Morning Exercise and Type 1 Diabetes

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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. 

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DaphneRobert StevensonEmmajoanPaul Recent comment authors
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Daphne
Daphne

I was glad to find this post. I was actually looking for answers, but feel less alone in this struggle. I was diagnosed 2.5 years ago at age 35, and still trying to get the hang of controlling my sugars. Most upsettingly, I found that getting back to intermediate yoga classes guaranteed my BG would crash every single time since there is so much weight-bearing, and I hate that I have to consume sugar in between – I worked off those calories only to consume then again, just like you said! No easy answers for any of us, but sending… Read more »

Robert Stevenson

Hi everyone, I’ve just came across this blog post and thread of comments. It’s so hard to predict what your blood glucose levels are going to do. Personally I have had a lot of success with training late morning. Eat breakfast, either an omelette or berries with yoghurt and protein, this doesn’t usually cause any massive spikes. Train around 11am, only resistance training. I’ve found mixing cardio and resistance training too hard to predict as there’s too may variables. Resistance training keeps my levels constant or rises slightly. My insulin sensitivity isn’t great for the next 3-4 hours. At approximately… Read more »

Emma
Emma

Hi Catherine-  I realise this is an old post but I was so glad to stumble across it today….Thank you so much for sharing this bog post!! I am experiencing the EXACT frustrations right now and to read that someone else has/is experiencing the same things makes me feel like I’m not so alone. Good behavior should be rewarded, right?! I am doing everything “right” and not achieving the results I want. I’m not going to let T1 diabetes stop me from exercising and doing the stuff I love but I wish it would cut me some slack!! T1 diabetes… Read more »

joan
joan

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

Paul
Paul

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… Read more »

Janean
Janean

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… Read more »

Janean
Janean

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… Read more »

Assaf

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! 

VirtueB

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… Read more »

Linda Stephens

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… Read more »

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