Type 1 diabetes...difficulties

[jem154]

I have type 1 diabetes and am struggling with managing insulin/food/exercise. I’ve reached wk 7 run2. This morning I tried running on an empty stomach after my lantus injection but without novo rapid - as advised by diabetic nurse specialist - test beforehand 10.4mmols. Run went ok but during warm down I could feel my bsugar going up. Test immediately afterwards 15.4mmols. Felt pissed off and unwell. Any advice...??!

[Twobells]

Blood sugar will drop after couple of hours unfortunately its trial an error when exercising, before I do any exercise I keep blood sugar around 8 , then test when I'm finished, but I generally do my exercise in mid morning time I have finished its lunch and its at this point I adjust my insulin.

Hope this helps. I always advised not to correct after exercise as blood sugar may be raised initially, but drop later even after a few hours.

[jem154 in reply to Twobells]

Many thanks for your reply! The bit I’m struggling to understand is why there seemed to be a sudden release of sugar into my system once I’d stopped running....I didn’t feel remotely hypo during the run... exasperating business!

[Twobells in reply to jem154]

When you run your muscles need more energy, the energy comes from your liver reserves and releases glucagon into your blood stream hence higher than you expected, once you stop you can hypo, so monitor closely.

[jem154 in reply to Twobells]

Thank you!

[Boabphil]

Trial and error as the previous person says. Not sure how intense your running activity was or how fit you are currently, but I wouldn't start intense exercise with 10.4mmol/l without correcting for it first, as if you are doing intense exercise (e.g. sprinting or weights or if you are not in shape) blood sugar will likely rise further. If you are doing a longer period of steady paced cardio-type exercise it should normally come down gradually though. 30 mins of cardio is usually enough for me to bring blood sugar back down. Normally for me it is best to start exercise with blood sugar in the normal range and take extra sugar to cover the extra effort. As I use a pump I would normally take a reduced covering dose of insulin while the pump is removed to cover the basal - you have Lantus so shouldn't have to worry about that. There may be certain do's and don'ts - speak with your nurse/doctor - but I think everyone has to find out what works best for them - everyone's body will react slightly differently to exercise - for instance I am very sensitive to activity and usually always need extra sugar to cover this. Best of luck.

[jem154 in reply to Boabphil]

Thanks very much for your reply - it’s really useful to hear how other type 1s manage! I think my exasperation level has gone back down a bit today and “acceptance” has kicked back in. I’ve had diabetes for 34 years and sometimes the day to day struggle of it can sometimes get to me - I think I just wanted there to be more of a formula for successful exercising. Today’s run was better, not perfect but better.

[Boabphil in reply to jem154]

It can be tiring I know, but don't let it stop you exercising. Apart from good control it is the best protection against long-term problems. I've had Type 1 for 39 years now and still learning lessons. As you get fitter and lose weight your body may gradually need less insulin as it responds more to exercise. Keep checking sugar regularly, try not to over-compensate with too much insulin - as a previous person said - your sugar can continue reducing for a quite while after exercise. Be careful with any trends of increased number of hypos and be prepared to reduce insulin intake if necessary in discussion with diabetic nurse/doctor.

[jem154 in reply to Boabphil]

Thanks v much for your advice and encouragement - much appreciated