Exercise strategies


#1

Hello all,
I am trying to incorporate an exercise routine in my schedule. I have been discouraged the last few months because I experience a rapid drop in bgs when i exercise. I am fearfull of getting low in the gym and passing out.

So my strategy has been to do a 20% tempt basal decrease starting an hour before I start exercising and then 2 hours after I am done. I also take 30carbs before I start. The result are the same no matter what. 30 minutes into my work out i get a rapid drop to about 90 and my panic mode kicks in. Also i am working out in the afternoon which is a insulin sensitive period for me.

Can you please let me know what you guys are doing before and after working out. Thank yoi.


#2

I have a few thoughts about your exercise and blood glucose drops. I think your tactic to set a temp reduced basal rate is a good one. If a 20% reduction is not producing the desired results then I would experiment with 30% and even lower, as necessary. Don’t be afraid to set temp basals in this situation to as low as a complete basal turn-off.

You need what you need and personal experimentation should act as your guide. It helps to write down what you’re doing so that you can glean information from that later.

I don’t think it’s good to feel fear with a 90 BG reading but if you have significant insulin on board from your lunch insulin dose then that is a reasonable concern.

I share your afternoon insulin sensitivity; this is fairly common. Is your lunch-time meal insulin still working typically when you work out in the afternoon? If so, you could reduce your meal-time insulin dose when you anticipate working out.

Bottom line, however, what works for other people may not work for you. Personal experimentation combined with keeping a record will reveal what works for your unique metabolism.


#3

Aerobic exercise about doubles your insulin sensitivity. If you try to calculate (guesstimate) the amount of IOB you’re bringing into the equation at the beginning of the exercise, please take into account

  • remaining IOB from previous meal bolus (previous would be pretty significant for anything up to 3 hours ahead, and still non-zero for up to 6 hours)

  • remaining IOB from your basal rate - if you want to lower your basal IOB at the time of exercising, you’d need to start lowering your basal about 90 minutes ahead. Reducing about 60 minutes beforehand takes care of the worst peak - might fit for Fiasp, you didn’t write what’s in your pump.

I’m trying to adjust my IOB to fit the balance between COB or other aftereffects from my previous meal and my expected ISF during exercise, and keep carbs at hand to fill in anything beyond what I can level at with reducing Basals beforehand. This seems to work well with light (aerobic) exercise that doesn’t cross the anaerobic threshold, and other hypo-magnets such as housekeeping or gardening…
An exception to that would be what is marketed as “life kinetics” - while the exercises can be designed to be entirely non-strenuous, and with little impact on heart-rate or breathing, the combined challenge of consciously discoordinating multiple patterns in movement, and then stealing the mental capabilities by trying to recite a simple poem for example have a truly flooring impact on BGs. I’m using 15 minutes of that when I find that I’ve underestimated a meal, and need a rapid-acting way out of the 200s.

Between T1D and T2D, the major difference in IOB after a mea lies in timing: a T1D can calclulate the amount of acting insulin quite precisely, while a T2D has the additional amount his body was able to produce and considered necessary. If a T2D is waiting too long after a meal, his body wlll have done whatever it could, while if he starts his light workout sooner, he can count on his body to insert less insulin into that equation as his snsitivity rises during the exercise. The benefits of a still working pancreas…


#4

What kind of exercise is it?

Do you leave it at the 20% decrease while exercising? You can try a more aggressive decrease, or even turn it off completely while exercising.

That drop 30 minute drop when you are starting is normal, because your body is using all the different fuel sources that are available to it - muscle glycogen, fat metabolism, and the glucose that is available in your blood.

The number 90 is not really the thing to be concerned with. What’s important is what it is going to be in the next 10 minutes or so.

Fast-acting carbs right at the start and within the first 15-30 minutes can provide your body enough to counter that early drop. What carbs do you use?


#5

Thank you…your suggestions are greatly appreciated. I have been worried about total insulin suspension at work out. I tried yesterday and I was pretty stable around 107 for about 20 minutes.

I was not considering my IOB but I will now try to decrease the temp basal 90 minutes earlier. Like you said if it works for me.


#6

Thanks Quo…you gave me wonderful information. The influence of IOB I was not factoring in. I need to pay more attention to its affect even when I am not working out.

As Eddie suggested to go for a suspension of insulin for part of the workout.

I take regular insulin humalog.


#7

Hey Aleben,

We have an article by a personal trainer who has suggestions on how to manage blood sugar during and after exercise to prevent highs and lows. Hope this helps! Please keep us updated with your progress!! What kind of exercises do you like to do? :slight_smile:

https://beyondtype2.org/blood-sugar-control-during-and-after-exercise/


#8

Thank you, this was an excellent article and I learned a lot and will incorporate some of the suggestions as well. I hope I find the correct formula for my need.


#9

I read the suggested article. Unfortunately it seems that all the recommendations start with adjusting your insulin. Topic is posted in the T2 catagory. I would like to remind everyone that all T2’s are not using insulin, some use other medication and many (especially those who exercise) do not use medication. Then of course there are T2’s who require insulin to control their diabetes.

I control my T2 with diet and exercise only. It was almost impossible to find information about exercising not using insulin. It would be a benefit to many to find someone experienced exercise who understands of a T2 using diet and exercise only, or minimal medication.

It would be interesting to see if there is any information on the percentage of T2’s using Insulin.


#10

Hi Tom,
When I was trying to control my diabetes with just medication, diet and exercise. I never had an issue with my bg. I would take a 90 minute class without feeling the effects of a low.

Now being insulin dependent I find it harder and at times frustrating to complete a routine. I definitely understand you wanting to ensure that everyone’s need are meet. Perhaps this is one way of getting the conversation started.

Thank you for your comments.


#11

Have you looked on Beyond Type 2 for answers or even to ask the question?


#12

I am not sure you were responding to me. First I went through learning how to exercise over 10 years ago, I have worked with a trainer most of the times and with a T1 semi pro baseball player . I am a runner although at 73 I limit myself to 5K. Regulating my BG for 10K is a bit more difficult for me.

I looked through the site when it first opened. I checked today on the exercise portion.

Nothing really earth shattering, basically the same as my Diabetes education 11 years ago. I have worked it through what I need to know for myself.

Diet and exercise only and I limit myself to 30 carbs a day, and keep my A1c in the 5.0s , I don’t take breaks. I just work hard at keeping myself healthy.


#13

I agree there is not much on the T2 forum. I was just saying to make it more interesting it would be a good idea to start using it.


#14

I’m glad you found it helpful, Aleben! :slight_smile: