Exercise/Exertion Question for the T1's

[Ashintheuk]

A question I've never asked, so doing so now.

I have exercise triggered Reactive Hypoglycaemia.
When I am sedentiary, I produce little insulin of my own according to a c-peptide test a few years ago (in the T1 range).
I've had to up my exercise (walking) to help ease a back problem, and have had to make significant adjustments to me basal and bolus.

How much difference does walking make to your insulin dosing ?

TIA

 

[Juicyj]

Hello @Ashintheuk Depends on the individual/weight/physiology, insulin on board, duration of exercise, time of day, hormones, food eaten etc etc, there are many variables to insulin dosing for exercise.

As a t1d speaking from personal experience, for walks up to 30 mins in the morning no adjustment required, however in the evening I prefer with no active insulin on board. I use exercise to manage my condition too - so if running high then walking/running for 30 mins will help bring me back into range. I also make sure I always carry glucose, been caught short before which has been scary so glucotabs are always in a pocket now.

 

[Ashintheuk]

Hello @Ashintheuk Depends on the individual/weight/physiology, insulin on board, duration of exercise, time of day, hormones, food eaten etc etc, there are many variables to insulin dosing for exercise.

As a t1d speaking from personal experience, for walks up to 30 mins in the morning no adjustment required, however in the evening I prefer with no active insulin on board. I use exercise to manage my condition too - so if running high then walking/running for 30 mins will help bring me back into range. I also make sure I always carry glucose, been caught short before which has been scary so glucotabs are always in a pocket now.

Thanks for the response. I've gone from 28u of basal down to 18u with an increase in the walking I'm aiming for 10k + steps per day, and don't need any bolus with meals when walking. If I sit for a meal, and do nothing, the numbers are always north of 10.0.
I'm just trying to gauge how much insulin I am making now, and how it compares to T1s. I had the C-Peptide test done 6 years ago and it was around 1.02 with 1.10 being the baseline for normal numbers. I'm not sure how active I was before doing it as I didn't really understand how the RH was working (I need to do another one under sedentary conditions as I work as a CAD draughtsman and nailed to the desk for 8+hours a day

 

[Tony337]

Hi

My good control of my levels went to excellent when i got my first libre......

I was able to analyse my data to the nth degree and i did and was able to link walking (i don't class walking as exercise) to insulin and food intake.

I can only share a typical day for me and add i have always been sensitive to activity in the legs since i was a small boy 50 years ago which according to my mum startled the doctors....apparently its in my medical records....

Monday to friday i'm up at 5.45am and my levels rise by a couple of mmol/l.
I take 10 units of Levimir then walk to work and my levels drop by 2 mmol/l.
No food just coffee.

I average 15000 steps per day and sometimes have lunch (which i take novorapid for).

I use the activity in my legs with my background insulin to stay level.
If i'm rising un expectedly i get a wriggle on and this will bring it down to where i want to be.
If this doesn't work i will take a drop of novorapid.

My latest hba1c was 39 which is 5.7 in old money...

I hope this makes sense.....
Activity with my legs combined with insulin and food plus analysing the data has put me in a great place.
oh and i suppose 50 years of doing it must have some effect.


After re reading my post i think its the data analyses from the libre that has the biggest impact on my success.

I wish you well

Tony





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[Ashintheuk]

Hi

My good control of my levels went to excellent when i got my first libre......

I was able to analyse my data to the nth degree and i did and was able to link walking (i don't class walking as exercise) to insulin and food intake.

I can only share a typical day for me and add i have always been sensitive to activity in the legs since i was a small boy 50 years ago which according to my mum startled the doctors....apparently its in my medical records....

Monday to friday i'm up at 5.45am and my levels rise by a couple of mmol/l.
I take 10 units of Levimir then walk to work and my levels drop by 2 mmol/l.
No food just coffee.

I average 15000 steps per day and sometimes have lunch (which i take novorapid for).

I use the activity in my legs with my background insulin to stay level.
If i'm rising un expectedly i get a wriggle on and this will bring it down to where i want to be.
If this doesn't work i will take a drop of novorapid.

My latest hba1c was 39 which is 5.7 in old money...

I hope this makes sense.....
Activity with my legs combined with insulin and food plus analysing the data has put me in a great place.
oh and i suppose 50 years of doing it must have some effect.


After re reading my post i think its the data analyses from the libre that has the biggest impact on my success.

I wish you well

Tony





i

Hi Tony. I'd like to say how pleased I am that I'm not the only one dealing with this...but then the challenges aren't something I'd with on anyone else. I got a chest infection at Christmas from the RSV virus, was bedridden for a few days with a raging temperature. Despite not having any appetite, was needing 45u of basal to keep the numbers down along with 1u of bolus for every 6g of carbs. Good to see you are seeing such good control. I walked 18k steps yesterday and it helped a lot.

 

[Tony337]

Hi Tony. I'd like to say how pleased I am that I'm not the only one dealing with this...but then the challenges aren't something I'd with on anyone else. I got a chest infection at Christmas from the RSV virus, was bedridden for a few days with a raging temperature. Despite not having any appetite, was needing 45u of basal to keep the numbers down along with 1u of bolus for every 6g of carbs. Good to see you are seeing such good control. I walked 18k steps yesterday and it helped a lot.

Hi
Thats an awful lot of insulin when you were ill!
I take 10 units of levimir during the day and 14 units in the evening.
I never increase that just my fast acting novorapid if i need to.

The effect of walking on my insulin and food intake has always fascinated me and as i said the libre enabled me to analyse the data.

I'm a school caretaker and can choose how and when i do my jobs so to get a wriggle on if my levels are rising is really easy for me as is sitting down at my computer.
It sounds a bit trivial but its enabled me to achieve a good level of control.

Good luck with your endeavours and keep us posted on your findings.

I have tried to suggest walking as an aid to improved levels in the past but i found quite a bit of negativity came back which i put down to the fact it must just be me.

Tony

 

[Ashintheuk]

Hi
Thats an awful lot of insulin when you were ill!
I take 10 units of levimir during the day and 14 units in the evening.
I never increase that just my fast acting novorapid if i need to.

The effect of walking on my insulin and food intake has always fascinated me and as i said the libre enabled me to analyse the data.

I'm a school caretaker and can choose how and when i do my jobs so to get a wriggle on if my levels are rising is really easy for me as is sitting down at my computer.
It sounds a bit trivial but its enabled me to achieve a good level of control.

Good luck with your endeavours and keep us posted on your findings.

I have tried to suggest walking as an aid to improved levels in the past but i found quite a bit of negativity came back which i put down to the fact it must just be me.

Tony

Hi Tony, The numbers were wild. Viral load causes the adrenal gland to make a lot more cortisol, which in turn causes insulin resistance Research points towards it being an evolutionary trait to keep people alive when they couldn't forage or hunt.
When I see T1s talking about 'sick day rules' and upping their insulin, it's for this very reason.
I'm on 18u now of Abasaglar in the evening and 24 hour coverage for my long acting requirements. Only really using super fast acting Fiasp right now when doing carbs with a family meal and not able to time walking with it. Unfortunately, I moved from the factory floor 30+ years ago which was very physical to the drawing office which isn't. Walking helps enormously for me, I walk quickly and gives an average of around 100-115bpm when I do which is a cardio workout.

 

[Tony337]

Hi Tony, The numbers were wild. Viral load causes the adrenal gland to make a lot more cortisol, which in turn causes insulin resistance Research points towards it being an evolutionary trait to keep people alive when they couldn't forage or hunt.
When I see T1s talking about 'sick day rules' and upping their insulin, it's for this very reason.
I'm on 18u now of Abasaglar in the evening and 24 hour coverage for my long acting requirements. Only really using super fast acting Fiasp right now when doing carbs with a family meal and not able to time walking with it. Unfortunately, I moved from the factory floor 30+ years ago which was very physical to the drawing office which isn't. Walking helps enormously for me, I walk quickly and gives an average of around 100-115bpm when I do which is a cardio workout.

I understand and resistance dooms us all although i do things my own way if i'm struggling as i stop eating for 24 hours.....i have a sensitive stomach so find it quite easy to only eat carbs once a day and it works but again it might only be just me.

Ultimately what are we actually doing?

Experimenting on ourselves to see what works but i cannot recommend that because we are all different.
I don't see a specialist or DSN as i tend to end up arguing lol and fear i've become a pompous old so and so.

Good luck

Tony