I’m trying to lose some excess fat and have been working out daily for about a year. Now i’ve only been a Type 1 diabetic for about two years now (onset in my late 30’s, unusual i know), but my progress feels slow. Part of the problem is i’ve had a difficult time managing my blood sugar during cardio. I use an insulin pump (Omnipod) and have experimented with different temp basal adjustments but haven’t found a great formula for preventing myself from going hypo (short of excess sugar/gatorade which kind of defeats the purpose).
One thing i've tried recently is to go do my workouts about 30--45 minutes after a meal. Doing that pretty much eliminates the need for using bolus for that meal (up to about 40g carbs).
It's reduced my overall daily insulin consumption significantly--but i wonder if it's as effective for loosing weight as the conventional temp basal + exercise approach?
Oh , how would a CGMS fit in ??..a simple question , not necessarily a simple answer .
Regardless EXERCISE is good for all ( even for our 11 year old Rottweiler .
I would think: fewer calories , fewer things to burn off , while moving around …weight loss will occur, if you put out more , than you take in .
I am not an expert to respond to your question , yet I move and my weight has been stable …my choice , I don’ t want to loose weight .
At the simplest level, weight loss is about eating fewer and/or burning more calories than you need when everything is balanced. So your new method sounds like you have been able to eat fewer calories (because no need for glucose to treat hypos during exercise), right? And if you’re blood sugars are on-target, then seems to be working for you.
But when it comes to losing fat, are you really eating that many fewer calories–how many calories of glucose were you consuming to treat the lows?
I may have to try the no- or low-bolus before a meal and exercise after, but so far that whole stomach discomfort of bouncing around while food digests just seems to defeat me
I think you maybe right and it’s somewhat of wash either way. One nice benefit is it’s great for treating guilt after a big meal. I’d rather go spend 30 minutes on an elliptical then take 8 units of insulin.
Exercise is very variable - you may find a very different BG response to 30 min on an ellipitical than you would to 30 min in a pool. And your response to the elliptical may be very different than my response to the same elliptical workout. Variables include how hard you exert yourself, how well you are trained for a particular exercise, how often you do it, your overall condition, etc.
So if you’ve found an approach that works with this particular exercise - not bolusing for 40g of carb - that keeps your BG stable and prevents hypos, then you absolutely have found a great approach. This 40g of carb is 160 calories per day; that would add up to 17 pounds of weight loss if you did it every day for a year. And that’s only one year. Keep it up!!
There is nothing magic about the temp basal approach - that is just one of many options to adjust for exercise (you might be interested in the Colberg “Diabetic Athlete’s Handbook” book which goes through others including reducing bolus insulin as you discovered on your own). I don’t have a pump so clearly I can’t adjust my basal - and I exercise before I eat not after, and I exercise at a higher rate for a shorter time - so clearly my approach to balancing BG is very different than yours. But if yours works for you then that is a huge accomplishment and you should go with it.
Great feedback, thank you. I do enjoy the new approach of having a meal then exercising instead of bolus. I do this every day, but as Jag1 pointed out it does vary. Three days a week i do weight lifting instead of cardio, and frankly i haven’t made a major effort towards calorie reduction. I’ve definitely found after the weight lifting i need a corrective bolus whereas i do not after cardio. It seems that all in all gradual (as opposed to drastic) fat loss is pretty much expected.
Yeah, I gave up on the scale when my waistline started shrinking and the scale continued to move the wrong direction. Now i try and focus on waist size and overall body fat percentage.
In regards to journaling, that’s a great suggestion lotsofshots. I’ve thought about doing a food/exercise journal, i’ve just never taken the plunge. Anyone recommend a good iPhone app for this?
Ok…I have a problem that’s opposite of yours…I go high bg during and after cardio, If I attempt to treat the high with correction dosage, I will have to rescue myself three hours later or have to snack at 2-3 mark. Read the Colberg book, he covers this also…here is what I do to encourage a stable BG throughout…two hours prior to a workout I eat a meal high in protein/fat and low or no carb. I calc the dual wave insulin dose (see the TAG site) to deliver over 3 hours. You might be able to set a lower temp basal for your excercise program and not have to eat extra calories. Evidently whatever is in your system is burned a little too efficiently - you need to slow that metabolic system down with protein/fat and/or reduce background insulin. Congrats on the inches off!
You should probably exercise much longer than 30 minutes to lose weight. You’'re simply burning muscle glycogen during the first 30-90 minutes. Eat less fat. Eat less of everything. And if you really want to lose weight, pick an exercise that keeps you going long and slow for hours.
It’s usually closer to 45 minutes on the elliptical (which according to the machine is about 525 calories). I could try a lower intensity and do it for 60 minutes…but that’s about the most extra time i can throw at it on a daily basis. The job, wife, and kids might take exception to an extra two hours everyday. =)
I have absolutely no experience trying to lose weight or how to go about losing weight.
I concur with Joe, though, about burning more glycogen versus fat in shorter versus longer bouts of exercise but the ratio of glycogen versus fat depends a lot on how hard you are working out for those minutes. You can’t help but burn some glycogen no matter what you are doing, but lower intensity workouts will burn a higher proportion of fat versus glycogen. The tradeoff with lower intensity workout is that you burn fewer overall calories, though, and may not burn as much fat even though your proportion of fat burned might be greater. If you turn up the intensity too much, say above 85% of max, you start to approach anaerobic threshhold where very little, if any, fat gets burned during your workout. If your’e really anal, you stage the intensity of your cardio workout to maximize fat burning but I have no idea how you would do that.
My feeling though is that if you are working out comfortably for 30-45 minutes on the elliptical, feeling a nice burn and a little out of breath at the end, you’re doing fine.
I asked my Doc about this and he said when I exercise (usually late afternoon) I should be cutting back on my fast acting at meals. He said normally at least by half, so what you’re talking about makes perfect sense. I kept eating to keep my BS up and like you said, defeats some of the purpose. I’m still getting benefits for my heart, lungs, muscles but not losing weight!
as long as your bgs are good, then you’re in good shape for now. but keep a close eye on it over time as your body changes, and if you’re changing your routine. at low intensity, the muscle mostly burns fatty acids and bg. at high intensity, muscle burns mostly glycogen and the liver can actually start dumping glucose into the blood, raising bg. but it’s a spectrum and most people fall somewhere in between, so it’s finding what works for you (based on your specific intensity). and it sounds like this works for you.
but how your body responds to a specific intensity is important to keep in mind because it can really change what you need to do with your insulin. for ex, i go for a run after dinner and usually don’t need to bolus for ~60g cho (and many times have to lower basal, sometimes to 0 for 1 h). but that’s based on a running at a moderate intensity. on the days that i push myself hard, i’ll find that i usually don’t need to do a big basal change and sometimes need to issue small boluses mid-run (0.2-0.5U) based on my CGM trend. but then i’ll have to cut insulin boluses when i eat for recovery.
as far as weight loss, total calories is most important. the fat and bg come from existing food and fat stores, so you’re burning what is already on board. the glycogen will be replaced by eating carbs in the future, so the carbs that you eat over the next 24-48 h will go into glycogen storage (rather than staying in the blood or being stored as fat). so it all works out in the end, as long as you’re not eating too much post-ex, which can be really tempting.
i’m really glad to hear that you’ve made good progress! good luck and i hope you have continued success!
Hey Tom, couple of quick off topic questions if I may.
How soon after you eat do you go for your run? I usually go for my run after breakfast and I eat only slightly less carbs than you, but, since I’m currently on MDI, I have to take a small dose of Novolog to cover the carbs or I’ll spike into the 200s.
Since you are on a pump, do you just increase your basal for that time period?
When I can help it, I head out about 15 min after dinner (usually potato or rice). In that case, my bg usually rises slightly for about 15 min into the run but then starts to steady and fall slowly. On most runs I actually have to drop my basal rate by 50% or more to keep it above 100. When I get back, I usually have to raise the basal or take a small bolus or I’ll climb though.
I don’t have a lot of experience with morning runs (<-- not a morning person), but I did go for a few while I was on vacation. In those few cases I did end up spiking and needed to bolus mid-run. I suspect that it was because I usually eat something quicker acting like a granola bar or life cereal for brkfst. It could also be that my insulin sensitivity is overall lower in the AM, not really sure.
i’m usually hesitant to bolus during a run for fear of going low, but will i climb consistently. how much do you take? do you find yourself going low at all? just curious in the event that i do find myself going for morning runs again!
Congrats on the weight loss Seagator, glad you are able to keep moving at your young age! Most of the folks responding to this post are pump users. The insulin used in pump delivery is very fast acting. If you make a mistake in your food to insulin calculation, you can drop your BG very quickly. The tighter one’s BG control is while using a pump the more one is exposed to sudden low BG’s that can result from activity. The originator of the post is trying to juggle diet & exercise & BG control calculations in the most efficient way so he can continue to gain muscles and loose fat. I’m a Dr. Oz fan also - great motivation.
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