Albert Einstein is said to have defined insanity as  "doing the same thing over and over again and expecting different results."  Those of us in the diabetes community would twist his words a bit. 

To go truly insane, try doing the same thing over and over again and getting completely different results.

Every Thursday for three years now, my daughter has taken a ballet class at 5 p.m.  The class is the same length and includes a similar combination of exercises each week, in about the same order.  The degree of difficulty has increased over the years, but more in terms of balance and flexibility than intensity of exercise. 

Every Thursday she has an after school snack around 3 or 3:30 and save the occasional outlier, begins the class with a blood sugar in the mid-100's.  We go for stretches where that blood sugar holds nicely through the class, with a slight decline of maybe 20-30 points, but nothing significant. 

Then for no apparent reason, the class starts to tank her.  Last week, I thought it was the new site.  The week before I thought was a fluke.  Three weeks in a row seem to point to a new pattern.

She started yesterday's class with a blood sugar of 120.  For a little insurance, she chomped a glucose tab before she headed in the door.  A little snack might have been preferable, but none was at hand. She finished the class at 49.  She'll need a temporary basal rate and/or a semi-substantial snack next week before she begins dancing. 

This has happened before with ballet. We change our pre-class diabetes routine and it works for a few weeks or a couple of months. Then suddenly the numbers will start to creep up during class instead of down.  We'll stop the temp basal or the pre-class snack again, and she'll begin to come out even. 

When I create my revolutionary giant spreadsheet of all possible blood sugars cross-referenced by all possible physiological and environmental factors, cross-referenced by daily routine, I might find an answer.  I could find this issue correlates with growth spurts, a concurrent preference for eating apples, the atmospheric conditions, or when the site was last changed.  It seems just as likely I'd find no cause at all.

It's one of those many diabetes situations to which all I can do is react.  We'll put the stop-gap measures in place which are necessary to keep her safe, and keep checking to see if they've worked. It's a most maddening aspect of this disease.  A + B doesn't always = C.  And the factor which led to a different outcome is often a mystery.

As we left the dance school yesterday, my daughter lamented the situation, but for different reasons.  "I like it best when I'm 75 or 80 when we leave.  Then I can take one of the lollipops from the front desk for the ride home."  A worthy goal for next week, indeed.

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