How to increase am blood sugars before gym

[Mich1]

Hi everyone, I’m type 1 and still quite new to things (Jan 2019). Nevertheless, I continue to slowly build up on my exercise regime but having difficulty with lows and hypos.

At present I take 9 units of basal (reduced by 3 units recently)at night and carb count on Novorapid.
My morning readings are always on the lower side between 4.2 and 4.6, despite reducing my basal by 3. On advice of my dietician I do not inject prior to going to the gym. However, I have to eat some breakfast in order to drive to the gym and up my readings. At present I am trialling porridge and orange juice.

If I do aerobic workout this is fine but have to take glucose after 20 mins and at the end - usually between 8 or 9 jelly babies and I am finding that building up to a decent run of 40 mins or more is impossible.

I’m fine if I do resistance training or weights but would prefer to do this without food.

I have gained weight in the last 3 weeks, when I am trying to lose weight ( my food type and Cals is strict) Finding everything frustrating.

My present thinking is I need to get my morning readings up. Any thoughts would be greatly appreciated.

 

[Thebearcametoo]

My daughter’s dietician has a particular interest in sports so is very good at tweaking things, I think some more info for you from your dietician would be more helpful than just ‘don’t inject’. The idea of the basal is to keep your levels stable and within target and the consultant said nearer 4 on waking is better so I suspect they wouldn’t want you to tweak that too much. My understanding is that certain exercises affect your blood glucose more than others so having someone with a sports speciality helping you tweak how to do your workouts and what to eat before would be good.

 

[Mich1]

Thank you so much for your advice. I have to say the Dietician has been excellent. I was taking a large amount of carbs/glucose and reduced Bolus prior to this, so dropping an injection has been great but still not enough. We’ve discussed changing my basal type and going to 2 injections but am trialling my present way before doing this. The hope was the reduction in basal would up my morning readings. Even after breakfast, I have difficulty getting my levels up. (If I didn’t need to drive in the mornings it would be fine).

I record and keep a log of how different types of exercise affect me. I know that aerobic (running) sends me low and that weights and resistance (anaerobic) sends me higher. At present I’m just focusing on running to try and get a grip on that. Prior to my diabetes, I would do a combination. A specialist trainer would be great.

I thought that any pointers from members on here might also be useful - and any thoughts are extremely appreciated.
I am very much a learner, soo new to this, and often think is there another way to look at things? There is so much experience on here. I wish there could be a blueprint for insulin and exercise!

 

[Robin]

This isn’t particularly exercise related, but I had a problem when I was on Lantus, because what kept me steady during the day dropped me at night. I swapped to Levemir, which I split unevenly, taking 2.5-3 units at bedtime and 5-6 at breakfast. Seems to work for me, and also if I am exercising, (I tend to go for long walks every now and then) I can reduce the dose and know it’ll work instantly.

 

[Thebearcametoo]

If you’re someone who likes reading up on stuff then the Think Like A Pancreas book has loads about exercise and Gary Schneider has a particular interest in exercise. I don’t know if he has stuff online too.

The Type 1 Diabetes by Dr Ragnar Hanas book is good too. It’s about kids and adolescents but is a huge resource for diabetes info.

 

[Matt Cycle]

Hi Mich. 🙂 It's possible you're in the honeymoon period still producing insulin and may need further basal reductions. I don't know what basal you're using but as Robin mentions Levemir is very good for splitting doses with quick effect, i.e. you don't have to wait 3 days to notice a change. Did you have a c-peptide test on diagnosis? What ratios do you use for your NovoRapid? As you've found aerobic exercise will tend to lower blood glucose and anaerobic can do the opposite. This published paper is quite good on explaining how it happens.

http://insulinfactor.com/graphics/pdf/t1_diabetes_and_vigorous_exercisel.pdf

Runsweet has lots of useful info on T1 and exercise. I'm not an expert in any way but in my experience and speaking to others the effects are quite individual and the only way in founding out how it affects you personally is just going out and doing it. Through a process of trial and error over the years I've found I need reduce my basal before and after cycling (a bit easier to do now I'm on the pump). I don't touch the bolus before I go out and then top up with things as I go along depending on what my bg is doing. I'm close to underweight so I don't have any issues with eating extra.

 

[Mich1]

This isn’t particularly exercise related, but I had a problem when I was on Lantus, because what kept me steady during the day dropped me at night. I swapped to Levemir, which I split unevenly, taking 2.5-3 units at bedtime and 5-6 at breakfast. Seems to work for me, and also if I am exercising, (I tend to go for long walks every now and then) I can reduce the dose and know it’ll work instantly.

Thank you - that definitely makes a lot of sense to me.

 

[Mich1]

If you’re someone who likes reading up on stuff then the Think Like A Pancreas book has loads about exercise and Gary Schneider has a particular interest in exercise. I don’t know if he has stuff online too.

The Type 1 Diabetes by Dr Ragnar Hanas book is good too. It’s about kids and adolescents but is a huge resource for diabetes info.

Thank you. I bought Think Like A Pancreas and found it very useful initially. It talks about using a pump a lot and unfortunately I’m not on one at present. I will definitely have a look at the Hanas book. Thank you.

 

[Mich1]

Hi Mich. 🙂 It's possible you're in the honeymoon period still producing insulin and may need further basal reductions. I don't know what basal you're using but as Robin mentions Levemir is very good for splitting doses with quick effect, i.e. you don't have to wait 3 days to notice a change. Did you have a c-peptide test on diagnosis? What ratios do you use for your NovoRapid? As you've found aerobic exercise will tend to lower blood glucose and anaerobic can do the opposite. This published paper is quite good on explaining how it happens.

http://insulinfactor.com/graphics/pdf/t1_diabetes_and_vigorous_exercisel.pdf

Runsweet has lots of useful info on T1 and exercise. I'm not an expert in any way but in my experience and speaking to others the effects are quite individual and the only way in founding out how it affects you personally is just going out and doing it. Through a process of trial and error over the years I've found I need reduce my basal before and after cycling (a bit easier to do now I'm on the pump). I don't touch the bolus before I go out and then top up with things as I go along depending on what my bg is doing. I'm close to underweight so I don't have any issues with eating extra.

Thank you so much. I’m going to sit and have a good read tonight.
I had thought about the honeymoon period as I haven’t needed to be too worried about my Bolus amounts and have been taking around 10% less immediately after exercise. My ratio is 10g to 1 unit. Initially even doing Yoga or Pilates was sending me too low and I was having to top up with carbs but I now seem to have mastered that. I’m recording and logging everything and doing my best to find my way but progress is slow, however I won’t give up. It’s reassuring to know that it took you sometime to find out what worked best. I don’t have a great deal of weight to lose, so think I might put that on one side for now and get into more of a pattern with running. It might be better to focus on weights and anaerobic in terms of weight loss but if my morning readings aren’t right Then so be it. Thank you once again for taking the time out and finding me all of those links.

 

[missclb]

Hi @Mich1 – perhaps you could do a bit of anaerobic to start, then do a run? Let them balance each other out. Failing that, I tend to stick with glucose tablets and means i'm not eating sweets whenever I need a boost. Or a small drink of fruit juice, that's my other favourite.

You sound like you have a great attidue to your relatively new diagnosis, well done. And good luck with it all. Please do share your findings as you go, so everyone can benefit.

 

[SB2015]

Hi @Mich1

Like @Robin I struggled when on Lantus. When I switched to Levemir and split my basal insulin I had a lot more ability to adjust for lows in the morning and highs during the day (the split was not even).

In the early months after diagnosis, I found it hard to predict what insulin I needed, as I still had some beta cells that after a bit of a rest, they would decide to jion Lin again and chuck out some insulin. Hypo. Then they got tired and went on strike again, hyper!! .....

For exercise there are a variety of strategies, and you will need to try the different approaches and find out what works for you. I do think that getting the spit basal, using Levemir, will help to get things more settled at the start of the day, and therefore dealing with your exercise regime will become easier to predict.

 

[Mich1]

Hi @Mich1

Like @Robin I struggled when on Lantus. When I switched to Levemir and split my basal insulin I had a lot more ability to adjust for lows in the morning and highs during the day (the split was not even).

In the early months after diagnosis, I found it hard to predict what insulin I needed, as I still had some beta cells that after a bit of a rest, they would decide to jion Lin again and chuck out some insulin. Hypo. Then they got tired and went on strike again, hyper!! .....

For exercise there are a variety of strategies, and you will need to try the different approaches and find out what works for you. I do think that getting the spit basal, using Levemir, will help to get things more settled at the start of the day, and therefore dealing with your exercise regime will become easier to predict.

Thank you, that is very useful and I certainly will mention it at my next appraisal, I think it is the way forward. Lots of hypos at the moment and I’m still not managing to do as much exercise as I like but I’m sure it will sort.

 

[Mich1]

Hi @Mich1 – perhaps you could do a bit of anaerobic to start, then do a run? Let them balance each other out. Failing that, I tend to stick with glucose tablets and means i'm not eating sweets whenever I need a boost. Or a small drink of fruit juice, that's my other favourite.

You sound like you have a great attidue to your relatively new diagnosis, well done. And good luck with it all. Please do share your findings as you go, so everyone can benefit.

Thank you, some good advice. I went back to basics and did just running for a week and then a week of anaerobic weights. I’ve reduced my basal further but I’m still always below 5 in the morning, so I’m guessing that’s just the way things are going to be. If I’m exercising in the morning then it’s porridge and blueberries and no insulin. This works for yoga, Pilates and weights. For running I need more carbs and haven’t quite got the hang of things yet but having a fruit juice helps. I’ve tried fruit juice watered down whilst running but found that I was putting on weight with that and like yours and others suggestions think that my basal isn’t quite right. On days when i’ve Done a lot or often the day after exercise I’m often having hypos, so that would support this thought. I don’t like sugary things either so will try the tabs, failing that I’m going to test bananas as I’d far sooner have something a bit healthier. I’m recording everything and got a whole spread sheet going with different variables, so I will keep adding to this page if it helps anyone else.
I’m going on holiday in June, so need to try and see how swimming works out but I just haven’t dare! Getting my head round holidays is a whole other adventure but there is a lot of advice on here, so think I have it sorted (Frio wallets purchased). Thanks once again!

 

[trophywench]

If I were you - I'd get hold of a Libre since it means you can basal test all through the night without the need to keep waking up - once the sensor's established and you've grasped how near or otherwise it is consistent with your fingerprick testing - you only need to scan it every 8 hours, so then check the readings when you get up to see what it's been doing overnight and attempt getting the dose, timing or type of insulin to address the peaks and troughs.

 

[SB2015]

’m going on holiday in June, so need to try and see how swimming works out but I just haven’t dare! Getting my head round holidays is a whole other adventure but there is a lot of advice on here, so think I have it sorted (Frio wallets purchased). Thanks once again!

Swimming was something I took a long time to try after diagnosis. I was worried that I would hypo and not notice. At the gym I went to, I spoke to a member of staff (and very nice ex pupil). She simply came in with me, and swam the lengths with me, had fun racing each other. I checked every 10 lengths and gradually got sorted what reductions in insulin I needed before and after. Just as you are diong with your other activities, keeping logs, adjusting things bit by bit and finding what works for you.

When I got the Libre, exercise just became a lot easier, especially swimming. No need to stop dry my hands, find my glasses, fingerprick, test. Just stop, swipe, swim on. Also good for less interruptions in matches, and as it is so easy to do, I just swipe between points and know where I am at. Not only does it show the level but also the direction of travel. I find when diong sport I need to remember that there is a time lag (about 10 min) so I start to eat jelly babies around 5.5 if I have a downward trend, where as normally I would be reacting at 4.5.

Holidays just need a lot more planning and taking more ‘stuff’ with you. As you say there is plenty of advice on here, and I have built up a checklist and that is the first bit of packing that I do.