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Unhealthy attitude towards food

G

Glerma1

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Being a T1 I’ve always known the more carbs I eat at a meal the harder my BS is to control. Leading me to not eat at times and feel like I’ve failed when I do eat and my BS go out of control without a known reason.
I’m aware that there a number of variables out of my control that affect my BS but the biggest 2 are eating and exercising. The rises in BS with exercise varies significantly not allowing me to see any pattern other than HI sugars of varying amounts which can take hours to correct as I hv to be cautious I don’t become hypo from previous exercise combined with bolused insulin amounts
Anyone else hv this and how do u handle it!?
 
Getting the timing of your bolus right is a really good way to reduce spikes after food @Glerma1 That can make a big difference. Also, keeping carbs consistent in individual meals helps perfect the bolus timing and amount, eg always having the same amount of pasta, etc.
 
SimonP said:
What kind/duration of exercise are you doing? Do you adjust insulin dosage/food consumed before and during exercise?
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I do elliptical on high tension for 60-90 minutes or so weight lifting for 45-60
I usually exercise without eating prior to it as I know my BS will rise. It’s intense exercising that does this but that’s pretty much what I do mostly. I don’t eat during exercising. My BS starts rising about 30 minutes in and will rise rapidly going up 100-200 from start of exercise.
 
Have you tried bolusing without food before exercise?
It was suggested for me when I climb. Although cardio exercise (cycling, running, etc.) causes my BG to plummet, climbing has the opposite effect. Therefore, I would bolus for the expected rise.
I would recommend to be conservative regarding how much bolus to take but for me it worked if I calculated a dose that, under "normal" circumstances would result in a BG of 3.0 but the liver dump through climbing ensured I never experienced a hypo.
I would inject the insulin just before I started climbing which allowed for me to warm up (no BG rise) and then keep going for about 90 minutes. I probably needed to bolus earlier but as I drive to the climbing wall, I do not want to risk hypo if the drive took longer than expected due to a traffic jam. As your exercise is shorter, you may need to time your bolus a bit earlier, if possible.
 
If you did the elliptical for a longer I think you'd probably find your BG would start to drop (though it would be high by that point), completely agree with @helli, take some bolus, be conservative.

Exercise always uses glucose, but lower effort (however you measure it - power, heartrate, feel) produces fewer exercise-induced stress hormones which means the liver doesn't produce as much glucose to "help you", this is why aerobic/endurance sports will tend to reduce BG, while anaerobic exercise will increase it.

There is more complexity around habituation to exercise and it then producing fewer stress hormones so less of a rise, and also the fact that the liver eventually scales back production if you do high intensity exercise for a long time. But certainly start with the above and work from there.

One thing to be be aware of if you do bolus as suggested, is that the bolus itself may well last longer than the exercise, so post-exercise you will likely have IoB and no liver glucose production and heightened muscle insulin sensitivity (caused by the exercise), so be careful of post-exercise low blood sugar - have a snack before you drive or walk home, etc.
 
@Glerma1 I have just read your other thread and realise you are on a pump.
The reason I described my pre-climbing bolus in the past tense is that was what I used to do before I had a pump. I now increase my basal before climbing. The duration and increase will depend up on your body and exercise but I try to increase my basal by 40% an hour before starting climbing to last until an hour before I plan to stop .
For me, this works even better than the bolus and I do not need to worry about the snack @SimonP mentioned. Although this could have something to do with the mid climb cake I have half way through - I climb for 90 minutes, have a tea and cake break for 30 and climb for another 90 minutes.
The continuous temporary basal increase also feels gentler than a bolus "spike" at the start.
 
helli said:
@Glerma1 I have just read your other thread and realise you are on a pump.
The reason I described my pre-climbing bolus in the past tense is that was what I used to do before I had a pump. I now increase my basal before climbing. The duration and increase will depend up on your body and exercise but I try to increase my basal by 40% an hour before starting climbing to last until an hour before I plan to stop .
For me, this works even better than the bolus and I do not need to worry about the snack @SimonP mentioned. Although this could have something to do with the mid climb cake I have half way through - I climb for 90 minutes, have a tea and cake break for 30 and climb for another 90 minutes.
The continuous temporary basal increase also feels gentler than a bolus "spike" at the start.
Click to expand...
I think changing basal might do the trick
Never thought of it to be honest so I’ll do today and see how it goes
 
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