Managing exercise and insulin

Tracie1212 · Mar 2, 2018

My levels are unstable find that even light housework pushes levels up. Have been on dafne course try to carb count and use CP calculator. If I try to adjust fast and background insulin I get shakes but if i dont adjust am left with high levels. Should I try aim for blood of 8 two hours after eating and inject to correct if higher. Type 1 for 16 years I inject novorapid and lantus. On 2:1 ratio for breakfast then 1:1 rest of day. I have tried 2:1 at other meals but go low. Its really hard work trying to stabilise. Please help if you can. Thanks.

Juicyj · Mar 2, 2018

Tracie1212 said:
My levels are unstable find that even light housework pushes levels up. Have been on dafne course try to carb count and use CP calculator. If I try to adjust fast and background insulin I get shakes but if i dont adjust am left with high levels. Should I try aim for blood of 8 two hours after eating and inject to correct if higher. Type 1 for 16 years I inject novorapid and lantus. On 2:1 ratio for breakfast then 1:1 rest of day. I have tried 2:1 at other meals but go low. Its really hard work trying to stabilise. Please help if you can. Thanks.

Hi Tracie, do you have your DAFNE handbook around ? DAFNE teaches not to test/correct within 4 hours otherwise you're insulin stacking which can lead to a hypo, DAFNE also educates about basal testing as above all else this is the starting point of getting your control right, you can break it down into 4 time frames: http://www.salforddiabetescare.co.uk/index2.php?nav_id=1007 If after doing the basal testing and getting your basal dose adjusted correctly and your're still left with high levels then your carb/insulin ratio needs adjusting. I am more 'insulin resistant' in the morning so my morning ratio is at it's highest then. I drop it for lunch but raise again slightly for evening as more sedentary in the evening. Also keep a diary to record results and insulin taken with amount of carbs, it will help you to see what patterns form and make decisions then. I became more confident after doing DAFNE about adjusting my doses, how do you feel now you've done it and are you more inclined to adjust your own doses now ?

Tracie1212 · Mar 3, 2018

Juicyj said:
Hi Tracie, do you have your DAFNE handbook around ? DAFNE teaches not to test/correct within 4 hours otherwise you're insulin stacking which can lead to a hypo, DAFNE also educates about basal testing as above all else this is the starting point of getting your control right, you can break it down into 4 time frames: http://www.salforddiabetescare.co.uk/index2.php?nav_id=1007 If after doing the basal testing and getting your basal dose adjusted correctly and your're still left with high levels then your carb/insulin ratio needs adjusting. I am more 'insulin resistant' in the morning so my morning ratio is at it's highest then. I drop it for lunch but raise again slightly for evening as more sedentary in the evening. Also keep a diary to record results and insulin taken with amount of carbs, it will help you to see what patterns form and make decisions then. I became more confident after doing DAFNE about adjusting my doses, how do you feel now you've done it and are you more inclined to adjust your own doses now ?

Tracie1212 · Mar 3, 2018

Thanks for your reply. Dafne has helped I monitor carbs and adjust . I have reluctantly stopped taking vitamin C as think this spiked my levels. Plus stopped sweetners. My stress levels are high due to bereavement and looking after a very frail elderly parent. I have more energy in the morning but am wiped out after lunchtime injection. This has always been the case since diagnosis. Went to bed last night on level of 13 had not eaten since 3.30pm. On waking it was still 13. I inject lantus first thing in the morning. I was splitting it with night time injection but constantly felt unwell overnight so consultant told me to take it back to morning injection only. I put so much time and effort into management of this its exhausting.

Juicyj · Mar 5, 2018

Hi @Tracie1212 It's highly unlikely that Vit C has spiked your BG levels unless it's loaded with sugar, more likely the stress you are under is causing your levels to remain high, stress is known to release hormones such as cortisol which causes BG levels to remain high, hence why getting some exercise will help, so even getting out for a daily walk of about 30 mins will help. If you're not feeling well taking lantus then ask your team to change your basal, tresiba has a much more stable profile, one injection a day, some people do have an adverse reaction to lantus so it's worth trying this. Let us know how you get on ?

Type1Bri · Mar 5, 2018

Adrenaline and stress do odd things to my bloods. Have a look at how my diabetes responded yesterday in a half marathon race
https://type1bri.com/the-big-half-how-d-played-ball

RuthW · Mar 16, 2018

NoKindOfSusie said:
Circus that's basically my experience, any kind of serious exercise just makes you feel awful after a few minutes. It is really annoying to realise that it isn't even diabetes that is causing this, exactly the opposite, it's the TREATMENT for the diabetes which is causing this, not that we have any choice.

I usually take 0.5 to 1 unit with breakfast because I am trying to eat low (well no) carb and I have to admit some sort of carb content for the peppers and onions in a vegetable omelette or whatever it is. Probably half a unit is still too much but I would rather be low than high given the long term risks. Before running I have tried eating apples (14g each) and so on but either it isn't enough or it isn't fast enough. Sometimes if I am below 6 before bed I will eat a couple of crackers (5.3g each) and they go in far faster but I would be terrified of trying to do that as a way to fuel running because you'd end up at some scary number before you knew it.

It just doesn't seem like there's any way to have enough fuel on board to actually do a half hour run, without the drugs ruining it. That's probably about what I used to do, half an hour each way. The only backup plan I have is to just keep sipping glucose drinks as I go but that seems very easy to get wrong and end up damaging yourself. At the end of the day it feels like there are a lot of things you can in theory do with diabetes, you can eat big slices of chocolate cake and meals with chapatis and white rice and you can go running. While I wouldn't want to speak for anyone else, for me the risks of doing these things outweigh the reward. And I do not say that lightly.

The long-term risk of hyperinsulinemia is Alzheimers so running a bit high might not be so bad.

https://www.news-medical.net/news/2...-between-diabetes-and-Alzheimers-disease.aspx

NoKindOfSusie · Mar 17, 2018

RuthW said:
The long-term risk of hyperinsulinemia is Alzheimers so running a bit high might not be so bad.

https://www.news-medical.net/news/2...-between-diabetes-and-Alzheimers-disease.aspx

It's sort of getting to the point where I don't care anymore. No matter what you do or even what you try to do someone will come out with something like this... and people claim that diabetes is not progressive... there's so many traps and pitfalls that you are never going to be able to avoid them all.

EllieM · Mar 17, 2018

I've been T1 for 48 years, first 12 pre blood testing meters. My HbA1C has averaged between 7 and 8. (I'm sure it was worse for first decade.) No current diabetic complications and my consultant's only concern is low blood sugars. OK, maybe I have a miraculous cope with high blood sugars metabolism but ....

Live a little - if you can't cope with higher blood sugars you can be more careful.

Remember the statistics of bad diabetic results are full of people who never blood test.

Care but don't let it rule your life.

T1 is not the same as T2.

kev-w · Mar 17, 2018

I'm usually 'good' at exercise & insulin, I just swam for 30 minutes yesterday, 1150metres, but this morning woke up hypo at 5am, had glucose tabs, went back to sleep and woke up a bit back at 2.9 on a finger prick which shouldn't have happened as my blood was a slightly rising 7 at bed time.

Traps & pitfalls.... But I've my shoulders to train at lunch and if the afternoon works out I've got my young un to take swimming, I just need the headache to go away

therower · Mar 17, 2018

@kev-w. Don't you just hate it when the D manages to catch you unawares. Bloody cowardly to kick you in the groin ( mods don't like the other word) when you're asleep.
I'm sure you'll get swimming, you're not the type to let it get 2 over you in one day.

Look on the bright side. Your headache was free. A night on the town would have probably had the same outcome but put a hell of a hole in your wallet.

kev-w · Mar 17, 2018

therower said:
@kev-w. Don't you just hate it when the D manages to catch you unawares. Bloody cowardly to kick you in the groin ( mods don't like the other word) when you're asleep.
I'm sure you'll get swimming, you're not the type to let it get 2 over you in one day.

Look on the bright side. Your headache was free. A night on the town would have probably had the same outcome but put a hell of a hole in your wallet.

I did the swimming, but not the gymming as I wrote the morning off with a bouncing blood, never mind I can do them tomorrow when I take the little un back.
I could cope with a hang over in my sporting days, play RU on a Saturday afternoon, have a night out with the team and be up for a game of RL on a Sunday morning, and that was before digital blood testing and insulin pens
I think I'm still alive thanks to lucozade sport....

Gillyflood · Mar 28, 2018

Hi all, I have been reading with great interest as I have completely lost my mojo where exercise is concerned. If I'm being completely honest, I am totally fed up with being T1. A couple of years ago I was diagnosed with breast cancer and so had a mastectomy, chemo, radiotherapy and at one point, due to a bad reaction to one specific type of chemotherapy, had to take a course of steroids which played havoc with bg levels. Reconstruction is on the horizon, which is a great thing, but I have had enough of things being taken off, stuck on and in to my body and would just like to feel 'normal'. I am slowly changing my diet to one that has a lower carb content and I would love to get back to being active - even a little every day would be great. When I work, the days are long and sedentary. I have two great girls who miss me when I am at work and who are stuck to me when I am not. I guess I am feeling overwhelmed and a little under-supported and I am hoping that there are members on the forum who can give me some sound advice and encouragement on my way?

Thank you in advance x

Juicyj · Mar 31, 2018

Hello @Gillyflood The best way to start exercise is to find something you really enjoy and start gently so walking or swimming, perhaps something you can do with your girls, as long as you look forward to it and plan for it so that you do get out then it will remain enjoyable

eng · Apr 5, 2018

I've been T1 diagnosed some 33 years ago and over the last 10 years have put a considerable amount of weight on, this is due to my job being sat on my backside for considerable amounts of time. I self prescribed the Libre some 24 months ago and after a while grew the confidence to reduce my carb input which allowed me to loose a stone. Although I struggled to loose any more, So I decided to get back on the bike. What I've found there is no rhyme or reason with Diabetes.

A few weekends ago I Carbed up (3 slices of toast) pre ride with no bolus insulin, Started the ride at 12 mol/l, mid ride at 10 mile my numbers were <<6 mol/l so mars bar and finished ride after another 12 miles with numbers <4mmol/l so had a second mars bar (Other chocolate bars are available) and a hour or two later my numbers were 6mmol/l. Two weeks later I did the same but numbers were 10mmol, 11mmol and 12mmol, the same toast, the same basal & bolus, the same previous even meal, and no mars bars this time. No rhyme or reason with diabetes!! The libre gave me the info to make those informed decisions though!

On the whole I usually find my numbers usually fall for some 4-6 hours after a vigorous exercise, I recently did a evening ride which had my numbers falling well into the early hours which I will remember next time!

Only suggestion for those looking at exercise, Find something you enjoy. Don't care what people may think, Its their issue not yours. I often say to people I'm a vision in Orange as I have a vivid orange cycling top. Push yourself a little each day or each time you exercise, and the pounds will start coming off when they are ready, even if you are eating more carbs to keep your blood sugar levels.

The Libre is working for my as my last visit to specialist my Hba1c was 5.5 which both me and my specialist were happy with!

LocoRoco · Apr 6, 2018

Hey everyone ,

I do strength training 5 times a week .

It helps me quite a lot with the spikes . But still getting the hang of it and monitoring my body respones to excercise and certain meals - still didnt come up with golden ration for eliminating hypos and hypers .

Also having a balanced diet . Not using LCHF diet but I stick to the high carb low GI - wholebreads , fruits , vegetables and also protein - fish , chicken , cottage cheese with jam .

I am also encouraging my friend which is also T1 to hit the gym with me , so we can compare and have fun together , but she had a hard period in her life for past few months ...

Its that wonderful feeling of exhaustion after excercise for me which helps me mentally cope with diabetes .

Broomthebeast · Apr 8, 2018

LocoRoco said:
Hey everyone ,

I do strength training 5 times a week .

It helps me quite a lot with the spikes . But still getting the hang of it and monitoring my body respones to excercise and certain meals - still didnt come up with golden ration for eliminating hypos and hypers .

Also having a balanced diet . Not using LCHF diet but I stick to the high carb low GI - wholebreads , fruits , vegetables and also protein - fish , chicken , cottage cheese with jam .

I am also encouraging my friend which is also T1 to hit the gym with me , so we can compare and have fun together , but she had a hard period in her life for past few months ...

Its that wonderful feeling of exhaustion after excercise for me which helps me mentally cope with diabetes .

Yes I do that too! Well strength training 4 times a week, HIIT once a week. It helps with everything really: lowers stress, bumps up metabolism (the after-burn!! I have to drastically lower my insulin levels after a workout, and can see the effects on my reader up to 24h-36h later!

Juicyj · Apr 10, 2018

LocoRoco said:
Its that wonderful feeling of exhaustion after excercise for me which helps me mentally cope with diabetes .

Couldn't agree more

Neximus · Apr 25, 2018

Managing Type 1 diabetes and exercise is not simple but it is perfectly possible to deal with. I’ve had frustrating times but managed to get round them.

I do a lot of road cycling and tend to ride 3 days a week covering a total distance of around 100 miles pw. I rarely have hypos or hypers when riding but that is down to planning and experience (and things have gone horribly wrong a few times!).

I am currently using a medtronic 640G insulin pump. My strategy is to eat at least 2 hours before exercise and I reduce my bolus by 20%. I also reduce my basal rate by 50% 2 hours before I set off. By the time I start my rides I have some (but not a lot) active insulin in my system. This is vital because it avoids hypos. But it is important to have “some” background insulin.

I always take far too many sugar gels with me (to keep my mind at rest!) and I keep well hydrated. If I have got it right I use no more gels than a non type 1 cyclist but I tend to need more to keep my sugars safe.

I BG test on my rides every half hour or so. I’d love a Freestyle Libre but can’t afford and GP won’t prescribe. My cycling friends don’t mind stopping and I think they’re pleased for the rest!

My biggest ride is the Prudential London Surrey 100 miles which I completed in 5hrs 38 mins. I have also cycled abroad in significant heat (40c) but have kept BGs in range.

I am simply saying that whilst it is difficult to exercise as a Type 1 it is not impossible. We are all different and some simply can’t do it and stay in range but I do think that for most of us it can be done with a bit of planning.

I have used injections for most of my life and when I had a long acting and short acting insulin I cut my long acting by 50% on riding days and reduced short acting before exercise by at least 10%.

I hope that is useful.

bluebeach · May 10, 2018

Neximus said:
Managing Type 1 diabetes and exercise is not simple but it is perfectly possible to deal with. I’ve had frustrating times but managed to get round them.

I do a lot of road cycling and tend to ride 3 days a week covering a total distance of around 100 miles pw. I rarely have hypos or hypers when riding but that is down to planning and experience (and things have gone horribly wrong a few times!).

I am currently using a medtronic 640G insulin pump. My strategy is to eat at least 2 hours before exercise and I reduce my bolus by 20%. I also reduce my basal rate by 50% 2 hours before I set off. By the time I start my rides I have some (but not a lot) active insulin in my system. This is vital because it avoids hypos. But it is important to have “some” background insulin.

I always take far too many sugar gels with me (to keep my mind at rest!) and I keep well hydrated. If I have got it right I use no more gels than a non type 1 cyclist but I tend to need more to keep my sugars safe.

I BG test on my rides every half hour or so. I’d love a Freestyle Libre but can’t afford and GP won’t prescribe. My cycling friends don’t mind stopping and I think they’re pleased for the rest!

My biggest ride is the Prudential London Surrey 100 miles which I completed in 5hrs 38 mins. I have also cycled abroad in significant heat (40c) but have kept BGs in range.

I am simply saying that whilst it is difficult to exercise as a Type 1 it is not impossible. We are all different and some simply can’t do it and stay in range but I do think that for most of us it can be done with a bit of planning.

I have used injections for most of my life and when I had a long acting and short acting insulin I cut my long acting by 50% on riding days and reduced short acting before exercise by at least 10%.

I hope that is useful.

Hi, amazing, I also like riding the Nike and just planning to do it again on a daily basis going to work by bike appr. 25 km per day. This is a bit specific because I would bike ön the morning and in the evening and I am curr ntly having treshiba 36 hours long lasting, and novorapid for short. Do you have such experience? Also I am wonder what effects you had in the following days, after stopped cycling. In my case I should reduce insuline in the next day too. Zoltán

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