Exercise and insulin

My endo recently told me it’s time to start taking Lantus to help control my fasting BGs. I had previously been able to keep it at bay with intense athletic training two times a day, 12 hours apart (5am workout and 5pm workout). That was all well and good until it wasn’t.

I’d like to continue my workout routine and my long distance running (10 miles) because it’s always been my lifestyle, from the time I was a competitive athlete and now into my retirement.

Any tips on how to prevent exercise induced lows later in the day/night when taking Lantus? Also, when is the best time to take Lantus, before or after workout? If I wake up with BG 150-180 range, I can safely exercise without taking insulin?

I used to inline skate 20-25 miles per day during the week and 40-50 miles on Saturday and Sunday. Now I have cut back and only skate 20-25 miles on Saturday and Sunday and none during the week. I had a similar doctor recommendation but found that the Lantus/Levemir (I was on one or the other depending on Insurance coverage of the moment) made me constantly go hypoglycemic several times at night. I am also on Humalog fast acting insulin for meals.

The Humalog is mostly out of the system within 2 1/2 hours and pretty much totally out within 4 hours. By tweaking Humalog based on food and exercise, I no longer had/have either high or low episodes. The Lantus stays in the system for about 22 hours so was never able to tweak to find dose that did not cause problems with low BG at night. I totally discontinued use of Lantus/Levemir.

Exercise is always a trick you have to learn. There are some professional athletes that are type 1’s. Each of us if different so you literally have to experiment with what works. And it also means you are in the honeymoon phase which is also a little trickier because sometimes you are still making insulin.

@CJ114 is right in that sometimes it’s easier to adjust with fast acting because Lantus is an all day thing. In the US they like to start you with long acting at first and then progress you to fast acting. In other countries they do the opposite. I think if you ask your doctor and tell them why, you should be able to get fast acting. Or fast acting and a really low dose of long acting.

I snorkel and I usually start out a little higher and temp decrease my basal insulin setting before I snorkel and while I snorkel and this has worked really well for me. You just can’t do that type of thing with one long acting shot. And for me the trick is sometimes 4 hours after intense exercise. It’s the sometimes that can throw me!!!

A CGM is the most helpful for everything!

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Your gonna need a Dexcom sensor. Your just gonna have to get one to continue safe performance at that level, I think. Your just in the category of exercise that demands it. If insurance wont cover, ask the Doc to file under ‘medical necessity.’ Its going to cost some money, but trust me that it will be worth it.

I think most people here will advise a G6 model, although some might say G5. The diabetics are pretty on top of how to restart the G6 to save some money. They told me to get a G6 and I did. No problems so far, except the following.

The adhesive isn’t as good as it used to be, so if your sweating while u exercise, you will need some adhesive backup.

The adhesive isn’t good at all, even if you’re not sweating!
Skin Tac however works great.

My last few boxes of sensors have had great adhesive. I know Dexcom has been working on the adhesive problem for a while. I thought they got it sorted, obviously not if you’re still having issues.

I did already post this before, so I’m sorry I’m being redundant. But it just shows you with some extra work you can exercise and just keep track of your Bg’s. If he can I can sort of thing?

Thanks for the info. My Dexcom hasn’t arrived yet but I’ve used the freestyle libre and felt that was very inaccurate compared to a finger prick, so I’m hoping the Dexcom will be a lot more helpful during exercise.

Get an Apple watch so you can see your BG level on the watch face while you’re working out.

Good looks. :+1:

If you get the Nike edition, it includes a lot more excersise and workout info that the other watches and apple health don’t include.

That’s sweet. Mainly with my long runs and strength training morning workouts, my lowest BG has been in the 90s. However, hours later I’ll be in the 40-60 range. Hoping tracking more accurately with Dexcom and the watch will help avoid those.

Definitely get the Nike edition. It was made for people like you. I love mine, but I don’t workout. The bands are better on the Nike versions. You’ll get all the Dexcom alerts on the watch.

Thanks for the info!!

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I get on an exercise bike for 10 miles plus (easy setting because of my back) almost every day but I have choices to when as I’m retired. But I usually wait until I’ve eaten something, wait for the starting to trend up and dose a lighter dose (halfish depending what I ate?) then get on the bike for an hour. It usually works out, but sometimes it doesn’t!

The kind of drop you’re talking about I have had happen hours later after snorkeling a few times. In my case I chalk it up to maybe more ocean currents so I worked harder at swimming, maybe the water was warmer etc…I should have dosed less for the meal after etc. That is where a dexcom comes in really handy to let me know so I can correct it before it goes there. I did drop drastically anyway hours after once, but it was really choppy water and the current was stronger, I was almost getting seasick. We didn’t stay in long but hours later I was having to gobble fruity bears. Another learning experience. The swimming was fine, the dosing for the meal afterwards was where I made the mistake.

PS I do have a pump that I decrease insulin before and during my snorkeling, this is where a pump is also very useful)

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