It's all going wrong :(

[imtrying]

Sorry for the negative post guys but I?m just feeling a little deflated at the moment.

After going on my carb-counting course during October, I got my HbA1C down to 7.6% which was the first time I?d been in the 7s for years (previous one was 8%, before that 9.something and before that 10.4%). My levels improved and I got my hypo awareness back. Then in December I joined a gym?I?ve struggled ever since with hypos during, immediately after, 2 hours after or during the night, and also struggled with post-exercise readings in the 30s. (this is all while doing the same routine ? I thought changing it would make it much more difficult to see any patterns).

I saw my diabetes team and they changed me from 1 pm dose of Lantus to split doses of Levemir. They thought my highs were probably because my Lantus had run out (injected 10.30pm and would go to the gym about 7/7.30pm when I got in from work.

This does seem to have improved things, as no 30 readings, but I am still going up into the high teens. I emailed my DSN and she suggested increasing my morning dose by 1 or 2 units to see if that sorted it out, which I will be trying tonight. My worry is though, that I?m not high during the day, so won?t this make me more at risk of hypo? Exercise is supposed to be healthy and yet I am having to do 1 or 2 EXTRA injections to correct the high readings

Also, for the last 4 days I?ve been waking up much higher than I?ve been going to bed, which to me would indicate nighttime hypos?.but it wasn?t doing this last week and I haven?t made any other changes, so it doesn?t make any sense to me

I don?t know if there is an answer, but I?m fed up. As a result of all these problems, my HbA1c has gone up to 8%, and having worked so hard to get it down, I?m gutted, frustrated, angry, upset and had enough 😡

 

[Phil65]

Sorry for the negative post guys but I?m just feeling a little deflated at the moment.

After going on my carb-counting course during October, I got my HbA1C down to 7.6% which was the first time I?d been in the 7s for years (previous one was 8%, before that 9.something and before that 10.4%). My levels improved and I got my hypo awareness back. Then in December I joined a gym?I?ve struggled ever since with hypos during, immediately after, 2 hours after or during the night, and also struggled with post-exercise readings in the 30s. (this is all while doing the same routine ? I thought changing it would make it much more difficult to see any patterns).

I saw my diabetes team and they changed me from 1 pm dose of Lantus to split doses of Levemir. They thought my highs were probably because my Lantus had run out (injected 10.30pm and would go to the gym about 7/7.30pm when I got in from work.

This does seem to have improved things, as no 30 readings, but I am still going up into the high teens. I emailed my DSN and she suggested increasing my morning dose by 1 or 2 units to see if that sorted it out, which I will be trying tonight. My worry is though, that I?m not high during the day, so won?t this make me more at risk of hypo? Exercise is supposed to be healthy and yet I am having to do 1 or 2 EXTRA injections to correct the high readings

Also, for the last 4 days I?ve been waking up much higher than I?ve been going to bed, which to me would indicate nighttime hypos?.but it wasn?t doing this last week and I haven?t made any other changes, so it doesn?t make any sense to me

I don?t know if there is an answer, but I?m fed up. As a result of all these problems, my HbA1c has gone up to 8%, and having worked so hard to get it down, I?m gutted, frustrated, angry, upset and had enough 😡

Sorry to hear you are going through a tough time with your D Katie, it's so frustrating that you think you are being proactive with the exercising only to get slapped in the face by hypos and high readings.....I'm sure we have all been there....don't worry you will work it out. It is just as important to be healthy,exercising,eating well and generally looking after your health and not just your Hba1C. Is there any more news on a pump?....for me, exercising was really tough on MDI, was never sure if I was going to go hypo or sky high, since having my pump it is so much more practical and I exercise with so much more confidence. 🙂

 

[novorapidboi26]

The background running out could be the problem, but it could also be a lack of insulin when exercising.............

Do you do pre gym blood sugar readings...............?
When do you have dinner?

When I exercise after dinner my BG still went up even with a carb free meal, a slice of bread and some insulin was enough to keep me going......

The next few days I need to reduce my background in both the morning and evening to keep the hypos away.......

 

[Copepod]

Worth giving the extra 1 or 2 units of evening Levemir as suggested by your DSN a few days trial - it might work, and with long acting insulins, it takes a few days for changes to have effects.

Frustrating, of course, but as long as you're enjoying gym etc, then keep going as best you can.

I'll just make one suggestion that might be worth sharing with your DSN if Levemir still doesn't suit you after several weeks - Humalin I is an old (and cheap) insulin, medium acting, so relatively responsive to changes before / after exercise - it suits my somewhat irregular exercise patterns, including some night time physically active work eg manning checkpoints, moving kit etc on adventure races.

 

[everydayupsanddowns]

Sorry to hear you are going through the D mill at the moment Katie.

You are right - it is very frustrating when you do your best to keep things consistent, but get wildly variable results.

Have you taken a look at www.runsweet.com? It has all sorts of articles about sport/exercise with T1 and might just give you food for thought...

From what you say you are still getting a rise after exercise. I thinnk Alan had exactly this when running, and did something completely counterintuitive (like eating before going?) which fixed it for him. Hopefully he'll be along later to say what it was that he did! Perhaps a small snack (with insulin) before you go?

And as Phil says - if you *do* decide to go for a pump, you might find things like exercise much easier to manage.

Keep plugging away. You will find something that works eventually!

 

[Northerner]

...From what you say you are still getting a rise after exercise. I thinnk Alan had exactly this when running, and did something completely counterintuitive (like eating before going?) which fixed it for him. Hopefully he'll be along later to say what it was that he did! Perhaps a small snack (with insulin) before you go?
...

I usually rise during a run, unless I have run in excess of 5 miles. However, I used to rise even more until I started having a small carby snack immediately AFTER exercising, no matter what my levels were, and found that this prevented me from rising further! I have found that a Belvita biscuit is a good fix for me, at around 9g carbs.

I have never experienced highs in the upper teens/20s/30s after exercise though, but then it is fairly clear that my pancreas must still be doing something because I'm only on one unit of basal, so my experiences are no doubt quite different to others'.

 

[imtrying]

Sorry to hear you are going through a tough time with your D Katie, it's so frustrating that you think you are being proactive with the exercising only to get slapped in the face by hypos and high readings.....I'm sure we have all been there....don't worry you will work it out. It is just as important to be healthy,exercising,eating well and generally looking after your health and not just your Hba1C. Is there any more news on a pump?....for me, exercising was really tough on MDI, was never sure if I was going to go hypo or sky high, since having my pump it is so much more practical and I exercise with so much more confidence. 🙂

Thanks Phil, it's always more reassuring to know others have had the same problems. No news on the pump yet, but was told to wait until this week to hear more, so fingers crossed it won't be long until I know 🙂

The background running out could be the problem, but it could also be a lack of insulin when exercising.............

Do you do pre gym blood sugar readings...............?
When do you have dinner?

When I exercise after dinner my BG still went up even with a carb free meal, a slice of bread and some insulin was enough to keep me going......

The next few days I need to reduce my background in both the morning and evening to keep the hypos away.......

Hi NRB,

yes I do. I test before, during, after and 2 hours post after. As sometimes I hypo and sometimes I go high, it's made it very difficult to adjust my starting bg as they don't seem to have much affect! I 'usually' am around 9 before starting.

I go from work (leave at 5.30pm), home (7pm) to get changed and straight to the gym...so I eat dinner (if anything) when I get back from the gym, usually around 9pm/9.30pm.

 

[novorapidboi26]

I go from work (leave at 5.30pm), home (7pm) to get changed and straight to the gym...so I eat dinner (if anything) when I get back from the gym, usually around 9pm/9.30pm.

This could be another reason for the highs...............I dont know the exact science, but as your exercise your muscles will use up there stores of energy, this process is direct, but then they need to replenish and absorb from the blood stream, as you have no insulin, or no quick acting and little background there is no way for any glucose in thee blood to pass through into the muscles, so this may trigger a response from the liver to help out, but still no insulin, and so the BG goes up...........

Try having a small carb, doesn't need to be quick acting, take some insulin, then go to the gym.................see what happens........

I also experience this, and it annoys me that I have to put in carbs when I am looking to lose weight...........

 

[imtrying]

Worth giving the extra 1 or 2 units of evening Levemir as suggested by your DSN a few days trial - it might work, and with long acting insulins, it takes a few days for changes to have effects.

Frustrating, of course, but as long as you're enjoying gym etc, then keep going as best you can.

I'll just make one suggestion that might be worth sharing with your DSN if Levemir still doesn't suit you after several weeks - Humalin I is an old (and cheap) insulin, medium acting, so relatively responsive to changes before / after exercise - it suits my somewhat irregular exercise patterns, including some night time physically active work eg manning checkpoints, moving kit etc on adventure races.

thank you. I've done 1 extra unit this morning so will see what happens - 1 hypo at lunch so far! and thanks for the tip, I'll keep a note in case they're stuck for ideas 🙂

 

[imtrying]

I usually rise during a run, unless I have run in excess of 5 miles. However, I used to rise even more until I started having a small carby snack immediately AFTER exercising, no matter what my levels were, and found that this prevented me from rising further! I have found that a Belvita biscuit is a good fix for me, at around 9g carbs.

I have never experienced highs in the upper teens/20s/30s after exercise though, but then it is fairly clear that my pancreas must still be doing something because I'm only on one unit of basal, so my experiences are no doubt quite different to others'.

Thanks Alan. During the week I do tend to eat afterwards as this is my dinner. Sometimes I don't if I've bit the highs already as I was kinda thinking the food and what to inject for it would just confuse things! Will see what happens tonight...Do you think I should be injecting for dinner? Or half the dosage I would normally?

Sorry to hear you are going through the D mill at the moment Katie.

You are right - it is very frustrating when you do your best to keep things consistent, but get wildly variable results.

Have you taken a look at www.runsweet.com? It has all sorts of articles about sport/exercise with T1 and might just give you food for thought...

From what you say you are still getting a rise after exercise. I thinnk Alan had exactly this when running, and did something completely counterintuitive (like eating before going?) which fixed it for him. Hopefully he'll be along later to say what it was that he did! Perhaps a small snack (with insulin) before you go?

And as Phil says - if you *do* decide to go for a pump, you might find things like exercise much easier to manage.

Keep plugging away. You will find something that works eventually!

Thanks Mike 🙂 I will keep plugging until I find a fix! Eating beforehand is just out of the question for lots of reasons 🙂 (like it's at least an hour drive home so can't eat then, I can hardly spend my working time eating just before packing up and leaving to go home! plus, I've found it takes my body around 3 hours to digest....otherwise I'll feel sick when exercising. I think my body just likes to be awkward and testing!). should find out this week if I can have a pump or not!!

 

[imtrying]

Try having a small carb, doesn't need to be quick acting, take some insulin, then go to the gym.................see what happens........

I also experience this, and it annoys me that I have to put in carbs when I am looking to lose weight...........

NNOOOOOOOO I'm exactly the same as you - I don't want to have to eat when I'm exercising to try and lose weight plus I can't really eat before going as I finish work and go straight there, so can't eat when I'm driving...nor do I have anything to eat!

What do you eat?

This is all so annoying.

 

[AJLang]

Good luck with getting the pump

 

[Northerner]

NNOOOOOOOO I'm exactly the same as you - I don't want to have to eat when I'm exercising to try and lose weight plus I can't really eat before going as I finish work and go straight there, so can't eat when I'm driving...nor do I have anything to eat!

What do you eat?

This is all so annoying.

I do think that if you haven't had any insulin (apart from your basal) since lunchtime and you are then exercising (starting around 9.0) then this will be most likely to be causing the highs. I do understand about not wanting to exercise immediately after eating, but perhaps you could just have a snack like a muesli bar and a little insulin beforehand? Before diabetes I used to get up at 5:30, have a cup of tea and then go out running, but quickly came to realise that I can't do that and rely on my basal insulin alone - I have to have an injection, slice of toast, then wait an hour. At first I didn't like running so soon after eating (the reason why I never used to eat beforehand), but it has got much better now and doesn't bother me.

Your difficulty is that, if you ate and injected as you left work, you have then got to drive wondering if the insulin will drop you low. Perhaps you could have something simple like OJ and some insulin just before exercising?

 

[imtrying]

I do think that if you haven't had any insulin (apart from your basal) since lunchtime and you are then exercising (starting around 9.0) then this will be most likely to be causing the highs. I do understand about not wanting to exercise immediately after eating, but perhaps you could just have a snack like a muesli bar and a little insulin beforehand? Before diabetes I used to get up at 5:30, have a cup of tea and then go out running, but quickly came to realise that I can't do that and rely on my basal insulin alone - I have to have an injection, slice of toast, then wait an hour. At first I didn't like running so soon after eating (the reason why I never used to eat beforehand), but it has got much better now and doesn't bother me.

Your difficulty is that, if you ate and injected as you left work, you have then got to drive wondering if the insulin will drop you low. Perhaps you could have something simple like OJ and some insulin just before exercising?

ah thanks Alan, I'm glad I at least made some sense! And what you're saying does make sense about having insulin (though the reasoning I don't lol but one thing to learn at a time!)

Would I be ok injecting for something like OJ that's purely fast-acting??? Or would it be better to inject with something like the Bel-vita biscuit things?

Thanks for your help.

 

[everydayupsanddowns]

My (very hazy) understanding is pretty much what NRB and Northie have been saying. You need insulin while exercising to avoid a liver dump.

If the exercise makes you more sensitive to insulin, and you were to take OJ and/or a cereal bar before you drove (how long is your drive?) I would expect your BG to rise slightly - as OJ faster than insulin onset - then come down during exercise as your sensitivity increases.

This is all guesswork based on my 'going to the gym after breakfast' though, so may not work for you at all 🙄

 

[Northerner]

ah thanks Alan, I'm glad I at least made some sense! And what you're saying does make sense about having insulin (though the reasoning I don't lol but one thing to learn at a time!)

Would I be ok injecting for something like OJ that's purely fast-acting??? Or would it be better to inject with something like the Bel-vita biscuit things?

Thanks for your help.

The Belvita biscuit would be better as it would more closely match with the insulin action, I would have thought. 🙂

 

[imtrying]

If the exercise makes you more sensitive to insulin, and you were to take OJ and/or a cereal bar before you drove (how long is your drive?) I would expect your BG to rise slightly - as OJ faster than insulin onset - then come down during exercise as your sensitivity increases.

Thanks Mike. My drive is minimum an hour, usually hr and 15 minutes, can be longer if traffic or an accident.

I think I'd feel a bit nervous injecting before I drove - especially as 85% of my drive is down the A12 at 70mph!

Do you think I should just eat a Bel-Vita biscuit or cereal bar-type-thing when I get home & inject for it...then go to the gym?

 

[imtrying]

lol ok scrap my last post - Alan's just answered it Mike!

Alan - would you suggest I inject my 'normal' ratios for the Belvita thingy?
And do I need to change ratios for dinner after exercising?

Or just do them all at normal levels and see what happens?!

 

[Northerner]

lol ok scrap my last post - Alan's just answered it Mike!

Alan - would you suggest I inject my 'normal' ratios for the Belvita thingy?
And do I need to change ratios for dinner after exercising?

Or just do them all at normal levels and see what happens?!

I think it is likely to need some trial and error and plenty of testing. For me, my pre-exercise dose is at my normal ratio, but I will adjust my post-exercise ratios to take account of increased insulin sensitivity as a result of the exercise. Another difficulty you must have is in eating so late and having active bolus when you go to bed - I rarely go to bed less than 5 hours after eating.

 

[everydayupsanddowns]

I tend to reduce bolus pre-gym by approx 20% (and set a 40% TBR for the duration these days too), plus add some top-up carbs, then bolus the rest of the day as normal. YDMV! 🙄