I was diagnosed type 1 about 3 years ago, started pumping about 1 year ago, and started running about 3months ago. Right now my runs are 30 min or less and i am taking my pump off completely during the run. My issue lies with eating the right amount of carbs before the run. I typically eat very few carbs all day then have to eat something completely out of my normal menu before aeven a short run. I have found that getting my BG up to about 175-225 will get me right back into the 80-100 range after my run. What are others eating/drinking before runs or workouts? Sometimes I feel like I'm eating junk just to run and burn it off.
Trial and error. You may want to consider stopping the pump, or setting your basal down to 50% or less, before you start running.
You can NEVER discount the usefulness of a CGM for this situation though. Of the three people I see daily who have gotten a CGM, all three say they could never live without it. I feel the same way. Getting over 17000 BG readings in a day gives a whole new perspective on how food, insulin, and activity affect sugars.
I love the idea of a CGM, just not sold on the cost/accuracy yet. If I can keep up the running/work outs for a while I could probably justify the cost.
Yeah, you need to accept that it won't be accurate. Even the newer ones. My accuracy is affected by water consumption, (dehydration makes it less accurate,) how quickly my sugars are dropping or rising when I calibrate, and how long the sensor was sitting on the shelf before I started using it.
Thankfully, Aetna covers it at the same rate as Pump supplies, and Minimed only bills me for the coinsurance portion, not the deductible. The Minimed sensors are marketed for 3 day use, but I find mine work best on days 3 through 7. So I use about 45 sensors a year, and don't pay much for them.
i wasn't aware of the dehydration thing, thats good to know.
I'm a federal employee and while my insurance (BCBS) is good for most things it only covers 70% of my pump and cgm (if i had one). I think I figured it to cost me roughly $1k for the first year which included the unit. Price isnt really the issue though, if it is going to meet a need I'll get it. Before working out and running I didn't see the need, i just checked 10 times a day.
My husband is a Federal employee with BCBS. I became LADA (Type 1) three years ago, too. You saved me from figuring out the potential cost of a cgm. Thanks! That was good info to know. I don't do insulin, yet, and eat <30 carbs per day. I do intense Zumba classes for one hour. I never go low, though. I consumed FAGE full fat plain yogurt with some sunflower seeds and truvia before I exercised and only went down to 90 last night. I think I'm stil eaking out a bit if insulin. Right now, extra vegetables seem to work for me before Zumba or something like cardio kick boxing, too. I''m thinking of asking for insulin only because no matter what my intentions are, I cannot make the gym more than 2-4 times a week.
Just an FYI, theres two levels of BCBS and I have the lower one.
What are you taking if not insulin?
Not to jump on Sheila's toes, but (AFAIK) often times, LADA takes a while to fully wipe out the beta cells, so with exercise and diet, LADA individuals can postpone taking insulin for a few years.
My uncle recently was DX'd with LADA, and my aunt thinks she is some witchdoctor, so she comes to me and says, "He can keep his sugars around 175 by using my special formula of vitamins and this special fruit juice. You should try it too, you could stop taking insulin." I feel bad for the guy, when he finds out that he can't keep 175's forever. All I can do is keep my distance I guess. Some people get so into alternative medicine that they can't recognize when it isn't working.
One of my coworkers is a fed for the FAA (I'm a contractor) and she just got the Dexcom 7. She's had it less than a week and already says she can't live without it.
You've said what you do with your carbs, but not what you do with your insulin. Are you on injections or a pump? If injections, which insulins and when?
This is a very important part of managing exercise.
You may want to take a look at this article for information about figuring out a specific carb/exercise ratio, but remember the equation really has to involve at least carbs, exercise, and insulin.
As an example, with a pump, I reduce my basal rate by about 50% an hour before a long run, then take in about 20 grams of carbs an hour.
If I was on injections, I might reduce my long-acting insulin on the days of a run of 18 miles or more.
For all runs, I'm very careful with mealtime insulin. I try not to have a meal close to a run. If I have to eat within a couple of hours of a run, I reduce the insulin to carb ratio.
If I find myself starting an unplanned run, with more insulin than I would like in my system, then I eat right before I start.
I no longer drive my blood sugar way out of range just to keep from going low. I understand the fear. I used to do that. But it's really not necessary. Have some juice or a gel or even glucose tablets before starting, then carry and use more food on the run.
This am I woke with a BG of 86. Took my regular daily basal Lantus (18 U) and 2 slugs of OJ and went out for a 2 hr 60 Km ride (flat, minimal wind). The only fuel during the ride was 8 baby carrots. When I got back BG was 63. Which is what I would have figured as I typically drop 10 pts/hr of riding for at least the first 2 hrs. Beyond that time/distance I'm not sure yet as I haven't done longer rides. Carrots were a poor substitute for a banana but it was all I had available at the time and was curious if it would bump my BG at all which it obviously didn't.
Nothing. I eat low carb and exercise, but my low carb is following Dr. Bernstein, who is stricter than most. I don't eat any fast acting carbs, ever. I started doing this as soon as I thought I may be diabetic, before the tests came in. It seems to have preserved some pancreatic function. I've been doing this 2.5 years. It is just a matter of time before my pancreas loses all function. I know that. I tried taking Glucophage XR, but it does absolutely nothing for me. I'm going to ask for a small amount of insulin in a couple of weeks. Yes, exercise can keep me at a waking fasting bg of 90, but I am needing to skip days between workouts because of the arthritis. If I consumed readily available carbs before working out, I would get so thirsty, that I would spend half my time grabbing my water bottle.
Oh, for sure, miketosh about the LADAs - latent diabetes of the adult. They understand it so poorly because we don't have large numbers to study - and many are misdiagnosed as Type 2 until it is too late to preserve their pancreatic function. I was lucky. I argued with my Endo that I thought I was diabetic. He tested me to prove me wrong. My antibodies said it all. LADAs have great variability. I have comorbid autoimmune thyroiditis, Hashimoto's, and have antibodies that suggest I'm brewing RA. I did not become LADA until I was 56yo. It is not as aggressive in the destruction as someone who gets it at 5yo.
Honestly if I go longer than 30 minutes without my pump, I go high... I learned somewhere that aerobic exercise releases insulin resistant hormones while you are exercising, so with that, I used to keep my pump on (with about 30% lowered basal) and would not eat before a run. I would also run with some dextrose tabs on me, which I occasionally needed. Everyone is different, this was my experience, and hope you can figure something out!
Welcome to working out and pumping! It's definitely a process of trial and error. I ride my bike a lot and am now training for a 1/2 marathon in February. I really started riding hard and training for triathlons about a year ago. I use to take my pump off before all of my bike rides until I started talking to some other diabetics and reading more about it. Ideally don't take your pump off, turn it down. Trial and error will tell you how much. Your muscles can take up glucose without insulin when you're working out, but are more efficient with glucose on board. Not to mention much more highly sensitive to insulin while in action. This will be more important if you ever get into longer distances/times.
The following are my current guidelines (not hard and fast rules): In my experience I have to pay attention to 3 main things to not have a low during a run: 1) I pay attention to when was my last meal was, like miketosh mentioned. I won't run if I've bolused more than 2u in the last 2 hours, it always ends in a disastrous low. The rules are different for everyone of course. If I feel like going anyway and it was around 2 units and under, I'll eat about 20g of carbs. 2) Decreased basal rate. I turn down my basal rate about 1 hour before the run. If it's less than 30 min run I set my basal at -30-50% (depending on intensity), if it'll be greater than 30 min I'll set it at -70-80%. And finally 3) Duration/intensity of run. If it's less than 30 minutes I don't usually eat, if it's longer than 30 minutes I'll have a few glucose tabs and a clif shot, or a banana. Then I'll eat about 7 g of sugar every 20 - 30 minutes depending on how I'm feeling and what my CGM says. My current favorite running carb is Trader Joe's Kettle Cooked fruit chews. They're soft, and compact and about 7g of carb per cube and super super tasty. :) Not sure of the sugar type (aka how rapidly absorbing), but I'm sick of glucose tabs at the moment.
Good luck with the running. It's a lot of fun and worth the bg hassle! And of course when I say trial and error, error means bg's in the 50's 2-3 miles away from home. I wear a spibelt http://spibelt.com/?gclid=CKWjqLeIuq0CFWgaQgodYCQv_w. And put my food and fast acting glucose in the pouches, even when it's just a short run...just in case...And as long as I'm talking about safty, I also always wear a medical ID.
Hope some of this was useful!
I pretty much stick to a low carb diet all day, but use some caffeine to get me through work outs and soccer. I know it's bad :-( However, to avoid the swings in BG numbers and fuel any activity late in the day, I'll eat a whole wheat bagel and banana in the mornings. That usually gives me enough fuel and I won't burn out. Throughout the day it's lean meat, chicken breast, turkey meat, etc. Anything but the white breads but stay low around 20-30 carbs per meal or snack. High protein keeps the munchies away, but eat small meals every 2-3 hours.