So, in the last maybe... couple of months, but definitely the last month, I've been having a really hard time getting my I:C under control. I've been training for a half marathon, and until now, whenever I exercised a lot, I would need LESS insulin to cover the carbs. Now, it's ridiculous how out of whack my levels are. For instance, today I'm working at a coffee shop, and I had an apricot scone. I figured, pretty carby, right? So I guessed about 50 g of carbs. I've already changed by I:C for the afternoon to 1:5 (it was 1:7). Now here I am two hours later, and I'm at 265, steadily climbing. So far, I've given 17.35 units to cover 1 scone (and the subsequent BGs.) Even if it was 70 g of carbs, that's still a hell of a lot of insulin. I've done basal checking, and I think(?) my basals are alright, but I haven't done the checking in the last month. I'm just so frustrated because not a day goes by when I don't hit at least 200. I should probably just commit to doing lower carb, but I still don't understand why, when I'm running like 13-15 miles a week, I'm needing MORE insulin! Maybe there're some runners out there who've had this experience before. Any input would be appreciated.
EDIT: I should note that I just changed my pump site yesterday and it seems to be fine...
I don't run and don't use a pump so I don't know if I can help much, but I'm sorry you're hitting 200 so often. I would definitely do lower carb though if you think that may help and nothing else helps. Maybe someone who runs or does a lot of sports will be able to help you figure it out. Maybe it is just that your basal need is going up or something else like a virus which is asymptomatic is going on. If I bolused 17 units for anything I would be worried I would pass out very quickly but I have relatively low needs right now and I'm usually pretty insulin sensitive.
It is possible that your training has exceeded your ability to recover. When that happens, stresses build up in your body and it can cause a range of problems. This is called Overtraining. If you have mildly overtrained you can deal with it by giving yourself a couple days of recovery. Sustained overtraining can really mess up your metabolism. It is common to have high levels of cortisol and corresponding high blood sugars from overtraining. Insulin resistance may also occur.
It is also possible that you have sustained some injuries which could cause inflammation and higher blood sugars. And I know that perhaps 13-15 miles a week is not a lot, but if you are not used to that level of training it can be.
Also let me say that guessing on carbs and insulin it's not gonna work well. I remember when I was not low carbing and guessing almost every day! It's just too many variables.
I believe in D when we can commit to something that limits variability and doesn't feel as a sacrifice we should go for it.
You might be right, Brian. I don’t feel like I’m massively overtraining, but it’s possible my 8 miler on Sunday threw things over the top. Today I was trying to correct for a high after lunch, and now I’ve been dealing with intense lows all evening. Can’t seem to win, but I guess I’ll just have to ride it out best I can.
You may need to eat more fat and protein, this will smooth out those highs and lows. I could never eat a scone or any baked wheat product and not expect a spike into the 200's. I just started going to the Gym and have a personal trainer, I have been hospitalized and recovering from a major organ transplant for a year, I'm working out every other day with weights and core training (using a big rubber ball) +walking 3.5 miles. My blood sugar was very unpredictable after workouts, I started eating some fat about two hours before my workouts and this smoothed out my highs and lows to a point I can live with. Exercise is always going to cause BG swings and some lows during the recovery stage just keep an eye on it.
If you are building massive amounts of muscle, then you'll be needing more insulin.
If you are needing more insulin because of adding all that muscle... both your basal and bolus needs will go up. It's unoptimal to put all your corrections into bolus if your basal needs to come up too.
Unable to determine exactly how old you are just by looking at your picture but... in teenage years my insulin needs were very very high. Growth hormones and all that. I take half as much insulin today. 17 units for a scone? Yeah that would've been about right when I was a teenager :-)
It might be that the food you ate was very high glycemic and your insulin couldn't catch up with it. When I eat food that is high glycemic I need to use (fast acting) insulin about 40 minutes before I eat, even though the fast acting is supposed to start in 20 minutes. An apricot scone at Panera Bread, for example, is almost 70 grams of carbohydrate. So it could be that you underestimated the carbs in the one you had. I have come to the conclusion that the type of carbohydrate (high or low glycemic) does make a difference.
Hmm, I'll have to think about a good snack I could eat like an hour or so before... maybe string cheese. I actually do okay with figuring out my insulin needs during workouts, generally.
Haha, a few years past the teens :) I'll be 30 in a year - probably done growing! But I think you're right on rechecking my basal levels. I'm going to do some basal testing this afternoon, since that's where these highs are creeping up on me.
You're right, Deb, of course - probably shouldn't have eaten the scone in the first place! I'm usually more circumspect in my food choices, but I was at a coffee shop with only baked goods, working there all afternoon. I thought I was making a safer choice, but... well, lesson learned.
It is hard what about doing a temp rate. Don’t forget if you excercise for an hour your body afterwards may eat up the scone with less insulin because your body is still being affected from the run. What are your A1C numbers. Sometimes If my numbers are climbing I will see what the correction is and that will not help lower it. I may have to put in 5-10 carbs and temp rate it. If you are getting low numbers do a temp rate and it will help with the basal. Always ask your doctor. A nutritionist is also the best. Better to work with one when you exercise. My nutritionist can change basal rates instead of seeing the doctor. Good luck. Be safe
I run, have trained for many long races, use a pump and have had very similar experiences. Did you run in the morning before you ate the scone? I ask this because I usually run before eating breakfast in the morning, and my usual pattern is as follows: when I test right after running, my blood sugar is usually okay, a little lower than before my workout; I'll eat and bolus for breakfast, and within an hour or two my blood sugar has gone up by a LOT. I am pretty conservative with correction doses to avoid lows, but when I workout in the morning especially, I have to monitor my blood sugar as closely as possible up until lunch, when things usually even out.
My endocrinologist has explained this to me - this phenomenon of a blood sugar spike after strenuous cardio exercise - and while I don't remember the physiological specifics, I know it is rather common. I'm always afraid of getting low while running (or driving to work after) so, as I mentioned, my approach to this is pretty conservative. I know that some people will adjust their basal for post-exercise and I am going to start trying that. My doctor has never recommended changing my carb ratio, but usually looks to the basal for problem-solving.
I don't run in the mornings for that exact reason! Or if I do, I have to be sure to eat an hour or so beforehand. My understanding is that it's a liver dump - if you do intensive exercise before eating, your liver thinks you need fuel. I tried morning runs for a little bit, but I had the exact same experience - I'd go for a run, come back, BG would be fine, then an hour or two later, I'd be up to the mid-200s. I didn't want to get up early enough to eat before, so now I do my training runs around 5 pm. I think maybe I just stressed my body out and it didn't know what to do with itself.
I think you are right. I have just never been able to get into a consistent after-work routine, I am too much of a morning person (or more like NOT an evening person). So I wrestle with this on a regular basis. And on the weekends, when I have more time in the morning and eat a snack before a longer run, I almost never encounter this, or at least not to the same extent. Maybe I will try a small snack on weekdays and see if that helps.
The Diabetic Athlete's Handbook by Sheri Colberg has some good (and surprising!) info on how your body and blood sugar work when you exercise. I haven't read the whole thing cover to cover but I've found a lot of good ideas for before, during and after exercise that helped explain some of the really weird things that seem to happen sometimes! Diabetic Athelete's Handbook
I don't have specific advice, but I can tell you that I've managed two marathons and I could not believe the screwy things my BG did while training! At least know you're not alone, even though its still really annoying! Everyone says to go get exercise- its good for you, helps you build muscles, pumps your blood, strengthens your heart and lungs, is good for your liver, reduces (sometimes) weight and cholesterol and insulin resistence- but it sure can wreak havoc on your bloodsugar in the mean time!
