I start the "DO IT" program at the Joslin Center in 7 days. Never did anything like this, but this one makes me very nervous. I am good at learning new things and adapting and am looking forward to new perspectives.
BUT I don't exercise, because every time I do I suffer for days with low glucose--really low (below 40.) Gardening, leaf raking, baseball, sightseeing, etc. turn my control inside out. I had to walk up 890 steps during vacation and had problems for days. Part of "DO IT" is an hour of exercise everyday.
Caveat: When I was diagnosed, exercise was taken off the board. I was no longer allowed to play softball, field hockey--I was even removed from gym class. It is mentally ingrained.
I will be alone. In all my work travels by myself I did well--15 years of on the road excursions, but there was no exercise. I am worried that this will be a major problem for me and, honestly, I am terrified. I will hit a grocery store for evening snacks, juice for lows, etc.
I was also diagnosed in the time before home bg meters when exercise was widely viewed as lethal to a diabetic.
That said, I took up regular walking not long after that, and feel it really helps me in many ways.
I really have to incorporate it into my base thoughts about bg management. Not as an afterthought but as a base part of it. If I don't get exercise for more than a day or so, my basals and I/C ratios go way way up. And if I doextensive outdoor or indoor work (e.g. painting the house, raking leaves, for hours and hours, nothing intensive but long-duration) I have to drop all my basals and I/C ratios dramatically.
A few people have shown up here and told me that if I have to adjust my basals and I/C based on exercise history over the past day or so, that "I'm doing it wrong". Well, that's just the way I work, and I've got 30+ years under my belt doing it, and I suspect others do it as well.
Every so often I think about quitting my desk job and getting a job that required me to walk extensively. Mailman :-). I think it would be a good change for me.
Hi Spock. Every time I hear stories like this, I thank everything that is holy for the world renowned pediatric endo that I had. Exercise was required (besides, how could I go to summer camp without it?). This was back in 1966. I tried the endo in my new town after we moved and he tried to get me to quit figure skating because I was going low between breakfast, my morning skate, school, and then lunch at noon. I was about 14 at the time. So I used my training from my old endo, ate half my brekkie before skating, and half on the way to school. So I was fine.
Keep lots of glucose tabs or whatever (I love Starburst candy). Do It will teach you how to handle insulin adjustments, exercise, and food. A whole new world will open up for you. I know lows can be uncomfortable, but these folks will look after you. Test a lot and you will get the hang of this. Have fun and then move on and find something you enjoy. Maybe a bike ride with a loved one in the summer?
This may be a simplistic idea and you may have tried this but have you tried eating carbs before and after exercise? I eat pieces of candy and protein snacks throughout the day and this seems to help stop the bad lows for me. I also only do walking, gardening etc. Nothing too strenuous but I'm going to add bicycle riding back in soon.
Am much more of a newbie than you are at this point, but my thoughts: Even though the exercise is making you nervous, it's really a perfect opportunity to expand your horizons in a bit of a safety zone. You'll be traveling alone, but once on location will be surrounded by experienced people who are there to help you get over that hurdle. That's why you're going. It's exciting!
I forget whether you're MDI or pump, but in either case less insulin prior to exercise will help. And definitely make use of those post-Halloween candy sales. My go-to is smarties - doesn't taste good enough to want to eat too much, but is basically pure dextrose; one roll is 6g of carbs.
Have a wonderful trip!
Schedule exercise for after a meal. Give a bolus reduced by about 25% for that meal.
Exercise an hour to two hours later.
After exercise, treat any low(er) blood sugar.
Set a temporary basal rate over the next 8 hours of -10 to -20 percent.
If I continue this for more than a day, I will also lower all my pump settings including my I:C ratio, ISF, and basal. Also, if I have more than about three lows in one day then I'll lower settings even further.
Exercise has a HUGE impact on blood sugar and pump settings for me, as others have mentioned. Definitely something that needs planning and adjustment.
Do It is an interesting program.. They will get you through exercise.. and how to deal with it.. Do not like how they do not validate parking... its a bit pricey to park for the days... Bring some juice and some small snacks with protein in them for the car ride, but youll be alright once your there... stressing will only make it worse...
Best Reply Ever!! Exercise was never restricted for me, and it is an important part of my every day. I'd rather skip a meal than skip a walk or a hike. Snacks are hard to carry around, so I pack glucose tabs, or smarties. Do It and you will learn to Love It!!
I wouldn't worry too much about the exercise. The staff are very good; you'll test before and after exercise and they'll probably insist that you take a 15 carb snack if you're under 90 either time. The exercise program is individualized and you'll be allowed to start off with something like a slow walk on a treadmill if that is what you're comfortable with.
Have fun - Boston can be lovely this time of year,
Have you tried tai chi. Dr. Paul Lam has a tai chi for diabetes programme, you can buy a dvd from his website. Realise this may not help you on the DO IT programme, though.
Wow, that's unfortunate that society wasn't able to help you more and that you've carried it with you for this long although when I was a teenager, I listened to horrible heavy metal music and still do that pretty regularly.
Re exercise. I have done quite a bit of it and I suppose I just blast through stuff. Certain things, like big races, I will bring my meter along in Race Ready Shorts which were rx'ed by Jerry Nairn, a star of the Sherri Colberg book who has run dozens of marathons, 50-60 or something like that, which is a lot for anyone, diabetes or not.
Most of the time, I will just rely on my CGM an a few little bags from the craft store (like $1.00 for 100, which will last me for > a year...) bags of jelly beans and Smarties that I've arrived at as a very portable solution. I disagree with eating and cutting boluses. I like to clear out IOB and have flat BG. For 3 miles, I'll fuel with a glass of skim milk, maybe 6-8G of carbs and that's about it. It will nudge my BG up an trigger the "predicted high" about a mile in and then the "predicted low" as the milk seems to burn off. I am glad that Maurie has shared that they will support you through "Boot Camp". I hope you can make the time to get the Big Blue Test App and log your results! It's an interesting time of the year as it sort of slogs along then as 11/14 approaches, events will pile up the tests. It would be great to count yours!
I appreciate your feelings about exercise, but perhaps you have built up a binary view of exercise. Either you are walking up 890 steps or you are a couch potato. Perhaps the way to approach it is just one step at a time. So you can't go do a gym class, but you can go to the grocery store and walk through every aisle. Right? That is exercise. Or once a day, take the elevator one floor below your target and walk up one flight of stairs. Every day. Then when it becomes routine, add another flight. Once you can do that and feel like you have control, then step it up. It is entirely valid that going from zero to 60 with exercise causes a huge imbalance. For someone who is not glucosally challenged, they will just walk around sore for days. But for us, the lows and changes in insulin sensitivity are much worse. So that is my second point. Don't look at exercise as a single event, it is a continuous and ongoing change in lifestyle. As your body slowly adjusts to being more active, you will need less insulin and be more fit, and while you may need extra snack and you should over time experience smaller swings. It is really true, your body adjusts to exercise and it becomes the new normal. Just take it one step at a time.
I actually do a lot of those things, such as park in the outreaches of a parking lot. I am quite active, but not in a get the heart rate up kind of way.
