Temp basal rates for exercise

[spideog]

OK, so it's only been a week on the pump so far, but despite how much fun it is learning the new gadget I am getting impatient with sitting around on my backside doing nothing and need to think about getting out running again.

I have quizzed the nurses several times on how best to approach changing the basal rates for doing exercise and read all the stuff I could find in the various manuals, but the best I can find is a "suck it and see" approach as to what changes to make. Now I realise that in a couple of months I'd probably be saying the same to anyone else asking the same question as you just have to go and try a setting and see what happens. That isn't much help though when your starting from scratch again in knowledge of how the bodies insulin/ sugar needs change with exercise. The last years I have learnt what my "sugar" needs are to compensate for the fixed insulin rates are when on MDI, now I need some clues as to what the "insulin" requirements are as that is now the one that can be adjusted.

So I'm planning on going out with my club for a run on Monday so will be about an 45-60mins worth of steady pace for me. But whilst knowing that it still a wild guess wondering what kind of range of change I should be looking at making?
Reduce the basal by something in the 0-30% range, or by 30-60% or maybe more than that?
I have at least been able to gather that the change to the basal should be started from an hour before your start, and probably continue an hour or so after finishing as well.

Just need to get some runs in soon as I've a half marathon coming up in three weeks, and a championship team relay race which I expect to be picked for in two weeks.

 

[ams162]

hi

we were told to reduce dylans rates by 20% dont know whether its different for u being older or not but so far i havent reduced too much at all for sport just football matches like u say i think its prob trial it and see but its nice to know a starting place isnt it

hope u find the right thing for u

anna marie

 

[spideog]

Thanks for that.

It is actually useful to hear what "real" people have done, rather than just a nurse saying try it and see. Not sure how much difference the age difference would have, if any, but I guess Dylans football playing is a bit more energetic than what most people get up to.

 

[phoenix]

For runs of about an hour I reduce the basal to 40% That's because I always drop dramatically at about 2 miles. it usually works if i remember to turn the basal down at least half an hour in advance, otherwise I still have a tendency to find myself very low 20 min down the line.

I'm experimenting with longer runs, yesterday I ran 14 miles ( around 3hours.. I'm 58 and very slow).I reduced the pump to 60% about 40 mins before the start. Just before starting glucose level was 5.6, I took 1 dextrose, I then took another dextrose at the start of each circuit (about 5km). At the end glucose level was 5.9. I was pleased with that but I also often have post run hypos about 4-5 hpurs later. yesterday I decided to keep the temp basal going for another 5 hours, during which time I had half an hour in the bath without a pump but also bolused normally for lunch. It worked really well, no hypos and level again in the 5s before dinner.

 

[spideog]

That is great info on what works for you, thanks.

I think I'll be taking a meter with me for the first few runs and see about stopping part way round just to see what is happening. I'll also plan on taking that half marathon I've got coming up slow as well so I can stop and test on the way round. It's not on a particularly fast route anyway so I can just use it as an experiment for a couple of fast road courses later in the year.

Will take quite a bit of self control for me to actually go slower than I'm able to in a race, and even more to be able to make myself stop and test. But I do set out with good intentions. :lol:

 

[spideog]

All sorts of wrong tonight.
Well it could have been worse, but I was just a bit lucky with the timing.

Went out for my first run since getting the pump running with insulin, but decided I was safest to go with my club rather than on my own. I had some food a couple of hours before hand as per usual, but I reduced the bolus amount from what the pump suggested. I then reduced the basal to -30% from an hour before I was to go for the run.

Tested just before and was at 9.6. Previously I would have possibly taken an energy gel at that level just before gunning, but decided not to today as I was turning the insulin down instead. The run itself was fine, although I think i was imagining a feeling of the set moving.
Finished and I went straight off to do another test, wasn't feeling obviously low, but it's never too easy to gauge when running. Test was 2.6. :shock:

Good job they didn't send us out for another lap.

I think it could be a combination of not having reduced the insulin bolus beforehand by enough, and maybe the basal setting as well. Will have to do some runs without having eaten during the previous 4 hours to figure that one out I guess. If I need to do that all the time though then it will mean some very early starts on some race mornings.

 

[sugar2]

Ecck!

I know we are all different, but for me (so you may be different) if I was going running for an hour, I would actually take teh pump off. I do this when swimming. I run a temp basal rate of about 50% for a hour before I go (depends what BS is atteh time) and then just take the pump off (the freedom!0 obviously, need to test, and possibly adjust when I have finished, but to be honest, i rarely need to,

I do know that my metabolism (or whatever it is) means that exercise really does impact my insulin needs.

 

[spideog]

That is a couple of people suggesting that they remove the pump to me now. I'll maybe give that a try tomorrow to see what happens. I think I do need to keep the pump on for longer runs though if I do attempt any more marathons, but will be quite a while yet before I get back up to that kind of mileage.

 

[Cheryl]

Very late into this one I know, but there's a couple of useful sites to look at: www.runsweet.com set up by Prof Ian Gallen with input from Sir Steve Redgrave, my consultant regularly mentions it to me. There's also diabetesnet, though I'm not sure of the exact web address but there's a big section on exercise & combining insulin reduction with extra carbs for the best result. It's American so you'll need to convert mmol/l to the US system.

 

[donnellysdogs]

I would agree to perhaps turn pump off or down to 10%.....however don't forget the basals that you have 2-3 hours before doing the run will be most active...not the ones that are are one hour before you run or whilst running.

I know that for me personally I have to lower my basals 2 hours BEFORE I walk my dogs (not running though!!!).....and if I go on a course where I am sitting down for 3 hours....then I need to alter my insulin upward 2 hours BEFORE I go on the course...and I also consider the length of dog walks in time and the length of the courses for the times that I then come off the temp basal rates.

You may find that switching the pump off when actually running will not suit..and will just give you a high 2-3 hours afterwards....I found that I had to suck and see....and my alterations are always 2-3 hours before being active or non active.....

 

[Cheryl]

I agree with donnellysdogs timings. When I swim (usually 18:15-1900) I do a temp basal from 16:15-17:15 of 50%. I also stop for a swig of sports drink every 10 lengths or so (30 grammes of carb in total), this way my BG usually only drops 4-5% during my swim.
I've had a lot of problems with post-exercise hypos though & am now experimenting with doing a temp basal of 80% for up to 24 hours after my swim and then 90% through the second night. Though they only recommend such long term post-exercise TBRs if you exercise less than every other day. Apparently if you exercise more frequently than that, your liver is always replacing its stores of glycogen so your basal requirements will always be a lower to account for that.

 

[onlytwintip]

Hi,
I think this is something that is different for everybody. I cycle around 30-40 mile smost days and I need to put the basal rate down to 20% an hour before until the end of the ride. I also, weirdly need to take a bolus of 2U straight after the run to not go up too high. Weird as most people talk of hypo's after exercise, I have the complete opposite (maybe adrenaline or something...).

Anyway the best way I found was trial and error.

 

[spideog]

...Apparently if you exercise more frequently than that, your liver is always replacing its stores of glycogen so your basal requirements will always be a lower to account for that.

I did find that when I took a couple of weeks off training recently and my levels went high pretty much most of the time and no amount of correction was bringing them back down, well it would temporarily, but then back up again a couple of hours later. It's not an issue if I'm only taking a day or two off training, but seems that longer than that and the basal levels I currently have set become totally wrong.

My daily total number of units for bolus is generally about twice the amount I'm taking for basal.

 

[Cheryl]

Have a look at www.runsweet.com/AvoidingHypos.html Part 2 of this provides a guide on reducing insulin overnight after exercise & explains about only needing to do so if you exercise less than once every other day. I guess that it's logical therefore to apply the reverse action if you usually exercise every day but for whatever reason cannot do so for a while. Ask your DSN, they may suggest a temp basal of e.g.120% if for the duration of a non-exercise period for you. Either that or programme a separate basal profile for non-exercise periods.

 

[spideog]

That is what they told me to do, my answer was that I didn't intend for going that long without training to be happening again for a long time so I'm not going to bother trying to figure it out for that situation.

Have a couple of marathons to train for, I can find enough excuses to skive off training sessions as it is. Don't need another excuse of having to try out some non-exercise basal settings.

 

[Cheryl]

:mrgreen: wish I had your dedication! At least you have a good idea if forced off the road for any reason. Good luck.