Exercise challenge

I think one of the things that annoys me a bit about articles that go on about how great exercise is for diabetes is that none of them talk about how HARD it is to manage in terms of blood sugar!

Tonight I swam 1 km in the pool. It took around 30 minutes (hard to tell exactly, as I didn't have a watch and can't see the clock).

At around 6:00 I tested at 4.2 mmol/L (76 mg/dl) and ate a few glucose tablets. At around 6:30 I set a two-hour temporary basal of -30%. I also ate a 10g dinner with no bolus.

At around 7:30 I tested at 5.7 mmol/L (103 mg/dl) and ate two glucose tablets.

At 8:00 I was 8.5 mmol/L (153 mg/dl) and swam for 1 km.

I felt terrible while swimming, not from diabetes but from asthma, I think ... after the first 150 m or so I could barely breathe and had zero energy. I had stupidly forgotten my inhaler at home, but swimming takes so much effort to pack and catch the bus and change and pay the $6 (!) drop-in fee that I didn't want to call it off. By the end I had a headache and felt sort of dizzy. I felt like I could have swum more but felt like it was probably a bad idea when I couldn't breathe properly. Even after stopping the wheezing lasted a good hour or so before finally going away. Next time I will for sure use my inhaler before going and also mention it to my doctor if I feel so horrible again while swimming.

At around 8:45 I finished swimming and tested at 5.7 mmol/L (103 mg/dl). Unfortunately I had to wait an hour for the bus because I missed the one I intended to catch. At around 9:30 I tested at 7.7 mmol/L (139 mg/dl) and took a full correction.

Then I got home and tested at around 10:45 ... and got 15.4 mmol/L (277 mg/dl). I had been feeling like maybe my blood sugar might be perfect (this is the first time I've tried wearing my pump while swimming), but alas, it was not to be. But at least I didn't go low!

In the past I've tried taking my pump off entirely for swimming, which has always ended disastrously ... blood sugars of 17 - 20 mmol/L (300 - 350) and ketones of 1.0 - 1.5 (normal is 0.0 - 0.5). This time around ketones were 1.1 (that's equivalent to large) with my high blood sugar. I truly don't know how people can suspend their pump or take it off during exercise. I don't know if it's too little insulin causing this (I thought so when I disconnected, but now I'm thinking maybe not) or something else about swimming that triggers it.

Anyway, I just did a 4.0 unit correction and will be up monitoring ... Some reward for exercising, high blood sugar, ketones, and staying up half the night. Hopefully I won't crash overnight. I'm taking tomorrow off, but I would like to make swimming a regular event three or so times a week. So I should get to try again in about two days.

I'd guess the "culprit" for the high would have been the dinner with no bolus. If I eat that closely to exercise, a couple of hours, I'll bolus to cover it. The 153 might have been the start of the up but if it's "going" up, like multiple tests in a row, I would consider the food on board and "cover" that too? At 6:00 your'e eating "a few" glucose tablets which should by itself get your BG where it needs to be but also eating *and* cutting basal, all of which would jack your BG up. I know there's a whole bunch of stuff to do but, when I'm exercising, I like to just get my BG where it needs to be with as little sugar and insulin floating around. Then I have about 10-15G of carbs and work it off. I don't usually see the skyrocketing BG.

That being said, great job swimming 1K! Managing getting there on the bus, etc. is a HUGE chore and, even on it's own w/o diabetes, that's a great achievement. I would like swimming if we had a pool at our house. When we moved in 2009, one of the houses we looked at was pretty nice in terms of meeting our house requirements and had a really nice L shaped pool that would have been awesome but we realized that none of us are "work" motivated enough to keep it up so no pool for me. One of my friends had suggested doing a local (i.e. easy...) triathlon last summer. I blew it off as I was engaged in race training but maybe next year, since MrsAcidRock said she'd shoot me if I ran Chicago again.

(ok Jen, I got a "reply" email and note "2 comments" on the "Blogs" page but can't see your comment! Oh well, off to work!

I know, I can't see it either! Can't figure out what's going on ...

Hi Jen!

I am having the same problems as you. I have been riding my bike for an hour each time three days a week. I found out that if I bolus for the food I eat before the ride I start going low. I reduce my basal rate 50% an hour before the ride. I started my ride this morning in the 160 range and finished up at 108. As soon as I finished the ride I gave myself around a 5 unit bolas and a 1/2 hour later I am in the 180's and have now jacked up my basal rate 200% for an hour to try and get it to come down.

This is my routine every time I ride my bike because I can't figure out anything else that works.

Hope you figure out something. UD

I found swimming difficult to adjust to, bg wise. I used to go sky high after swimming then crash in the evening. In the end I got so fed up with all the hassle I just ended up going walking.

I was high until about 2:00 AM and was fine this morning (5.4 mmol/L, 97 mg/dl), but about half an hour ago tested becasue I was STARVING and found I was 1.7 mmol/L (31 mg/dl)! Yikes!!! On Wednesday when I swim again I will definitely have to see if I can sort this out so my blood sugar isn't so crazy! Swimming is the one form of exercise I love (as opposed to forcing myself to do it).

What I seem to have noticed with me : when I am out of my :"normal shape " , ie having done less regular exercise than previous( for what ever reason...found fantastic excuses with the hot summer weather :) ) ...BG comes down much quicker and will rebound quicker/higher .This will generally stop when I get serious again , about getting heart rate up etc. I also learned , that after " hard exercise " ( in my mind you did with your swim and getting back home !!??) I shut the temp bolus off and give a small amount of a bolus .( Canada Games Pool ??)

I'd say don't eat so much beforehand. Try to keep your BG flat and have a very small snack beforehand and see how it goes? That seems to work ok for me. I'm such a wuss about swimming though.

I find it weird because in total I only ate 26g of carbs (four glucose tablets in total, plus 10g dinner), and a lot of that was over an hour before exercise. I will try not eating much beforehand tomorrow and see how it goes. Timing is so hard because I pretty much have to skip a meal in order to not eat or else eat and bolus and have IOB when I exercise.

What I do sometimes, particularly for "bigger" runs in the evening, is to have a snack, maybe 15G of carbs @ 2:30-3:00, bolus for it and the insulin is mostly gone by 5:30-6:00 when I run. If there's a bit left, or my BG isn't quite where I want it, I'll add a small, quick snack (skim milk, V8, maybe a handful of chips...) before I go and then about 10G of gatorade 3 miles into the run. I think a couple of hours is kind of in line with the food being digested while you're working out, to provide fuel. I'm sure this varies but I've gotten ok results with this approach. If my BG is higher, I can just skip the snack and run. I usually have the gatorade anyway and just sort of check (CGM, although a year or so ago, I was taking my meter to "calibrate" the process. I noted the CGM tends to read lower while I'm working out so I cut back on these snacks, turn the lower/ temp bolus off w/ a couple of miles to go and have seen less pronounced spikes afterwards). It's always a constant struggle but so is keeping your BG flat sitting on the couch eating potato chips. And the potato chips taste *a lot* better after a workout!