Struggle to work out without sugar crash

[Crix]

Hi all, I'm a 29 yr old newly diagnosed type 1 diabetic, and although I feel like I'm starting to get better at controlling my blood sugar in normal life, I can't exercise without having a steep crash in my sugar level. I've seen some posts here by marathon runners, not even needing to eat during an hour of running, but it leaves me wondering how on Earth you can get to that level? Right now, I drop like crazy even with light exercise (30 minute power walk or 10 minutes on a cross-trainer), even with a 60g carb meal beforehand and only 24hr long-term insulin. I'm not particularly overweight and walk for an hour most days as my commute. I know I have some natural insulin production still, but there must be a way of being able to exercise and get around this? I want to be able to go for a run!

 

[Inka]

I think we all respond to exercise slightly differently @Crix I agree with you about the people who walk for miles on one Dextro tablet. I couldn’t do that! So, don’t worry about them - try to experiment to find what works for you.

Could you reduce your basal on exercise days? What basal do you take and when? If you’re dropping after 10mins on a cross-trainer and 60g carbs with no bolus it sounds like your basal might need adjusting. Also, you mention 24hr insulin which suggests you’re on a once a day basal. You’d get more flexibility on a twice a day basal as you could adjust each portion as needed.

 

[Spathiphyllum]

Hi all, I'm a 29 yr old newly diagnosed type 1 diabetic, and although I feel like I'm starting to get better at controlling my blood sugar in normal life, I can't exercise without having a steep crash in my sugar level. I've seen some posts here by marathon runners, not even needing to eat during an hour of running, but it leaves me wondering how on Earth you can get to that level? Right now, I drop like crazy even with light exercise (30 minute power walk or 10 minutes on a cross-trainer), even with a 60g carb meal beforehand and only 24hr long-term insulin. I'm not particularly overweight and walk for an hour most days as my commute. I know I have some natural insulin production still, but there must be a way of being able to exercise and get around this? I want to be able to go for a run!

Do you have a Libre 2 or similar? If not, get one; then read this and use the tables: https://www.ncbi.nlm.nih.gov/pmc/articles/PMC7702152/

I was diagnosed 4 months ago, and discovering these guidelines-- solid, research-based, from international experts in exercise and T1D-- gave me the confidence to get back to jogging very quickly. All the best!

 

[rebrascora]

Another vote here for a more flexible basal insulin ie split dose Levemir if you are not already on it.... I couldn't manage without adjusting my basal insulin for exercise on a 12 hour basis, although my problem is that I drop during the night after exercise rather than during it... sometimes during as well particularly if I have active bolus insulin on board but to much lesser extent that during the night after exercise. Perhaps my low carb way of eating helps to stabilize my levels during exercise, but then my muscles seem to suck all the glucose out of my blood whilst I sleep to replenish their stores, so night time basal needs to be low or zero to prevent nocturnal hypos.

As @Inka says, we are all different and you have to find a strategy which works for your body and it takes time and trial and improvement. The important thing is to keep yourself safe by ensuring that you have plenty of hypo treatments close to hand and ideally Libre or other CGM to monitor levels and top up preferably before you drop too low.

It sounds like you are still very much in the early days of diagnosis so your own natural insulin production may also be making things extra tricky. It has taken me a couple of years to get it sort of figured out but I still get caught out. Just recently my levels have changed and started going high during exercise and I am needing a small correction and then I drop like a stone but I find exercising when levels are above 10 really hard work, but at least with Libre I can keep a close eye on things and then have a jelly baby if it is dropping too fast..... Makes you really appreciate how clever your own pancreas was at balancing things for you before your immune system decided to damage it.

 

[Crix]

Thank you @Inka @rebrascora @Spathiphyllum for your helpful replies!

For me the problem is mostly the drop during the activity, luckily don't seem to have much problem afterwards in the nighttime. I tried again this week and reduced my basal (Lantus, 8 units) by 25% the night before - was tough to keep glucose down during the following day but it meant I could run for a short time after work and had a much gentler drop than before. Also tried sipping some cola and having a few squares of chocolate during the activity which seemed to help (thinking to try and find a carbohydrate gel instead though - eating chocolate/sweets while breathing hard was a bit tricky! And a fizzy drink was a bad choice while running!).

As you rightly assumed, I do still have some natural insulin production which I know will be making this harder. Its also a good point about more flexibility with the 12hr basal, but Lantus is working a lot better for me during regular non-workout days so going to try and figure this one out without changing back, I think! And yes I have libre 3 (having the continuous monitoring is such a game-changer!! It has already saved my ass during my first hypo earlier this week) and currently making sure to only work out with friends around until I get this figured out, just in case.

And thank you for the paper reference @Spathiphyllum, that was extremely helpful!