I was diagnosed with T1 April 1, 2012 (funny joke, eh?) at age 21 and had a really rough transition into the diabetic lifestyle. Currently, a year and about 4 months later, I've become more use to this lifestyle and have my sugars well on their way to controlled. My last A1C on July 16, 2013 was 7.4% (pre-diagnosis it was 15%!) and I eat about 150 carbs or less daily. However, during this transition period and adding insulin into my life, I gained a lot of weight; about 50 lbs :(
I was recently approved for insulin pump therapy and will be fully on the pump this upcoming Tuesday 8/20/13. For right now though, I'm on humalog and lantis quickpens. I test about 7 times or more daily.
SO! The real situation is, now that I have become more comfortable with my T1 diagnosis and lifestyle change, I'm ready to combat the weight gain. I generally do an hour workout 5x a week. I mix it up between zumba, yoga, cardio, and weight training. After each work out, my blood sugar is really unpredictable. It can be as high as 240 or as low as 60 with seemingly little to no explanation. I work out around noon each day, about an hour and a half after a 30-40 carb breakfast. My BG levels before working out usually range between 120-145 (I don't mind them being higher due to the upcoming exercises). I'm really confused why this is happening, especially the highs.
Of course there are sick days where my BG is just bad, but this is a daily occurrence it seems and it happens way more than I feel it should. Any suggestions from my more experienced diabetic peers? Thanks!
You will love being able to use temp basals on your pump to offset your exercise. Waaaayyy better than MDI. I would think the zumba and cardio is lowering and the weight lifting is raising you. And the yoga is negligible. I would first focus on dialing in the correct basal rates on your pump and then start experimenting with your workouts, e.g. a reduced temp basal for cardio and an increased temp basal for weightlifting. If you still drop despite temp basals, you may need to eat/drink some carbs before or during. Keep in mind that the effect of a temp basal does not kick in for at least an hour, so you want to set it before your workout.
The more you do the same exercise routines and log what happens, the quicker you can figure it out.
Strength training can raise your BG, the adrenaline will boost BG. I've noticed that those highs aren't nearly as "sticky" as highs from donuts or cheese fries but they still bother me. I haven't ever done Zumba but have done yoga, cardio and weights. I'll only see a "boost" from running if I run really fast (it hasn't happened for a while, I had some injuries this year and have lost about 3-4 minutes off of my 5K times, which seems to be where the "boost" lives...which is ok BG-wise but is a bummer...). I think that if you're working out an hour and a half after your breakfast, it might be that your breakfast is still "deploying" and some of the boost is from that? I like to eat ahead of time enough for the insulin to clear out before I work out. If it's weight stuff, I usually do that when I get up and lift and sort of manage the rise with a higher basal rate and eat when I'm done. If it's cardio stuff (mostly running...), I get up early, eat and then walk around the house in circles, figuring out playlists, getting jelly beans and other pre-running crap. Sometimes there's a little "tail" on the insulin there but getting going early to clear out IOB can make a big difference! Good job on the A1C though, that's a great improvement. It took me 24 years to be bothered with a pump and I've really enjoyed having them. It makes diabetes less work for me and that was huge!!
You make some really good points. I'll try giving my body a little more time to digest breakfast and maybe warm up with some light movement to get it ready for the intense work out. Perhaps an issue is that I jump right into intense cardio (usually interval running). I do notice that these highs are usually pretty easy to fix as well. A little applesauce and a few units post work out cover it no problem.
I'm really excited about my pump! I hear it's a life changer :)
I haven't had a chance to set up my pump yet. I don't actually get to wear it until this upcoming Tuesday :) I've been keeping a diligent log for the past two weeks to record my highs and lows with exercising for my endo. I will keep all of your suggestions in mind though. Thank you!
Anaerobic exercise (intense, short efforts - weight lifting, running sprints, etc.) tends to raise BG levels.
You can mitigate these effects by timing changes to your pump basal rate, increasing/decreasing insulin boluses, and adding/subtracting food to your pre- during- and and post-workout sessions.
I'd suggest reading Walsh & Roberts book first, then read Colberg's book. Both are easy reads and chock-full of just the sort of information you are looking for. Once you start working out and using their guidelines, your goal should be to test and log your BG numbers as much as possible, and with as much detail as possible. That way, you can see what you are doing and what sort of effects your exercise-food-insulin regime is having. Then you can tweak and improve on what you are doing. As someone here a tudiabetes said, "We are our own best lab rats."
ive been to some diabetic sports seminars. thats what our endo told us there: make studies. there are over 50 factors that can affect your bg. each sport is different, the time in the day is different, the amount of insulin in your body is different, etc. so what the doctor recommended was to change one of the many factors that can change your bg. write everything down, what you ate before, what you bolused before, how long the workout was, how intense, what kind of workout, how you kept your basal at the time, etc. if you notice something is not right, change ONE of those many many factors. i know its hard work, try to do it over the time and find out the rule that works for YOU the best. each diabetes is different, so find out how yours is! contact me, if you have questions, i have some problems expressing myself in english, lol love, swiss
Your English is very good and what you're saying is exactly correct. I am *extremely* conservative in eating during the week and also going into races. Many of my more "interesting" (in the Chinese curse sense of the word...) have been from engaging in food adventurism the night before long runs. I will not *ever* eat pasta Bolognese the day before a long run ever ever ever again.
I've been doing it for a few years now and, as long as I get up early for breakfast, I'm fine eating toast along with bacon and eggs w/ some spinach in it before long runs and my BG will be pretty much flatted out by the time I run. I test before I eat and then, a couple hours later, before I run. If it's lower than I want, I'll eat some fast acting carbs or a cookie or something like that before we blast off. The diabetes is a huge chore but running is enough fun for me that I don't every want to skip a workout b/c of diabetes. There's always a solution to most diabetes problems. I've spiked before runs (excitement) and been low before runs (eeek, terror about passing out and getting picked up by EMTs alongside of the Prairie Path!) but I've worked through them and around them. If I try something a couple or three times and don't get the result I want, I figure it's either more or less insulin or more or less food and just kind of figure out a solution based on the stuff I've got in the pantry.
I've been looking into tweaking my C:I ration just a tad for breakfast and while doing some research, I've stumbled upon many recommendations for "Pumping Insulin". I've already got it in my cart on Amazon :) My blood sugar must be all over the place at the gym. I tend to do sprinting, elliptical training, and weights when I'm in the gymnasium area. Zumba is mostly just cardio and I do notice that I only go low during zumba (and strangely enough during yoga too).
I didn't have a spike or a drop at the gym today though. I had a 15 carb applesauce pack right before my workout. It seemed to help a lot.
This is a really great idea! I know I always want to change many things at once when it comes to managing my diabetes. I really enjoy going to the gym and plan to make this apart of my lifestyle change, so I will have plenty of time to change one factor at a time. I've been keeping a log with insulin doses, food, workouts, and the such for about a month now. Thank you so much, I will be in touch :)
I got "Pumping Insulin" and "Think Like a Pancreas" based on recommendations from the other message board I used to hang out at, right before I got my pump and they were hugely influential on my thinking about how to go after this stuff. Although so was partying my brains out in the 80s and 90s and figuring I know my way around uh, ways to adjust one's chemistry. I also liked Ginger Vieira's book "Your Diabetes Science Experiment" a lot, it's a bit more "test and see what's going on..." with pretty precise directions. I thought it was "lighter" but was flipping through it today and it's as heavy as the other ones, in a good way, but has a lot of personality. I would put that one and TLAP tied in first and then "Pumping Insulin". The one thing that I'm not as keen on about TLAP and PI is that their carb recommendations for running a long way seem a bit excessive. I can usually get through a 1/2 marathon on 40-50G of extra carbs but I think they'd put me at around 70-80, not a huge difference but, if you're working out a lot, it's an extra cheeseburger/ week or so. I was gonna go through YDSE again but didn't get around to it but you might like to check them all out. Or shoot, just read them all? I did but have forgotten about 90% of what's in them but used what I read to sort of influence things about what one can or can't do.
The Colberg book was interesting and inspirational but I didn't get as much out of it as the examples seemed to be more a collection of "war stories" than "here's how to run 20 miles..." which is what I was looking for at the time. Although I think the answer to "how do I run 20 miles?" is to say "I'm going to run 20 miles and work your way up to it.
