Levels crashing after a short gradient climb

D

digihat

Well-Known Member
Relationship to Diabetes
Type 1
Good Morning everyone 🙂

Was just wondering how people find their levels when going up any form of slight gradient? I find when walking levels stay steady drop a little of course, then when hit a hill not necessarily steep gradient after about 5/10 minutes I'm often a straight arrow down often heading to hypo treat it of course. I'm trying to increase my walking intensity as I've mainly done flat since diagnosis last year. I take somethin occasionally beforehand.

An example just got bus back home it stops bottom of a hill not very steep walk up it and another gentle one before getting home heading to hypo

Just feel a bit stuck on what's best to do
 
I have the benefit of my pump tracking IOB (insulin on board), and that seems to make a fairly significant difference to the way my BGs behave, and whether or not I need to take some precautionary carbs before setting off, in the middle, or at the end.

Walking seems to kick-start insulin doses, and supercharge any on-board insulin. If I’m walking before meals or 4+ hours after my last meal (so with not much IOB) I can relax more, and don’t need to worry so much about precautionary carbs.

I’m not sure I’ve noticed much difference with slight gradients myself - but a lot of the walking I do doesn’t have much in the way or rise and fall.
 
I would say it depends what your body is used to.
I live on a hill and have no choice of walking on the flat unless I take the car. So walking home from town which is about 20 minutes uphill does not have much impact on my BG.
I agree with @everydayupsanddowns that insulin on board can have an impact, especially when I am doing more exercise than usual. So trying to leave 4 hours between my last bolus and the kind of exercise which can cause my BG to fall always helps. But I appreciate this is not always possible, especially if you have been out for lunch.
In that case, I would suggest eating something (without insulin) small before you start or taking a little less blus with your last meal.

It takes some trial and error to find out what works for your body.
And then, if you continue to increase your walking intensity, you may your body changes so you don't need that carb top up for your final "spint" home
 
Hello @digihat,
My circumstances are pretty different to yourself; I surrendered my panc'y to pancreatic cancer some 4.5 years ago; you are highly likely to be in a transition from a fully functioning panc'y to something less! But I think the principles are the same for you and I for managing exercise.

If you know that extra exercise is inevitable (eg your bus stop leaving you with a hill to negotiate for the last bit of your journey home) then you need to anticipate that problem and either start snacking before the exercise causes your BG to rapidly drop or even factor that into your bolus dose before the preceding meal. The HUGE advantage that you have today, which a few years ago was effectively unimaginable, is your CGM. I would strongly suggest that you have the "low alert" setting (which Abbott insist on calling an "alarm") set at something like 5.6. Then as your BG starts dropping you are getting due notice that it's time to eat something modest, such as a biscuit or even dried fruit - but not necessarily the full-on hypo treatment of Dextrose or jelly babies etc.

Precisely what type of snack and how many carbs is something you have to learn from trial and experiment. We are all different in our metabolic responses. You've been wrestling with your D management for about 9 months (I deduce) and I've found after 4+ years that I semi-automatically, ie with relatively little thought, manage my very varied daily routines adequately and now also happily take on a completely different set of circumstances without too much fuss. For example I've just spent 7 days away in an Inverness hotel with inflexible half-board arrangements, part of a group visiting over 30 Archaeological sites of interest in the Highlands of Scotland, with minimal advance detail of how far we would be walking on each day, nor how much cross-country 'climbing' would be ahead of me. I had a modest selection of snacks in my rucksack and let my CGM tell me how I was doing, so what responses were needed. I ate a more generous breakfast than usual and scaled down my meal boluses; that scaling down was a complete guess on day one, adjusted the next day as I "learnt" from my CGM responses of the previous day what could be a bit better for the next day.

The 7 day outcome was far from perfect, but I've not had a single hypo, I've spent some extra time above my preferred limit of 10mmol/L, I've split my meal bolus doses frequently (since I never knew how many carbs would come with my evening meals, nor when the plate of food would be in front of me, nor how greasy that plate of food would be - so how slowly it would digest). Overall I had a great week, had way more exercise than I would in a week at home, drunk a few more glasses of wine than normal and drove 1150 miles for my return trip.

If your exercise is becoming part of your normal routine, you may find that as you get fitter, your extra need for carbs might reduce a little (or you just routinely, sublimally, factor this now normal requirement into your changing daily needs). And, as I did last week, you should also with time and learning gain an increased confidence in simply adjusting insulin doses plus altering carb ratios for different circumstances. The BIG thing is just reminding yourself that if your BG is dropping you simply have too much insulin on board or too little carbs and you have a degree of management over those 2 variables. Of course if your pancreas is still sometimes helping you (!) then you don't have as much foresight or control. But being ready to add a snack while walking and letting your CGM alert you is way better than realising you've gone hypo and needing to stop, treat and wait for recovery. It's not easy, but is doable and today's tech is a great help. That snack can even be a toffee or mint at short intervals.
 
I'm not sure it's all down to fitness, I'm quite fit, I regularly do reasonably long distance cycling (>100miles), but yesterday assembling flatpack shelves and furniture all afternoon and evening (low stress, but constant activity) I had to eat an extra ~100g of uncovered carbs.

I will also go low when I mow the lawn/do the gardening and if I walk around shopping e.g. following my teen and tweenage daughters (bag carrier and money provider, I know my place 🙂). Perhaps my flat-pack (and shopping and gardening) fitness is not up to scratch 😉 or perhaps habituation changes the response as I don't find much effect with <1h bike rides (though perhaps this is because I already subconsciously account for it be eating in advance, reducing dose, or I am riding harder as I'm used to it so generate sufficient hepatic glucose.)
 
SimonP said:
I'm not sure it's all down to fitness
Click to expand...
I kind of agree - I think it is down to your fitness at THAT activity.
Like you, I consider myself pretty fit and can walk for miles with no impact to my BG but if I changed the walking to running over a shorter distance, my BG reaction would be very different.
Oh, and the conditions - walking in the wind and rain might cause a rise whereas a walk in the sun will keep it stable.
You clearly need to practice putting up more shelves ... probably while it is raining🙂
 
@everydayupsanddowns @helli @Proud to be erratic @SimonP thanks sharing your insights and experiences above everyone it is very helpful. I gym twice a week and have got that mastered with BGS generally just seems to be walking that struggle with the most as I like to go for long walks with some incline ideally.

@Proud to be erratic thanks for the very detailed account you provided about very insightful. You weren't far off about 10 months officially unofficially over a year now. Yeah honeymooning at the moment is slowly coming to a end levels aren't as wild compared to the early days thankfully. Yeah I use quite a bit of the tools you have described above still trying to figure out what works best for me overall. I can do 5/6 miles on the flat no problem add a little all goes wrong ha.
 
Also important to consider when you last injected bolus insulin. I can have lunch and walk along the flat an hour or two afterwards with no real issue, but if I climb a hill and maintain my normal fast pace so my heart is having to work harder and I am breathing more deeply especially if I am carrying something, so I am having to work harder, it will drop much quicker. I see less of a impact when no bolus insulin is active in my system.
 
And I find that the same for myself. But, alas, often certain activities can by no means always be programmed to deconflict with having bolus active in me. Like last week, I just had to work with the prevailing circumstances and most of the time I didn't have a clue if the "next site" was going to need a minor stroll or a major hike and scramble. I could have constantly been asking the organiser and got a better feel for what was ahead, but there were 24 of us and I didn't want my needs to become dominant.
 
Running hard screws my BG for hours afterwards with it going sky high. Walking quickly, even a very steep walk, for the same time lowers it.
 
You must log in or register to reply here.
Back
Top