Type 1 Running - Any advise on Bg drops?

[Tom_Stickler]

Hello all!

I'm a runner but have been struggling with rapid drops of levels as soon as I start running. I have included a snap shot of my first 10km from this weekend to give an idea. I have done the usual things like drop basal rate (suspended it even), ate 2 bananas 1 hour before, I even had Lucozade and a squares bar halfway around. Oddly enough, as soon as I finished my run, my levels climbed without any intervention.

I'm planning to run a half marathon in January but at the rate my levels drop, the maximum I'll be able to run is 90 minutes.

Any advise/stories would be greatly appreciated

 

[helli]

Did you
- reduce your bolus dose when you ate?
- ensure you had no active bolus on board when you ran?
- include any sugar in your water bottle such as weak fruit juice or squash?
- measure your BG with a finger prick at the end of the run?

 

[Tom_Stickler]

Hi @helli

Thanks for your questions:

1. I didn't have any bolus when I ate
2. There was a small amount of bolus onboard (1u) left over from breakfast
3. I was drinking Lucozade on the way round - I had about 500ml
4. I didn't no - I only had my libre but it still shows a big drop which is the concern

Hope this helps!

 

[SimonP]

How long before you started running did you suspend your basal, did you have any active basal onboard at all when you started the run? I assume you did as you had active bolus from breakfast. I'm on MDI, but from what I've read some pump users reduce or suspend basal some hours before they start exercise to avoid having very much IoB at all.

How long did the run take ~1h or thereabouts I assume? I'm a cyclist not a runner, but for me eating ~30min before the end of a ride won't help unless they're very fast acting carbs. I end up with digestion being delayed by ~30min while cycling. I assume running may be similar, which may explain the post-exercise spike.

I assume the uncovered bananas and running high to start with were a purposeful choice (or were they a side effect of nerves too - been there done that when starting long distance rides)? I think I might try eating much closer to the start (on the order of 20-30min) so that you get some benefit at the beginning with a positive trend and some slower release then once your digestion slows down. I'm not sure how fast bananas are digested at the best of times mind you!

 

[rebrascora]

Personally I would not be doing any exercise other than a gentle walk if my levels were that high! Anything above 15 puts your body under increased strain, particularly your vascular system. Generally I don't exercise above 10 as I find it much harder on my body.
Have you been diagnosed long? Just wondering if your body is still producing some insulin itself ie. honeymoon period and that contributed to the drop.

I find that protein eaten 2 hours before works best for me for extended exercise with the odd bit of carb top up like a piece of dried fruit if levels start to drop. I follow a low carb way of eating, so the protein release is starting to kick in as I start my exercise.

 

[Tom_Stickler]

Thanks @rebrascora.

I have been diagnosed for almost 7 years now but unfortunately the only option for me at the moment is to raise my levels high given the big drop that comes. If i start exercising when my levels are around 10, I would normally hypo after 20 minutes.

 

[Tom_Stickler]

@SimonP Thanks for this.

I suspending in 1 hour before and had 1u of active bolus on board.

The run was just under an hour. I did have 2 bananas 2 hours before the run but this also didn't seem to help. This is what caused me to run high. This was my choice as, at the moment, it's the only way I can run without having a hypo. It's almost like I'm racing against my own Bg!

It's a bit of a slog figuring this out and all the usual advise for some reason, doesn't want to be working with me

 

[Inka]

Hi @Tom_Stickler I’m not a runner but I do go hiking. I’d try having zero IOB when you start your run. I’d also try suspending the basal 2hrs in advance. I’ve found that things work out best for me if I keep feeding in glucose/snacks at regular intervals. I’m sure someone on here talks about that too - about having glucose gels every X minutes. When I’m hiking I try to stay above 6 and feed any drop.

Could you experiment with shorter runs to try to work out a speed of drop with no bolus insulin on board? I too wouldn’t exercise with blood sugar that high. I understand why you did it (because of the drop) but I’d try to start lower and work on counteracting any drop with carbs and snacks. You say you had 2 bananas two hours before the run - I’d try a snack maybe 30 mins before the run or even closer to the start time.

 

[Tom_Stickler]

Hi @Tom_Stickler I’m not a runner but I do go hiking. I’d try having zero IOB when you start your run. I’d also try suspending the basal 2hrs in advance. I’ve found that things work out best for me if I keep feeding in glucose/snacks at regular intervals. I’m sure someone on here talks about that too - about having glucose gels every X minutes. When I’m hiking I try to stay above 6 and feed any drop.

Could you experiment with shorter runs to try to work out a speed of drop with no bolus insulin on board? I too wouldn’t exercise with blood sugar that high. I understand why you did it (because of the drop) but I’d try to start lower and work on counteracting any drop with carbs and snacks. You say you had 2 bananas two hours before the run - I’d try a snack maybe 30 mins before the run or even closer to the start time.

@Inka Thanks for the advise - I'll give that a go. I have a 5k run tonight so I'll see how I get on

 

[pistolpete]

Those are some big numbers Tom 🙂, Its difficult to choose but my approach is to diet well for execise and no IOB too. Bananas are fab but an hour before they will just spike your levels and be gone by the time you start running.

I cycled 25 miles on Saturday, low carb (probs around 15g) for lunch so no insulin. As you can see a steady rise until I finished, I go pretty hard so zone 3 and some zone 4 I take high carb snacks but didnt use any.

 

[rebrascora]

Thanks @rebrascora.

I have been diagnosed for almost 7 years now but unfortunately the only option for me at the moment is to raise my levels high given the big drop that comes. If i start exercising when my levels are around 10, I would normally hypo after 20 minutes.

I would say that there is another option and that is to time your carbs better so that they are releasing when you need them not before you need them or opt for slower release food with fats and protein if you are going to eat an hour or two before, so that you don't spike high but the glucose is releasing over a much longer period whilst you are exercising.

 

[Tom_Stickler]

Those are some big numbers Tom 🙂, Its difficult to choose but my approach is to diet well for execise and no IOB too. Bananas are fab but an hour before they will just spike your levels and be gone by the time you start running.

I cycled 25 miles on Saturday, low carb (probs around 15g) for lunch so no insulin. As you can see a steady rise until I finished, I go pretty hard so zone 3 and some zone 4 I take high carb snacks but didnt use any.

View attachment 27732

Thanks for your advise @pistolpete

Some great levels there! I'll have a look at doing that too. Based on what people are saying I think the IOB is probably a big contributing factor - no matter how small amount is onboard?

 

[Tom_Stickler]

I would say that there is another option and that is to time your carbs better so that they are releasing when you need them not before you need them or opt for slower release food with fats and protein if you are going to eat an hour or two before, so that you don't spike high but the glucose is releasing over a much longer period whilst you are exercising.

That's a great idea - thanks @rebrascora !

There is defiantly out of contract with the carbs I'm eating so it's definitely worth bearing in mind 🙂

 

[Tom_Stickler]

Thanks for all your advise gang! This is certainly really helpful and gives me something to work towards on my next runs - I'll certainly keep you posted

 

[helli]

There are quite a few great suggestions.
If it was me, I would try them one by one rather than all at once.
And keep with the shorter runs and build up.
And don't forget that the effect of exercise can last up to 48 hours.

 

[pistolpete]

Thanks for your advise @pistolpete

Some great levels there! I'll have a look at doing that too. Based on what people are saying I think the IOB is probably a big contributing factor - no matter how small amount is onboard?

Cheers Tom, Yes I think IOB is mostly your trouble. Try some slow release carbs like flapjack rather than Lucozade and squares bars (these are pretty much junk carbs) more importantly good luck with the half marathon.

 

[Tom_Stickler]

Cheers Tom, Yes I think IOB is mostly your trouble. Try some slow release carbs like flapjack rather than Lucozade and squares bars (these are pretty much junk carbs) more importantly good luck with the half marathon.

Thanks @pistolpete