Exercise

[woollygal]

So my doc is constantly telling me to exercise to reduce my sugars.
Stupid thing is up to about 3 years ago I used to do loads. I stopped because my ibs exploded and I was getting injured and then eating went weird and then the D!
I think all this is done to the D and for some reason I’m scared of my body and the D and exercise!

with food I know what I can and can’t eat. With exercise I have no control.

anyhoos. Today I had a driving test and instead of sitting in centre knitting while I waited I went for a walk. Only 16 mins and not overly quick but it put sugars up so must have done something. Increased from 6.2 to 7.3 in those minutes.
1 hour later it dropped to 5.1 I had half a mattessons sausage then 1 1/2 hours later the other half as felt bit sick. Got home short time later and my sugars were 4.8. Woooo!
Sat at home doing some admin had a hot choc and 1 hour later still a 4.8.

now doc always tells me I shouldn’t drove below a 5. So now I’m
A bit stuck. How do I incorporate exercise and my job (driving instructor) when I don’t know how my body will react to the exercise.
Do I need to increase carbs (I don’t really want to) but then how do I know how much etc.

mall very complicated. Very good my sugars have dropped but to drive I need to stay in the 5s. Obviously at home like now it doesn’t really matter.

 

[KK123]

So my doc is constantly telling me to exercise to reduce my sugars.
Stupid thing is up to about 3 years ago I used to do loads. I stopped because my ibs exploded and I was getting injured and then eating went weird and then the D!
I think all this is done to the D and for some reason I’m scared of my body and the D and exercise!

with food I know what I can and can’t eat. With exercise I have no control.

anyhoos. Today I had a driving test and instead of sitting in centre knitting while I waited I went for a walk. Only 16 mins and not overly quick but it put sugars up so must have done something. Increased from 6.2 to 7.3 in those minutes.
1 hour later it dropped to 5.1 I had half a mattessons sausage then 1 1/2 hours later the other half as felt bit sick. Got home short time later and my sugars were 4.8. Woooo!
Sat at home doing some admin had a hot choc and 1 hour later still a 4.8.

now doc always tells me I shouldn’t drove below a 5. So now I’m
A bit stuck. How do I incorporate exercise and my job (driving instructor) when I don’t know how my body will react to the exercise.
Do I need to increase carbs (I don’t really want to) but then how do I know how much etc.

mall very complicated. Very good my sugars have dropped but to drive I need to stay in the 5s. Obviously at home like now it doesn’t really matter.

Well your Dr is wrong. First off I am guessing you are on a glucose lowering medication such as insulin (or one of the others that come under the DVLA regs) and even then you need to be 4 or above to drive, not 5. When you test prior to driving, if you are 4 or over then you CAN drive but you must take a 'snack' if you're between 4 & 5. If you are over 5, you don't need the snack. I think they get confused with the other bit of the legislation which states IF you are driving and have a hypo, you must stop driving and then you need to get yourself up to 5 to drive. Obviously, no matter the rules it may sometimes be prudent to get yourself above 5 if you feel or know that you tend to drop quickly etc.

 

[woollygal]

Well your Dr is wrong. First off I am guessing you are on a glucose lowering medication such as insulin (or one of the others that come under the DVLA regs) and even then you need to be 4 or above to drive, not 5. When you test prior to driving, if you are 4 or over then you CAN drive but you must take a 'snack' if you're between 4 & 5. If you are over 5, you don't need the snack. I think they get confused with the other bit of the legislation which states IF you are driving and have a hypo, you must stop driving and then you need to get yourself up to 5 to drive. Obviously, no matter the rules it may sometimes be prudent to get yourself above 5 if you feel or know that you tend to drop quickly etc.

I’m not on insulin just trulicity. She has always said I need to be above 5 or if anything did happen with it being diabetes it may cause issues. In my job I can’t risk it. I’m not talking about hypos i don’t get them.
Just how do incorporate exercise and food etc

 

[KK123]

I’m not on insulin just trulicity. She has always said I need to be above 5 or if anything did happen with it being diabetes it may cause issues. In my job I can’t risk it. I’m not talking about hypos i don’t get them.
Just how do incorporate exercise and food etc

Well she's still wrong. If it was a scenario where you FELT hypo's when you are in the 4s and you KNEW because of previous patterns that you are not fit to drive whilst in the 4s then maybe she has a point. I can't risk it in my job either s0 I follow the law and check, check, check. All I can say re exercise and food is also to test and test.

 

[HSSS]

When you were first diagnosed you were sent on this forum all the links directly to dvla that show your gp is wrong and what KK123 says above is right. Maybe you need to print them out, remind yourself for reassurance and then and deliver them to her as she’s causing unnecessary worry for you.


https://www.gov.uk/diabetes-driving


https://assets.publishing.service.g...e-to-insulin-treated-diabetes-and-driving.pdf



https://assets.publishing.service.g...vers-with-diabetes-treated-by-non-insulin.pdf

 

[HSSS]

Oh and a Walk does that to me. Short blip upwards followed by lower for a reasonable amount of time afterwards.

 

[woollygal]

When you were first diagnosed you were sent on this forum all the links directly to dvla that show your gp is wrong and what KK123 says above is right. Maybe you need to print them out, remind yourself for reassurance and then and deliver them to her as she’s causing unnecessary worry for you.


https://www.gov.uk/diabetes-driving


https://assets.publishing.service.g...e-to-insulin-treated-diabetes-and-driving.pdf



https://assets.publishing.service.g...vers-with-diabetes-treated-by-non-insulin.pdf

I remember them I struggle to understand them!

 

[HSSS]

See post #2

if your glucose is 5.0mmol/L or less, eat a snack.
If it is less than 4.0mmol/L or you feel hypoglycaemic do not drive.


If hypoglycaemia develops while driving stop the vehicle safely as soon as possible.
• You should switch off the engine, remove the keys from the ignition and move from the driver’s seat.
• You should not start driving again until 45 minutes after finger prick glucose has returned to normal (at least 5.0mmol/L). It takes up to 45 minutes for the brain to recover fully.

 

[woollygal]

See post #2

if your glucose is 5.0mmol/L or less, eat a snack.
If it is less than 4.0mmol/L or you feel hypoglycaemic do not drive.


If hypoglycaemia develops while driving stop the vehicle safely as soon as possible.
• You should switch off the engine, remove the keys from the ignition and move from the driver’s seat.
• You should not start driving again until 45 minutes after finger prick glucose has returned to normal (at least 5.0mmol/L). It takes up to 45 minutes for the brain to recover fully.

imeven more confused.
Dr has said of below 5

See post #2

if your glucose is 5.0mmol/L or less, eat a snack.
If it is less than 4.0mmol/L or you feel hypoglycaemic do not drive.


If hypoglycaemia develops while driving stop the vehicle safely as soon as possible.
• You should switch off the engine, remove the keys from the ignition and move from the driver’s seat.
• You should not start driving again until 45 minutes after finger prick glucose has returned to normal (at least 5.0mmol/L). It takes up to 45 minutes for the brain to recover fully.

I think I’ve not been clear. When dr says do not drive under 5 she has said eat something to make sure it goes back to 5. she has been very clear I can’t (shouldn’t) go lower than 4 as I’m not on insulin.
she has explained that I’m fine to drove on a 4 as anybody is. Not the best maybe but ok. But if I did have an accident or was stopped and they found I had the testing kit that that may cause a problem simply because I am diabetic and on meds. If I wasn’t diabetic and just normal it wouldn’t be problem. But because of the diagnosis it was safer to be at 5 or above so that it couldn’t be used against me.

 

[HSSS]

Ok you said that she told you not to drive below 5. Not quite the same thing.

The rules are in three parts

1.Check before setting off and 2 hrly thereafter.
2. Legal to drive above 4 at outset. Eat if below 5 (to avoid dropping lower than 4 later)
3. If you hypo (or feel it) whilst driving stop. Get back to 5 then continue to wait another 45 mins before driving again.

So in fact she has said what the rules say. Only she has scared you with the “ it may cause a problem” bit. It just means they may want to check your meter to check you’ve complied with the rules. So long as you have, don’t worry in my opinion.

and honestly on a routine check they aren’t going to be randomly searching your vehicle just in case you have a meter they could interrogate!

 

[DCUKMod]

@woollygal - if you are very concerned, my suggestion would be you consider doing some things. These are what I would do in your shoes.

Firstly, I would have a good think about whether I intended to maintain the exercise routine. Exercise, as you have discovered, doesn't have to be about lycra and barbells. It's just about moving about a bit more. That could be parking in the farthest reaches of the supermarket carpark, or parking at one end of town when the focus of your errand is at the other, and getting a few steps in that way. I have also noticed, by parking if the most distant parts of carparks, I pick up few trolley and door dings, so an added bonus!

If you intend to keep some exercise up, then you have to decide how you will handle it, which is what your thread is about.

If you want clarification for yourself on the driving regulations, then a call to the DVLA might help. It might not. I must admit my understanding concurs with @KK123 's interpretation. That mirrors the description given by a Diabetes Consultant who spoke to our local DUK group a while ago. He was very keen to make the position clear, as the sort of befuddlement you are experiencing is not uncommon.

If you don't fancy calling the DVLA, then a call to your local Diabetes Centre might be helpful?

To be clear, I am not, and never have been on any meds for Diabetes, but if I had to be over 5 to drive, I would really only be able to drive a little while after meals, and certainly I'd not be able to ever get myself to a fasting blood test any further than walking distance, or by bus/train.

Then onto the read crux of the matter - If you regularly find yourself having to eat to match your meds, my form of logic would suggest the meds maybe aren't quite right for you, or your way of living.

Bearing in mind we are living with a condition of a disordered metabolism, leading to higher than desired blood suagar, taking medication to drive the numbers down, only to then have to take onboard carbs to drive them back up again seems bonkers - especially if you are still on the trimming up trail.

I know your doctor seems keen on Trulicity and the like, but if they aren't able to provide you with something making a better fit for you, then I would be inclined to ask for a referral to the secondary care diabetes teams. In my little town, we have satellite clinics from the bigger, city-based hospitals on a regular basis. Maybe you have something similar around?

Reading your posts for many months now, this has been a recurring theme. If your GP feels unable to accommodate the requests you make, you are, under the NHS entitled (a word I detest) to a second opinion.

In your shoes, I'd be getting my thinking can on, and maybe start researching whom you would like your second opinion to be from. You can request a named referral.

 

[woollygal]

Spoke to dvla and they can’t give an answer because they aren’t medically trained!
Just referred me to the fitness to drive guide which doesn’t actually say anything about if not on insulin you have to be above or whatever level!

 

[HSSS]

I have to agree the dvla stuff I linked to says insulin (and only insulin) on one leaflet with actual levels specified

and all other treatments are lumped together on the other including other glucose lowering meds that are not insulin with no levels mentioned. Not the best or the clearest message in that respect.

anyone know of anything more specific?

 

[woollygal]

I have to agree the dvla stuff I linked to says insulin (and only insulin) on one leaflet with actual levels specified

and all other treatments are lumped together on the other including other glucose lowering meds that are not insulin with no levels mentioned. Not the best or the clearest message in that respect.

anyone know of anything more specific?

I don’t get how people are saying Dr is wrong.
There is nothing I can see that says she is right or wrong. It doesn’t really say anything unless insulin is involved.

 

[NicoleC1971]

Spoke to dvla and they can’t give an answer because they aren’t medically trained!
Just referred me to the fitness to drive guide which doesn’t actually say anything about if not on insulin you have to be above or whatever level!

I am a trainer and notice that on this thread we seem to be getting into the weeds with exercise/activity question.
I understand that you don't want to risk losing your job but I think you are a long way from that scenario but hypo s are a risk which is why your gP warned you. To be taken off the road you'd need to have required assistance with a hypo whilst driving and reported it e.g. my type 1 friend made a mistake with low sugar lucosade and crashed into the back of a bus thus the authorities were involved and her glucometer showed that she had tested below 5 and had not allowed enough time for the corrective carbs to work and had not retested before driving again.
As a trainer, I'd say you are risking your longer term employability by remaining sedentary e.g. diabetic complications. I didn't have my licence taken away for having a low but because I became partially sighted (extreme example here sorry).
Walking is going to be a great way to get active particularly after meals as it will use up some excess glucose before it can be stored as fat and it is low impact. Keep checking blood glucose and you will get used to how your body responds; if seeing a figure below 5 makes you uneasy you could keep a pack of raisins on you or some other such thing that doesn't tempt you to eat them in excess!
I'd also agree that it would be great if as a result of walking and dietary changes, you get to reduce or come off some meds.
I'd also hope that as you used to really love it you will re discover other ways to get back into it that won't damage your joints if you're overweight. Hope you can find your exercise mojo again and don't be scard of the D!! (Have run 2 marathons with insulin so if I can do it...)

 

[woollygal]

I am a trainer and notice that on this thread we seem to be getting into the weeds with exercise/activity question.
I understand that you don't want to risk losing your job but I think you are a long way from that scenario but hypo s are a risk which is why your gP warned you. To be taken off the road you'd need to have required assistance with a hypo whilst driving and reported it e.g. my type 1 friend made a mistake with low sugar lucosade and crashed into the back of a bus thus the authorities were involved and her glucometer showed that she had tested below 5 and had not allowed enough time for the corrective carbs to work and had not retested before driving again.
As a trainer, I'd say you are risking your longer term employability by remaining sedentary e.g. diabetic complications. I didn't have my licence taken away for having a low but because I became partially sighted (extreme example here sorry).
Walking is going to be a great way to get active particularly after meals as it will use up some excess glucose before it can be stored as fat and it is low impact. Keep checking blood glucose and you will get used to how your body responds; if seeing a figure below 5 makes you uneasy you could keep a pack of raisins on you or some other such thing that doesn't tempt you to eat them in excess!
I'd also agree that it would be great if as a result of walking and dietary changes, you
I'd also hope that as you used to really love it you will re discover other ways to get back into it that won't damage your joints if you're overweight. Hope you can find your exercise mojo again and don't be scard of the D!! (Have run 2 marathons with insulin so if I can do it...)

It isn’t about hypos. I dint get them. False ones potentially but not life threatening ones. Even at the start the dr was very clear I couldn’t get hypos. It was more about if an accident happened and it was found that I was diabetic then levels would be an issue. If a non diabetic was in same situation it wouldn’t be because they are non diabetic. Morally I think that’s wrong, regardless of diabetes if you haven’t eaten for hours and even if you have you have to be fit to drive but that’s another argument! I know when I gave yo eat because I can feel I’m but great. Concentration wise and I make mistakes. Probably everyday mistakes a normal drivers makes and doesnt think anything if it but fir me I take notice and I hate that those mistakes happen!

it would be easier for me if I could say 4 is fine eat at 3 or even 5 eat at 4. Makes it nice and clear. Then I know what I’m doing. Although to be extra helpful I haven’t hit the 4s today!

Im not good with vagueness which is very much the dvla way!

 

[NicoleC1971]

It isn’t about hypos. I dint get them. False ones potentially but not life threatening ones. Even at the start the dr was very clear I couldn’t get hypos. It was more about if an accident happened and it was found that I was diabetic then levels would be an issue. If a non diabetic was in same situation it wouldn’t be because they are non diabetic. Morally I think that’s wrong, regardless of diabetes if you haven’t eaten for hours and even if you have you have to be fit to drive but that’s another argument! I know when I gave yo eat because I can feel I’m but great. Concentration wise and I make mistakes. Probably everyday mistakes a normal drivers makes and doesnt think anything if it but fir me I take notice and I hate that those mistakes happen!

it would be easier for me if I could say 4 is fine eat at 3 or even 5 eat at 4. Makes it nice and clear. Then I know what I’m doing. Although to be extra helpful I haven’t hit the 4s today!

Im not good with vagueness which is very much the dvla way!

Normal bgs for a human adult have a tight narrow range and I imagine you might feel hunger if your blood sugar drops rapidly or goes below 4. Please trust what you are feeling but don't overdo the snacks because it doesn't take much to bring a bg up if you are not taking insulin.
Sounds as if you are generally on an even keel. I only mention hypos because your drug is designed to get your body to produce extra insulin to overcome your insulin resistance and your need for it may reduce if you make your body more insulin sensitive by walking or eating less carbs.
I hope your fingers aren't getting too sore from all the testing!

 

[HSSS]

I don’t get how people are saying Dr is wrong.

Because you misquoted her. You reported she gave a blanket don’t drive under 5 when actually it was more nuanced than that

 

[HSSS]

Even at the start the dr was very clear I couldn’t get hypos. It was more about if an accident happened and it was found that I was diabetic then levels would be an issue.

Trulicity can cause hypos. Not sure why you think it can’t.

In any accident any contributing factor might be an issue. For a diabetic on insulin (or glucose lowering medications as you are) they may want to establish if the proper procedures have been followed and if that was a factor.

Have you even had numbers under 4? Or felt hypo such that you shouldn’t drive? Or set off under 5 without a snack? None of the figures you quote in the first post suggest you were breaking any rules.

 

[KK123]

I don’t get how people are saying Dr is wrong.
There is nothing I can see that says she is right or wrong. It doesn’t really say anything unless insulin is involved.

I think it was more to do with what you said the Dr said that made us think she was wrong. Once you corrected what she actually said, then she was right. Your medication seems to come under the 'glucose lowering' category so the same rules would apply as if you were on insulin.