Day 31 – Afrezza and Tresiba Post Russia

Here I am, 31 days after leaving for Russia, back in the States for the 4th day. I have many questions, because my use of Afrezza and Tresiba have gone up considerably.

Reduced Tresiba in Russia

My questions come partly from my earlier post, where I noted that I had reduced my basal insulin usage considerably upon arriving in Russia.

When I left the USA for Russia, I was using 46 units of Tresiba a day, for a flat line basal. Total, while in Russia, I had reduced my basal 30% to 32 units a day. I am not sure of why I needed the reduction, but I was thinking it was both exercise and the natural non-GMO food.

Reduced Afrezza in Russia

My bolus insulin usage also decreased significantly while in Russia. My diet had not really changed, other than the type of food eaten – meaning naturally grown, in season, and non-GMO.

In fact, I ate a lot of high carbohydrate items that I normally would not eat in the USA, like baked goods and bread. Diabetic friendly foods and drinks are found in cities like Moscow and St. Petersburg, but not in Crimea.

Total, in 23 days, I used exactly 1 box of Afrezza (60x4u, 30x8u), compared to my normal of 2.5 boxes (135x4u, 90x8u).

I normally use a bolus ratio recommended by one of the Afrezza gang, which is to use 4 units of Afrezza if my carbs are greater than 24, and 8 units if greater than 36. In Russia, I found that 4 units was more than enough for most meals over 36 carbs, and under 60.

Increased Insulin in the USA

On my first day back in the US, July 14, I had wild highs in the afternoon. I attributed it to being tired and potentially a false “dawn phenomenon” since my body thought it was early morning. However, I also went high that night, as well.

I have since adjusted my Tresiba up to 40 units, and I am thinking I need to raise it again in a couple of days. I still get the wild highs in afternoon and early morning.

The Questions to Answer

The questions I have are:

Why did I need such a decrease on arriving in Russia?

This I cannot answer.

Why did I need an increase on returning to the USA?

I cannot answer this one either.

Have I changed the amount of exercise I am getting?

Not really. The first day, maybe, but not since. I still walk 4-5 miles a day. Even when I was not active in Russia, I did not have a rise in glucose levels.

Have I fundamentally changed what I eat?

This is the big question.

My normal (US) diet usually consists of yogurt in the morning, salads for lunch, and a rounded meal of meat, veggies, milk (whole, non-homogenized) and maybe a small amount of carbs. I rarely snack, other than a bagel in my Tuesday staff meetings.

In Moscow, I started the days with eggs, yogurt, meat, veggies, and usually a small parfait. Lunches were a variety of Russian foods (high in potato and cabbage content), and dinner was usually something like beef stroganoff and the normal restaurant accompaniments.

St. Petersburg was pretty stable. We ate at the cafeteria, and the “lunch lady” fed me chicken noodlelunch lady soup soup (2 bowls), beet salad, and chicken cutlets. Lunches and dinners were usually an ice cream, pastry, and some meat product.

Crimea was relatively stable as well. Breakfast was eggs with vegetables, pelmeni (dumplings), and cutlets. Lunch was usually ice cream, and dinner was always chicken cutlets or stew, and salad with a good amount of fresh tomatoes and cucumbers. I also ate one heck of a lot of fresh cherries, almost daily. We were buying a kilo a day, and I ate a good part of them in the evening.

I also drank a heck of a lot of water, and very little soda.

What is the difference in food?

The biggest differences I can see in the food are that the raw foods you buy in Russia are in season, some grown in hot houses, and are (likely) GMO free.

I also find things like yogurt to have less sugar content, dairy products are often raw products (milk, cheese, sour cream, etc.), and foods in general contain less added sugars. People in Russia are more health conscious, and when I would order the occasional “Coke Zero,” I would be encouraged by the waiter or waitress to order water instead.

When eating out, the portions in Russia are smaller, but that does not hold true at my mother-in-law’s meals in Crimea (where 3 servings is “starving” yourself).

I really cannot explain the differences in food, nor why my Tresiba and Afrezza usage are so different.

But one choice seems to stick out to me.