Factoring in exercise

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cadbury

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Relationship to Diabetes
Type 1.5 LADA
Hi Team

I was recently diagnosed with Diabetes, they think it's LADA (1.5) but I'm awaiting confirmation.
I am on rapid-insulin injections with meals. I understand the amount of insulin I take should mirror the amount of carbs I eat.

I don't go to the gym, but I do like going for fast-ish walks. I'm wondering how I should factor this in - if exercise reduces blood-sugar levels, I guess my question is ... if I am planning to go for say a 30 minute walk after eating, should I lower my insulin amount? Or have more carbs (but same amount of insulin)?

Thanks
 
Welcome @cadbury 🙂 You can do either - or both. The only way you’ll know what works is by careful experimentation. Always err on the side of caution.

Just a pedantic comment - mealtime insulin doesn’t “mirror carbs”. You just have a ratio you use: how many carbs one unit of insulin ‘covers’. So, 1:10g or 1:8g or 1:15g, 1:16g, 1:5g, etc.
 
Welcome to the forum @cadbury Glad that you have found us

Dealing with exercise will vary for each person and depend on when the intensity of the exercise and when you are exercising relative to when you eat. Both your strategies will work. If you are going to exercise after a meal a reduction in your bolus/mealtime insulin can leave you enough ‘spare glucose’ for your muscles (I know that is not scientific) . If I go for a full day of walking I find I still need to have Wurthers at intervals throughout the day to keep my glucose levels up above hypo land.

Doing something after any meal for at least 15 minutes is a great way of reducing the spikes that we tend to get after a meal. I try to do this but sometimes just slump. We are human.

Whatever questions arise just ask. Nothing is considered silly on here.
 
cadbury said:
Hi Team

I was recently diagnosed with Diabetes, they think it's LADA (1.5) but I'm awaiting confirmation.
I am on rapid-insulin injections with meals. I understand the amount of insulin I take should mirror the amount of carbs I eat.

I don't go to the gym, but I do like going for fast-ish walks. I'm wondering how I should factor this in - if exercise reduces blood-sugar levels, I guess my question is ... if I am planning to go for say a 30 minute walk after eating, should I lower my insulin amount? Or have more carbs (but same amount of insulin)?

Thanks
Click to expand...
Hi @cadbury - welcome to the club! In my very limited experience (since August 2023), you will probably need to experiment a little bit with the intensity of the exercise, the timing versus your last injection etc. I've found that doing exercise in the morning with just basal insulin and not having eaten keeps me very stable. If I eat before exercise, I inject 1/2 to 2/3 of the normal insulin, eat and then get moving. If I'm having an office day, I have 1.2 x my normal insulin levels as I'm not moving about. You'll find your own way but if you want to have a look at some great advice, have a look on the thread "getting back to exercise" that I started a while back. Several people on there really helped me come back from relative despair to doing all the things I want to do and possibly a bit more!

As they say above, ask away, nothing is daft on here.
 
Thanks all for the replies!

This all makes sense, but it does lead me on to my next question:
If I exercise enough to counter all the carbs I eat, couldn't I stop taking the Insulin completely?
Maybe if I can keep my sugar levels low by exercising (without taking Insulin), that would confirm that I don't need Insulin?

I don't know how realistic that is, I'm just trying to understand this better!
To clarify, I am on Novorapid with meals, and Lantus (slow-acting) once a day at night.

@SB2015 - when you go for a full day of walking, eating those Wurthers to keep your sugar up, do you still need Insulin? Would you be taking less?

Thanks!
 
Hi @cadbury - I wouldn’t recommend stopping your insulin. You’ll need to speak to your diabetes nurse / consultant who will explain what is and isn’t possible and the role of insulin.

Simplistically, insulin acts as a key to allow your muscles to take up glucose for energy and repair. There are some good explainer videos on line that really helped me.

To give my own example today, I had my normal breakfast but reduced insulin by a couple of units as I was going to go on a bike ride. During the ride, I kept topped up with a carb drink and jelly babies and no insulin. After 50kms, I stopped briefly (10 mins) and had a coffee and a flapjack with no insulin before getting back on my bike and going as hard as I could to consume the carbs. I still saw a rise in blood glucose but it remained under 10 mmol/l. When I got home after another 60 km, by blood glucose was starting to fall - it took that long! I then ate a huge meal but 2/3 the normal dose of insulin because the effort had stopped. Even though I’d put all that effort in, I still needed insulin.

Every day is a learning day with diabetes!
 
The_Bowlii said:
Hi @cadbury - I wouldn’t recommend stopping your insulin. You’ll need to speak to your diabetes nurse / consultant who will explain what is and isn’t possible and the role of insulin.

Simplistically, insulin acts as a key to allow your muscles to take up glucose for energy and repair. There are some good explainer videos on line that really helped me.

To give my own example today, I had my normal breakfast but reduced insulin by a couple of units as I was going to go on a bike ride. During the ride, I kept topped up with a carb drink and jelly babies and no insulin. After 50kms, I stopped briefly (10 mins) and had a coffee and a flapjack with no insulin before getting back on my bike and going as hard as I could to consume the carbs. I still saw a rise in blood glucose but it remained under 10 mmol/l. When I got home after another 60 km, by blood glucose was starting to fall - it took that long! I then ate a huge meal but 2/3 the normal dose of insulin because the effort had stopped. Even though I’d put all that effort in, I still needed insulin.

Every day is a learning day with diabetes!
Click to expand...
Hope all is well and proves once again you need to rely on real life experience as an individual rather than trying to extrapolate the likely results.
Like many I think we tend to think there is a linear relationship to exercise and insulin requirements whereas it is more complex.
My BG levels ( like just now) will often drop by 4-5 after a 30 minute brisk walk so equate to about 2u of insulin.
As I only take a max of 4 for b/fast and 6 for other meals ( am not low carb) then I could forecast that doing 3hours of walking would virtually eliminate the need to take bolus insulin but that is a heck of a lot less intensive a workout than your bike rides.
I doubt your carb intake on a bike ride is higher than my normal food intake so shows this diabetes malarkey is a lot more complicated.
ATB
I
 
cadbury said:
Thanks all for the replies!

This all makes sense, but it does lead me on to my next question:
If I exercise enough to counter all the carbs I eat, couldn't I stop taking the Insulin completely?
Maybe if I can keep my sugar levels low by exercising (without taking Insulin), that would confirm that I don't need Insulin?

I don't know how realistic that is, I'm just trying to understand this better!
To clarify, I am on Novorapid with meals, and Lantus (slow-acting) once a day at night.

@SB2015 - when you go for a full day of walking, eating those Wurthers to keep your sugar up, do you still need Insulin? Would you be taking less?

Thanks!
Click to expand...

Sadly it doesn’t work like that @cadbury We can’t survive without insulin. Exercise can help reduce the amount of insulin we need (or increase it sometimes too) and it can help our insulin sensitivity, but it’s not a cure for Type 1. Before the discovery and purification of insulin, every single person with Type 1/LADA died no matter how little they ate or how much they exercised. Insulin is your friend not your enemy.
 
Inka said:
Sadly it doesn’t work like that @cadbury We can’t survive without insulin. Exercise can help reduce the amount of insulin we need (or increase it sometimes too) and it can help our insulin sensitivity, but it’s not a cure for Type 1. Before the discovery and purification of insulin, every single person with Type 1/LADA died no matter how little they ate or how much they exercised. Insulin is your friend not your enemy.
Click to expand...
Hi @Inka - very well put! I’m new to this and for the first few months tried to minimise insulin like some sort of challenge. Nowadays, I don’t try to out exercise it or take out carbs - I just live my (slightly altered) life and use the insulin as best I can. Sometimes it works, sometimes I get it wrong but don’t we all? 🙂
 
Inka said:
Sadly it doesn’t work like that @cadbury We can’t survive without insulin. Exercise can help reduce the amount of insulin we need (or increase it sometimes too) and it can help our insulin sensitivity, but it’s not a cure for Type 1. Before the discovery and purification of insulin, every single person with Type 1/LADA died no matter how little they ate or how much they exercised. Insulin is your friend not your enemy.
Click to expand...
Great answer Inka and managing your diabetes is a combination of medication so generally insulin,diet and exercise.
You can adapt one of factors to change the input of one or more of the others not only to improve your control but give you the choice of living the life you wish to.
So if you want to eat more carbs then you can do so and manage it by taking more insulin or doing more exercise and at the end of the day the choice is constrained by your individual wishes and of course any limitations that you may have which limits for eg how much exercise you can do.
 
cadbury said:
If I exercise enough to counter all the carbs I eat, couldn't I stop taking the Insulin completely?
Click to expand...
In over simplistic terms exercise makes the insulin have taken work more effectively. It doesn’t make you produce insulin. If you stopped taking insulin you could become very ill, so you always need your background insulin even if you don’t take any with food during exercise.
 
I think its good to have some sort of idea of how much exercise = how much sugar / carb burn off.
(Makes me think of going to the gym and going for a coffee afterwards, then picking up a takeaway on the way home.)
.
I used to cycle and carried emergency jelly babies in case of sugar levels dropping. One JB = 5 miles cycling.
 
I reckon about 60g/h riding at 22kph, though it does depend on how much basal you take - if I reduce it too much I don't need to eat at all (5h+), and how much exercise you're accustomed to doing.

My power meter reckons that ~100W for ~10h is ~5000kcal or about 21 Mars bars, which works out about right as each Mars bar is apparently 35g of carbs (I don't tend to eat Mars bars while riding though, certainly not for 10h!)

YMMV of course!
 
Going back to my previous post I should point out that my figures refer to cycling on the flat.
.
On the flat ones consumption is calculated in, miles per jelly baby.
Up a one in ten for instance it is calculated in jelly babies per mile.
😉
 
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