Type2. Low carb, insulin and exercise

I want to first say I am not on insulin and never have been, so many more people with huge experience will have more accurate advice than me. But to keep you safe, you have a meter, don't take any fast acting insulin at all if your BG levels don't require it, and if you are still getting hypo near readings, also reduce slow acting. Hypos are not to be messed with and if you are doing true low carb your insulin requirements will plummet.

Have just posted this on another thread, so will post it here for you, simple food lists for low carbing.

Hope somebody with real expertise on reducing insulin comes in very quickly, sure they will, this is a wonderful forum.

http://realmealrevolution.com/real-food-lists#green

Hi @Stratos99

Let me tag @TorqPenderloin for you as he low carbs and exercises. I'm also going to tag @tim2000s to see if he has any advice.

I'm going to move your thread to Ask A Question as I think you might get more responses there to your question

Stratos99 said:

I've been exercising for the last 3 months which has proved hard balancing it with my insulin usage. I'm type 2. Usually on 22 levemir morning and night and 4, 6, 10 novorapid after breakfast, lunch, dinner.

I have had to change to no novorapid as I kept going hypo and levermir down to 10 twice a day.

However, now I'm low carbing, my bg levels are too low to exercise. Fasting reading this morning is 4.2. That's too low to exercise so what do I do?

My diabetic nurse is on hols for 2 weeks. Doctors appt in 2 weeks time. I just wondered if I should reduce long acting insulin again?

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What type of exercise are you doing? That's the first place to start.

Second is that you don't have to maintain the same dose of Levemir morning and evening, you can dose asymmetrically. This might give you more flexibility regarding bg levels and exercise.

Just as Tim mentioned, I don't take the same Levemir doses morning and evening. In fact, I tend to take very little in the mornings and a whole lot more at night. That's largely due to the fact that dinner is my largest meal and I eat very little in the afternoons (about the time my evening basal wears off).

As far as exercise and insulin: my general approach is to exercise as long after my last bolus as possible. That certainly makes things easier, but definitely not foolproof.

Most of the exercise I do is about either maximum strength or endurance. For example my last deadlift workout was 135lbsx6 225x5 315x4 405x3 475x2 505x1 (that's basically the Rippetoe approach btw).

Most of the endurance exercise is 45-60 minute runs at a slower pace (9-10 minute miles).

The only time I do anything very high intensity is after a "cheat" day when I need to burn up all my stored glycogen and get back in to ketosis quicker.

If I've been in ketosis for several days, I'm usually not afraid of a reading of 4.2 (although I have a Dexcom which is certainly a luxury). However, if I'm recovering from a weekend of high carbs, I would agree that it's best to be careful at a level that low because the chances of larger increases/decreases is much greater.

My experience is as follows. Apologies for the rather long windedness of it, but that's because it is.

I find that full on resistance training with no bolus on board results in a blood glucose increase as my liver dumps glycogen into my system. This jump (based on last night's experience) is around 4 mmol/l. This is for training that was sumo deadlifts, shoulder presses, romanian deadlifts, chin ups, gar hammers and predators. All done in sets of three. To counter this I need insulin on board, typically about 1u - 1.5u of active fast acting.

For more cardio, conditioning type work, if I have bolus onboard, my glucose levels drop dramatically, so I try to avoid having any. It's about timing of meals and reducing bolus for a meal pre-workout if I can't avoid having it on board.

After training, when using MDI, I run my overnight basal insulin 25% lower than normal, otherwise I end up hypo overnight. I don't tend to adjust my daytime basal though as I find it isn't necessary. My splits are normally 12u daytime and 6u night-time. After training my night-time is 4.5u.

I agree with @TorqPenderloin - I am happy to start at 4.2, especially when undertaking resistance or HIIT training as it doesn't lower my bg level. Cardio on the other hand is more tricky. If you are in ketosis, anything endurance shouldn't be dropping your levels as you should be burning fat rather than carbs.

Well, I spoke a little too soon. Here's a breakdown of this morning:

4:30am- woke up at 8.0mmol/l
4:31am- gave myself 1.5 units of bolus (novolog/novorapid) and 8 units of Levemir
6:15am- drop to 5.6 mmol/l
6:30am-head to the gym
6:30am-7:40am- levels rise until a peak of 9.3mmol/L
8:30am- Dexcom shows I'm back to level (5mmol/l)

Notes: Normally, I don't have a steady spike like this from the type of exercise I did. However, I had visited relatives over the weekend and chose not to stick to the low-carb approach. I also had taken yesterday off from the weight room (although I did a short 3 mile run).

Thoughts: For me, it seems to be all about depleting my glycogen reserves which is achieved through my usual low-carb diet and heavy exercise. Doing this acts like a "buffer" for additional glucose my body creates from the food I eat.

In contrast, when my muscles are full of glycogen, I require significantly more insulin and my fasting levels even increase as much as 1-2mmol/L. Any glucose my body creates has nowhere to go which results in hyperglycemia or more insulin (which leads to body fat storage).

Disclaimer- I haven't confirmed the science behind most of this. I'm simply sharing my thoughts around what does and doesn't work for me.