How to manage post work-out BG highs

You might need more carbs before the workout, but the dinner bolus also helped make that spike so drastic. Possibly if you had done the exact same thing but waited a little bit on the dinner bolus, it would not have been so bad.

If I am low and dropping, I wait on my dinner bolus until right when I start eating, or right after. I don’t bolus too soon before.

Yes, I agree, you probably need a bit more carb before you begin your swim to prevent the low down to 50. Either a larger bit of Snickers, or a couple bites of cheese, something to carry you over the full hour.

eddie2
thank you for your ideas and your suggestion. today i think i might try and have a little more of the Snickers bar. i was considering a can of tuna or some hard boiled eggs and some avocado before my swim, but i will see how hungry am.

also, i will do as you suggest about the dinner bolus timing. we shall see; experiment number 15 :wink:

i am not much of a prayer type of person, but i do say this one prayer every day and it goes like this: “God, grant me the serenity to accept the things i cannot change, the courage to change the things i can, and the wisdom to know the difference.” i think that that is what i am doing now. i dont want the D to beat me out of something that is not only healthy, but possible. i have hope and i am not going to let that go. wish me luck!!!

Do not ever quit! Never.
How long have you been a diabetic?

Remember, all this stuff isn’t just a science. It is more of an art.

this is embarrassing to admit, but i have been D for over 30 years. been pumping for 16+. for quite a while i was able to run and i would wear my pump and just set a temp basal for about 25% and drink diet gatoraid as i ran. strenuous exercise; i really pushed myself. but i NEVER had any kind of spike afterwards as i am now. this is all so baffling and so new to me.

and PS: i just ate 2 hard boiled eggs w/out a bolus to see how high that will bring me (i always need to bolus for eggs; no clue why, just do) i usually count 10gms carbs for the eggs. if my BGs are not over 150 in 1 hour, i will add either peanut butter or some of that Snickers bar.

I think part of the difference is that you take your pump off when swimming, but you did NOT when you were running! Remember - basal delivered NOW is insulin used for the next 4 or 5 hours!

Maybe consider trying a waterproof holder and wearing it while swimming? If nothing else, just as a test to see if it helps your post-workout spike?! If it helps, then maybe we can figure out an easy way to wear it.

here’s where i get confused: if i dont take my pump off until right before i swim, and i only am detached for an hour, then why isnt that basal already working in my system even AFTER my swim? i mean, if i detach at 3pm, shouldnt that basal insulin be in my system for at least the next 2 hours? and, if so, shouldnt my “spike” happen hours later as opposed to right after i reattach? this puzzles me.

I love your attitude and your prayer, @Daisy_Mae! Yes, I’m confused about the basal, too, seemingly not doing its job after your workout. But I think @Eric2 is right the spikes must be related to detaching the pump since you never got spikes running. Let us know how the eggs work out for your workout. Fingers crossed.

The pharmacodynamics graphs for subcutaneous insulin show that about half of an insulin dose is used in the first hour. The remaining half is used over the next several hours, because of the way your body absorbs it.

In your case, you are working with an hour’s LESS insulin. And the previous hours of basal before you detach, only about half of that is effective while you are swimming.

As an experiment you can try to make-up for the missing basal. A little up front, and the rest after.

Say you take 0.60 units of insulin per hour for basal. That’s 0.60 units you are missing. So what if you took a 1/4 of it before, and 3/4 of it after? So before you detach, you bolus 0.15 units, and after you re-attach, you bolus 0.45 units. That makes up the 0.60 units you didn’t get from basal while swimming.

If that doesn’t work, maybe 1/3. You can do 0.20 up front, and 0.40 after.

ok, so here goes: tried 2 hard boiled eggs, waited 1 hour, not one point budge in BGs. so, went for the Snickers bar; cut off a thick slice, waited 1 hour, not a budge (137) called my endo nutritionist; she said DO NOT GO SWIMMING at 137; that i need a longer acting carb mixed with protein. she even suggested eating a slice of pizza. (thats like 65 gms and a dual bolus for me !!! is she nuts? )

i dont want to give up yet. its only 4:15pm where i live (it is pouring rain outside, though) (what a great excuse to stay in :wink: )

i will forge onward !!!

Ha! I’d drive her nuts! I should send her my exercise log! :joy:

eddie2-
waited out the effects of the chocolate from the Snickers bar; i think i am on to something: my BGs went up to 188, so i was prepped to swim. walked 15 min to local Y, jumped into the pool and swam for 1 hour. post swim i was 75. walked home, still in perfect range. bolused for dinner, and now we will see what happens. i do like TRYING’s method of 1/2 a banana pre-exercise. i think i will try that with some peanut butter as soon as my husbands bananas ripen. sounds yummy. (i dont particularly care for candy bars)

and PS: my nutritionist can be a little bonkers with her methods and suggestions sometimes. you keep doing whatever works for you, no matter how kooky. (send me some of your info; i would love to see some of it ) :wink:

Hey, good job today! It’s awesome when you hit it right. Crazy how it’s like we all have a totally different disease. I rarely eat right before exercise, unless I am dropping or low. You guys are trying to eat the exact right amount. It’s all different for everyone!

BTW, if you are looking for a combination of sugar and fat, now is the best time of year. Eggnog! :yum:

Congrats, @Daisy_Mae, for the great workout and bd results with no low and no spike. I hope your evening meal goes well, too. @Eric2, if you don’t eat before you exercise, how do you keep from going low? Do you reduce your basal? I’ve tried temp basal but it requires a lot more planning and seems more complicated than simply eat something.

It’s crazy, but I don’t lower basal for runs, which it seems most people do. If my BG is flat, most of my workouts don’t lower me. If I run fast enough, my workouts spike me.

So the science behind all that (I think) is that your body releases stored reserves for energy when needed. But at low effort runs, you don’t need the release of stored reserves. You use some carbs, but you also use fat for some of the energy you are expending. So part of your fuel is from fat and some is from carbs.

Fat is a form form of energy storage, but it requires oxygen to use that energy. So you will partially use fat when you are doing aerobic work, such as a slower pace.

At faster paces (like your body thinks it’s being chased by a bear), survival kicks in. You don’t use fat for that. To ensure your body has what it needs, your body releases stored reserves. That’s where the spike comes in.

There is a speed where my body dumps EVERYTHING out, and my BG will spike like crazy. I’ve seen it go up 100 points in 20 minutes with absolutely no food. It’s like my body is saying, “As fast as your heart is pounding, you must be in trouble! Here is all the fuel I can give you. RUN!!”

So the short answer, why I don’t need to lower basal, I think is just that I am running at a particular pace that my net burning of carbs and my net release of carbs somewhat cancel each other out.

Thanks, @Eric2, for the descriptive explanation. Sounds like you are very well in tune with your body. All of what you say makes sense but applying it is more difficult. I don’t know what that perfect speed is to even out carbs burned and carbs released so I guess I have to resort to lows and spikes and try to minimize them as much as possible via extra snack and insulin. Everyday is a new experience!! :slight_smile:

I LOVE EGGNOG :blush:

Trying,
i am totally on board w/ you about what makes sense and what actually works for us as we are all different. i ended up waiting the SNickers bar out last evening, and finally got my BGs to 188, came down to 75 and didnt spike at all, even throughout the night. i would really prefer the banana with peanut butter but i have to get them to ripen first. i’m going to go with the Snickers bar again this afternoon. perhaps it was the fat content in the candy bar that helped to keep me stable. who knows. i feel like i should have a doctorate degree and practice as a rocket scientist in D mysteries.

Well, it’s not like I have a perfect BG all the time when running, I still have my share of ups and downs! :scream: It’s just in general I don’t drop every time I run, which always seems to be the concern with those recommendations people have about eating before you run.

If I follow the recommendations here - http://www.excarbs.com/ I am guaranteed to end my run with very high BG! But you might want to look at that site and see if their recommendations work for you. It’s a free site, and you can read their recommendation without actually following it.:relaxed:

If you have access to a treadmill, there are some tests you can do to figure out at what pace your BG starts to rise. That’s how I figured out the exact pace. The trick is to be perfectly level before you start. No food or insulin on board, only basal. Make sure your BG is as flat as possible. Start at a comfortable pace. After 2 minutes test your BG (no stopping, test while running, and do an actual BG test, not a Dexcom reading!). Increase the pace about 15 seconds per mile and after running another 2 minutes, test again. Keep going, no stopping between any of the tests or speed changes. At some point, when your body gets to the “Oh crap!” stage of running you will see a spike. If you get tired and never get to the spike, then try again another day and start at a faster speed than you did the first time. Eventually you will get to that pace where you see a spike. It may take some time and repetitions to figure it out exactly. And be warned - the pace where you spike is NOT a comfortable easy space. It’s going to be pretty fast.

Once I had become confident in the exact spike pace, I did a demo for my wife. She was handing me the testing stuff and she was freaking out. I started at a flat 60. My BG was dropping early in the run, and I got down in the 40’s and she was begging me to stop. I kept going and I said “Watch what is about to happen!”. I kept increasing the pace and a bit later my BG had jumped to above 150. It was such a cool graph to look at, knowing it was ALL running that did the spike, and knowing exactly where it happens.

For me this was an important thing to discover because it gave me a lot of confidence. I have actually been below 100 before a 5k race and taken a small dose of insulin right before the starting gun, just because I knew what was about to happen. That takes confidence, which eventually you can get when you see it enough times. (If you take insulin in that scenario, you BETTER make sure you run fast enough, otherwise you will be in trouble because you will plummet like crazy!!!)

Wow, thanks so much for the running tip to figure out the ideal running speed. I don’t have access to a treadmill, but I suppose I could do this anywhere using a stopwatch, or my Sony smartwatch. BG fingersticks might be tricky while running though! I’m really impressed with your ability to do this and also just for figuring this out, too. I will probably need several trials to come up with a good time. I usually run at a comfortable speed, whatever that happens to be for that particular day given how I am feeling. I almost never run faster than I am comfortable at. I guess this is the reason I don’t always spike. I spiked today by about 100, going from 60s to 150s. Thanks for the link. I am going to check it out to see if it will help me. I had read somewhere that if you do experience a low while running, it is better to increase the pace which should increase the BG. I don’t think I have ever experienced this though in my running, at least not that I was aware of. I’ve only been using my Smartwatch in standalone mode w/ the Dexcom sensor for a few months. Until then I was really unaware of my BGs since I did not carry my cell with me. So, I can definitely believe that your BG went from 40 to 150!