Avoiding Low Blood Sugars

[KevinHarney]

I posted this question under Adult Diabetes - Type 2 before I found Type 1 listed under Juvenile rather than Type 1 Diabetes.  Confusing for those of us that are Adults with Type 1 !!!!  I suggest changing headings to Diabetes - Type 1 (Juvenile)and Diabetes Type 2 (Adult) as they are more appropriately named.  I just looked under D for diabetes and only saw Type 2 Forum.  Just a symantics thing I guess - most people do not look under J for Diabetes info.  Anyway here is the question...

I am a 43 yr old Type 1 diabetic diagnosed about 5 yrs ago.  I currently exercise for 1 hour 3 x week.  Running.  I need to take in 30 g of fast acting Carbs before my workout to keep levels normal before during and after my workout.  I am currently taking 7 4g tablets but that is kind of a pain in the @#$%.  Is there a better or simplier way to keep levels normal?  The sugar tablets do tend to upset my stomach when I am working out but not majorly.

Kevin

[JDRF-VOL-RL]

Hello, Kevin!  Sorry to get you confused, maybe the MedHelp administrators are just trying to make you feel young at heart!  ;-)

I'm not a medical professional, just the parent of a kid with diabetes.  Great exercise question, it sounds like you're doing a very good job understanding how your body works.  I'd suggest you look at two paths for an answer.  First is around what type of insulin therapy you are using.  Are you on a pump or multiple daily injections?  Pumps are easier for runners and other athletes to use, because it allows you to turn off that basal rate which is causing your issues.  If you take a long acting insulin like Lantus, you cannot 'turn off' that insulin in your system when you exercise.  So that's the first thing I'd do, is looking at getting on the pump.  

The second path is around the types of carbs you take while exercising.  Glucose tablets are an excellent way to raise blood sugar quickly, because they are made of the most basic form of glucose, and it gets absorbed very quickly.  But I know many people that do not like them.  I met a marathon runner who works for Animas who was diagnosed when he was a kid.  During marathons, he uses packets of honey (like what you'd get at a restaurant).  He sticks them under a wristband, and pulls one out when he's feeling low.  Still a faster acting sugar than some, it's easier on the stomach, and it's easy to carry with you while running.  There are other options, as well, of faster acting sugars (skittles, etc.).  Try experimenting with some and see how you respond.  Good luck!

[KevinHarney]

Thanks for the great ideas.  They are much appreciated.

First I refuse to consider the pump at all unless I am medically forced to.  I just HATE the idea of having that thing attached to me all the time.  Preference thing.  I think they are great for kids.  But like you intimated they will not correct my problem of LOW blood sugars.

For the second point.  I was hoping for something that was less in the lines of eating.  Running upsets my stomach.  That is compounded by food being in it.  I can not run if I have eaten in the past 2 hours or it is the old heave ho....  :(  And I was hoping for something a little more regulated than food.  For example how much OJ or Food is not a precise as 30g of glocuse.

Wondering if perhaps there is a substance that I can take to increase sugar levels like I would take Insulin to lower them.  I guess that was more to the point.

[JDRF-VOL-RL]

Actually, a pump can help with lows during exercise, because you can turn off the basals which is giving you lows now.  But you're right, pumps aren't for everyone.  

Food/carbs are the only way to raise blood sugars.

[KevinHarney]

Not sure that it IS the Basals that are causing the lows.  But I think you are partially right.  I am on Lantus now and I am sure that plays a role in things but I was on Humalog N before and I would skip my dose of N the mornings (I work out at night) and I would work out and still had lows.  Bottom line is if you are at normal levels of 100 or so and go running for an hour no matter even if there is NOTHING in your system you will go low.

One of the questions I had was Can Glucogon or something similar be used to raise Glucose levels quickly and accurately?

[KevinHarney]

Perhaps dissolving the Glucose tablet in my water bottle might work.  As I usually run on a tread mill.

My problem is determining if I am sweating from working out or from lows.  Very hard to determine when I am working out and very easy to determine when I am not working out LOL

[kstreeter513]

I run between 4 and 6 miles a day 5-6 days a week.  But I use a pump.  I am on .7 units/hour normally.  Three hours before I run, I reduce my basal rate to .15 units/hour, and my blood glucose levels are usually the EXACT same when I am finished.  My blood sugar is not high before starting either.  It seems like the three hour mark is right when my BG starts to go up, but by starting my run at that time, it doesn't have time to go up very much.  Having the pump connected to you can be a pain in the neck ,but they are totally worth it...seriously..especially for runners.  Also, pumps are not just for kids. Many adults wear pumps.

[JDRF-VOL-SG]

My twin is a type 1 diabetic, as am I. Her lifestyle is very active with two horses. She finds that Gatorade or any sports drink is her best solution to lows. But I find that you have to drink a LOT of the liquid since it is more diluted than simple orange juice. Less likely to upset your stomach, though, for it is made for athletes. You might want to just substitute Gatorade for your water bottle. Sip a bit every few minutes rather than guzzling, and it replenishes electrolytes as well as glucose.

Yup, recognizing the low coming on is hard, for sweating just isn't any enlightenment for us. No real answer for that other than possibly a continual glucose monitoring device, which has its drawbacks as well as advantages.

[neilbason]

A Simple Insulin Dosage Calculator

By Neil Bason, Type 1 Carer

For people who inject insulin with a basal/bolus regimen, it’s often difficult to calculate the proper pre-meal dose.  After watching my partner struggle with the math for fifteen years, I decided to design a simple calculator to mimic the mental process that she uses to calculate her meal-time dose of insulin.

To calculate the number of meal-time insulin units to inject, the following must be establish:

1. Blood sugar level (using a blood glucose meter).  
2. The grams of carbohydrates consumed, from which you derive the number of insulin units needed to cover that intake.
3. The amount of exercise to be taken post-injection.

The mental process you must undertake to calculate your insulin dose is as follows:

1.  Blood Sugar:  Suppose your blood sugar reading is 195 mg/dl and your target blood sugar is 105.  Subtracting 105 from 195, you get 90, which is how much you need to lower your blood sugar.  One insulin unit lowers your blood sugar by 55 points, so you divide 95 by 55 to get 1.6 is the number of units you need to lower your existing blood sugar.

2.  Carbohydrates:  Now you have to count carbohydrates to figure out how many additional units of insulin you need to inject to cover your carb intake. If your ratio of insulin to carbs is 1 unit to 10 grams, 60 grams of carbohydrates requires 6 additional units of insulin.

3.  Exercise: If post-injection activity is planned, then you need to calculate how much less insulin will be necessary.

The above is the process that you carry out at every meal. The Insulin