Omnipod and exercise reductions - I've got it so wrong!!!

[mytype1.life]

Hi All. As the title suggests I really need some advice on basal reductions when exercising.

My DSN recommended 30% reduction half an hour before, during and 30 mins after.

My BS were not good this week. I obviously need to alter the reduction due to the readings and also the varying types of aerobic and anaerobic exercise. Here were my results:

After GRIT - 9.3
After body pump - 7.8
After a 30 min jog - 2.9
After interval training - 2.6

Any advice on aerobic training? I tend to have the same trouble when spinning. My ratio only seems to work for Bodypump.

 

[GrantGam]

Hi All. As the title suggests I really need some advice on basal reductions when exercising.

My DSN recommended 30% reduction half an hour before, during and 30 mins after.

My BS were not good this week. I obviously need to alter the reduction due to the readings and also the varying types of aerobic and anaerobic exercise. Here were my results:

After GRIT - 9.3
After body pump - 7.8
After a 30 min jog - 2.9
After interval training - 2.6

Any advice on aerobic training? I tend to have the same trouble when spinning. My ratio only seems to work for Bodypump.

Hello again

Did your DSN explain that any change in basal rate can take about 2 hours to take effect?

Also, are you making sure that you have no IOB from meal boluses prior to your exercise?

There's a lot of good information on this section of runsweet.com. I find suggestion 4. pretty interesting, although I've never actually tried it - I'm now definitely going to!

http://www.runsweet.com/starting-sports/avoiding-hypos/

 

[mytype1.life]

Morning @GrantGam

No, my DSN suggested 30 minutes before but it's clearly not enough. I find exercise has an impact overnight too.

Evening exercise I tend not to have insulin on board but weekend classes I would.

Thanks for the link I will check it out.

I want to go BodyPump in 45 mins but have just hypo'd again despite going to bed on a 9.0 which is technically too high

 

[GrantGam]

Morning @GrantGam

No, my DSN suggested 30 minutes before but it's clearly not enough. I find exercise has an impact overnight too.

Evening exercise I tend not to have insulin on board but weekend classes I would.

Thanks for the link I will check it out.

I want to go BodyPump in 45 mins but have just hypo'd again despite going to bed on a 9.0 which is technically too high

Yes that's quite poor advice from your DSN, do you have contact information for your pump rep? I'd imagine they're better informed.

Here's a credible dude saying that basal rates should typically be adjusted two hours in advance:

https://diatribe.org/issues/26/thinking-like-a-pancreas

Okay, so are you finding that you're having hypos during classes on the weekends but not during the week? If so, IOB may be largely to blame.

 

[catapillar]

It's pretty well accepted that basal rate changes will take 2-3 hours to make any difference, so if you see DP rise starting at 4am you want a basal rate increase kicking in at 2am to ward that off. Similarly, in preparing for exercise if you need a reduced TBR, you really want that runnin for at least 2hrs pre exercise. 30mins isn't going to make a blind bit of difference and suggests your DSN might lack a bit of understanding on how best to use a pump.

If you don't have good advice on how to use a pump from your DSN I would advise getting hole of a copy of the book "pumping insulin" by John Walsh, which does have good advice on how to use pump.

Also, have a look at available places on the animas sports weekend when they come around. It's a great weekend for type 1s looking to understand how to manage insulin and exercise. It's run by Ian Gallen and Alistair Lumb, of run sweet, and would be really helpful - https://www.animascorp.co.uk/SportsWeekend

 

[mytype1.life]

Thanks both - really helpful advice. I just haven't thought about it like that, seems quite obvious now!!

@GrantGam, sorry wasn't very clear. Hypos were generally just all the time. The readings above are Mon - Friday this week.

If I notice the IOB causing a problem I will reduce the bolus for the meal before exercise or even earlier that day if needs be.

Thanks @catapillar
Have you been to an Animas sports weekend? Are they all over the UK?

This morning was better. I did have a hypo first thing but treated that fine. BS was 8.0 at 8am. I reduced my basal 1.5 hours before exercise but also took my bolus 30 minutes in advance of my Branflakes.

I'm now back home after Spin class with BS of 4.5 so that's some progress. I have IOB and not sure of it's impact but to be safe I've had 15g of carbs (yoghurt). Let's see what happens at lunch time

 

[catapillar]

Thanks @catapillar
Have you been to an Animas sports weekend? Are they all over the UK?

I'm now back home after Spin class with BS of 4.5 so that's some progress. I have IOB and not sure of it's impact but to be safe I've had 15g of carbs (yoghurt). Let's see what happens at lunch time

Animas run the sports weekends in Loughborogh. I went last October, it was a great weekend with lots of top tips on things to try to manage different kinds of activity. And great to be with dozens of other type 1s all bolusing in the hotel restaurant!

If you are striving to improve hba1c then it's worth bearing in mind that just waiting to see what happens at lunch time after 15g of unbolused for carbs might miss out the spike from those carbs. Post prandial testing after exercise will help you figure out if you need to make adjustments to you I:C ratio for post exercise meals to take account of the exercise.

 

[mytype1.life]

Wow @catapillar the Animas weekends look amazing, I would love it! Unfortunately I've signed up to a run that weekend so am not available to go, will keep my eyes out for next years. Thanks for the info.

You are right re: missing the spike. I'm waiting until I have my next stock of test strips before I get too test happy as running low - my own fault!!

At least the basal reduction seemed to work this morning, better than the usual hypo. Will try again tomorrow.

My lunch reading was good today 2 hours after the yoghurt (6.5) but had a higher reading this evening - couple of potential reasons for this. Sorry to be dim but could you define post prandial testing? How frequently should I test after food to catch spikes?

 

[catapillar]

I think the animas sports weekend do sell out quickly/instantly and they do try to get two on a year, it's worth registering your details with them so you are first to know about dates if you are interested.

NICE guidelines provide that a type 1ady trying planning a a pregnancy should be supported to test at least 10 times a day. And someone exercisering should get enough test strip to test before, during and after exercise.

Post prandial testing is testing after you eat. I have a CGM so I see my blood all the time. But if I didn't, I would be testing 2 hours after eating.