Help


#1

OK - so I need help. I have been really stepping up my exercise routine - typically hitting the gym everyday for at least 35-50 minutes of cardio - and training with light weights every other day - once or twice a week, I’m taking pilates.

Here’s my question. I am having to eat A LOT to maintain decent bg during work outs. It seems a defeat of part of the purpose - weight loss.

I wear a pump, but I can’t figure out exactly how to time a disconnect to avoid the lows - and to avoid bouncing up during or after the work out.

Any suggestions from you guys?

Thanks in advance!


#2

There are many techniques discovered by trial and error.

Personally, I exercise after lunch. I reduce my bolus by 1 unit if I’m going to be exercising in the next 30 minutes and I remove my pump.

You don’t way what you mean by ‘maintain decent bg during work outs.’ Since you have to eat a lot I assume you’re trying to avoid lows during a workout.

One technique that people use is to use a 50% basal rate for the two hours before exercise and normal bolus during - but that was a marathoner.

Another technique, if you’re going low, is to eat less before exercise or reduce your bolus. John Walsh’s book “Pumping Insulin” (which you should buy) has a section on exercise in which he discusses Ex-Carbs - carbs you eat to prevent going low and which you substitute for you insulin. For example - if you’re going to run for 30 minutes and you weigh 135 pounds, you can eat 45 grams of carbs without taking insulin to cover for them (the numbers are made up for the example - don’t try to use them.)

To keep the pump from bouncing around during exercise you can wrap the tubing around the pump and put the pump and tubing in one of the many devices designed to hold an iPod or MP3 player, then attach that to a tight fitting elastic belt. If the pilates are not real vigorous you can just put the pump on the floor beside you.

Good luck,

Terry


#3

Hey Nicole,
I had the same problem when I first started riding a lot, and it can be really frustrating. I reduced my basals for a while, by about 25-50%, but never quite got it right. On the bright side, I have found (and heard from others) that once your body gets used to the increased activity level the lows don’t happen so often. Also, keep in mind that when you put down more muscle you’ll be burning more calories, so the extra calories you’re taking in don’t necessarily defeat the purpose :slight_smile:

One thing I’ve learned is that anaerobic exercise tends to make my BG skyrocket - so, sometimes I’ll push myself really hard before doing endurance exercise and then I don’t have so many lows.

Pumping Insulin is a great resource. Another book that really helped me is The Diabetic Athlete by Sheri Colberg.

Good luck!


#4

>>Pumping Insulin is a great resource. Another book that really helped me is The Diabetic Athlete by Sheri Colberg.<<

I second what Sara says. It’s also a matter of trial and error. I usually take the pump off if I’m exercising less than 45 minutes and cut my rate in half if exercising over an hour. You can also eat something light before you exercise.


#5

You are not alone in this. I just went on the pump this week and things are much better when I work out. But I too am working towards a weight and fitness goal for myself and was finding it frustrating to have to eat to keep up my blood sugars. Right now I have to turn my pump down to 25% as the 50% is still too high. Lifting weights and core classes also suck the sugar right out of my blood.


#6

I had this problem in a very big way when I started exercising seriously about 10 months ago. I was burning 600 calories a day on the spin bike, but eating 250-300 correcting the lows during and after exercise, and then going very high a couple of hours after exercise. Unfortunately, trial and error is the only answer, since we are all a little different.

I tried everything – 50% basal for 2 hours before exericse (but that meant having to know when I was going to have the time to exercise), extra carbs before exercise. But I was always going very high in the two hours after exercise. What works for me now is about 35-40 g carbs about an hour before exercise and a 120% basal rate for 2 hours beginning one hour before the exercise – I have a 1-2 hour delay before the insulin takes effect.

Also, if the exercise is weight training, I find that I do not need to make any adjustment,


#7

Jonathan,

I just joined this group so please excuse me for being stupid!!!

I am a type2 diabetic using insulin. I was surprised to find someone else with highs after excercise.

Are you saying that during/after weight training that you have lower blood sugars? I am trying to find a good way to keep energy up during a workout. So far I’m sucking down the gatoraide.

If you have suggestions please post comment… Thank you


#8

I am a type 1 diabetic. I use the insulin pump now. But when I was taking injections I had a tough time working out. First I would crash and then I would go high after the work out. I did some research and the reason was this:

You are taking two kinds of insulin: one long term and one short term. This type of insulin does not shut down when your body works out–it keeps on going. When you work out your body uses other channels to absorb glucose. This is why exercise is so beneficial to diabetics as it strengthens those alternative sources and also reduces insulin resistance. Anyway, when you work out, your body absorbs the glucose through these other channels and does not need the insulin. The problem is that the insulin is active in your system and is still drawing all of the available glucose as well–which causes you to crash. Insulin stays in your system, anywhere from 3 to 6 hours for fast acting and regular insulin to 8 to 24 for the long term insulins. So it is always working for you under normal days. When you exercise the use of glucose is sped up and so you begin to crash. (Clear as mud?)

So you are working out and you crash…even though you are supplementing with glucose, gatoraide, when you stop working out you find that you are high, why? Well, whenever you crash, your body responds by sending more glucose into the system from where the body has a reserve, the liver. You crash, the liver release extra to compensate. If you have already compensated, you get a double dose and a high blood sugar.

So how do you change this?? If you find out let me know. I am better, but still have not perfected a system yet.

When I took r and n, I waited to work out at a time when I knew that both r and n were not at their strongest in my system–somewhere at around 6 pm. I tested my sugar often, and I made sure not to begin unless my blood sugar was somewhere in the 140s. I would eat a snack 30 minutes before and bring my gatoraide. When I was done working out. I would make sure to test my blood sugar and eat dinner taking a dose of insulin with it.

Now that I am on the pump, I test my blood sugar and shut the pump off a full 30 minutes before I begin to work out. I do my workout–I still need some supplementation with glucose, but not as much. I still eat a snack before. When I am done. I wait until my heart rate is back to 119 and then turn my pump back on. I don;t seem to crash as much, and I don’t have the highs after the work outs like I used to either.

There is a really good book out there called The Diabetic Athlete. I highly recommend it. It has strategies and solutions for both Type I and Type II diabetes. But I also recommend that you also discuss these issues with your healthcare professional. They might also have some insight to help you out as well.

Good Luck, DD


#9

The Diabetic Athlete is a great resource, but your endo and CDE are the best people, even though they may be as stymied by what happens to you, because we are all different, and what works for one of us may not work for someone else. Plus, as we get in better shape, have less fat that we are carrying around, and become more cardiovascularly efficient, the way we process blood sugar changes.

The key is to test often before, during and for two hours after exercise, track the patterns, and then try to address them. The frustrating thing for me is that as soon as I find something that seems to work, it stops working.

Part of my problem with post-cardio-exercise highs was the reduced or stopped basal kicking in much later, driving my blood sugar up. The exercise was not enough to bring it down for a sustained period. I try to start exercise with my BG around 185-190 (I know that is too high), and aim to be around 80 when exercise is over.

With pure weight training, I have mostly protein to eat before it and now only see a minimal change in BG levels as a result of the exercise, but an increase during the 2 hours after, unless I workout with the higher basal rate.

Confusing enough? Next week, it will probably be different.


#10

I absolutely agree on checking with your endo. I also agree on the comment that next week it will probably be different. I think the key here is to keep on trying and keep on testing…it is the only way you will know for sure what your body is doing.