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Exercise and basal bolus problems

Chloelox

Well-Known Member
Messages
133
Location
North Wales
Type of diabetes
Type 1
Treatment type
Insulin
So I’ve just come back from a trip, with crazy fluctuating blood sugars from 23mmol dropping to 3.8mmol in half an hour. So I reduced basal while on my trip because I was doing a lot more exercise, probably triple of what I would do in a day with long walks in the sun sightseeing. Including needing a lot less bolus for food but ending up with creeping blood sugars. I put it down to the 28 degree weather and also the extra exercise.

I got home yesterday and kept my basal reduced and low and behold, 3 hypos in the night - all treated then 2 hours later I would need to wake up to treat another.

does anyone find extra exercise helped lower insulin intake, I would usually take 12 units basal but am now taking 10, probably going to end up reducing to 9 and then I’m taking 2-2.5 units for meals with an odd correction if sugars are high.

I should also probably mention I had my second covid jab a week ago so I’m unsure if these crazy fluctuations are delayed reaction as prior to my trip my blood sugars had been the best they had been in weeks and I really got it under control. In 3 days I seem to have managed to reverse all the good I did for lowering my hba1c lol.
 
Chloelox said:
does anyone find extra exercise helped lower insulin intake,
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In a word, yes.

Exercise increases insulin sensitivity. How much, is a very personal thing. But honestly, though some people can stay on the same levels for years at a time, I find insulin amounts can be pretty variable, you just have to keep adjusting them.
 
Yes, exercise reduces my basal needs for 24 to 48 hours.
But my second jab reduced my basal needs further - down to about 65% of what I normally take,
 
Reactions: ert
Not sure about the jab factor but heat and long walks take glucose out of your muscles slowly so that if your insulin is doing the same you can get hypos during and after the effort as you've discovered.
My only solution is to start out with a higher bg (more food or less insulin) or as you've done take the basal down. Pump people can do a temporary basal reduction or even unplug. If you know you've dropped by 6mmol by the end of that walk for example you could safely start out at 12. I find that if I start out too high then I feel awful and I seem to go higher. I suppose there's a 'sweet spot'.
The basal dose solution lasts a bit longer than he walk obviously so you may find you then go higher and have to mess around with correction doses which I personally find are very hard to get on top of.
 
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It does seem a very fine line between going up and coming down , Iv'e woken up with a bg of 12 and given myself 4 units extra and 2 hours later it's gone up to 16 and on another occasion woken with a bg of 14 given myself 2 units extra and 2 hrs later it's gone down to 5 . But don't give up you'll get there .
 
NicoleC1971 said:
If you know you've dropped by 6mmol by the end of that walk for example you could safely start out at 12.
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Why not start lower and munch something halfway the walk to prevent going low without having to start out high? Munching and walking go very well together
 
In Response said:
Yes, exercise reduces my basal needs for 24 to 48 hours.
But my second jab reduced my basal needs further - down to about 65% of what I normally take,
Click to expand...

I was the same following my jabs both times. I was expecting my levels to increase but no, hypo's all round for a few days so had to lower both bolus and basal to practically nothing.
 
Antje77 said:
Why not start lower and munch something halfway the walk to prevent going low without having to start out high? Munching and walking go very well together
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True but I hate crumbs in my handbag! Know many who know precisely when to time a jelly baby though...
 
KK123 said:
I was the same following my jabs both times. I was expecting my levels to increase but no, hypo's all round for a few days so had to lower both bolus and basal to practically nothing.
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I was high on the first jab for about 2 weeks, then blood sugars have been fine on this second one up until the day I went on my trip. So I’m leaning more towards the exercise and heat being the reasoning behind the fluctuations. As that’s the only thing different aside from the jab.
 

I agree, I find it depends on time of day aswell. Some mornings I can wake up high. Sometimes I have lie ins and wake up in target without adjusting any basal. I also find I’m more resistant to corrections in late afternoon/evening than I am in the morning too.
 

Hi @Chloelox ,

What were you treating the tripple night hypos with?
Fast acting only?
I find when my basal is too high on hotter days at work, I need to follow up with longer acting carbs. Which can at least prolong having another, if not stop a recurrence?

Yeah, there are days I need to drop mine by a couple of units. There can be corrections with me in the mornings though, but I put that down to liver dump, (don't do breakfast first thing, seems to be foot on the floor stuff.) I have to be carful with lows off that mid late morn.
 
Hi

I’m on a pump which automatically adjusts basal based on my BG

I have a quite active job and find my insulin needs change when not working even just weekends but more so when I’m off more than a few days.. my needs go up as I’m normally less active when not at work

Even my bolus and corrections change a little

I find also my insulin needs go up and down trough out the year. It can be a pain I wish it was as easy as finding what I needed and it stayed like that..
 


I treated with Fast acting 200ml Pepsi for the first one, the second hypo I treated with 200ml Pepsi followed by a 15g carb rice cracker then the third hypo I treated with 300ml Pepsi and a small piece of brown toast. Woke up 3 hours later going low again. I usually skip breakfast but I decided to eat this morning and give just 2 units of fast acting for 40g of carbs. Ended up high a couple of hours after, by mid afternoon I was back down at normal level with just a 1 unit correction.
 

I’m normally moderately throughout the week and find blood sugars to be quite steady and I had a good routine going. I usually do 2.5km -3.5km in steps a day. I did on average 10km a day on my trip. I have a libre 2 and it was struggling to keep up once the hypo started to hit.. and it was taking longer than usual to recover which makes me suspect the insulin in my system was just too much for the exercise, heat or both to cope with and I just ended up plummeting.
 

To be fair, if your woken low? The go to, is something sweet..
At work I carry Lucozade. I don't particularly like the stuff. & actually have JBs in my pocket & something longer acting in a bag.

My colleague glugs it too.. But it is a fast hit & I need to keep cracking on.

I noticed you mentioned using a Libre. (Teaching gran to suck eggs time.) are you double checking with the meter?
The Libre can lag well behind regarding a recovery from a low..

I empathise, one low at the wrong time can take the wind out of the sails. Recurring lows during the day? Not my idea of a good time..
 

yeah I tested against metre, libre said I was actually in range, a finger prick let me know it was reading 1mmol higher, plus I was having symptoms. I’ve lowered my basal to 10 units tonight so we will see what happens overnight.

no a day of recurring hypo’s makes me really weary of eating and injecting where more often than not I end up under injecting until I know for sure I can inject more and not crash into a plummeting hypo.
 
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