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Managing exercise and insulin

I've just been confirmed as T1 (LADA) rather than the T2 my GP/DSN thought. (I've been on insulin since early 2017).

I picked up this thread as I've been having big challenges with aerobic exercise causing rapid BG drops (starting from around the end of 2017). I can totally relate to NoKindOfSusie, and the issues she describes.

I can only dream of doing the long cycle rides or walks I used to do a few years ago. But everyone is different and I'm happy for those T1s who can.

My aerobic BG drops are fairly spectacular:
  • 15 mins brisk walking or 10 mins biking drops 3-4 points
  • 20 mins walking and I can be close to hypo
  • 10 mins very brisk walking once caused a 6 point drop
  • 20 mins vacuuming generally drops 3 points
I used to find badminton needed juggling extra carbs during play to maintain BG - testing every 10 mins. However, in the past month my body seems to have decided that badminton is now anaerobic exercise, and a couple of weeks ago my BG rose from 8 to 15 at the end of an hour's play (without eating carbs)...

My Freestyle Libre (self funded) often shows vertical down-trends and I have to be soooo careful then (as Libre's interstitial fluid measurement lags 15mins behind BG, I will then fingerprick to check where I actually am).

Occasionally my BG drops are so rapid that Libre presumably cannot believe it and responds with "sensor error, try again in 10 mins" or similar. Later when I look at the trace it will have a gap.

I've watched:

I also found this article useful: http://www.diabetesincontrol.com/ex...justing-insulin-dosing-for-physical-activity/

Paradoxically, I use my rapid BG drops to manage post meal spikes with carefully "calibrated" walks.

I just wanted to put my experience "out there". I'm not expecting any magic answers for myself, though.
 

Yes I reduce my pump basal to 75% of normal for the rest of the day and overnight after a ride. I am generally back to normal the next day.
 
What are the regulations for competative motorsport regarding type 1, is it the same s dvla for normal road driving?
P.S nice bike
 

Hi Juicyj -

As I have mentioned in previous posts I have recently been diagnosed with type 1 and am currently going through the honeymoon period so my levels are easier to manage, so this might not be 100% applicable to you but I thought it might be worthwhile sharing my experience adapting to exercise and a newbie anyway.

Prior to diagnosis I ran between 5k-10k 2-3 times a week, played 5 a side football for between 1-2 hours once a week and cycled to work (only a couple of miles each way) Mon-Friday.

I have just about got back to this level of exercise 6 weeks after being diagnosed. In regards to insulin, the advice for me was to cut out mealtime insulin for my evening meal after I had done some exercise (9 times out of 10 I exercise between 5pm-7pm). This was because I was on quite a low dose (I am currently not taking anything for any meals).

The difficult thing for me has been 1. Finding a way to carry all the stuff I need on a run and 2. Judging how much sugar I need to avoid a hypo. For running I found that a stretchy running belt works well rather than a bum bag to put my meter, phone and back up jelly babies in (https://www.amazon.co.uk/Running-Be...&qid=1534419104&sr=8-19&keywords=running+belt). The first couple of exercise sessions I did I used jelly babies to top up my glucose levels, but I found that they were hard to eat whilst running and they gave me a massive spike when I played football (I may have eaten too many)... I have now switched over to Lucozade sport which works really well and I go running with this in one of those hand held bottles.

I test before I set off and if my glucose level is under 8 I have been having either a full banana or part of a banana depending on how low it is and then having sips of Lucozade every 15mins or so. I still find that on run (between 30-45mins) even with a banana and some Lucozade I return just above 4mmol/L and have to keep an eye on myself.
 
Hi @tomrose I have to admit the issue of going low whilst exercising is something I try to avoid at all costs, so for me exercising whilst using a pump is easier as I can switch my basal pattern off completely for exercise, either by using a temp basal pattern or removing the pump altogether.

I try to start exercise with my BG levels above 7 for this reason so I have some 'give'. I carry glucotabs on me when running, admittedly a bit harder to swallow as my mouth is normally dry when running, but they are easy to carry. When I run I use my pump belt to carry stuff as I generally remove my pump for short runs which is then tucked into my lycra shorts to stop stuff bouncing about, I also use the libre which tucks into my back pocket and is ideal for monitoring levels during a run as I don't need to step and check, and the glucotabs are normally popped into my sports bra, sorry not relevant for males ! but can be tucked into the pump belt too if necessary.

I am not sure if your levels have been greatly raised whilst exercising yet, but when I go above 12 mmol/l I generally find exercise much harder as the glucose isn't getting into the muscles and I tend to slow down alot, hence why keeping good control for exercise is important.

Admittedly it is hard to manage exercise and maintain good control so I don't beat myself up if things don't go to plan, I try and learn why and to remember for next time, also take extra care in heat as levels can drop much quicker, something I learned on a parkrun a few months ago when I stopped halfway to treat and had to keep taking glucotabs so I could finish the run.
 

I find the little bags of jelly babies quite good - 42g, nine little ones. Small enough to carry around anywhere, not a bad dose for me, and none of the "now I've opened up the big bag, what do I do with the rest?" questions. Not entirely easy to find, but I think cadburys/amazon sell them in boxes.

This isn't necessarily normal, but I use a cycling top to run in, with the pockets on the back - emergency top in one pocket, pack (or two) of those jelly babies in another, head torch in the third, and in winter once I've warmed up gloves go in there too. Short top in the summer, long in the winter. Phone lives in a little pouch on a belt, along with some penguins or similar for if things get bad. Meter (libre) lives in my shorts or trackster pocket for quick access. But I'm running in rural places, which can be a bit remote.
 

Hi - I hadn't thought about using my cycling shirt with extra pockets! Good idea!
 

And today I discover why they're hard to find - they've just been discontinued. GRR. Oh well, off to DIY an equivalent.
 
Because it's summer holidays, i cycle around a lot more. I've had to minus 1 unit everytime i go out to cycle because of this and I just keep my supplies in a small backpack. Also make sure you have some sugar with you either in the from of a drink or sweets. Also if you do any sports like outside. Don't forget you can always stop when you don't feel right. Like especially sports of cycling and horse riding as you don't want to risk putting yourself or others in dangers.
 
Hi @Juicyj - This popped up on my Twitter feed today. Clearly it was a huge challenge and not for everyone, but an interesting read nevertheless:

My Summer Running Adventure as a Low-Carb Type 1 Diabetic. A Solo, Unsupported, 730 mile Run in 35 Days - http://type1keto.com/
 
Hi, I do 3X 60 min spin classes and 4 or 5 x HIIT sessions a week mixed with weights. If my sugars are above 9 before I start it’s too hard! Then I spike during sessions.

I use Lucozade sport & bags of skittles if I go low then skittles are better than jelly babies for me.

Generally low carb diet but mornings I’m usually low when I wake so it’s fruit and no insulin. If low middle of night raisins work a treat.

If I’m away or can’t exercise I struggle maintaining my sugars.

I’m 45 and T1 for 40 years but still find it hard and everyday is different. Even stress from work or family affects levels.

You will find a balance that works then just play around with it xxx
 

Great read and fascinating to see the results of his diet, insulin and exercise. I am toying with going longer distances purely to experiment with bg levels and see what the impact is, but doubt I'll ever come close to what this guy did.
 
Juicyj said:
Great read and fascinating to see the results of his diet, insulin and exercise. I am toying with going longer distances purely to experiment with bg levels and see what the impact is, but doubt I'll ever come close to what this guy did.
Click to expand...

It felt like quite a candid read, with the comments on dietary choices (or limitations) and hiccoughs like the full sugar coke. Just the sort of things we bump into any day of the week, although not usually as part of a mega treck like his!

I thought it worth sharing for those interested in exploring endurance without the necessity to carb up, or questions around "where does the energy come from for this, that or t'other".

To be clear, it won't be for everyone, but I thought it seemed a realistic tale of events.
 
Really, really interesting article. In 10 days time I'll hit my diagnosis anniversary (although by mid Aug last year Dr Google had already educated me as to what the problem was, I just needed the GP to catch up.....) and exercise is the thing I have struggled with the most. Mainly because my exercise isn't 'going for a run at 6pm', its just my normal life is active. When I sit at a desk all day I can bolus for carbs and all is fine. On one of my days where I'm on my feet all the time I need jelly babies to hand and carb counting is nonsense.

Is 70g of carb per meal really the advice? I know I'm a lighter build female, but I'd never be able to work my way through that much in one meal!

And I love this phrase "There is so much to learn. If only Type 1 was simply about balancing carbs and insulin!"
 
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I've found exercise the most challenging aspect of having type 1, simply because of the effort which goes into making it possible, so the calculations, the planning, the unforseen events and dealing with the after math, but in the short window I run/cycle/swim, for that very brief time I can to a degree completely forget my t1 status and for that very reason it makes it all completely worthwhile.
 

Circuspony - Where does your 70gr per meal come from? That's not a challenge of any sort, I'm just curious.
 
DCUKMod said:
Circuspony - Where does your 70gr per meal come from? That's not a challenge of any sort, I'm just curious.
Click to expand...

"I certainly did not intend to eat anything like the guideline mealtime recommendation of 70g of carbs per meal . 50g per day would be more than enough."

It's the NHS's recommendation
 
michita said:
"I certainly did not intend to eat anything like the guideline mealtime recommendation of 70g of carbs per meal . 50g per day would be more than enough."

It's the NHS's recommendation
Click to expand...

Ah, I missed that when I looked back. I focused on Ian's average of 56gr per day.

Apologies, @Circuspony
 
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