Exercise & Insulin

[LauraC27]

Good evening all...
So i have joined a gym .. i wanted to get into exercise again since being diagnosed 2 years ago i kind of stopped going! I joined mainly for the exercise/ work out classes such as spin, circuits, combat, abs etc.. which i really enjoy.. Anyway.. 2 weeks in and i am hypoing during (sometimes) & always after the class. The classes are quite intense & 45mins to 1 hour in length. The last class i did, i checked my BG it was 8mmol. I had a couple of gluco tabs just before the class and i still hypo'd!
What do i need to change here to stop a hypo happening? Do i lower my levemir insulin dose in the morning if i have a class that day.. do i eat a meal that morning without injecting? .. your advice please!
Its getting a tad annoying/ embarassing when i'm having to go into the corner shaking downing the sugar! also makes me feel pretty rough after which defeats the point of doing the exercise! Thanks everyone!

 

[therower]

Hi @LauraC27 . Congratulations on getting up the gym.
Hypos, **** annoying, we try to o something positive and it all seems to go awry.
A good cardio workout has the same affect on me as it appears to have on you.
Personally I never change my basal dose ( lantus for me ).
I've read your post and one thing I would say is........ you say you start a workout at 8.0, which is good but that's soon going to drop with intense exercise. You take 2 / 3 Glucotabs.
Imagine if you was going on along car journey, a few hundred miles let's say.
2/3 Glucotabs would be like putting enough petrol in your car to get you to the next petrol station.
Better to put enough petrol in for the journey and not leave it until the last moment.
In your situation, through a bit of trial and error I would look to take some long lasting carbs on board prior to exercise.
I find malt loaf good also a banana and peanut butter. Eat maybe an hour before your workout. You want the carbs hitting your system as you exercise.
I think you're doing everything right, just try different things and you'll get it right.
Good luck, keep exercising, because no matter what, it is a great benefit.

Hope this helps.

 

[catapillar]

Run sweet is a great resource for information on managing insulin and exercise - http://www.runsweet.com

Levemir is a nice flexible insulin that can be lowered on days when you are more active, so that might be something to try.

You might also want to think about what insulin you have in your system working from any pre exercise bolus. The bolus will be hanging around for around 5 hours after its given. So when are you eating and bolusing before the gym? I suppose it depends what time of day the classes are, you could try a few different options to figure out what works best for you:

1. If you know your basal works well and keeps you steady when not eating or bolusing you could try doing this the class without any bolus or food on board, you know like get up go to gym come home eat breakfast
2. You could try eating without any bolus and then doing the class. I suppose that depends on how high that sends you (there's an upper limit for where it's sensible to do intense exercise too) and how you feel when you're high
3. You could try reducing your bolus before the class, just take 50% off, or 25%, see what works

Or if youre not eating a full on meal pre gym you could have a look a pre gym snacks. You said you had dextrose tablets but still went hypo, but you could have an experiment with having a more complex carby snack, something like a cereal bar, that might last a bit longer. Or you could make sure you had lucozade to sip on to keep you bumped up during the exercise.

 

[Scott-C]

@LauraC27 , think about the way insulin operates over time, about 4 to 5 hours, and also the way in which glucose gets into cells to be used as energy - one way is presence of insulin, the other way is glut4 responders which pop their heads up when you're exercising.

You've gone into your class at 8 on meter. So far so good, but when was that in relation to your last insulin shot?

Let's say you're doing some gym stuff after your evening meal. If you've had some food and a shot for that in the last few hours, the insulin will be kicking in hard after about 45 to 90 mins, which is fine if you're just sitting in front of the telly, but if you're then gyming it on top, you'll have the insulin and glut4 kicking in as a double whammy so a hypo ain't a surprise.

Rewind that whole show in time a bit: having a meal, normally x units for that, but look ahead - you know when you sit down for lunch/dinner that you'll be doing some exercise a few hours later, so think about shaving back the units for the meal, because the glut4 action will be lowering you too, and you really don't want that on top of the insulin.

 

[LauraC27]

Yeah this all makes alot of sense..
Its complicated though isn't it!!
Suppose trial and error is the way forward until i figure it out!
Thanks for all that info all of you.. a great help!

 

[katmcd]

Hi @LauraC27
I had the same issues, usually do circuits or spinning or running for 60mins. Whatever I started on I'd always drop to the 4''s and occasionally 3's.
The best advice I was given was to take glucose regularly during exercise (drink form easier) and keep this separate from your hydration. 3x20g carb evenly during my spinning worked so much better than having 60g right at the start.
Quick acting insulin can still be working 5 hours later. Consider this when you exercise that this can drop you quicker-either lower your pre exercise dose with your meal or eat more carbs before and during exercise.
After exercise, muscles are taking in glucose, as is the liver. Reduce the insulin you take with the meal after exercise to prevent a hypo caused by your body replenishing itself.
I don't exercise everyday usually. But when I have, my basal requirements drop during that time. I usually need 2 units less than normal. But when it's spaced out in the week type exercise I usually just adjust my bolus insulin.
The runsweet website is great.
I've just been on a diabetes and sport weekend run by One touch. It was amazing and had lectures from Ian Gallan (who wrote the runsweet website), Alastair Lumb and James Moran-all about exercise, the body, insulin and nutrition. Think it's on next May. Search for #OTSW2017 on twitter as some of us put up key information slides.
Good luck!

 

[LauraC27]

Amazing! Thanks so much for this!! xx

 

[NoKindOfSusie]

I have basically given up on exercise.

Because of various medical things I have spent most of the last six weeks (since diagnosis) feeling like I have a blood glucose of 1, although it's usually 5.5 when I feel like that. I have tried to run at that level, I've tried to run at 6.8, I've tried eating apples before, I've tried drinking lucozade during the run. Nothing works. It's almost as if it's not the actual level, it's the sudden drop. So it doesn't matter what I do, I will always feel like death if I try to take any exercise.

And then they say "oh, you should exercise."

And what really winds me up about this is that it isn't diabetes doing this. It's the TREATMENT for diabetes doing it. It's insulin doing this.

Many things **** me off at the moment, this is most of them.

 

[Circuspony]

I have basically given up on exercise.

Because of various medical things I have spent most of the last six weeks (since diagnosis) feeling like I have a blood glucose of 1, although it's usually 5.5 when I feel like that. I have tried to run at that level, I've tried to run at 6.8, I've tried eating apples before, I've tried drinking lucozade during the run. Nothing works. It's almost as if it's not the actual level, it's the sudden drop. So it doesn't matter what I do, I will always feel like death if I try to take any exercise.

And then they say "oh, you should exercise."

And what really winds me up about this is that it isn't diabetes doing this. It's the TREATMENT for diabetes doing it. It's insulin doing this.

Many things **** me off at the moment, this is most of them.

I was getting like that, then another member told me to get carbs + insulin down me an hour before exercise and sugar (no insulin) into me just prior to starting. Made a huge difference. I definitely use up the sugar because I'm regularly <5 when I test before driving home and need a glucose tab.