Honeymoon Phase and Exercise

D

Drumbowie

Member
Relationship to Diabetes
Type 1
I am a recent Type 1 diagnosis - was admitted to hospital in late May following concern from Gastro team (long term Inflammatory Bowel Disease - story for another day). On admission, I was ultimately diagnosed with Type 1 (HbA1c of 106mmol/mol and >5 for ketones). The diagnosis explained a great deal of the symptoms I was presenting with. I have great support from my Diabetes Clinic Team. I recovered well and am now consistently averaging a BG of 6.1mmol/L and ketones in range. When discharged I was on NovoRapid and Abasaglar but over the weeks both have been reduced and now I only take my evening Abasaglar (bolus -7 units). I am still eating at regular times, carb counting (Carbs & Cals App) and making full use of my Libre2. My Libre2 estimated HbA1c is 6.7% 50mmol/mol).

I have been told that I most definitely in the 'honeymoon phase' and there is absolute confidence on my Type 1 diagnosis.

I exercised a great deal prior to me diagnosis and feeling unwell. I have reintroduced exercise, mostly strength training, walking at pace and the occasional moderate intensity HiiT. Despite having a decent breakfast (55g of carbs at 7.30am) I keep going low shortly after the exercise have have to have toast (21g of carb) or something similar to pull up my BG to around 6.5/7. Then when I have lunch (55g of carb at 12.30pm) I have gone high (>10) and if don't then do some kind of exercise I can rise to >13. I can also be low in the late evening so am having to have 'supper'- slice of toast - about 10pm to stop me dropping during the night

I am keen to know what the experience of others has been during the honeymoon phase and how doing they balance exercise and BG number? My goal is to get back to more intense exercise and Parkruns (PB of 5km at 27 mins, but now likely someway off that) and will discuss this with the clinical team at my next appointment.
 
Then when I have lunch (55g of carb at 12.30pm) I have gone high (>10) and if don't then do some kind of exercise I can rise to >13.

You might need a small amount of bolus/fast/meal insulin with your lunch then. You should get a pen that does half units, then you can take tiny amounts. During my honeymoon, I could not take any insulin at breakfast and be 3.8 at lunch, but I spiked to 13ish. My consultant explained that taking a small amount of insulin would help preserve my remaining beta cells longer, so I took my insulin and had a mid/late morning snack if needed (to stop any additional drop from my own insulin kicking in).

I’m not sure what you wrote about the Abasaglar. Did you mean to write “basal”? Anyway, you’d probably find a twice daily basal insulin more flexible as you could then take less during the day if you were exercising.
 
Inka said:
Then when I have lunch (55g of carb at 12.30pm) I have gone high (>10) and if don't then do some kind of exercise I can rise to >13.

You might need a small amount of bolus/fast/meal insulin with your lunch then. You should get a pen that does half units, then you can take tiny amounts. During my honeymoon, I could not take any insulin at breakfast and be 3.8 at lunch, but I spiked to 13ish. My consultant explained that taking a small amount of insulin would help preserve my remaining beta cells longer, so I took my insulin and had a mid/late morning snack if needed (to stop any additional drop from my own insulin kicking in).

I’m not sure what you wrote about the Abasaglar. Did you mean to write “basal”? Anyway, you’d probably find a twice daily basal insulin more flexible as you could then take less during the day if you were exercising.
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Thank you for the reply. I was thinking I may need a little NovoRapid (fast acting) at lunch and perhaps reduce my evening Abasaglar (long acting) dose a unit.
 
Drumbowie said:
Thank you for the reply. I was thinking I may need a little NovoRapid (fast acting) at lunch and perhaps reduce my evening Abasaglar (long acting) dose a unit.
Click to expand...

That sounds reasonable. Do you have a half unit pen for the Novorapid?
 
Drumbowie said:
I have reintroduced exercise, mostly strength training, walking at pace and the occasional moderate intensity HiiT.
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Different types of exercise will affect us in different ways.
Typically (although we are all different), strength training will raise BG and cardio will lower it. Depending upon your HIIT regime, it could push your BG either way.
It may be worthwhile looking at the affect of each of your types of exercise in isolation and not lumping them all together as "exercise". As a result, you may find you need different coping regimes for the different types ... or combinations.
For example,
- when I do a 45 minute spin class, I need to start with a higher BG and maybe a snack without insulin to avoid going low.
- when I go climbing, I need extra insulin to avoid going too high.
- when I do a gym workout, it is a combination of weights and cardio. I decide which I will do first based upon my BG: weights if I need to raise my BG and cardio if I need to lower it.

Another thing worth bearing in mind is "insulin on board". Exercise can make our bodies use the insulin more efficiently. Therefore, I try to avoid exercising within 4 hours of my last bolus.
And then there is time of day. It is common to experience a rise in BG at the start of the day. Therefore, it may be useful to do some cardio before breakfast to balance out the rise from Dawn Phenomenon with the cardio drop.

Finally (for now .. until I think of something else), is that any type of intensive exercise, can reduce your BG over the next 24 to 48 hours. This is why I lower basal my lower on the day following exercise.

In other words, exercise with Type 1 diabetes is definitely possible (including your 27 minute park run) but it will take some trial and learning to work out how to manage it for your body and your types of exercise.
 
Inka said:
That sounds reasonable. Do you have a half unit pen for the Novorapid?
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No. Sadly, my NovoRapid is in 1 unit increments. I am going to try reducing my Basal (Abasaglar) dose this evening and see what difference that makes tomorrow.
 
Drumbowie said:
No. Sadly, my NovoRapid is in 1 unit increments. I am going to try reducing my Basal (Abasaglar) dose this evening and see what difference that makes tomorrow.
Click to expand...
Why not get a half unit pen?
 
Drumbowie said:
No. Sadly, my NovoRapid is in 1 unit increments. I am going to try reducing my Basal (Abasaglar) dose this evening and see what difference that makes tomorrow.
Click to expand...
Given your small insulin dose, I highly recommend pestering your DSN for a NovoPen Echo which doses half units as well as having a memory jogger for when you injected your last dose.
It surprises me that single use pens which can only dose increments of whole units (as well as being less robust, take up more space in your fridge than cartridges for reusable pens and add more to the landfill waste) are prescribed as standard.
You will need your prescription changed for cartridges instead of pens and you will need a spare pen because, they can fail (albeit rarely) so you need a backup.
 
Drumbowie said:
No. Sadly, my NovoRapid is in 1 unit increments. I am going to try reducing my Basal (Abasaglar) dose this evening and see what difference that makes tomorrow.
Click to expand...

You need a half unit pen. They’re very useful - not only for small bolus adjustments, but also for more accurate correction doses.
 
Drumbowie said:
I am a recent Type 1 diagnosis - was admitted to hospital in late May following concern from Gastro team (long term Inflammatory Bowel Disease - story for another day). On admission, I was ultimately diagnosed with Type 1 (HbA1c of 106mmol/mol and >5 for ketones). The diagnosis explained a great deal of the symptoms I was presenting with. I have great support from my Diabetes Clinic Team. I recovered well and am now consistently averaging a BG of 6.1mmol/L and ketones in range. When discharged I was on NovoRapid and Abasaglar but over the weeks both have been reduced and now I only take my evening Abasaglar (bolus -7 units). I am still eating at regular times, carb counting (Carbs & Cals App) and making full use of my Libre2. My Libre2 estimated HbA1c is 6.7% 50mmol/mol).

I have been told that I most definitely in the 'honeymoon phase' and there is absolute confidence on my Type 1 diagnosis.

I exercised a great deal prior to me diagnosis and feeling unwell. I have reintroduced exercise, mostly strength training, walking at pace and the occasional moderate intensity HiiT. Despite having a decent breakfast (55g of carbs at 7.30am) I keep going low shortly after the exercise have have to have toast (21g of carb) or something similar to pull up my BG to around 6.5/7. Then when I have lunch (55g of carb at 12.30pm) I have gone high (>10) and if don't then do some kind of exercise I can rise to >13. I can also be low in the late evening so am having to have 'supper'- slice of toast - about 10pm to stop me dropping during the night

I am keen to know what the experience of others has been during the honeymoon phase and how doing they balance exercise and BG number? My goal is to get back to more intense exercise and Parkruns (PB of 5km at 27 mins, but now likely someway off that) and will discuss this with the clinical team at my next appointment.
Click to expand...


Hi,

Balancing blood glucose levels during the honeymoon phase can be challenging. After exercise, low blood glucose is common due to increased insulin sensitivity. Try adjusting your insulin doses and eating balanced meals with carbs, protein, and fats before and after workouts. Keeping detailed records of your BG levels, exercise, and food intake can help identify patterns. Discuss these observations with your clinical team for tailored advice. Best of luck with your fitness goals and managing your Type 1 diabetes!

Jack 😉
 
Hi @Drumbowie
Another advocate of the half unit pen. It took me a while to get these, but made a great deal of difference to my management as I was able to round to the half unit up or down as necessary, and this reduced the variation in my BG readings (pre sensor times)
 
Out of interest did you ever get tested for coeliac disease, it can cause inflamed bowel and high glucose levels
 
Half unit pen is a must in honeymoon period IMO - game changer for me (along with a change from Novorapid to Fiasp, which works a bit quicker and doesn't seem to last as long), with my Honeymoon Period just about coming to an end - my pancreas has gradually given up the ghost over the past 2 years and being able to make small increases in ratios to stop the spikes is a big help, and really helps with hypo-anxiety (I was too scared to increase by whole units) - exercise was very difficult for me initially as my BG would soar and plummet all over the place but with a few tweaks to ratios and careful monitoring its much better now - I am a hockey (field) umpire and my exercise is really mixed - short, sharp bursts of energy coupled with lots of brisk, and slow running and walking (forwards and backwards) so all of the textbook guidelines regarding exercise for me didn't really work (I cover roughly 5k per game, and often do 3 games in a day) - had to figure it out myself with trial and error - I always try to start with a min 7-8 mmol/L and make sure I'm well hydrated
 
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