Bloods after exercise

[Nathan Potter]

I’ve recently started a 12 week challenge where I’ve signed up to the gym and now go about 3/4 times a week, I’m quite fit anyway but this is still quite an increase in exercise for me. If I have a good run around from planned evening exercise (I play rugby and football) I usually have no fast acting insulin with my evening meal and just take my background insulin which almost always brings me within range in the morning before breakfast. With this big change in amount of exercise I’ve found my bloods are much harder to control as maybe my gym sessions are a lot harder and as I do more Ive become more sensitive to insulin so have dropped my background Lantus from 26units to 18 units to stop morning hypos.

What I am struggling with the most is the fact I have my evening mean after the gym and don’t give any fast acting insulin (as I usually wouldn’t after fairly intense exercise) but then find my blood sugar reading anything up to about 26 at around 10:30/11pm but If I were to inject at this time to correct it I would almost certainly wake up hypo. I’m worried that I’m doing my body some damage sleeping for hours with a blood sugar so high which bugs me even more because I’m usually so stable. Is there a way to keep my blood sugar more level post exercise and over night which would still bring me in range before breakfast the next day? Any advise would be much appreciated, thanks!

 

[rebrascora]

I'm no expert but I would give yourself a smaller bolus than usual before your evening meal and see how that goes and gradually increase it if you still go that high. Is there a reason why you have stopped doing the evening meal bolus? To me it makes more sense to take it before your evening meal and keep your BG low than not take it just because you have had exercise and let it get up to such dizzyingly high levels and than trying to correct it before bedtime and risk a hypo in the night.
The other option would be to have a lower carb evening meal.

 

[KookyCat]

I feel your pain. For context I’m very sensitive to insulin full stop, but especially so in the evening. I’m very active in general but found that exercise in the evening was a disaster at first. After much fiddling, testing and trying all sorts of techniques I found this approach works the best. I take tresiba instead of Lantus because it’s much more stable in me personally, and I take it in the morning. That way it’s potency is trailing out, so I can conservatively bolus in the evening when I’m being very active, the increased sensitivity isn’t as much of a problem then because my basal is trailing off. This also works better day to day because I’m less insulin sensitive in the morning up until around 2pm, then start to get more sensitive. If changing timings is too much to deal with then I’d be tempted to try reducing the lantus a bit more, with careful testing of course, so you can bolus for that evening meal even if it’s a very conservative bolus to take that bedtime blood sugar down. All that depends on how well the 18 units is working in general though, and whether it’s keeping everything ticking over. The other thing I’ve realised is that I need to eat before exercise, rather than after. So conservative bolus for the food, then the increased sensitivity during the exercise works to bring that down in combination with the moderate amount of insulin. Then I can top up with a little snack afterwards if the bedtime blood sugar is a bit lower than I’d like. Not sure any of that is helpful, but I hope you work it out 🙂

 

[SB2015]

I’ve recently started a 12 week challenge where I’ve signed up to the gym and now go about 3/4 times a week, I’m quite fit anyway but this is still quite an increase in exercise for me. If I have a good run around from planned evening exercise (I play rugby and football) I usually have no fast acting insulin with my evening meal and just take my background insulin which almost always brings me within range in the morning before breakfast. With this big change in amount of exercise I’ve found my bloods are much harder to control as maybe my gym sessions are a lot harder and as I do more Ive become more sensitive to insulin so have dropped my background Lantus from 26units to 18 units to stop morning hypos.

What I am struggling with the most is the fact I have my evening mean after the gym and don’t give any fast acting insulin (as I usually wouldn’t after fairly intense exercise) but then find my blood sugar reading anything up to about 26 at around 10:30/11pm but If I were to inject at this time to correct it I would almost certainly wake up hypo. I’m worried that I’m doing my body some damage sleeping for hours with a blood sugar so high which bugs me even more because I’m usually so stable. Is there a way to keep my blood sugar more level post exercise and over night which would still bring me in range before breakfast the next day? Any advise would be much appreciated, thanks!

Hi Nathan and welcome to the forum. Exercise is awkward to deal with, as it depends on so many different factors. I am like @KookyCat and very sensitive to insulin.

When on MDI I found it useful to switch to Levemir for my background insulin this enabled me to split it and I was able to reduce my overnight or my morning dose without effecting the other. This gave me more flexibility with dealing with evening exercise and avoiding overnight hypos.

Whatever you try it will always be a process of regular testing and making small adjustments. As @Benny G has said it is useful to remember that not only can we adjust our insulin doses but also the carb content in our meals. Switching some carbs to protein may help.

Another thought is whether you have considered asking to switch to a pump? I found I could not get the flexibility I wanted without regular hypos in MDI, and the switch made life much more flexible.

 

[Matt Cycle]

Hi Nathan. With gym work generally being anaerobic there's always the possibility of blood levels being pushed up. Agree with the others though about using Levemir as a basal - much more flexibility. Before and after exercise I tend to not mess too much with the fast acting (maybe slight reductions - any carbs during exercise are always free) and wouldn't consider eating without using it as even though the muscles are replacing glycogen I'd be high without it. Need my essential carbs to replace glycogen. The crucial reductions I make are with basal - much easier now I'm on the pump - so I can use a temporary basal rate (TBR) during exercise and afterwards - through the night and into the following morning. I've never used Lantus but when on split Levemir I tended to reduce both morning and evening doses on an exercise day and managed to survive.