Managing exercise using a pump

[Rodders56]

I have recently taken up cycling but am finding the management of blood sugar challenging. Even if I start off relatively high bloods (12 -14) I find that within an hour they are falling rapidly and I need to take on emergency carbs (jelly babies) just to maintain safe levels. I have tried reducing background basal to -90% for an hour prior and during the ride but it does not really help the situation.

I find that I am having to stop and wait for 30/40 minutes during the ride to let my sugars catch up which then just holds everyone else up whom I am with. I have also found that once I have finished a longish ride within a hour or so afterwards my bloods climb really high as my body is processing all the carbohydrates I had to take to keep me going

Essentially its like my body doesn't process the carbs quick enough to feed my muscles during exercise but then there is a lag of excessive sugars a few hours later

Any help or suggestions would be greatly appreciated

 

[Juicyj]

Hi @Rodders56 I know exactly what your experiencing as i've been there a few times myself and it's a pain having to stop, I tend to wait just 10 minutes but the glucose doesn't seem to hit the mark quick enough for me - then the ride is compounded by a lack of energy afterwards, it's quite frustrating. I use the Dexcom G6 so when I ride I can see my phone constantly on my handlebars and can see my BG levels at all times, it's helped in so much as I can take preventative action before the hypo and so stabilised my BG levels during the ride.

Here's my personal way of managing a ride, I try to start with levels above 9 mmol/l, I eat a small protein snack bar with about 10-15g of carb before I start my ride, I also add a flavoured glucose powder to my water and carry water too, so depending on what's going I have 2 options. I turn my basal off around 1.5 hours before I go out, I used to do it 1 hour before but it wasn't enough, I also stop half way for a milky coffee if I can, we go out for around 1-1.5 hours so it's a nice way to enjoy the ride more. I have had a few rides out whilst hypo and although a pain, it's often unavoidable unless you have something like the Dexcom. In regards to highs afterwards, you have to compensate for the lack of active insulin in your system, so it's almost a correction at the end, I tend to take a couple of units afterwards, even if i'm in the low 4's which seems risky but by the time it kicks in it can help avoid the rise, then just keep a careful eye on things, also during the night time too, I am more likely to go low in my sleep after an intense ride.

 

[Annamay]

Hi Rodders56,

As well as less basal just before and during the exercise you could experiment with how you eat before it - in the meal or snack before the exercise have less bolus than you'd normally take for it.

It's all a bit of experimenting. For me, I've started cycling a bit recently too and 50% lower background during the ride then check every 30/45 mins or so and if BGs go below 5 (ie before going low), then have a small snack / couple of sweets. Previously I used to not reduce the background and just have a banana beforehand (without bolus) and that worked for shorter exercise. For longer exercise, am more likely to go low a few hours later so need to reduce carb ratio at the next meal too. All depends on intensity and duration of exercise.

The dafne course has good advice on it (and I think there's refresher on exercise), if that's something your diabetes team can get you onto.

The runsweet.com website encouraged me as included discussion of how through trial and error others have managed blood levels during a marathon.

Hopefully you'll find something that works for you!