When you’ve got Type 1 diabetes, figuring out when and how to exercise takes a lot more effort than simply carving out time from a busy day. You need to ask yourself how long it’ll have been since you’ve eaten, or how long it will be before your next meal. You need to keep track of what your basal insulin is, whether and when you want to drop it, and what and when your last bolus was. You need to be sure to test your blood sugar before, during and after exercise. You need to carry some fast-acting carbs. And you need to know what effect different types of exercise will have on your blood sugar — for me, a half-hour walk will drop it, whereas a workout with weights will either keep it steady or make it go up.
Like many other people with Type 1, I’ve dealt with these questions and decisions nearly every day for the past 11 years — I’m not going to let diabetes stop me from staying in good shape. But here is my question to my diabetes on this otherwise lovely Wednesday afternoon: exercise is definitively good for my body. So couldn’t you cut me some slack?
I’m particularly frustrated at the moment by the difference time of day makes in how my blood sugar responds. I’ve been exercising mostly at 6:30 in the evening for the past couple months, in the form of an intense spin class. Crazy cardio + early evening timing = drop in my blood sugar. This is annoying in itself, because I often find that the insulin I take for lunch just hangs out in my body doing basically nothing until I hop on the bike. Then my glucose plummets and I have to stuff my face with glucose tablets just to stay in a safe range. The result? Early afternoon highs, and post-exercise lows — and the annoying feeling that comes when your disease forces you to re-consume the calories you’ve just worked so hard to burn. Also, while I’ve brainstormed with my endocrinologist about the insulin-hangs-out-till-I-exercise problem and have tried dropping my basals by 50% two hours before I work out (and for an hour afterwards), the problem still occurs.
But I find that when I exercise in the morning, my bg is even more confusing. Usually I avoid this by simply not exercising before noon — I don’t like to do so, and I know that anything before 7:30 or 8 is a guaranteed disaster. But just this week, my favorite spin teacher started teaching a class at 8:30 in the morning, a time that works better for my schedule. I thought I’d give it a try, in hopes that whatever hormones are wreaking havoc on my body before 8am might calm down by 8:30.
Unfortunately, they have not — which I discovered on Monday, when I headed to class having only eaten a spoonful of peanut butter, left my basal as-is, and watched as my blood sugar started creeping up around 20 minutes into the 40-minute class. It ended up stuck in the 160s for much of the morning, which is a pretty frustrating way to spend the day after you’ve managed to get yourself sweaty ten hours before you’re used to.
Fast forward to today: I ate yogurt with a bit of granola, a breakfast that usually would require more than 5 units to cover. I took 3.2 and headed nervously out the door. Went to class. Blood sugar was remarkably stable till three quarters of the way through, when it dropped to 80 and I took 3 glucose tabs just to prevent any possibility of a low.
I ended up fine. So I suppose I should be happy. But I’m not — because come Friday, if I go to the class again, I’m going to have no guarantee that my body’s going to react the same way. That scares me. And I hate that. I hate that trying to “do the right thing” for my health leaves me feeling terrified that I may actually do more harm than good. I hate feeling like I’m taking a gamble every time I try to avoid a morning exercise high. I hate having to take insulin when I exercise to begin with — it is extremely counterintuitive to me, and makes me scared. And since I am a guesstimator to begin with — I have never found an insulin-to-carb ratio that works consistently for me — I feel that there’s no way I can guarantee that what worked today will work on Friday.
So that’s my vent for the day. Long story short, I hate the fact that with diabetes, even positive behaviors, like exercise, are fraught with danger. I hate the unpredictability and the feeling that all the effort I put in to maintaining my health could, if I get it wrong, send me to the emergency room. So here’s my message to diabetes: if I work up the willpower to exercise in the morning, I wish that you’d leave me alone.
Hey Catherine. I know how you feel. I stopped running in the evenings because I could never predict what would happen and I had lows very often. I’ve found that running in the morning before I take any insulin (bolus) works best for me. I reduce my basal rate to 30% one hour before I run and after 2-3 mile (15 minutes) I take a energy gel that has 25g of carb. The gel works quickly but lasts longer than tabs do.
I also find that I usually need to take some insulin after a run to get myself down from the 150 safe zone to normal BS.
But everyone is different so you just need to try different things until you find what works.
For me, 1 unit of insulin before an intense early am workout keeps my bs stable. Otherwise it will go up. It’s tricky though, if the workout isn’t intense enough, the unit will make me drop. It’s usually different in the evening. It took a lot of work to figure out the balance of insulin/intensity. Fortunately, I have a great personal trainer who helped me tremendously.
I love that last line! LOVE IT! Its so true! I’ve dealt with the same issues. I can do the same routine and get different results 3 out of 5 times. I try to explain this to my non diabetic friends and they just dont get it. Was great to read it from someone that does!
I am SO on the same page, Catherine! In the past year, I have begun to experience the same type of post-work, during work-out lows in the evening that have driven me to leave the gym as early as 5 minutes into a workout, as well as finding that I can only lift weights at lunch, otherwise my BS will plummet. I am going to a new endo in June in hopes to start tweaking some basals and carb ratios to support my desired healthy lifestyle.
Out of curiosity, what age are you? I am in my mid-20′s and am wondering if this is common for a certain age range or if we have the joy of experiencing these stupid trends throughout the next 10, 20, 30+ years. I hope you can find some good ways to make your blood sugars work during your workouts!
Thanks for the comments! Simone, I’m 33 years old, to answer your question. I think it may have to do with morning hormones (same stuff that causes the pre-dawn effect) so I suspect it’ll be lifelong.
Also, any chance we’re related? (Two Prices with Type 1.)
We’re just starting to figure this out with Lia (10 yrs old) wanting to run cross country next year. Slow run = high bg. Sprints = low bg. Which category does racing others along trails, through woods, up and down hills, etc. qualify?
The bigger question: How on earth we will ever let her out of our sight is beyond me at this point.
Glad to hear others have problems with exercise! My issue is more the the high’s caused by working out in the morning – my blood sugars raising as I exercise. I appreciate some of the tips offered here in terms of pre-workout insulin.
From the conversation, seems that most of you are on pumps. I am still managing manually (21 years into this game – I’m 48). I’m beginning research on pumps and welcome any comments, thoughts and recommendations from other active diabetics. I power walk, strength train, interval trail (walking) so Latin cardio dance and practice an intensive style of yoga. THanks in advance!!
Hey, I don’t know about your particular situation, but I thought I might share a couple of ideas for people to consider:
- Keeping hydrated during and after a workout is extra important with diabetes as a high blood glucose can be in part because of dehydration.
- Anaerobic exercise (think weight lifting or even running/cycling where you are exerting short intense sprints of energy) seems to raise blood sugars in some people. (Here’s an article that goes over those two points and a few others http://animascorp.co.uk/connect/insulin-pump-experts?topic_id=1 )
- Also, I used to get horrible lows starting about 10-12 hours after a workout. One of my friend’s who has diabetes runs ridiculous amounts and told me it was probably because my body was using the carbs I was eating to revamp the glucose stored in my muscles. It gets used up with exercise and your body starts putting it back after, paying no attention that you bolused for a full meal. He said to try drinking a cup of chocolate milk after a workout. Apparently, it has the right ratio of carbs to protein for the job. It’s totally worked for me (although I have a half a peanut butter sandwich or chocolate almond milk, because I’m allergic to cow’s milk… as long as it’s a bit of protein with some carb.) It’s kind of a pain to eat after, but it saves me tonnes of eating later.
I don’t know if any of those points are helpful, but they have helped me out a lot! Exercising with diabetes truly is a total pain sometimes. I hope you’re able to figure out what works for you!
Thanks for the post, i can relate to many of the issues you have brought up. I also try to find the best balance when exercising, it seems the body can react differently every time.
good luck and keep on working out!
Hello, thank you for all of your thoughtful posts. I am in my late 20′s and glad to hear I’m not the only one struggling with what’s been mentioned! ( I know I’m not alone….but sometimes you feel that way).
I struggle with the increase in excerise and increase in low BGs. I am a pump-user- medtronic. No complaints on this pump. Have had diabetes for almost 10 years, and have had several pumps over the last 8 yrs.
My best success/predictability is exercising directly after breakfast, in which I’ve had 1/2 c oatmeal with 1/2 c yogurt, plus 1/2 c fruit and bolused approx 10- 25% of my regular insulin dose for a 20-30 minute jog. If I have time for 30 minutes and my fasting was above 100, I’ve tried no bolus and been good. However, it’s very difficult sometimes to combine the “finding time” issue along with perfect blood glucose planning, as was mentioned above. If it were only as easy as finding the time!
Lately I’m having trouble with immediate post-exercise low; followed by 1-3 hour post exercise elevation. Very frustrating, as I’m trying to work on weight loss.
Also, have done several 5Ks recently- which feels great to accomplish, but there is a lot of pressure compared to at-home exercise. I have had to check and recheck prior to the event and tweak, or eat carb-gel, etc…differently than I would at-home, due to the event having an official start time. At home, I may hold off starting or cut the exercise short, or go longer depending on my BGs prior and during. And, an organized event it’s much harder to be flexible. Also checking BG during an event is mentally tough for me- people watching, me taking the time when I’m trying to make good time.
If anyone has insight, I’d like it.
Hi, my diabetes was born on the 26th January this year, so in Diabetes years I’m a bouncing baby 4mth old T1D, not a grumpy and very hacked off 44 year old!
I have always been fit and healthy and up until last October when the real symptoms started was an 8min miler, cyclist, swimmer and champion dog walker! On diagnosis the docs told me it would take 18months or so for my bg to ‘normalise’ and that wouldn’t be able to do more than “a gentle walk” once a day for fear of hypo etc….
Then I had the fortune to be invited to an Animas sponsored ‘Sports weekend for T1D’s’ and wow, it changed my whole outlook on exercise.
Two books to read:
1. The Diabetic Athlete’s Handbook – Sheri R. Colberg
2. Think like a Pancreas – Gary Schiener
We were lucky enough to have Dr. Ian Gallen and his team from Runsweet talk us through how to manage basal/bolus/carb adjustments for different types of exercise at different levels of intensity – and guess what? It works!!
One of the attendees has written it up here, and there is a Facebook Group set up to share the learning here
I would love to hear more from T1D’s who are getting on with it and who will share the pitfalls as well as the good bits! Thank you for sharing your frustrations.
Hi. I am feeling better reading other pples experiece coz always thought i was alone. My problem is mainlly in the morning coz most mornings i wake with hypo or it wakes me up in the middle of the night and even though i boost it morning comes wen my body is so weak i dont have the energy to exercise. Still figuring out how to conquer it so i can exercise in peace. If someone has a tip on how to go around this i would appreciate. May God heal us all