Type 1 Diabetes and long cardio workouts

[SkirtsOnDirt]

I have had Type 1 for 8 years and have always been really active.  When I go to workout, I have to increase my reading to be over 200 for at least an hour prior to the workout.  But I still will start experiencing sugar lows about 30 minutes into the workout.  If I continue to work out for more than a half an hour, I have to take in over 30 grams of carbs to continue.  I love working out, but I have gained weight due to taking in so many carbs.  
Here is an example of an activity I do - Ten mile hike, steep incline = I have to drink atleast 120 carbs.
Help!!!!!  I don't want to gain any more weight.  I drink apple juice and eat PBJ's to keep my readings up during activity.  Does anyone have any other tricks?  More fat prior to working out?

[Forum-vol-wak]

I am not a physaicn or a dietaian - but a volunteer. and the mom of  a type one diabetic.I would suggest that you  see a diautican and a personal trainer they would be the best to help you and tell you what fooed to eat before during and after  a workout to get the most of the workout with out gaining weight, that is their job.  your  endocronolgist  should be able to recommed some for you.

[thecure]

Are you on the pump?

If not, you might want to consider switching to the pump. It gives you much more accurate insulin dosages which is known to prevent low blood sugars.

The pump has plenty of problems as well. What does your endo recommend?

[JDRF-VOL-SG]

I know of other type 1 diabetics who do strenuous exercise using the pump. These folks simply turn off their pumps while exercising to avoid lows. If using shots, you can't do that, but you may need to lower your pre-workout insulin levels some. My twin's doctor recommends sports drink such as Gatorade for active diabetics because it replenishes more than just carbs and it is absorbed into the body quicker than juice alone, so you might think about switching from juice to sports drink. It is obvious that you are burning those carbs and need them, so I would think that you may need to lower insulin before exercise so less insulin is working on those carbs.

[KevinHarney]

Why is everyone's response to tell people to go on the pump?  This is not a solution just a preference.  If you like it great but if not that doesn't help.

I too have to take in lots of carbs before I work out.  The only trick that seems to work for me is to take Glucose tablets or Glucose gel.  These have the sugar but not as many calories that go with the food you need to take for the same result.  I have to bump my levels up about 150 bp to be able to work out.  That is a HUGE amount of calories.  Glucose tablets go in and are used up during the workout because they are so fast acting.  By the end of the workout my levels are normal.  These are available at any pharmacy or drug store and are very cheap.  And they are precisely measured.  Usually Tablets are 4g/tablet and Gel is 15g/tube.

[JDRF-VOL-RL]

Kevin, the pump is suggested because it's the most effective way to deal with issues like this.  It also helps improve control overall.  But you're right, it isn't for everyone, and people won't know until they check it out.

[JDRF-VOL-SG]

I mentioned the pump in my first response because I know of folks who can simply turn theirs off entirely when exercising and this does help simplify the problem of dropping too low when doing strenuous exercise. However, that doesn't mean that a pump is a cure-all. I personally do not use a pump, and maintain a barely-above-non-diabetic a1c level that has not wavered at all since I started my current insulin regimen of Lantus and Novolog. So this is my personal preference -- in my case a pump cannot improve control since control is optimal right now with insulin injections. But the reality is that the Lantus is working 24 hours per day after injection and you can't completely turn that off like you can a pump.

Glucose tablets may indeed be a wonderful solution for long exercise, partly because you can carry lots of them with you without having lots of baggage. That's my primary problem with Gatorade (which also absorbs very quickly) -- you have to carry it with you.

[KevinHarney]

The other thing that I have heard is good is Honey packets - like from the restaurants - they are small and easy to carry and high sugar as well.

[quet_23]

I am in agreement with both sides of the coin on this. For starters you ARE overcompensating for your lows. The extra carbs are contradicting all of the exercise that you're doing.  The glucose tablets are a great low cal way to add 15 carbs without all of the extra carbs. I have been diabetic for almost 10 years, 1/2 on injections and half on a pump. Due to my active lifestyle and eating habits, I prefer the pump because I had too much variability on injections, so that was my personal choice. When I work out I suspend my pump to prevent lows and I will normally have a light snack (only if my sigar is below 100) before I exercise. It might be beneficial for you to seek the advice of a dietician to plan your meals accordingly. The one thing about injections for me, was I can't eat at the same tiem everyday and workout  in that manner, which is why injections didn't work for me. It has to be a consistent routine without a lot of variation. Hope this helps you

[Larz51]

I have been a type 1 diabetic for 40 years. I have to agree that the pump is not the answer to all problems. I was on the pump for two years and my a1c's did not change from the time I was on injections. My a1c's are usually 6.2. If your sugars are dropping during workouts you should not take any insulin for approx. 1 1/2 or 2 hour before working out. I have to add that the cost of pump supplies is rediculous 6500.00 for a 4 month supply. I think you should talk to your diatician

[rcg6681]

You obviously weren't using the pump correctly since you preferred injections, but whatever, you're right, that's your preference and your right.

If you have insurance, the pump is no more expensive than injections and 9 times out of 10 provide TIGHTER control simply because you can give yourself more exact dosages and calculate correction boluses more accurately.  

Let me ask you this:  Your target BG is 100mg/dL and you just checked your BG and it's 166mg/dL - how much insulin do you give yourself to bring it down to target?  If your correction bolus ratio is 1u:40mg/dL, how much insulin do you give yourself?  Do you take out a calculator and a magnifying glass for the syringe or something?  Pumps calculate the EXACT dosage needed - no more no less... it's hard to measure 1.65u of insulin in a syringe, isn't it?

Also, do you know how much insulin you have on board?  Do you write down in a log the exact time and amount of insulin you give yourself and then consult it when you go to give yourself another bolus or something?  If you still have .35u of insulin in your body from, say, a meal bolus a couple of hours ago, your pump will automatically suggest a reduced bolus of 1.3u instead of 1.65u.

I love my insulin pump.. I have such tighter control now that I'm on it.  I just can't understand how anyone could still prefer injections to it (unless the person is uninsured and it's a cost issue).

[rcg6681]

Yes, I would research the pump for this problem since your workouts are long.  If you're using a long acting insulin such as Lantus, it's providing you a steady stream of basal insulin all day non-stop.  With the pump, it supplies you with custom hourly basal rates that you can adjust.. so instead of one injection that lasts 24hrs, it will give you 1u or so per hour.  Because of this, when you take the pump off, your basal is therefore stopped...  I am also very active - when I go hiking or practice Muay Thai I simply take my pump off and never have a problem since there is no insulin being delivered during that time.  You can eat and drink all you want, but with insulin already in your body and the added activity, you might still hit lows.  

[keaton23]

I would suggest a different type of workout.  I myself am a diabetic and if i would wish to go on a ten mile hike like you I would need to eat plenty before and then during also.  Try to keep your cardio workouts from 30-45 minutes...

I would also suggest taking in a different source of carbs, apple juice or liquid sugars never last more than 30-60 minutes for me even when i'm not doing a highly intense physical activity.