Intense Anerobic Exercise (weight-training) and Basal Rate/Bolus Modifications

Hello everyone, I just started a pump earlier this week, and I have to say it is the greatest thing to happen to me yet. I know I’m just beginning but I can already see the brilliant aspect of this little device.

The research, as I’m sure some of you are aware, in regards to anaerobic exercise is rather scant. I’ve read all the exCarbs literature and seeing as I do very little aerobic exercise, that information is rather useless. Everything I’ve found is “inconclusive” as per the effect of anaerobic exercise on insulin efficacy, basal rates, glucose release etc. etc.

I had my first workout on the pump last night, and was happier with the result than expected. I weight train at intense weights. 80-85% of my max weight, low rep, high intensity. This is about the most intense anaerobic exercise you can put your body through. I always find a more severe effect on my blood sugars and absorption profile than what I read from people doing other less intense anaerobic activity. Are there any like-minded weight lifters here? I am still unsure as to my post-workout levels and what I should be doing with my basal rate.

I bumped my basal rate, two hours prior to my workout, for a total of four hours, at an elevated rate of 20%. I also bolused 6 units of Humalog right before my workout to account for the quick increase in blood sugars I always experience during a workout. I tested right before my workout at 7.8 mmol/L (~140) and ended up at 10.4 mmol/L (~188). I am thinking of trying 30% basal increase for the four hours, and keep the bolus the same.

What do some of you do?

Well, I’m not on a pump, but I do follow a similar weightlifting routine (5x5) with compound lifts. I really think you need to consider your pre and post workout nutrition in your thinking. Your blood sugar will likely react very differently depending on your nutrition. As to ExCarbs, I am not sure that approach works on anaerobic exercise, my impression is that it is focused on aerobic exercise for someone who is carb adapted. Perhaps other pumpers can speak more to these issues.

Hmm, I don’t know that I’d consider a 50 pt rise in BG due to your routine to be the problem, neccessarily. I might suggest that starting your routine in at 140, even after bolusing, might be more of the issue. Maybe shoot for a lower starting target, like something in the 80s?

I guess the other question I have for you is how much are you progressing on your current work-out plan? Of course we are all different, but 80-85% at low reps might be part of the issue if you are doing that all the time. Mixing things up with lower weights and higher reps will still give you a good anaerobic work-out, but switching up the routine usually stimulates muscle growth more than following the same routines to plateau. You might also get a different and more manageable BG response.

For me, adding cardio was the key. I run, doing intervals at 80-90% max for 30 to 40 minutes before I lift. The cardio drops my BG so I’ll usually start my weight routine somewhere in the 60s or 70s. The cardio also, definitely, flattens out my BG response from the weightliftineg so I might not get a rise at all. Even if I do, I’ll get a slight increase, somewhere around 20 points, and I’ll bolus and eat a normal meal an hour after working out which seems to blunt any post workout BG response.

I haven’t had to adjust my basal up, yet, for my weight routine. If anything, I’ll lower my basal for my cardio.

bsc - I have been focusing on primarily protein enriched meals after the workout and am incorporating small boluses as a result. I typically just do a pre-workout bolus for the BG spike, and then a small one if my post-meal contains any amount of carbohydrate. The reason I posted this was because on all the papers I’ve read on ExCarbs and exercise, it has almost strictly been in regards to aerobic rather than anaerobic. Anaerobic exercise gets some mention but it is rarely, if ever, in regards to heavy lifting.

FHS - Don’t forget that the 50 pt rise was WITH an increased basal rate and a pre-workout bolus. I tend to go into my workouts on somewhat of an empty stomach to increase the efficacy of the other supplements I’m taking. I was rather confused as to my reading right before as I was slightly low about 2 hours before and didn’t eat anything prior to working out. I’ve accounted for the carbs in the supplements with my calculations though. I’m more just curious what other people are doing to account for their spikes in BG and what, if any, changes they have noticed to their required basal rate post-workout.

As for progression, I switch up my routine and exercises to avoid plateaus. I try to avoid staying on any one exercise regimen for more than 8 weeks at a time. The most recent switch was from free-weight to bar due to a lack of sufficient free-weights at my gym. I have noticed a very sharp increase in my weights and size as a result, as is the case with any new routine. I haven’t noticed a drastic change in my BG or insulin requirements, but again, this is on a new pump, and I know people typically require less insulin on a pump rather than MDI.

I appreciate all the feedback though! Keep it coming :slight_smile:

Oh, I got that TheRabbit: 50 point rise after a bolus and basal rate adjustment. Apparently you don’t usually start out in the 140s but still finish in the 180s then? I guess that’s just a bit high for me, personally, and I’d be looking for ways to bring that post-workout high down below 120. That being said, the addition of cardio, and timing my work-out to finish 1 hour pre-meal seems to have dampened my BG spikes more than temp basals.

I went on the pump about 4 months ago so I I’m afraid I was already well into my work-out routine. I just had to set my basals accordingly. While on MDI, I did notice a big drop in my daily Lantus dose when I added cardio to my routine a year ago. When I say cardio, my running, at 80-90% max effort, is in no way shape or form aerobic. After 4 days on, I’m blasted and require a days rest to recover and replenish my glycogen stores. I’ve made minor tweaks to my basals for periods of inactivity.I haven’t taken enough time off, at this point, to see how much the basal settings on my pump would have to be adjusted up for extended periods of inactivity.

I’ve found that in the past I would just take a shot of humalog before working out, but that was on MDI when I wasn’t in superb control. I am just hoping to tweak my settings to maximize the benefit of the pump. I like the idea of having a special basal rate for my workout days. Much like you I am very set in my ways for working out and hope to accommodate for that, rather than deal with a new workout routine.

I also despise cardio, I usually run a 10k a year for charity, but training for that is reluctant and I do it only because I am locked in to the charity race. It’s terrible I know, but I’ve never been a cardio fan.

Yeah, I think, at this point, my basals are set to my general conditioning rather than specific work-out days. I’m four days on, one day off, so I’m more likely to adjust my basals for the day off rather than the days on.

I hate cardio myself, but the benefits for me have been clear. Since I’m a sprinter, there’s no way you’ll see me running out on the street. I hit the track or just use a treadmill. 10x200m, 4x400m, 2x800m, HR up to 90% max, 30-40 minutes total, 5 minutes of sprinting, done. I found that trying to set my basals for the 30 minutes I’m running just screws up the rest of the day. I accept that I’ll go low, get my lift in, move on.

I’m not sure if my comments will help you as I’m not weight training at such high intensity/low reps as you, so I have a different approach in regards to my basals/bolusing prior to workouts. I’ve also noticed that if I just begin my workouts with just 15-20 minutes of cardio prior to lifting, that quick spike in BG I usually see in beginning my weight lifting routine is significantly less. Prolonged weight lifting actually makes my BG drop so I end up doing a decreased basal rate (80% before, during & 2 hours after). I also reduce my carb ratio from 1:10 to 1:12 before weight lifting. If you happen to eat prior to weight lifting, possibly you need the opposite? Such as dropping your carb ratio & increasing your basal rate before, during & after? I’ve also noticed that my night time basal needs are significantly less after intense weight lifting & usually need a temp rate of 80-90% from 10pm-2am (I guess I’m the most sensitive then?) I hope some of this helps you or at least some one who might come across it!

Your BG goes up with very strenuous exercise because your body produce stress hormones epinephrine (aka adrenaline) and norepinephrine secreted by the sympathetic nervous system which is part of the fight or flight resonse, as well as glucagon, growth hormone and cortisol from other organs, all of which either interfere with the action of insulin or increase insulin resistance. This and other important information can be found in the Diabetic Athlete’s Handbook by Dr. Sheri R. Colberg. She is a PHD exercise physiologist, researcher, college professor and consultant. The book is available at Amazon in paperback and Kindle format. Dr. Colberg points out that each diabetic’s exact metabolic responses to exercise and medications are specific to the individual. Exercise is an additional variable in the problem of controling BG levels. She indicates that athletes need to experiment and find out individually that which works to control BG levels.

Also look into DESA (Diabetic Exercise and Sports Association) on the web. Although this group is just getting under way, there are some local chapters which may exist near you.

Since you practice extreme weight training, and if you are not already aware of Dave Tate and Elite Fitness Systems, I suggest you look him up on YouTube for video tutorials on weightlifting technique and his website for other information. He has an online store with all sorts of related equipment and supplies. Dave Tate was in his prime a champion strength lifter. He holds Elite status in powerlifting (in three weight classes) with best lifts of a 935 squat, 740 deadlift, 610 bench press and a 2,205 total.
You can sign up for the website (free). Recently he made available free to website members, his book, The Vault, in PDF format. It is a most comprehensive treatise on powerlifting training. If you cannot get a copy from the web, send me your email address and I will forward a copy.