SUGARS RISING AFTER EXERCISE

[Oliviag23]

I’ve been type 1 Diabetic for 24 years. I’m struggling right now more than I ever have. I’ve started doing dance cardio workouts, around 40 minutes.

I take the pump off for my workouts. How do I stop going low during or right after workout? I’ve tried temp basal beforehand, I’ve tried eating 15g snack, etc.

Also there’s other times when I do a workout and my sugars don’t drop until 4 hours later, so here’s my next question. If you’re sitting high after exercise (14 or above) do you correct? Maybe I shouldn’t be correcting? Should I half my correction? Also, after exercising, if you’re eating, do you bolus for it or just maybe give half?

I think it’s making it worse because I’m obsessing over it and I hate sitting above my targets, which I know it’s impossible to be in range all the time.

I just don’t know how to manage exercise and diabetes. There’s other times my sugars spike after exercise, should I correct or let them come down on their own?

HELP

ADDED: so I’ve just exercised and I had the pump off, I was 8.9 when I reattached pump and now I’m 14.1 and rising! I gave half of my correction but I’ll probably drop later. This is stressing me out.

 

[Pandora71]

I’ve been type 1 Diabetic for 24 years. I’m struggling right now more than I ever have. I’ve started doing dance cardio workouts, around 40 minutes.

I take the pump off for my workouts. How do I stop going low during or right after workout? I’ve tried temp basal beforehand, I’ve tried eating 15g snack, etc.

Also there’s other times when I do a workout and my sugars don’t drop until 4 hours later, so here’s my next question. If you’re sitting high after exercise (14 or above) do you correct? Maybe I shouldn’t be correcting? Should I half my correction? Also, after exercising, if you’re eating, do you bolus for it or just maybe give half?

I think it’s making it worse because I’m obsessing over it and I hate sitting above my targets, which I know it’s impossible to be in range all the time.

I just don’t know how to manage exercise and diabetes. There’s other times my sugars spike after exercise, should I correct or let them come down on their own?

HELP

Hi
Great that you are doing the exercise but for us type 1s it does make things trickier but worth doing for good heart and muscle health. Here are my suggestions but you are likely to need to tweak thse.
For cardiovascular exercise (run, jog, circuit class, spin class etc.) make sure you are at 15 before you start (eat more or reduce bolus or if on a pump put it into exercise mode 1/2 an hour prior).
Adam Brown has a great book called 'Rainbows and Landmnes' (free e version online and for sale at Amazon). The cardio drains your muscles of glycogen (stored form of glucose) and then the body needs to replenish that from your blood glucose. It does this whilst you are exercising and afterwards too hence the later in the day lows that can happen.
Doing weights or resistance will typically spike you a little so no remedial action amy be needed as the spike will likely subside once the stress of lifting weights goes away.
Conditioning type movements like kettle bell sqings, box jumps, burpees etc. will likely also drain your blood glucose.
In order not to dent your exercise mojo, go a little higher than you'd like (will only be for a short time) and if you do go low, don't over treat as you don't want your good habit to be underminded by going on the diabetes type 1 rollercoaster!
Don't give up as you are going to feel good once you've cracked it!

 

[Oliviag23]

Hi
Great that you are doing the exercise but for us type 1s it does make things trickier but worth doing for good heart and muscle health. Here are my suggestions but you are likely to need to tweak thse.
For cardiovascular exercise (run, jog, circuit class, spin class etc.) make sure you are at 15 before you start (eat more or reduce bolus or if on a pump put it into exercise mode 1/2 an hour prior).
Adam Brown has a great book called 'Rainbows and Landmnes' (free e version online and for sale at Amazon). The cardio drains your muscles of glycogen (stored form of glucose) and then the body needs to replenish that from your blood glucose. It does this whilst you are exercising and afterwards too hence the later in the day lows that can happen.
Doing weights or resistance will typically spike you a little so no remedial action amy be needed as the spike will likely subside once the stress of lifting weights goes away.
Conditioning type movements like kettle bell sqings, box jumps, burpees etc. will likely also drain your blood glucose.
In order not to dent your exercise mojo, go a little higher than you'd like (will only be for a short time) and if you do go low, don't over treat as you don't want your good habit to be underminded by going on the diabetes type 1 rollercoaster!
Don't give up as you are going to feel good once you've cracked it!

Thank you so much for all the tips. I am on an insulin pump. I just find it so difficult to sit higher after a workout and I instantly want to correct lol! I think I need to stop obsessing over it because as you said, I’ll only run high for a short time

 

[helli]

Do you have a temporary basal after exercise?
I have a post exercise profile set up on my pump which is about 20% lower than my usual profile and no increase for DP. I use this for 24 hours after exercise.
I will correct as usual if I go high but the reduced basal reduces the risk of hypos.
I suspect I may need a different insulin to carb ratio for that time but I as it is quite low anyway (and harder to change) I don’t bother.

I manage my BG during exercise by ensuring I have no active bolus on board prior and suspending my basal 20 minutes before I start so that it resumes 20 minutes before I finish.
Edited to add: Iam surprised by @Pandora71 suggest to start with a BG of 15. I was advised to avoid exercising when my BG is that high because it would put a strain on my body and cause my BG to rise even higher. I am for a BG of around 7 because the suspended basal and no bolus on board will reduce the hypo risk sufficiently for me.

 

[Oliviag23]

I don’t have a post exercise set up but I’m going to the clinic on Tuesday so I might enquire about this! I only have the one nasal pattern right now but an exercise one sounds ideal

 

[Oliviag23]

Do you have a temporary basal after exercise?
I have a post exercise profile set up on my pump which is about 20% lower than my usual profile and no increase for DP. I use this for 24 hours after exercise.
I will correct as usual if I go high but the reduced basal reduces the risk of hypos.
I suspect I may need a different insulin to carb ratio for that time but I as it is quite low anyway (and harder to change) I don’t bother.

See sometimes when I put temp basal on after exercise I go really high!

 

[helli]

See sometimes when I put temp basal on after exercise I go really high!

Is that immediately after exercise or later ?
I sometimes find my BG can shoot up after exercise which I assume is due to a liver glucose dump of some sort. But later that evening, I will go low again.

 

[Oliviag23]

Right after I will start to rise, and then when I correct I drop! But I don’t want to not correct because I hate sitting high. Unless I half my correction. It’s so difficult!

 

[helli]

Right after I will start to rise, and then when I correct I drop! But I don’t want to not correct because I hate sitting high. Unless I half my correction. It’s so difficult!

Can you halve your correction dose?

My other thought is that it could be related to not having enough “basal on board” when you finish exercise because you removed your pump.
Although we use fast acting insulin it is not that fast so the basal we are using now was pumped at least 30 minutes ago. So, when you reconnect your pump, you have no basal for now and it takes at least 30 minutes to build it up. Therefore, your BG will raise.

I am not sure if I am explaining this very well. I hope it makes sense.

As I have a patch pump, I do not remove it for exercise but suspend my basal which means I can I suspend it during exercise.
Maybe you could do something like give yourself a bolus equal to 30 minutes of basal as soon as you reconnect.

 

[Oliviag23]

So if I put 0 grams into the pump, it will calculate my correction and then I’ll just half it, yeah!

 

[Oliviag23]

Guys, I’m at my end with having Diabetes lol.

I’ve just done my exercise and my sugars are spiking, this happens often whereas sometimes they drop before I even finish the workout.

I take my pump off for exercising for 40 mins because when it’s on, I go low every time. But when I finished exercising today I was 8.9 and now I’ve spiked to 14.1 and rising. PLEASE HELP!

I’ve given 0 grams into the pump and halved the correction it was going to give me. My friend told me she halves hers and it works. But what am I doing wrong?!

Also I’m obsessed with checking my Libre. How long should I wait after correcting to check my sugars?

 

[Pandora71]

Do you have a temporary basal after exercise?
I have a post exercise profile set up on my pump which is about 20% lower than my usual profile and no increase for DP. I use this for 24 hours after exercise.
I will correct as usual if I go high but the reduced basal reduces the risk of hypos.
I suspect I may need a different insulin to carb ratio for that time but I as it is quite low anyway (and harder to change) I don’t bother.

I manage my BG during exercise by ensuring I have no active bolus on board prior and suspending my basal 20 minutes before I start so that it resumes 20 minutes before I finish.
Edited to add: Iam surprised by @Pandora71 suggest to start with a BG of 15. I was advised to avoid exercising when my BG is that high because it would put a strain on my body and cause my BG to rise even higher. I am for a BG of around 7 because the suspended basal and no bolus on board will reduce the hypo risk sufficiently for me.

We certainly do not want to be over 7 for most of the time but running a little high just prior to exercise is a way to manage the drop that either intense cardio or low intensity but long duration exercise, will cause.
My suggestion si that if you know your bg is going to fall by 5 or more then start at the higher sugar and end up on 7 after the session rather than having to drop out due to hypo.
Do you think being temporarily hyper is going to be detrimental over the longer term?
Or be fat fuelled which works well for me (body does get used to alternate fuel supplies other than glucose in the muscles)! If I fast or simply have a fat/protein breakfast and therefore no bolus I can also follow your excellent suggestion of no active bolus on board.

 

[everydayupsanddowns]

Sorry to hear exercise is making you jump through lots of hoops @Oliviag23 - but stick with it! By the sound of things you’ve got a great analytical approach, and some really gpod practical ideas.

Just keep experimenting.

And don’t get too mad when you find the right thing and is works for a month, but then your diabetes moves the goalposts (again!).

 

[Pandora71]

Thank you so much for all the tips. I am on an insulin pump. I just find it so difficult to sit higher after a workout and I instantly want to correct lol! I think I need to stop obsessing over it because as you said, I’ll only run high for a short time

Yep. I think the Rainbows and Landmines plan is that you end up where you want to be e.g. start higher to end up in normal range! I've just updated my Tandem pump so it can now be in exercise mode for a set period with a higher range of blood glucose (hopefully you have or will soon get, a Dexcom cgm to help with your issue).

This the American type 1 guy who describes a useful approach to exercise

 

[everydayupsanddowns]

Basal reductions can take a little while to get going, so starting a TBR half an hour before your session starts should mean less iob.

When is the class in relation to meals? I’ve been doing some hard landscaping in the garden (lots of digging, carrying heavy stuff, and swinging a sledgehammer) and I’m definitely having to reduce my food bolus if that insulin will still be active while I’m working.

It might help to delay eating until after your session?

Are you taking fast carbs as well as taking your pump off? If your class workout is pretty full-on your digestive system may be on pause, and those carbs are only arriving once you finish?

 

[helli]

Do you think being temporarily hyper is going to be detrimental over the longer term?

No. That is not what I suggested.
The problem with being hyper is that is prohibits exercise.
When you have the benefits of a pump, for example, I can suspend my basal, as I explained above.

 

[everydayupsanddowns]

I’ve given 0 grams into the pump and halved the correction it was going to give me. My friend told me she halves hers and it works. But what am I doing wrong?!

Seeing a big rise after exercise must be so frustrating @Oliviag23

Did you eat fast carbs as well as take your pump off?

Try to hang in there until the correction dose has had 4-5 hours to work - then you’ll know if that half dose worked, but that the timing was just ‘off’?

Have you ever looked at Extod? That’s meant to give helpful advice for people with T1 wanting to try different sorts of exercise.

https://extod.org/

Hope something there helps.

 

[SimonP]

Have you ever looked at Extod? That’s meant to give helpful advice for people with T1 wanting to try different sorts of exercise.

https://extod.org/

Hope something there helps.

Late to the party, I agree Extod is useful (and they have documents available on their downloads page now I believe), though I do think you'll have to experiment your way through as the bulk of the guidance is for new starters to exercise and the course itself is really designed to help healthcare professionals to help T1 diabetics take first steps/get back to exercising. I did think the course content was useful and it reminded me of things I'd forgotten. I'd certainly suggest going to the next event as probably the most useful aspect was discussing with other attendees what they do to deal with their exercise requirements. it was really nice to talk people doing a wide range of exercise types and at a range of intensities/"achievement levels". It puts things into perspective.

Typically one doesn't find advice as to how to deal with a given exercise situation, presumably because everyone is different. I don't want a copy & paste answer but I do want to understand the range of effects people get from exercise and the approaches they take to dealing with it. It was useful for this.

The problem with being hyper is that is prohibits exercise.

Hmm, I don't agree, I'm sure I started a thread on this very subject.

I take the pump off for my workouts. How do I stop going low during or right after workout? I’ve tried temp basal beforehand, I’ve tried eating 15g snack, etc.

15g is not very much, I don't do what you do, but would happily eat 30g+ of uncovered carbs pre-exercise (riding bike, playing badminton, martial arts). Can you set your temp to start earlier too (already mentioned above too)?

I just don’t know how to manage exercise and diabetes. There’s other times my sugars spike after exercise, should I correct or let them come down on their own?

HELP

ADDED: so I’ve just exercised and I had the pump off, I was 8.9 when I reattached pump and now I’m 14.1 and rising! I gave half of my correction but I’ll probably drop later. This is stressing me out.

I would certainly take smaller correction doses than usual post-exercise. Have you tried just leaving it alone? I rarely go high after exercise these days, but when I have in the past I found it came back down quite quickly of its own accord.

Good luck and let us know how you get on.