So, I went up to the maximum dose of ozempic last week. Yesterday, I was due for my weekly injection that I had put off to taking after supper.
So after my one hour swim yesterday, my Dexcom alarmed for a low at my setting of 75. I noted it and thought I’d keep a watch but the next reading was 49!!! Yikes!! So, I treated with 10 g of sugar. It came back up.
So today, before I took a swim, I ate a small mandarin orange. I also ate some nuts after I got out of the pool. After I took my shower, I felt shaky and my blood sugar was 62. So, I treated myself and it went back up.
I am just wondering why this happened out of the blue like this. I’ve never gone low like this before. While I did start a higher dose of Ozempic the week before, yesterday was day 7 and the med should have been getting low in my system.
Of course, I suspect it’s the higher dose of Ozempic. My previous A1c was 6.8 and my average sugars have been running about 149 or 150. I think I’ll write to my Endo and ask his thoughts. I just wonder going forward if I need to pre treat before exercise with more carbs or a different carb. My blood sugar was about 115 before I started my swim. In the past, this wasn’t a problem, but I would often have a 15 g snack before just to make sure I didn’t go low. There are people here with much lower A1c’s than I have.
What do you do to prevent low’s when you exercise?? I was curious about this.
Hi jean63: I’m t1 for about 12 years now. I purchased a swim spa just to help me burn sugar. I eat a higher carb breakfast of flax, chia, and hemp seed(think oatmeal but better), and usually two turkey sausages. I bolus 2 units usually about 30 minutes before eating. I might wake up at 100 but within 5 to 10 minutes I dawn effect and end up at 120 to 150 before even eating. So, I immediately (within 15 minutes if possible) start my 20 minute hard swim against the jets. I have to manually test my bs after 20 minutes of hard swim. And it is always a surprise. Perfection is i am down to 85 and I get out and usually don’t gat dizzy. It can continue down another 15 or so points. If I get a reading of 100 I usually get out to be safe. Sometimes I’m still up like 130 so I swim another 10 minutes. Yes, very aggravating sometimes but usually get by with one strip. I do have libre and it is a big help but when bg is changing rapidly I just have to use strips. So I would suggest exercise right after your carbiest meal or in the am if you have dawn effect. If I start going back down below 120 before I swim I abort the swim. Why the wide range doing the same things? DIABETIES DARN IT!
HI Mark,
Congrats on the SwimSpa!!! Thank you for your response!!! You raised some good points. I think at this new dose of Ozempic, I might have to change things up a bit. Before, I was on a pretty low carb diet and all was fine. We swim in the afternoon and that’s normally the time of day when my blood sugar is the lowest. We really do like to exercise that time of day too, which is a shame. I am not a morning person. I am not olympic swimming either! I take it fairly low and slow. I wouldn’t mind “having” to eat a baked potato for lunch and exercising afterwards. Ha, ha, ha! I miss carbs but had to stay low to keep my blood sugars under control. I worry though, by adding carbs if I’d gain weight. And I will have to check my BS manually during exercise now. No, darn diabetes is not easy!!!
I am a T1 too.
Exercise bike. I use it to stall a climb or bring down a higher number than I like or I will take less insulin for my meal to be able to ride it afterwards. I can also eat something extra to be able to ride it, but I try not to do that. In my case I can adjust my insulin to ride it.
Swimming has been a trick for me. I usually swim 1-3 days a week for 2-3 hours in the ocean. What I was doing was reducing basal insulin on my pump and maybe a 12 gram snack beforehand to swim. But as I got used to swimming for long lengths of time I had to stop reducing my basal. I have a tendency to drop slightly the first hour and then my BG level climbs and climbs.
In my case it’s been problematic as it was explained to me my liver is dumping glucose to help fuel me after a while of swimming. But I have DP or FOTF, so I avoid eating in the am. So trying to eat in the am for fuel beforehand has been an issue as my Bg level skyrockets easily and then I have to have more insulin and time to get it to come down before I swim. I start my swim in the early afternoon. It does keep my BG level more even keel when I can get it to work. So I am still working on figuring it out. But our body does want fuel to exercise within a few hours beforehand or it tries to use the bodies stores.
Swimming is considered cardio and resistance training. Hence the drop but also the potential for the climbing effect you can get from intense exercise…
I am a T1 though and exercise can be a real trick for us to figure out. My hubby was/is a T2 under control and can just decide to go swimming with no issues. So I’m not sure what the answer might be for a T2 on Ozempic as it probably changes what you have to do too. It stimulates insulin secretion, blocks the liver releasing as much glucose and slows down digestion. It might take some figuring out too.
Do you take any other medications that might contribute to hypoglycemia such as a sulfonylurea or insulin. Below is a list of common sulfonylureas, they work by helping you pancreas produce more insulin.
- DiaBeta, Glynase, or Micronase (glyburide or glibenclamide)
- Amaryl (glimepiride)
- Diabinese (chlorpropamide)
- Glucotrol (glipizide)
- Tolinase (tolazamide)
- Tolbutamide.
Contacting your endo is a great idea he might want to adjust your medications. Possibly turning back you Ozempic or another medication you may be taking,
Good question Gary!!! No, this is my only diabetes med. I think I am just going to try to eat more carbs today before I exercise to see if that prevents a low. I have been on a pretty low carb diet in the past. Perhaps I can start to add some carbs back into my diet and see how it goes.
I am amazed that as a type 2 you have a CGM when you are not injecting insulin. This is a standard of care that most T2s can only dream of, you must have excellent insurance and an excellent doctor willing to prescribe it.
I would be careful when adding carbs back into your diet, doing so can be a slippery slope. If your diet is healthy and something you have become accustomed to it might be better to first consider adjusting your medication.
Gary, I was on multiple daily injections at one point when I had side effects to all the oral meds they had given me. But, I changed Endo’s and this one tried me on Ozempic and it worked for me with no side effects!!! I kept my CGM and hope that my insurer won’t stop approving it. I love it!!! I learned so much from having it. I tried the Freestyle Libra but it was very inaccurate on me. Yes, I think I did have a very good Endo to recommend it. My insurance didn’t approve it until I got on insulin however.
First off some one on this forum needs to invent a swim watch that allows the Bluetooth of the Dexcom to work underwater.
I had to start artificially raising my BS a little prior to going in the pool, so I didn’t go low by the end of my session. Oh I should mention I use a lap pool for up to two hrs per session. I swim for just over a measured mile. Early on but the time
I got back to the dressing from I’d be low or getting there.
Over the years we all have gleaned what we need to do to survey. And I for one have gleaned a lot from this forum.
Bluetooth won’t work underwater. The signal is just too weak.
Most signals including radio waves are also blocked by water.
You would need to come up with a new carrier wave technology that passes through water in order to get that to work.
I mean we all need to deal with the reality of physics.
If you can come up with something, something won’t kill people, then I think you will be a billionaire.
@John70 I ocean swim and I could not get the Dexcom to read. It just will not communicate underwater. But I have used a Libre before and knew you scan it. I put the Libre reader in a waterproof pouch and I can scan it while I’m swimming. That allows me to stay out in the ocean for 2-3 hours at a time and not have to worry about what my blood sugars were doing. I take gummy bears out with me to down if needed. I have ordered some vegan gel packs to try.
I still wear my Dexcom as it’s better… But I self fund the LIbre for swimming purposes.
Thank you for sharing that about the Libre, Marie!! That has inspired me to give the Libre another try. It just so happens that it’s time for me to buy my Dexcom 3 month supply and I am dreading spending all that $$, so I am going to give the Libre another try. Before, it did not correlate at all with the Dexcom so I stayed with the Dexcom. Maybe I gave up too soon. When I checked my blood sugar today against the Libre, it correlated nicely. With just having type 2 with my sugars under good control, I think twice about the price of the Dexcom. I do like the low alert though. It’s saved me a few times. So, I don’t know what I’ll do. I am hoping the price of the Dexcom 7 comes down like they say it will.
@jean63 Unfortunately the Dexcom is better and more accurate. I had a Libre first and was completely happy with it it, until I wore a Dexcom. I Now I wear both because of swimming.
Given that the Libre is a lot cheaper and if price is an issue, it is a wonderful piece of tech. I know plenty of people that use it as I have a bunch of friends in the UK and that is what they use there. By restarting the Dexcom you can lessen the costs some for it. I also used the Libre on my diabetic dog and had a miao miao attached to it for alerts and better accuracy, although I guess the new Bubble is preferred now.
The new Libre2 is more accurate and has a high and low alarm so that helps. It has been the same price as the 14 day Libre.
I’m a bit late to the discussion. I am an carb restricting, exercising type 2 DM. I have been on increasing dosages of Metformin for years, to the max dose of twice daily 1,000 mg. Sometime during this time I added Lantus and most recently MDI, Humalog.
When I started MDI I was having difficulty exercising, My BG could be 140+mg/dl and in 15 minutes it would drop quickly going hypo if I continued.
I spoke to my doctor about cutting the Metformin in half. I was really thinking about the GI issues with that drug. It has helped with the gastric issues some, but what it did was make it where I can ride 2 to 3 hours without danger of a hypo.
Metformin does not affect stomach emptying like Ozempic or stimulate the secretion of insulin, but it reduces glucose release from the liver and increases insulin sensitivity. I doubt my Beta cells have much ability any more to secrete much insulin.
Back to you, I wonder how much the stomach emptying delay has on increasing BG. You might need to consume the pre-swim carbs earlier to get the effect you want. This means paying attention to your CGM. Good Luck.
My uncle was part of a team that worked on ways to communicate with submerged submarines. It required a huge amount of power and ultra long wave transmission.
I don’t think there is any way to make a small device like a CGM sensor and transmitter to reliably transmit under water.
The technology that Apple and Samsung are developing to use spectrographic analysis of blood through the skin is not likely to work well with water between the watch and skin. Maybe they will come up with a watertight seal between watch and skin.