Exercising for the first time

Bex,

first thing, go out and buy yourself a heart rate monitor. You really need to make sure you are controlling your effort properly to be able to build up your base fitness level. Garmin, Polar and Timex all do a whole range with some very reasonably priced basic ones, right through to several hundred pounds depending what you want.

If you are starting from scratch, throw any targets related to speed out of the window and just concentrate on fitness, the speed (if you want it) will come later.

A very handy formula for target heart range is the MAF formula, from a guy called Phil Maffetone, for Maximum Aerobic Funntion, very simply 180 - age, with a few adjustment factors depending on your personal circumstances. For you, as you are a complete beginner I'd go with 180-age-5. For me I go with +5 as I'm an experienced athlete, so that gives me 180-39+5 = 146.

When you go out jogging, do not let your HR go above this level, for at least the next 3 months I'd suggest. If that means you have to slow down, or even walk, then that's what you should do. The reason for this is that what you need to do is to develop a good base level of fitness. This will help in a number of ways; your metabolism will becoem more predictable which will make your response to insulin and food intake more predictable; it will help you understand better how you respond to exercise; it will improve your insulin sensitvity; it will allow you to exercise more regularly because you will not be overdoing it each time.

I suggest you pick a target time for exercise to start with, say 20-30 mins, and when your fitness is starting to improve, defined by being able to jog for all or most of that time, then start increasing duration or speed gradually.

I do all of my training based on HR, with the majority of it outside the racing season being controlled at these "easy" HR levels. Like you I'm new to diabetes, but not managing exercise. So far, I've not had to alter insulin levels for shorter sessions of an hour or less, but I have done for longer runs of 2-3 hours or more. What I've been doing is making sure I don't have any active bolus on board, so exercise before meals or 2-3 hours after. I always take my test kit with me, and test every 6km (around 30-35 mins at my steady pace) and take a medium acting carb source in case I find my level dropping. You need to keep testing to get a pattern of how exercise affects you.

One reason you may have seen the drop and then massive spike is becasue you are working too hard, hence the HR monitor advice. For me, I know that on a cycling time trial I don't need any carbs beforehand as the adrenaline response from the hard work will dump glucose from my liver and I can see a rise from start to finish, you may be seeing the same.

That's quite a lot to squeeze into one post and for you to understand, feel free to ask any more questions or even drop me a PM.

Dave

terrific reply dave, i know i didnt ask the question and im not even t1 but thanks anyway lol, very interesting

Hi Bex,
Bananas don't really affect my levels and if you're going for a 30 minute run, you'll want something faster acting like a bottle of Lucozade Sport. You'll need to experiment a bit with how much sugar you'll need to cover the 30 min run, but start off with the assumption that 10g of sugar will bring your levels up by 2mmol/l. Assuming the banana didn't contribute to your levels during the run, I'd start off with a drink containing 30g of sugar, which is what a bottle of Lucozade Sport contains.

Oh and I always carry my sugar meter and some dextro tablets with me when I run. I put them in a bum bag, which makes me look like a bit of a plonker no-doubt. I find it difficult to tell whether I'm hypo or not when I'm knackered from exercise and I don't want to find myself out in the middle of nowhere with no BG meter or sugar.

I won't go into basal dose changes as you said you don't want things to get too complex, but as far as your post meal hypo is concerned you could either increase your carb content for that meal or decrease your meal time bolus. UP to you.

Bex,

Runsweet is a site that was set-up for type 1's who enjoy their sport, here is the link to the website:

http://www.runsweet.com/

For me tonight, just a steady run, but the added variable of the heat threw a spanner in the works.

Started at 5.7, 6km later down to 3.8
Half an energy bar, 22.5g of carbs
Finish of the run, 9km, back up to 5.4.

I prefer the approach of test and manage over the blunt instrument of just assume a sugar need before you start, because there are too many variables involved.

As an example, a 10k run last week saw me go 7.3, 5.7, 4.9, with no carbs that day, even though it was just as hot, and heart rates were similar for both runs, today's run was actually a bit slower.

Bex
Well done for getting out there despite being relatively newly diagnosed and in this heat etc..... I am a runner and a Type 1 (30+ years) and all I can say is that balancing aerobic exercise and blood sugars is tricky but please keep trying as you will feel better for it and mitigate some of the cardiovascular consequences of having diabetes.

Things to bear in mind are that your blood sugar will usually drop in response to exercise if you're starting at a normal level. If you start out 'high' then your body can't access the sugar in your blood and pumps out more from your liver so you'll go even higher and feel terrible. Your blood sugar will continue to drop after exercise as you've experienced.
Sprints or other short sharp exertions can cause a more rapid drop but it doesn't sound as if you're there yet.
Hence I have sometimes felt like I was on a roller coaster of blood sugar crashes and rises with no control over my body and perhaps I'd be better off doing some yoga.

I don't want to make it complicated for you but perhaps you could drop your basal dose by 2 units on running days to prevent the nightime post run hypo or take on a snack at bedtime (slice of wholegrain toast or other low GI snack) since you can clearly afford a few extra calories.

Pre exercise you could top up your banana with a couple of oatcakes - something to give you a sustained energy boost rather than having to turn to jelly babies.

As previously mentioned do take your kit with you just so you can feel confident!
Your're not going too fast - you should be able to say a few words whilst running/walking. Please do some stretches so that you don't get injured as well as getting some good shoes and the right bra!

BTW I got a pump so that I could mamage exercise easier (I have a constant drip of insulin going in which I can turn down for a set period before, during and after a run all of which has helped me run with smoother blood sugars and no nasty dips.....

I'd be mindful to avoid the midday sun in this weather. Folk are passing out just going to the shops. Well done for seizing the initiative. Be careful.

Hi Bex, the drops in BG after exercising is not the adrenaline. Adrenaline causes blood glucose to rise as it promotes glucagon production.

Your insulin is more efficient after exercise because the act of exercise makes your cells more absorbent. The process for this is complicated and involves a few different types of molecules that signal to a muscle cell that it is exercising. These signal molecules make more insulin receptors (known as GLUT4 receptors) appear at the surface of the cell. Having more of these receptors at the cell surface means that less insulin is needed to regular blood sugar levels. Hence the hypos.