Getting back to exercise!

[The_Bowlii]

Hello there - starting my first ever thread.

I was diagnosed with Type 1 diabetes about a month ago. My biggest concern was getting back to exercise as I’m a keen cyclist and squash player. I have to admit I thought it was the end of all that and have been very upset with what seems to be so unfair.

Roll on a month, I’ve met the dietician and talked to a friend of a friend with T1D and it all looks manageable! I’ve played squash 3 times in the past week and done 25 miles on the bike. I’ve gone low on BG once after squash and during my bike ride had to consume a couple of gels after 45 mins and 1h30.

There are so many things to consider including starting BG, recent food, duration, intensity, insulin dosage etc. I’m just doing it by trial and error right now to set a baseline and then make changes to each of the variables to measure the impact. Luckily, I’ve got my lovely wife along for the ride…

If you’re reading this and you have words of wisdom or even any questions, please feel free to respond.

Happy exercise, whatever your game!

 

[helli]

The top tip for me when I was exercising on MDI was to put diluted fruit juice/squash in my water bottle.
I found this much better at constantly keeping my levels from dropping rather than treating with gels/dextrose once they were already low.

 

[The_Bowlii]

The top tip for me when I was exercising on MDI was to put diluted fruit juice/squash in my water bottle.
I found this much better at constantly keeping my levels from dropping rather than treating with gels/dextrose once they were already low.

Thanks @helli. What’s MDI please?

Did you make any changes to your basal or bolus insulin doses prior to exercise? I’ve seen posts where people reduce bolus insulin by half ahead of longer cycling activities. And other people who split their basal between morning and evening. So many things to think about!

 

[helli]

MDI is Multiple Dose Injections - injecting as opposed to insulin pump.
Sorry for the extra acronym.

I did not reduce my insulin prior to exercise as, for me, this lead to higher BG which made me too lethargic to exercise. Hence the strategy to top up my glucose en route.
I also avoid "IOB". Yes, another acronym. This stands for Insulin on Board but really means Bolus/Fast acting insulin active in your body. Fast acting insulins such as NovoRapid and Fiasp are active for about 4 hours. As exercise makes our body more insulin sensitive, I avoid exercise for about 4 hours after eating/bolusing. This is fine for a squash game (or in my case a Spin class) but less useful for longer exercise such as a 3 hour cycle ride (or marathon) where you may need to refuel. In that case, I would reduce my insulin to carb ratio for "in exercise fuelling" to about 50%.

When injecting, I did not split my basal but this was some time ago (I have been pumping for 8 years) before Levemir was an option. A longer lasting basal such as Tresiba (or, in my case, Lantus) assumes the same basal needs for 24 hours. I do not think that splitting insulin is an exercise related change - some people need more insulin and different times of the day.
However, I would reduce my basal by about 20% for the next 24 to 48 hours after exercise. This is not possible for the very long lasting basal insulins like Tresiba but worked for me with Lantus and I see no reason why not with Levemir.

Sorry, I feel I have been waffling but I wanted to add that this is my technique for my exercise. Your needs may vary ... and not be the same every time ... depending upon duration, type of exercise and fitness level.

 

[Rob Oldfield]

Two words from me: Jelly Babies. Fabulous little sugar hits that can be piled into cycle tops and grabbed as and when. The key thing about them is that it really needs to get to stupidly high temperatures before they show any sign of melting.

 

[sharie]

Hey, I am also recently diagnosed , I have a very active job and have found myself reducing my long acting by quite a bit , I’m still playing about with it all as well which, is really the way forward. I have to say It does feel a bit odd having to medicate yourself , all by yourself by listening to your body, and a little scary, but I’m getting more used to it by the day.

 

[T1Nick]

For me, and many others for sure, exercise has always been one of the most difficult areas to get right when it comes to BG control. My main advice (after 40 years of trying to get it right) is keep on checking your BG regularly as changes happen so much more quickly when physical activity increases. My main exercise is tennis and I check my BG at every change of ends (every 2 games). This works as it is a natural break in play and therefore doesn't hold up the game for everyone. How I used to manage before FGM / CGM I'll never know - I probably always ran too high for fear of hypo mid-game. Of course there was no real way of knowing with any sense of accuracy.
I agree with Helli that it's much better to try and keep your levels steady during exercise than it is to wait until things go very low or very high before acting. Stopping or recovering from a hypo mid-game or mid-activity is just not good for you or the quality of your play. At best it is distracting and diorientating, at worst it can be dangerous!
So I aim to start a game with BG levels between 7 and 10 and, as stated above, then test every 10 mins or so. If my levels start to decrease slowly then I will turn off my basal first (easy with a pump). If this doesn't correct it I will then drink some sports drink. If this still doesn't work or if levels start to drop quickly, then it's chomp the Jelly Babies (but it's a bit late and not ideal by then). If levels start to rise as I'm playing then initially I'll do nothing but if it continues I will pump in a unit of Fiasp to try to trim the levels back down. It's fair to say that this doesn't always work as the insulin takes too long to react (yes even Fiasp) but sometimes it does and anyway it stops me worrying that I'll go too high which can affect energy levels and performance.
One other thing I've learned is that checking BG levels after exercise is also so necessary. I have to drive home from tennis and I'm constantly checking my BG levels during the journey and for at least the next four hours as, again, things can change rapidly. One small wish is that the Libre App would work with Android Auto so that I could have my BG levels displayed on the car Infotainment system!!

I hope this helps give you some pointers so you can find what works for you!

 

[nonethewiser]

Hello there - starting my first ever thread.

I was diagnosed with Type 1 diabetes about a month ago. My biggest concern was getting back to exercise as I’m a keen cyclist and squash player. I have to admit I thought it was the end of all that and have been very upset with what seems to be so unfair.

Roll on a month, I’ve met the dietician and talked to a friend of a friend with T1D and it all looks manageable! I’ve played squash 3 times in the past week and done 25 miles on the bike. I’ve gone low on BG once after squash and during my bike ride had to consume a couple of gels after 45 mins and 1h30.

There are so many things to consider including starting BG, recent food, duration, intensity, insulin dosage etc. I’m just doing it by trial and error right now to set a baseline and then make changes to each of the variables to measure the impact. Luckily, I’ve got my lovely wife along for the ride…

If you’re reading this and you have words of wisdom or even any questions, please feel free to respond.

Happy exercise, whatever your game!

Well done, well impressed mate.

Kendal Mint Cake works fast for treating hypos, you can buy small bars from likes of outdoor shops & online.

 

[RichardsUsername]

Hello there - starting my first ever thread.

I was diagnosed with Type 1 diabetes about a month ago. My biggest concern was getting back to exercise as I’m a keen cyclist and squash player. I have to admit I thought it was the end of all that and have been very upset with what seems to be so unfair.

Roll on a month, I’ve met the dietician and talked to a friend of a friend with T1D and it all looks manageable! I’ve played squash 3 times in the past week and done 25 miles on the bike. I’ve gone low on BG once after squash and during my bike ride had to consume a couple of gels after 45 mins and 1h30.

There are so many things to consider including starting BG, recent food, duration, intensity, insulin dosage etc. I’m just doing it by trial and error right now to set a baseline and then make changes to each of the variables to measure the impact. Luckily, I’ve got my lovely wife along for the ride…

If you’re reading this and you have words of wisdom or even any questions, please feel free to respond.

Happy exercise, whatever your game!

Exercise for me is the fastest and most effective way to drop the glucose as I can tend to go into double digits quite easily. Quite lucky really because exercise is not an option for many people, definitely not the routine I do. Which is based on intensity. Even though physical activity is recommended but not appropriate for some, which is why most of the focus is on diet. Ideally you want to use all the tools available to you.

 

[The_Bowlii]

Hi all. Thanks for all the comments. Anyway, quick update on tonight’s slight fiasco…

I decided to do 35 mins indoor cycling on the turbo trainer. BG was at about 7.5 but hadn’t eaten or injected for 5 hours. After 10 mins of moderate intensity, I started drinking orange juice (thanks @helli) diluted 50/50 with water as my BG started to drop. 20 minutes in, I was at 3.5 so stopped and took 3 jelly babies (thanks @Rob Oldfield) and sat down. Levels rose again to about 7 so I completed the last 15 minutes of the ride without any further problems.

What have I learned?
- don’t do relatively intense exercise after not eating for 5 hours and sitting on your bum at work all afternoon
- start with the carbs sooner if levels show any sign of dropping
- don’t overdo it you idiot, it’s your first time on the turbo since diagnosis!! (Actually, that’s my wife who said that)

Stay tuned as I work out how to turn myself inside out whilst being a type 1 diabetic .

 

[The_Bowlii]

Exercise for me is the fastest and most effective way to drop the glucose as I can tend to go into double digits quite easily. Quite lucky really because exercise is not an option for many people, definitely not the routine I do. Which is based on intensity. Even though physical activity is recommended but not appropriate for some, which is why most of the focus is on diet. Ideally you want to use all the tools available to you.

Hi Richard. Yes, I think I’m similar. On a bike ride on Sunday, I started at around 7.5 and within 10k I was popping gels after a low level alarm on the Libre app.

Also, I notice after meals that if I just sit around, my BG is initially fine and then creeps up 3-4 hours later. If I exercise, however, even just a walk round the village, I don’t see the same effect. Any thoughts?

 

[RichardsUsername]

Hi Richard. Yes, I think I’m similar. On a bike ride on Sunday, I started at around 7.5 and within 10k I was popping gels after a low level alarm on the Libre app.

Also, I notice after meals that if I just sit around, my BG is initially fine and then creeps up 3-4 hours later. If I exercise, however, even just a walk round the village, I don’t see the same effect. Any thoughts?

I read in an article the more intense the exercise the quicker your glucose drops. Another member didn't agree entirely. But only the other day I dropped from about 17.0 down to 6.7 in 4 hours if I remember right. Because I used intense exercise. I don't really want to be getting readings that high but it's good I can do something about it pretty quick.

 

[helli]

After 10 mins of moderate intensity, I started drinking orange juice (thanks @helli) diluted 50/50 with water as my BG started to drop.

Sorry, I was not clear. My diluted juice is drunk instead of water not as a hypo treatment

 

[The_Bowlii]

Sorry, I was not clear. My diluted juice is drunk instead of water not as a hypo treatment

Thanks @helli - I was also drinking it instead of water assuming it would keep me stable but it appears I was expending more energy than I was taking in. I wasn’t using it as a hypo treatment so no worries there.

 

[The_Bowlii]

Well done, well impressed mate.

Kendal Mint Cake works fast for treating hypos, you can buy small bars from likes of outdoor shops & online.

Thanks @nonethewiser - it’s just that it feels like it’s dissolving your teeth!!

 

[SimonP]

I don't want to swamp the thread, so here are a couple of links to where I've posted some of my experiences about
cycling (and badminton and other sports I used to do):

Endurance sport - to bolus or not to bolus?

Hello I’m Type 1 diabetic and I use a Medtronic insulin pump, which provides bolus and basal insulin. I like to partake in endurance sporting events. These can sometimes be 8hrs plus. I would normally not take any bolus, eat breakfast, and turn my basal down to 10%. Basically, only 10% basal...

www.diabetes.co.uk

https://forum.diabetes.org.uk/boards/threads/cycling.102207/#post-1207010

Hi Richard. Yes, I think I’m similar. On a bike ride on Sunday, I started at around 7.5 and within 10k I was popping gels after a low level alarm on the Libre app.

Also, I notice after meals that if I just sit around, my BG is initially fine and then creeps up 3-4 hours later. If I exercise, however, even just a walk round the village, I don’t see the same effect. Any thoughts?

If I do even a little bit of exercise (like walking my youngest to school, back when she was at a school that was walkable - admittedly she was usually jogging to keep up or on my shoulders) vastly improves insulin sensitivity (and effectively considerably changes my normal carb ratio). I normally only notice this when I don't do anything (WFH) and go high and stay there, as when I go to work I'm usually wandering around the place even if I don't cycle in.

Well done, well impressed mate.

Kendal Mint Cake works fast for treating hypos, you can buy small bars from likes of outdoor shops & online.

+1 for Kendal mint cake, it's also possible to eat it if you really can't stomach food (I regret eating the greasy cookies I picked up at a café earlier in that ride) but need it as running low.

 

[The_Bowlii]

Hi all. Thanks for all the comments. Anyway, quick update on tonight’s slight fiasco…

I decided to do 35 mins indoor cycling on the turbo trainer. BG was at about 7.5 but hadn’t eaten or injected for 5 hours. After 10 mins of moderate intensity, I started drinking orange juice (thanks @helli) diluted 50/50 with water as my BG started to drop. 20 minutes in, I was at 3.5 so stopped and took 3 jelly babies (thanks @Rob Oldfield) and sat down. Levels rose again to about 7 so I completed the last 15 minutes of the ride without any further problems.

What have I learned?
- don’t do relatively intense exercise after not eating for 5 hours and sitting on your bum at work all afternoon
- start with the carbs sooner if levels show any sign of dropping
- don’t overdo it you idiot, it’s your first time on the turbo since diagnosis!! (Actually, that’s my wife who said that)

Stay tuned as I work out how to turn myself inside out whilst being a type 1 diabetic .

Morning all. My levels have been all over the place since last evening. Actually rose overnight but then fell to 3.6 this morning even though I had a big breakfast with matched insulin. Currently waiting to get to "5 to drive" before going to work. I hope I get the hang of this at some point...

 

[SB2015]

Morning all. My levels have been all over the place since last evening. Actually rose overnight but then fell to 3.6 this morning even though I had a big breakfast with matched insulin. Currently waiting to get to "5 to drive" before going to work. I hope I get the hang of this at some point...

Things will get easier and it is a case of trial and improvement for all of us.
After intense or prolonged exercise it is not uncommon to have a drop later on as your muscles restock with glucose. Some find that they need to reduce their bolus for a meal after exercise.

In these early stages you may well have some beta cells that are still making insulin, some of the time, so they also make things harder to predict. You have already recognised that there are many variables to manage, and you are using a sensible analytical approach. It is impossible to get things perfect but we each do the best that we can, and it does not need to stop you doing things, it just requires a bit of planning and preparation.

With regard to driving, it is important to not only get back to 5 after a hypo but also to wait for 45 minutes after your levels are back in range. That is the one that caught me out a number of times. I now test 45 minutes before I need to drive and make sure that I head off any possible lows to avoid delays.

Keep the questions coming.

 

[nonethewiser]

Thanks @nonethewiser - it’s just that it feels like it’s dissolving your teeth!!

Lol yeah it can do but boy does it work fast, good to keep handy if bg is dropping rapidly.

 

[Rob Oldfield]

Any news on getting the Libre 2 yet @The_Bowlii ? That'll make a big difference in terms of keeping in touch with what your sugar level is doing.