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Type 1 Adjusting insulin for exercise - advice

O

O_DP_T1

Well-Known Member
Messages
458
Location
United Kingdom
Type of diabetes
Type 1
Treatment type
Insulin
Hi all,

I am currently on Humalin M3 and exercise every other day, the problem I am having is that I usually train in the evenings during the week and after training I have a protein and carb based shake but I am still getting lows at around 2-3am, usually I have my level between 7-9 after the shake but it still crashes.

Sooooo the question is with Humalin M3 and you make daily adjustments to dosages, can I reduce the insulin on training days to stop the night lows?

My DSN says that any changes on that insulin regime with take around 72hours to take effect so you can't really change it daily. Any advice would be great.
 
Where are you based? Why are you on mixed insulin and not basal bolus (which would be much more flexible)?
 
Based in London, I'm not on basal bolus because I've managed to get good control on twice daily until recently.
 
O_DP_T1 said:
Based in London, I'm not on basal bolus because I've managed to get good control on twice daily until recently.
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It seems to be accepted that basal/bolus will Trump mixed insulin all day, everyday. I can't really quantify that, as I was straight on MDI at diagnosis. I imagine there must be good rationale for that though. From what I understand about mixed insulin is that less injections is the only benefit...

I think intermediate insulin peaks somewhere between 5-8 hours? Does the hypo happen 5-8 hours after your evening injection?

Insulin sensitivity is temporarily increased when you exercise. That increased sensitivity would be very, very difficult to manage on your insulin regime.

I'd request your diabetologist to run through the various insulin therapy options available to you so as to gauge what will be best for your lifestyle:)
 
GrantGam said:
Does the hypo happen 5-8 hours after your evening injection?
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Yep around that time, thing is if I reduce it to stop late night hypo's on training days then the none training days are crazy high in the mornings, like today was about 11, so I'm trying to figure out if it's possible to increase/decrease the evening insulin based on training days. But there's not much info anywhere to be found.
 
O_DP_T1 said:
Yep around that time, thing is if I reduce it to stop late night hypo's on training days then the none training days are crazy high in the mornings, like today was about 11, so I'm trying to figure out if it's possible to increase/decrease the evening insulin based on training days. But there's not much info anywhere to be found.
Click to expand...
I don't think you're going to make much headway with mixed insulin and sporadic exercise (as in, not exercising every single day, at the same time and same intensity).

With MDI, you can take less basal in the morning (if on a split basal dose) when you're planning a busy day/day full of exercise, etc. And if there's any change of plans last minute, you can simply compensate for the lack of basal insulin with rapid acting insulin.

I'm afraid I can't offer any first hand advice regarding your insulin regime, but I know that it only works well around absolutely rigid routine. There is marginal wiggle room for changing that routine, so you're kind of stuck I would have thought. MDI is designed to give the diabetic as much flexibility as possible, it would seem like that type of insulin therapy could benefit you greatly.
 
Thanks @GrantGam I'm kind of in 2 minds to swap to MDI or not as I've been on mixed insulin since I was diagnosed in 1978 and tbh I've managed to get very good control on it until now.
 
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