So I'm getting a bit frustrated trying to mix exercise with insulin injections.
Here's the deal:
- I like to work out first thing in the morning
- I wake up in the 7s and 8s (126- 144) although I'd like to be lower
- I'm hungry right when I get up
- When I exercise, my bgs drop as much as 5 mmols depending on what I do.
So if I have breakfast before I work out and don't take insulin, my blood sugar is high enough to prevent a low, but then I'm just burning off what I ate, so what's the point?
If I wait to have breakfast, I have lows. Maybe not the dangerous lows, but enough that I get shaky and frantic and light-headed.
I've tried eating a little bit, like a half a banana just to bring my sugar up enough to work out and have breakfast later, but then, same problem, I'm just eating to exercise.
Any thoughts on what I could do? I prefer working out in the morning because it fits into my routine the best.
So in my view, you don’t exercise to burn off the calories. If you want to create a calorie deficit, do that with your diet. You exercise to improve your fitness and metabolism. If you take in just enough carbs to keep your blood sugar at a good level and stable during exercise, then that is “perfect.” The important effect of the exercise is your improved insulin sensitivity later in the day and the overall improvement in metabolism you get from being more fit.
I know what you’re saying, frustrating! Try and look at it like you’re exercising to raise your metabolism which should help to lose weight plus all the other benefits. I try and split my meal in half and eat some before and some after . Sometimes 3 of those glucose tabs are just enough to get me through a workout. I’m trying to lose a few pounds and it feels like I’m just going in circles!
Kelly , I wonder if the thought of getting your waking numbers lower in place would help …in other words : working on supper /overnight numbers first ???.
A few ideas on this, your morning numbers should be changed by your long acting insulin and not really exercise(At least that’s how I try to do it) Also a low glycemic index diet has helped me with less lows and way less higher numbers. it’s just even, which has been much, much easier on my day to day life. Basically eating low GI foods means that whether I exercise or not my bs isn’t bouncing around like crazy, which means if i have a spontaneous workout it won’t kill me. Or decide to be lazy my numbers don’t skyrocket.
Yes I have been struggling with my overnight numbers. If I go to bed at 6.0, I’ll still wake up at 8.0. They told me that means I need more levemir at night but when I take it, then I go low throughout the next day. Like I thought levemir is supposed to keep you steady throughout the day?
As it turns out, most people fine that their basal insulin demands vary markedly throughout the day and night. Overnight, your body will go into overdrive “clearing” the insulin in your blood stream. Most diabetics find that their basal insulin requirements go up dramatically during windows between 2-6am. For many, this is the source of the dreaded Darn Phenomenon. Just using a flat basal dose with Levemir may still leave you unable to properly match you overnight demand. Some people actually take NPH overnight to more closely match that surge in insulin requirements overnight.
A lot of people find that levemir doesn’t last 24h for them or that they have wildly varying insulin sensitivity throughout the day. You could try splitting your dose and take it 12h apart. That might help.
Kelly , do you do a finger poke around 3 am ? Could you be re-bounding from a low and or live with dawn phenomenon ??
I think from my reads about Levemir , that Kat has a great suggestion by splitting . Maybe also some protein and carbs will reduce your numbers at wake up …try and test ( and repeats !)
I used NPH prior to pumping ( 2001 and prior to having Lantus/Levemir avaialble in Canada ) and it was hell for me , lots of lows at wake -up ; I personally would not go that route .
I think others are suggesting too , try to get your fasting number down ( basal numbers ) , ie not by exercise …my dear , it is complex !
I guess I thought Kelly was already using a split Levemir dose. Please understand, I was not suggesting that Kelly revert to NPH, I was suggesting that if a split dose of Levemir still leaves her unable to meet higher overnight insulin demand, some people have found that a augmenting nighttime dose of NPH provides just the right peak.
I have checked my bgs in the night and I’ve found that it’s steady until about 4 a.m. (if i go to bed at 11 and wake up 6:30). I’m just doing one dose of Levemir at bedtime. What is the advantage of splitting doses?
I have tried to give myself a little bit of quick acting before I got to bed if I’m high at bedtime and it’s still a few mmols higher in the morning.
On the exercise side, is everyone suggesting, a lower gi snack before exercise, without insulin? I haven’t tried that yet…
For most people, Levemir does not last 24 hours, so to achieve a “flat” basal, you can split your total basal dose in half and take half in the morning and half in the evening (12 hours later). But many people find that their basal requirements are higher overnight, and that it helps to have a higher basal rate overnight so you can split the dose unevenly. You can do two things, you can make the evening dose higher (i.e. 60/40%) and you can stagger the timing.
But before we get into that, let me ask you an even more basic question. If you weren’t taking a morning dose of Levemir, were you taking your Novorapid before workout and then not eating before workout? If you were, then everything becomes clear.
Your Novorapid is a bolus dose of insulin that “covers” your breakfast. Only take your bolus in preparation for eating. Taking that dose of insulin and not eating will likely give you a hypo even if you don’t exercise.
If I am just off track, then just ignore whatever I said.
ok, I’m sorry to be so boneheaded about this. After exercise, you are often insulin sensitive (often by a lot), you may need only a fraction your normal bolus to cover for carbs.
Again, in my view, you need enough glucose to fuel your exercise, that does not take away from the benefit of exercise. But if it really bothers you, then skip the insulin, eat no food and use an adjusted bolus after exercise with an insulin to carb ratio that works for you.
Only because of your dawn phenomenon would I suggest to take a low gi snack including protein at bed time and see where it takes you . I have read on TU , that lots of folks
are " creating " higher BG readings, if they do not eat breakfast .
And yes, when I do" my training " I eat without giving insulin .
I cannot answer your question about splitting doses,( no Levemir experience ) other than it makes sense , if the insulin does not last 24 hours …you may want to read up at the TU Levemir users Group
On the side …are you becoming insulin pump material ??
The point is that exercise makes you healthy. You really should consult with a nutritionist about this.
Your exercise is not simply ‘burning off what you ate’. Otherwise nobody would lose weight by exercising unless they also starved themselves. There is a distinction between foods that will keep your BG level during and after exercise and food that will add pounds. There has to be. I don’t happen to know what they are, but there has to be.
That’s why you should see a nutritionist!
Until then my short term advice is to eat before you exercise, probably some high fiber cereal or toast with peanut butter.
Since you can’t change the time that you exercise, and since you’re not going to give up exercising (we hope), the only other things to change are the food you take in, or the timing of your long-acting insulin.
“Eating to exercise” is not a bad thing, but that’s not really what you’re doing. You’re eating to keep your BG up. You’re exercising to stay healthy.
After all this interesting stuff here …will I meet you at the Calgary Marathon finish line , May 30 ?? …I will do the 10 K ( due to lack of training , no 1/2 M ;-( ) …I start at 7.30 Am and wear a Team Diabetes flashy T-shirt .Don’t know my bib number till I pick up the package on Sat.
Exercise is sooooo good for us that even if you don’t drop pounds, it’s very much worth doing. I hate every second of it, but my numbers throughout the rest of the day are much better when I move my butt in the a.m.!
Here’s what has worked for me: a low-cal but dextrose-rich treatment to fuel the exercise. I exercise before breakfast. Depending on starting number and how long/intensely I move, I pop one or more glucose tablets. The only calories in those is from the glucose, so there’s no slowly digested fat, excess calories, etc., to haunt me later. Because I have a strong dawn phenomenon, a single tablet with 4 grams of dextrose can lift me a good 20-40 points. Later in the day and with more insulin on board, I might need more tablets for similar amounts of exercise.
After exercise, I check again, bolus for breakfast. Sometimes, again depending on numbers and exercise length/intensity, I use a lower temp basal rate until lunch. If I used MDI, I would probably take a little less breakfast bolus.
Best wishes as you figure your routine out. Let us know how it goes.
