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Type 1 Hypo When Walking

A

annienich63

Member
Messages
21
Type of diabetes
Type 1
Treatment type
Insulin
Hi
Recently attended useful conference re. Managing bs and exercise and motivated to do more but still can't understand why I can have a hypo when popping out for a 10 minute walk or walking round shops yet on the odd time attempted 5k parkrun albeit slowly bloods stable around 10? Frustrating!! Feeble excuse not to exercise at all
 
Does it have anything to do with insulin on board?
When we exercise, our bodies are more effective at using insulin. Therefore, if we have recently eaten, we may have fast acting "insulin on board" that we burn quicker and are more likely to go hypo. Whereas, if we exercise with little or no fast acting insulin since our last meal, our BG is less likely to drop.

Or, did you find the park run hard work?
If so, it could be that your body was stressed so your liver released more glucose to manage that stress.
As we get more used to different types of exercise, the effect that type of exercise has on our BG changes.

Or it could be that your body was having a "funny turn".
 
helensaramay said:
Does it have anything to do with insulin on board?
When we exercise, our bodies are more effective at using insulin. Therefore, if we have recently eaten, we may have fast acting "insulin on board" that we burn quicker and are more likely to go hypo. Whereas, if we exercise with little or no fast acting insulin since our last meal, our BG is less likely to drop.

Or, did you find the park run hard work?
If so, it could be that your body was stressed so your liver released more glucose to manage that stress.
As we get more used to different types of exercise, the effect that type of exercise has on our BG changes.

Or it could be that your body was having a "funny turn".
Click to expand...
 
Thanks for your response. Found the parkrun really hard as do very little exercise so no wonder my body reacts. It's the hypos when doing very little catch me out. I only have 3 units at breakfast and don't know then how far I'm going to walk to adjust! Trying not to make excuses to not excercise after being at the conference where half the attendees were then doing the swansea half marathon!!
 
I suspect that when you do a parkrun you're all geared up for it, so a blood test before hand and are generally prepared for your blood sugar to maybe go low. A walk round the block? Maybe not so much?

Honestly, after 48 years I still find hypos (one of) the worst things about being diabetic. I feel like all diabetic consultants/nurses should be forced to experience one just so they realise how unpleasant it is. :) (Though to be fair, I've noticed that my consultant in New Zealand is much more concerned about hypos than anyone I've dealt with before. I don't know whether this is a general trend or whether it's just her.)
 
EllieM said:
I suspect that when you do a parkrun you're all geared up for it, so a blood test before hand and are generally prepared for your blood sugar to maybe go low. A walk round the block? Maybe not so much?

Honestly, after 48 years I still find hypos (one of) the worst things about being diabetic. I feel like all diabetic consultants/nurses should be forced to experience one just so they realise how unpleasant it is. :) (Though to be fair, I've noticed that my consultant in New Zealand is much more concerned about hypos than anyone I've dealt with before. I don't know whether this is a general trend or whether it's just her.)
Click to expand...
 
Hi @annienich63.
As someone on insulin for 51 years I concur with @helensaramay@EllieM and @ringi that the adrenaline release associated with the anticipation of a run and the vigorous nature of the exercise will push BSL s up. I have been there many times!!
The other thought is that, as well as it being a non-stressful event, taking a walk just after insulin and breakfast, could increase absorption of some of the recently injected short-acting insulin. And there may not have been time for your blood sugar to rise from intake of your breakfast and in fact the walk might have slowed the uptake of sugar from your meal as some blood would have been diverted away from your digestive system to supply you muscles with oxygen etc.
This increased in insulin absorption would apply particularly if the area the insulin was injected in was being exercised (e.g. leg).
If you had injected your insulin into your leg on those short-walk-then-hypo occasions you might wish to try the injection in another area e.g. your abdomen area to see if there was any difference in response. ( but check this suggestion with your dsn or doctor first.)
 
kitedoc said:
Hi @annienich63.
As someone on insulin for 51 years I concur with @helensaramay@EllieM and @ringi that the adrenaline release associated with the anticipation of a run and the vigorous nature of the exercise will push BSL s up. I have been there many times!!
The other thought is that, as well as it being a non-stressful event, taking a walk just after insulin and breakfast, could increase absorption of some of the recently injected short-acting insulin. And there may not have been time for your blood sugar to rise from intake of your breakfast and in fact the walk might have slowed the uptake of sugar from your meal as some blood would have been diverted away from your digestive system to supply you muscles with oxygen etc.
This increased in insulin absorption would apply particularly if the area the insulin was injected in was being exercised (e.g. leg).
If you had injected your insulin into your leg on those short-walk-then-hypo occasions you might wish to try the injection in another area e.g. your abdomen area to see if there was any difference in response. ( but check this suggestion with your dsn or doctor first.)
Click to expand...
Thank you for explaining. It normally happens not long after breakfast or lunch so makes sense that the insulin is acting before the food. Guess my excuse for not doing parkrun because of hypo fears is a not justified!. My brother has been type 1 40 years but there's only so many times I can have him on speed dial so all advice is really helpful!
 
annienich63 said:
Thank you for explaining. It normally happens not long after breakfast or lunch so makes sense that the insulin is acting before the food. Guess my excuse for not doing parkrun because of hypo fears is a not justified!. My brother has been type 1 40 years but there's only so many times I can have him on speed dial so all advice is really helpful!
Click to expand...
?Plus could it be that the exercised body part has the insulin residing in it and come to think of it even the abdomen gets exercised with a walk, probably not as much as one's legs though !!??
 
annienich63 said:
Thank you for explaining. It normally happens not long after breakfast or lunch so makes sense that the insulin is acting before the food. Guess my excuse for not doing parkrun because of hypo fears is a not justified!. My brother has been type 1 40 years but there's only so many times I can have him on speed dial so all advice is really helpful!
Click to expand...


Have you considered a pump to minimise the impact of exercise some?

you can give smaller amounts more accurately over a longer period as well as shut of background to increase bgs as necessary.
 
Engineer88 said:
Have you considered a pump to minimise the impact of exercise some?

you can give smaller amounts more accurately over a longer period as well as shut of background to increase bgs as necessary.
Click to expand...
Hi @Engineer88 If the bolus has already been given I am not sure a pump is any better in the walk just after breakfast scenario.
Whether is is better for a park run etc ,maybe, but how to deal with the blood sugar rise due to adrenaline (in me that effect can peak at the 3 to 4 hour mark*)? And then there is the known risk of hypo at the 6 + hour mark. Believe me I have tried with the pump. It may be that the pump might work better the less years on insulin one has been.( the more 'flexible' the blood sugar/insulin response seems to be- just a personal theory !!)
I started on the pump at the 45 year mark on insulin and the only accomodation that worked was to only do moderate to light exercise, like quick alternating with slow walking, non-competitive, with some weights on. kayaking (but not racing) etc. That way the adrenaline surge appears to be minimal and I get by by just reducing my basal rate by about 20% for 4 hours or so.
Having said that if I watch a scary or thriller movie I have to pre-bolus equivalent of about 40 g carbs, increase basal 20 to 30% for minimum of 5 hours and eat no carbs within 2 hours before until at least 4 hours after the movie commences. Even then does not work sometimes as the adrenaline surge seems to push the sugars up to peak at 3 hours or greater *(like with very vigorous exercise > 2 hours).
Of course if one has a CGM and can view the BSLs post event it may be possible to find better or more accurate causes and solutions !! Let's hope so !!
 
kitedoc said:
Hi @Engineer88 If the bolus has already been given I am not sure a pump is any better in the walk just after breakfast scenario.
Whether is is better for a park run etc ,maybe, but how to deal with the blood sugar rise due to adrenaline (in me that effect can peak at the 3 to 4 hour mark*)? And then there is the known risk of hypo at the 6 + hour mark. Believe me I have tried with the pump. It may be that the pump might work better the less years on insulin one has been.( the more 'flexible' the blood sugar/insulin response seems to be- just a personal theory !!)
I started on the pump at the 45 year mark on insulin and the only accomodation that worked was to only do moderate to light exercise, like quick alternating with slow walking, non-competitive, with some weights on. kayaking (but not racing) etc. That way the adrenaline surge appears to be minimal and I get by by just reducing my basal rate by about 20% for 4 hours or so.
Having said that if I watch a scary or thriller movie I have to pre-bolus equivalent of about 40 g carbs, increase basal 20 to 30% for minimum of 5 hours and eat no carbs within 2 hours before until at least 4 hours after the movie commences. Even then does not work sometimes as the adrenaline surge seems to push the sugars up to peak at 3 hours or greater *(like with very vigorous exercise > 2 hours).
Of course if one has a CGM and can view the BSLs post event it may be possible to find better or more accurate causes and solutions !! Let's hope so !!
Click to expand...

If you get a pump and CGM you can close the loop which is the most ideal situation and which I've done.

Not sure on the theory I'm afraid, 27 years diabetic started a pump after 23. unless you mean starting at a year or two which all diabetics should these days frankly.

Post breakfast if you know you will go for a walk you can delay the bolus or extend it which would allow breakfast to be absorbed before insulin hits. I also found I needed much less insulin and can give fractions of a unit increasing accuracy.

I don't do long lasting exercise as it doesn't agree with me personally. I find walking can be very tricky though so sympathise with OP
 
Engineer88 said:
Have you considered a pump to minimise the impact of exercise some?

you can give smaller amounts more accurately over a longer period as well as shut of background to increase bgs as necessary.
Click to expand...
Hypos when exercising was the major justification for me to have a pump.
As @kitedoc mentions, there is little impact with the bolus. However, the huge benefit is the control of basal so I reduce my basal before exercise and, therefore, have less insulin on board whilst my body is using it most effectively.
There are some exercises which result in a bigger liver dump.(climbing for example) so I increase my basal for these sports.
Over time I have learnt how different sports affect BG... although this changes.
 
helensaramay said:
Hypos when exercising was the major justification for me to have a pump.
As @kitedoc mentions, there is little impact with the bolus. However, the huge benefit is the control of basal so I reduce my basal before exercise and, therefore, have less insulin on board whilst my body is using it most effectively.
There are some exercises which result in a bigger liver dump.(climbing for example) so I increase my basal for these sports.
Over time I have learnt how different sports affect BG... although this changes.
Click to expand...
Thank you @Engineer88 ,
I agree that the % delayed bolusing could work. In Australia we lag behind as the closed loop pump systems are not available here yet. I note that with systems like Libre and fractional dosing pens there has been an argument that they can provide results as good as pumps ( but i bet the authors have not thought about closed loop, auto dose reduction for low bsls and also about getting up at say 4 am to test and dose for any DP !)
 
kitedoc said:
Thank you @Engineer88 ,
I agree that the % delayed bolusing could work. In Australia we lag behind as the closed loop pump systems are not available here yet. I note that with systems like Libre and fractional dosing pens there has been an argument that they can provide results as good as pumps ( but i bet the authors have not thought about closed loop, auto dose reduction for low bsls and also about getting up at say 4 am to test and dose for any DP !)
Click to expand...


You can build it yourself, if your interested look up androidAPS - I believe there is a specific Australian group also
 
Engineer88 said:
You can build it yourself, if your interested look up androidAPS - I believe there is a specific Australian group also
Click to expand...
Thank you for that. I have an Animas pump (which as you know takes Dexcom CGM) (and my pump's warranty does not run out until late 2019, after which it is a choice of Tandem or Medtronic). And I have an IPhone. (but due for replacement probably within 12 months). But I shall look into it.
 
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