Type 1 and running

Type 1 and LADA
1

Guys, I know that you're tired of hearing about this, but I'm still struggling with how to control my blood sugar during intense exercise.

first of all, I use to be on the Omni pod because #1, I hate attaching things to my body, #2 that pump is too high maintenance, #3 the deductibles were too high. # 4 I really didn't think that it was that much more of an advantage over just syringe and vial. #5 I was having the same issues even with the pump so I think its me and my lack of knowledge and not so much the type of insulin delivery that I chose to use.
These are all just my opinions, so please don't be offended...

with that being said, here is the scenario...

I run about 12 miles a week. But, I find that I'm hitting a wall at the end of my runs...when I do my post-exercise bg check, I'm either too low or too high.

I generally run in the morning before work (approximately 400am in the morning.) the night before my last meal is usually around 8pm. I will take 20 units of levimir at 9pm and then hit the sack. I will get up about 12am to check my bg. I will take my correction insulin dosage for any adjustments that need to be made. I'll go back to bed and wake up at 4am. my bg is most of the time in good shape between 100-130. I will run a 5k, return home and my BG will be 50-75 points higher.

So i reasoned that my liver was possibly doing a glycogen dump and that the levimir simply couldn't handle it. So I started taking 1 to 2 units of novolg approximately 10 minutes before my morning run. That seemed to work out okay. eventhough sometimes i may get hypo from using too much. But the problem is that I'm constantly trying to predict and compensate for glycogen release. Sorry for the long rant, but does this make any sense to anyone. Or, is there another way. Is basal insulin supposed to cover glycogen (from carb loading)?

Speaking of glycogen and carb loading....here is another issue that I'm having. If I carb load, does it really matter where the carbs come from?? I hear a lot about the glycemic index and sustained energy, etc. But if I'm eating carbs now in preparation for a run tomorrow, does it really matter whether the carb is whole grain pasta or gummy bears candy?
It all gets stored if not used, and then released as glycogen later right? The sustained energy concept to me seems to only apply if you need energy right now, but spread out over a period of time.

somebody help!! I've been a diabetic for 7 years, and i still can't figure this thing out. my Endo is a good guy, but he's overweight and obviously has no interest in exercising. I need some advice from some experienced athletes that can guide me in the right direction.

thanks,

eric

2

At 4:00 AM, I'd guess it's dawn phenomenon. I *loathe* morning runs and prefer going in the evening, after work, before I eat with little going on BG wise. That being said, the last 3 years, I've run with a group that goes on Saturday mornings, training for a couple of marathons and a 1/2 last year. If I'm high, I'll bolus but like 1/3 the usual correction dose before I run. I've noticed that DP highs seem to blow away. I can get some adrenaline, or maybe glycogen, I don't read that much about that stuff highs when I really nail 5K runs but, a lot of times, during the week, I'm dragging after work or morning cross-training, etc. and the runs are less intense.

I don't bother carb loading that much. I eat a big meal two days before a marathon and that's about it. I mostly figure if I eat some breakfast early on race day (or AM run day...) and get the insulin clear before I blast off, things will go ok and it usually works out that way. I've got a CGM and RaceReady shorts to carry my meter with me and am pretty confident that 5K= about 10G of carbs, maybe 8 on a good day, maybe 15 on a rough day. I think the theory about carb loading is that the carbs you don't burn immediately, to walk around your house watching the Kardashians (my last pre-race activity...) will be stored as fat, which can then fuel you out in the 16-18-20+ miles, when you've burnt off a lot of what ordinarily fuels activity.

3

rock, i appreciate your reply. i'm guessing that that you're not a big fan of carb loading and probably think that it's overhyped and unecessary. is that right?
after looking at your "5k=10g" theory, I would assume that carb overdosing is probably overkill, even for a marathon.
with that being said, i think from here on out, i'm going to actually cut back my carb intake and focus more on bg stabalization.
at first, i thought that 10g for a 5k doesn't seem like enough. but, after looking at the size of one of my 1g (1000mg) vitamin tablets;I guess it is. 1 gram is actually quite huge. so just imagine 10 of them! That seems like more than enough energy to me.
thanks again

4

I run 2-3 mornings a week. My BG is normally between 80 - 110 at the time I start my run and may be as high as 150 - 160 by the time I return. I bolus when I get back before I eat breakfast and find that my BG returns to a normal range quickly. Without doubt, the spike is worth it because my BG remains more stable for the rest of the day. I discussed this with my Endo last week and she agreed that this is nothing to worry about and that it would be inadvisable to take any units before running. I prefer to run in the morning as my BG tends to behave more predictably than in the evenings, but that's just me!