Change due possibly to different insulin?

[kimlala]

I am a runner, have been for the last 20+ years. When my adventures started with diabetes my levels would increase drastically after running 8 miles (175-250). For the last 2 weeks doctor started me Levemir and Novolog, with this I have been dropping to 57-70 after exercising. I always carry glucose tablets with me (one day I forgot, and was paranoid the whole time). Could it be the new insulin, I am not ruling out heat (temps. in the 100's, but use to living in dry heat). Definitely a new adventure! Also, noting with low carbs it is difficult to keep out of low levels. No carbs, low carbs, low fat, high protein, high fat; I have to find balance. Think that will be my mantra today.

 

[catapillar]

What insulin were you using before?

 

[kimlala]

What insulin were you using before?

Tresiba, doctor tried this several different times, but had reactions to it. Before Tresiba, Januvia and Invokamet. Doctor was trying something different, but oral couldn't control my levels (root canal sent me spiraling down and weight loss of 10 lbs. in 2 days). Before oral was on Treshiba. I can't recall what insulin he started me on last November. I am finally seeing a specialist in July, and about a week ago I requested GAD-65 along with C-Peptide blood tests. I was surprised my doctor had not performed those test, and in the beginning I was clueless and believed the doctor knew best.

 

[catapillar]

Levemir is quite flexible as a basal insulin, it's quickly responsive to dose changes, so on days with long runs you can think about reducing your levemir dose for the run.

You can also look at adjusting your bolus dose to take less than your usual I:C ratio for the meal befor the run, ideally you'd really want to start the run with no insulin on board, so 4-5 hours after your last bolus.

You might want to think about some complex carbs pre run.

 

[Scott-C]

I am a runner, have been for the last 20+ years. When my adventures started with diabetes my levels would increase drastically after running 8 miles (175-250). For the last 2 weeks doctor started me Levemir and Novolog, with this I have been dropping to 57-70 after exercising. I always carry glucose tablets with me (one day I forgot, and was paranoid the whole time). Could it be the new insulin, I am not ruling out heat (temps. in the 100's, but use to living in dry heat). Definitely a new adventure! Also, noting with low carbs it is difficult to keep out of low levels. No carbs, low carbs, low fat, high protein, high fat; I have to find balance. Think that will be my mantra today.

Kim, can I ask, were you on a fast acting insulin before starting Novolog? The other insulins/meds you mentioned are basals, and oral lowering tablets, so if you weren't using a fast acting insulin before now, there's quite a lot of subtleties to using it properly and it might be that your doc hasn't explained it to you.

For example, if I was having a meal with X carbs, I'd take Y units for it if I knew I was going to be sitting around for the rest of the day, but if I knew that I was going to be doing an 8 mile run after it, I'd cut X down substantially, because I know that the exercise will allow me to burn off the glucose with less insulin.

Sounds like it's early days for you, but, if it's any small comfort, I did a lot of cross-country running, cycling for 50 to 80 miles, ski-ing for 6 hour stretches and hacking about in small racing dinghies all day before dx, and, after a short break to recover from the initial DKA and learning the basic rules, I carried on doing all that after dx without any difficulties. Just takes a bit of time to figure out a few adjustments which need to be made.

 

[kimlala]

Levemir is quite flexible as a basal insulin, it's quickly responsive to dose changes, so on days with long runs you can think about reducing your levemir dose for the run.

You can also look at adjusting your bolus dose to take less than your usual I:C ratio for the meal befor the run, ideally you'd really want to start the run with no insulin on board, so 4-5 hours after your last bolus.

You might want to think about some complex carbs pre run.

Thank you for the info. on Levemir. I will try reducing the dose when I run or possibly taking when I get home. I usually run every day, right after Dawn Phen./liver dump. Diet has been work, since I have been trying to follow Dr. Bernstein's book. I think in general I need more carbs.

 

[kimlala]

Kim, can I ask, were you on a fast acting insulin before starting Novolog? The other insulins/meds you mentioned are basals, and oral lowering tablets, so if you weren't using a fast acting insulin before now, there's quite a lot of subtleties to using it properly and it might be that your doc hasn't explained it to you.

For example, if I was having a meal with X carbs, I'd take Y units for it if I knew I was going to be sitting around for the rest of the day, but if I knew that I was going to be doing an 8 mile run after it, I'd cut X down substantially, because I know that the exercise will allow me to burn off the glucose with less insulin.

Sounds like it's early days for you, but, if it's any small comfort, I did a lot of cross-country running, cycling for 50 to 80 miles, ski-ing for 6 hour stretches and hacking about in small racing dinghies all day before dx, and, after a short break to recover from the initial DKA and learning the basic rules, I carried on doing all that after dx without any difficulties. Just takes a bit of time to figure out a few adjustments which need to be made.

Scott, I am in the early days and trying to figure it out. I was on several other insulin while in the hospital and for a short time after. At that time I responded well with exception of night hypos. Doctor decided to try oral medication and that worked for a short time (one illness sent it all to pieces, along with rapid weight loss). From that point, we were never able to stabilize my levels on oral meds.

My levels use to run extremely high after running (150-270+). Doctor couldn't understand this, for exact reasoning that exercise burns glucose, but I keep records of all my levels! lol This drop in levels only occurred after new meds. I usually run on an empty stomach, early morning. I think Catapillar is right that I need to readjust Levemir. I see a specialist in July, and hopefully he will have a better understanding of what is going on!