenon. This happens when your body releases hormones in the early morning hours, which can increase blood sugar levels.
Adjusting your overnight insulin dose by two units might help, but this should only be done under the guidance of your healthcare provider. You might also consider using a continuous glucose monitor. To track fluctuations overnight, as this can provide valuable insights into when the blood sugar rise occurs.

Bruising at injection sites:

Small bruises at injection sites are fairly common, usually caused by hitting a small blood vessel. To reduce bruising, make sure you are rotating your injection sites to avoid using the same area repeatedly, which can lead to skin sensitivity.
Using proper technique, like injecting at a 90-degree angle if you are using a short needle (or slightly angled if needed), can also help. If bruising persists, you can try icing the site briefly after injecting. However, avoid reusing needles, as this increases the risk of bruising and infection.

Precautions for soccer:

Joining soccer is a great way to stay active. Physical activity can affect blood sugar levels, so be sure to check your blood sugar before, during, and after practice.
Keep fast-acting glucose sources on hand, such as glucose tablets or juice, in case of low blood sugar.
You may need to adjust your insulin timing around practice. For example, you might need to slightly reduce your pre-practice insulin dose (with your doctor’s advice) to help prevent exercise-induced lows.
Wearing a medical alert identification is also a good idea in case of emergencies.

These initial steps should help you manage your type 1 diabetes more confidently. Let me know if you need any additional tips on adjusting insulin or safely managing exercise.

I hope you are satisfied with my answer. For further queries, you can consult me at icliniq.

Thank you.