Hello All ... Like many I'm a type 1 on a insulin pump.
I'm curious to know how many work with the issues around exercise and blood sugar rising in the early morning time frame. I like training with weights. I find that when I work out my blood sugar rises. Even Cardio in the morning has the effect. Curious if others have adjusted their basal for this time, bolus etc... If I perform these exercises later in the day I have the reverse effect - lower blood sugars.
Mornings can be hard. Bernstein advises against morning exercise. Many of us start off with Darn Phenomenon and if you have any trouble sleeping you can extra stress hormones in the morning. If you can shift your exercise to the afternoon or evening you may have better luck. Otherwise you may just have to come up with a bolus approach to counter the rise.
Tee hee - not sure if that was an intentional typo or not but I love the idea of a "DARN" phenomenon - seems to apply to the whole darn disease! :)
All kidding aside, I do tend to agree that as with so many things with this condition, some trial and error may be needed to get the right balance for you and your schedule. Depending on the pump model (and your comfort with adjustments) you also may be able to have an alternate basal pattern for the days you exercise in the morning. That basal could be set higher in order to combat the morning blood sugar rise.
Good luck!
When I get up in the morning I correct with bolus insulin, maybe several small doses and most of the time I finally have a BG that's not climbing (My BG is never stable always going up/down) buy about 11am. I just use my CGM to guesstimate my insulin needs. I take Prograf® twice a day and it causes my BG to slowly climb for 2-3 hours. Every day is a little different so a basal adjustment does not work.
My morning DP, exercise, and coffee are managed with a basal setting that covers these. I prefer to get my exercise before lunch. Do try adjusting your basal rate for this effect.
I fight a significant dawn phenomena as well. Over the last few years my morning eating schedule migrated to eating later and later. I now eat breakfast between 11 a.m. And 1 p.m. I also pre-bolus up to an hour, while keeping an eye on my CGM to avoiding going too long and dropping hypo.
That delayed breakfast pattern led me to only eating two meals each day. I’ve done this for a few years now and find it works out well. Sometimes I meet people for lunch and I have breakfast. I eat dinner between 5 p.m. and 7 p.m. Because I like to have my digestion well advanced before I go to bed. I get better sleep that way.
As far as morning exercise goes, I find it does not drive my blood sugar down much. I’m a walker.
When I was on MDI including basal Lantus, morning exercise was great because I didn't have to fight my basal with glucose tabs like I did during exercise at any other time of the day, plus no residual bolus insulin in my system pre-breakfast.
Now that I'm on a pump, I have more flexibility to shut down or reduce my basal at other times of the day, but that requires some logistical coordination, whereas in the mornings I can just leave the basal flowing and run and experience a moderate rise in BGs, e.g. start the run around 100 mg/dl, end it around 130 mg/dl.
My body feels quite sluggish in the mornings, so I don't run quite as fast as I do in the afternoon or evening, but I'm under the impression this is actually useful from a training perspective. But I'm not sure if that's empirically supported.
I have a basal "bump" from like 2:00 AM until 5 or 6:00 AM. I usually lift 3-4 days/ week. I also have a CGM and pretty much "keep an eye on it" going into the workout, which is pretty easy as I get up early to have a couple of cups of coffee beforehand. I'll kind of just go by the feel, if it seems to be oozing up, I'll either crank the basal to 200% or do a correction bolus on maybe the current number plus maybe 10-15 points (since it's going up...) and go lift. I'm mostly doing P90X3 so the workouts are 30 minutes so I'll peek at the CGM at 15 minutes and hit some more insulin if I need it. If it really flies up, I'll chance bolusing for breakfast, finishing the workout and then testing my BG when I'm done to see what's going on. If it keeps flying up, I can squeeze in a shower before I eat although there's certainly an element of risk there too.
Thanks for the post. I just started Insantiy -- fast cardio. it drives my BG up like crazy! Maybe I should switch to P90X