exercise and low bg - frustrated

[Alexandra20]

I'm finding it extremely difficult to exercise without having to eat first to prevent a low blood glucose, eat immediately afterward because I have a low blood glucose, or having a high glucose afterwards followed by a low bg later. I'm currently using an insulin pump and have tried several things like suspending it an hour before and during exercise, changing to a temp. basal afterward, and at times giving a correction bolus when my bg jumps from 5 mmol/L to 18 mmol/L after certain workouts. Nothing so far has helped me eventually avoid a low bg - although most other times my blood glucose is fairly normal. While trying to manage my body weight, it's really frustrating to have to eat every time I work out. Am I the only one with this problem and does anyone have any suggestions?

[JDRF-Team-CDB]

My 16-year-old daughter has taken up surfing and is having the same experience. She's okay without eating before her swim-team workouts, which seem awfully intense to me, but something about the surfing (the cool water, the intensity) causes her blood glucose to drop every time. She typically has to eat both before and after to prevent lows, and sometimes still gets low. She's not on a pump, just on a nightly Lantus shot and Novalog before meals.



Being 16, she's happy to get to eat and not have shots, although at some point the calories may catch up to her.



Have you tried moderating your exercise? Are you doing really intense things, like spinning or running?

[Larry68]

Hi Alexandra,



I am a type 1 of over 40 years, and I am fortunately still able to engage in periods of heavy exercise. I do not use a pump, but i do use a similar regimen with long acting insulin and short acting bolus before meals or when high. I have found that I can compensate easily for calories burned during exercise with fast acting carbs (orange juice) prior to and during exercise, based on my BG levels. The effect of the carbs is immediate and the rate of increased glucose availability matches the rate at which exercise burns it off. Eating a slower carb or protean only results in a delayed high and no benefit during exercise. Reducing insulin before exercise creates the risk of an unexpected rise in BG, which you definitely do not want. This will cause the muscles to starve, as the glucose can’t be utilized properly.  The result for me is aching muscles for days.



In short, what works best for me is to leave my insulin levels alone, presuming I start at a good BG level. I match my exercise with OJ intake. The boxed juice is convenient (though usually labeled for children), pasteurized, low acid, and will stay fresh in heat or cold for a long time.



Please consider this my input from experience, and not advice. We each must find the solutions that work best by trial and usually lots of error. The important thing is to find a solution that works.



Larry

[JDRF-Team-JW]

Hi Alexandra,



I agree with the comment above that everyone should find what works for them. However, since I'm also on the pump I figured I'd share my regimen with you. What I do, basically, is half an hour before I work out I lower my basal to 50% for half an hour + the time I'm going to be excercising (so if I'm working out from 11-12 let's say, I'd reduce my basal by 50% for 1.5 hours, starting at 10:30 am). I've noticed it works well for me and I don't have to eat extra snacks. Whenever my sugar is under 120 or so, before I work out, what I do is I'll eat a couple of glucose tablets and go excercise, but check my sugar every 15 minutes to make sure I'm ok. That has worked for me as well. I hope you'll find the right way for you too. Consider talking to your endo about it -they may be able to suggest a better way, or at least some things to try and see what works. Good luck!

[Ellen60]

I am a Type I diatetic who loves to run.  I am on a low carb diet and take lantus in low does and novolog when eating meals with more carbs than usual.  Usually I can run 30 minutes without a low by just drinking 2 cups of coffee with milk.  However, recently I am finding I am going down very low.  Tried Drinking juices with carbs, raisins etc. only can run for 2 miles.  I weigh 104 lbs 5 ft. and do not want to gain weight since I work hard at keeping my body fit.  I weight train 4 times week.

These lows have only happened recently--do no want to lower lantus dose at night because I strive to keep between 90 - 100 in morning  140 1 1/2 hours after meals.

Any suggestions