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Managing exercise and insulin

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

Apologies, @Circuspony
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No need for apologies - I've been trying to track down the 70g on the NHS website. I'm not a low carb person but there's no way I'm eating 70g per meal.
 
Circuspony said:
No need for apologies - I've been trying to track down the 70g on the NHS website. I'm not a low carb person but there's no way I'm eating 70g per meal.
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I've read loads of places referring to "usual" or "normal" as being around 200gr a day, so it could just be as simple as 200/3, but of course, I speculate.
 
My son is 13 and has taken up rugby over the last year. When he trains regularly his bloods seen more even, we are definitely encouraging fitness!
 
Thanks for sharing this!

I’m newly diagnosed (Feb) as T1 and have had insulin fluctuations over the past week weeks going up in dosage to the mid 20’s. I have also struggles with fast acting.

Recently I started training again and have really focused on my diet and meals reducing my carb intake while increasing my fat and protein intake (approx c 20, f 45, p35)

Since doing this I’ve found that my sugars have levelled and I’ve actually reduced my insulin requirement to a basal dose of 16. I know I’m likely in the honeymoon phase still but has anyone else seen this?

I currently am train 4 times per week and am focused on strength training with limited cardio.

Thanks
Duncan
 
I can really imagine how gutted you are not to be able to run when you enjoyed it so much but think positive, what else could you do that would improve your fitness and make you feel better about yourself. I run and walk and also do Pilates several times a week and that is brilliant for core strength and flexibility and that's good for your moods too. Good luck, it will get better for you I'm sure x
 
It's absolutely doing my head in this. I started about a month ago doing 30-40 minutes on my indoor stationary bike. I decided I wanted to get fitter.

Every time I do it, it absolutely burns through my BG like hell. The amount of times when I finish I am hypo'ing or on the verge in killing my ability to exercise. The most obvious occasion was when I decided to eat before it, not take any insulin, managed to push my BG level to 12.5, hopped on the bike, 30 minutes later I had fallen to 4.2 and verging on hypo'ing.

I just went to exercise just now, I was 5.7, nowhere near high enough for me to do it. Grabbed a slice of toast, measured 10 minutes later, I had DROPPED to 4.0. Now needed another slice of **** toast just to avoid a hypo, and now 30 minutes later I'm back where I started at 5.7 which nowhere close to being high enough for me to exercise with.
 

Thoughts which this brings to mind :

What insulin regime are you on? If MDI, there will be your basal still working.

Somehow you either need more food or less insulin. How to achieve that really depends on you - some will eat sugary things while exercising to keep a steady supply going, some will pre-load with food, some will lower their basal.

When you're dropping, do your legs feel it? My hypo awareness is quite good when exercising - my legs stop working I'm getting better at checking for problems earlier though, also pre-loading - not to have my level high (though sometimes it is), but to have the food coming into effect while I'm out. I can generally do an hour on that. On longer things (the very occasional 2 hour run), I'll always eat half way round.

My annoyance is tweaking the basal has an effect for rather longer than the hour or so I want to take effect.
 
The insulin I'm on is Novorapid as my fast acting and Abasaglar as my night time long acting Insulin. 16 unit per night for my long lasting one. That keeps me steady throughout the day. I'm generally around 5.5-7.5 all day every day now, but when I exercise my BG plummets. Generally I just find it's better for me to just eat something before it, try and drive up my BG higher than normal for a 10 minute window basically, then exercise and by the time I'm off it, the exercise has pulled it back down. Just means I need to exercise at specific times. For example I just had dinner just now, was 4.7 or so, had the dinner, took now insulin, drove me up to 8.7, hopped on the bike for 20 minutes, got off and I'm back down to 5.2.

As for hypo awareness, when I exercise I don't feel it most of the time to be honest. I just know from exercising that it drives it down so I'll have my machine next me and measure it after 30 minutes of exercise. I think it is mostly the intensity of the exercise that's doing it to be honest. I go pretty hard on the bike, about 12-12.5 miles in half an hour. When I am doing steady cardio it doesn't react this way. I played football every week for years and only every hypo'ed twice during it.
 
I have found that firstly I need no to minimal fast acting on board and I also need to eat a cereal bar (I use tracker bars) about 10 mins before. Having fast acting on board sends me from 10 to hypo with just 20 mins of gardening!
 
It's been interesting to read the challenges and potential solutions that people are listing. I try and go mountain biking around the local woods twice a week and then do a couple of gym sessions + a personal training session (need the motivation!). My Saturday ride is typically around 4 hours and has always been a challenge, typically I could consume around 2000 calories in energy bars during this period. This approach has allowed me to do long rides but clearly means that I will eat as least as many calories as I consume, with the oscillating blood sugar later in the day I suspect I would often consume double the number of calories . . . not a good start. After starting some personal training sessions in attempt to get fitter my discussions with the trainer suggested I should look at the low carb approach, I only do this when cycling at the weekend but now have a very small injection before my breakfast which is a nice fatty but very low carb omelette and a very small glass of fruit juice. This approach has allowed me to cycle for 4 hours eating only a banana during the ride, not surprisingly this has made the riding easier and allowed me to lose more weight! I have generally reduced carb intake at all meals (approx 2/3 of previous amount) which has been beneficial but I have found that trying to continue the very low carb after the long rides typically results in me spending the majority of the afternoon sleeping :-( For the gym sessions I've established an exercise regime that allows me to do the gym sessions without the need to eat extra food and then just lower the insulin dose before my meal eating the regular amount of carb. The other life changer for me has been the FreeStyle Libre CGM which means that even on a bad day with exercise the ability to see the trend in blood sugar has allowed me to manage it, unfortunately like so many people I have to fund these myself but the difference they make is worth the sacrifices!
Exercise is clearly beneficial for everyone but particularly for those with diabetes - I'm glad to see the discussion and ideas on this forum!
 
Hi @James_Donnelly It's true that different exercise types affect the BG levels differently, I find that my BG doesn't fluctuate more than 2 mmol/l if doing a steady jog for 30-60 mins, however when I hit the bike and cycle hard I too can easily see my BG levels drop to a hypo, so always keep an eye on it more so when out on the bike, i've had to cycle home on jelly babies a few times now as struggled to get my BG levels up. It helps me to start at around 9-10 of higher and then I stop for a carby snack mid way, also without any quick acting insulin on board too. Try keeping a diary to track your BG levels, insulin on board and carbs eaten, that way you can start to build a picture of what works for you.
 
Hi Duncan,

Yes i've seen this and if there is a 'honeymoon phase' then i'm still in it after 14 years! I haven't been perfect throughout the whole 14 years since diagnoses and certainly have had many a high reading. I'm just thankful that exercise has been a big part of my life since leaving school. I've tested and tried various things that work for me and currently for the last 2.5 months i've only been taking my glargine on a night as the exercise/eating is keeping everything stable otherwise. I'm at my review next week so will be keen to see what my HBA1c is.
 

Hi James,

Don't forget that exercise can also have an accumulative effect where blood sugar control is concerned. The best way for me to describe this is in my case..if i were to have a 'break' or 'rest' period of a week or two from exercise ,which i do every now and then, i tend to find my sugar control is great during the first week of rest even though i haven't exercised.
 
Hi @James_Donnelly . I do a lot of exercise and over time have developed some simple rules that I try and live by. I also suffered quite a lot with rapidly dropping BG but this is an inevitable part of diabetes and exercise. There are some things you can do to improve it however. Time of day is very important. Ideally you wouldn't exercise within 4-5hrs of doing a bolus injection. this is because you will have insulin still left over in the background that will exacerbate it. I tend to find, as @Al_H points out that the morning is the best time to do this. The reason is that you don't have lots of background insulin/food in your system. I can do 2 units of Novorapid and go out for 2-3hrs without having to take on any carbs. Realistically though, most of us try and exercise whenever we can get the chance. For those of us on MDIs, we just need to try and maximise the distance in time from our most recent bolus, or failing that then reduce bolus significantly before exercising.

Re: eating toast before exercising. My experience shows that it just doesn't bring up BG quickly enough. I take either OJ or some form of quick acting glucose. I then top it up with glucose tabs/juice to address in BG drops during exercise.

Good on you for getting back into exercise. The long game is definitely worth it
 
Michael Moseley


Michael Moseley did one of his programmes about fitness and days that women should eat before they exercise, men should eat afterwards. I now have breakfast before I go out running or walking and that seems to work very well. Worth trying but if you feel rubbish when running try going for a brisk walk if you can. It'll bring down your BG and make you feel better mentally. Good luck!
 
I have always exercised, a lot. Recently finding that on runs, initially my bg spikes (this is new) but then comes down. Also recently, on longer runs of 10k and upwards, occasionally my bg just starts climbing and climbing and I have no idea why. I carry humalog with me now, but 1 unit can bring me crashing down. Bit difficult to manage! Seeing endocrinologist tomorrow so will ask about that, and only just joined this discussion so haven’t read all the posts (apologies).
 
Hi @Fifismum Just a thought - do you eat or have any quick acting on board before your run ?

I do 5km runs and am on a pump so turn the basal down to 60% before I run and find my levels stay below 9 at the end but can dip a bit later, it's the adrenaline that keeps me up on park runs and races, on my own and a relaxing run I tend to stay pretty flat.
 
Just catching up on this thread reading about 260g carbs a day? I'm puzzled by this, I eat carbs but couldn't process that many a day, no matter how complex they were, even training hard and 15 years younger I'd not pass 200g and I was a stone in weight heavier, and I can't manage 200g a day these days.
Anyway I came to moan about Tresiba and it being a bit of a struggle managing blood glucose levels and training and how inconsistent it seems to be when your training patterns are consistently inconsistent. I think I'm about 4 months into it and am if I'm honest having some doubts I'm not writing it off quite yet but.....
 
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