It’s been awhile since I’ve posted a personal blog post on TBSW, and honestly I wasn’t sure what I should even write about. Things have been more or less pretty stable on the diabetes front. A few highs, a few lows. The usual, and pretty boring. I’m in the process of finding a new endocrinologist here in Minneapolis, but I’m not quite ready to write about that. So I popped over to the results of the poll I did awhile back to see what people were interested in. Out of all the topics, the number 1 result was Fitness & Nutrition. I’ve been dealing with some stalled weight loss, which I’ve written about over on my other blog, With Faith & Grace. I haven’t written that much about it over here, so feel free to catch yourself up on the saga.
That being said, I thought it might be good to share a bit about how I exercise with diabetes because exercise is such a big part of weight loss but it’s also a really big part of overall diabetes management. Even if you’re not actively seeking to lose weight, exercise can be a doozy. More than one PWD I know has said they actively avoid (pun intended, duh) exercising because it can sometimes create more problems than it’s worth. Ever hear of “drinking the gym”? That’s when you consume via a juice box all the calories you just burned because you went low. It’s not fun and it can be really discouraging.
Since I’ve been trying to lose weight for so many years, I’ve had a lot of practice exercising with diabetes. It takes practice to learn what your body does in response to exercise. As I’ve learned through observing myself and others, there is not one set way that your body will respond to exercise. Some people have their BGs go up, some go down. Some go down later, some go down right away. Some need to eat, some need to lower their basal, some need to suspend. It’s all very unique and of course that makes things really aggravating because why can’t there just be one way to do this?
One thing I’ve learned about myself over the years is that my body really despises going without insulin. When I was on the Medtronic pump, I could never take it off without ending my workout with a sky-high BG, or at least one about an hour after I was done. I grew accustomed to actually bolusing to replace the basal after a workout. My body knows when I’ve deprived it of insulin and it is having none of that. Now that I’m on the Omnipod, I don’t have as much of a problem because the pump doesn’t flop around the way that the tubed pump did.
I’ve also learned that I can’t exercise with my blood sugar to low either. So I need insulin, but not too much. For awhile I was doing my exercise after dinner, because I had the boost of carbohydrates from my meal, which helped my blood sugar stay stable and also gave me some extra energy, and I would bolus half of my usual dose. I rarely eat just so I can exercise, but calories from a meal are calories I’m going to be consuming anyway as part of a healthy diet. I just time things so that they are to my benefit for exercise. Insulin takes time to start working so I won’t tank while I’m exercising. The exercise also helps boost the insulin so that it keeps the BGs from spiking once I’m done.
Of course, this isn’t perfect. I sometimes still go high or low, depending on how my body reacts to the exercise or if my carb counting was off. For the most part, this system works pretty well. Sometimes I will exercise before dinner if I know I won’t have time after, and in those cases, I make sure that I don’t have any active IOB and I will make sure that my blood sugar is in the upper 100s. If I have IOB from a full bolus, I don’t usually exercise because I know that’s too much insulin in my system. I also like to make sure my BG is up high enough, usually upper 100s or lower 200s, because that gives me a cushion for the inevitable drop. But I try not to exercise before a meal because it’s more unpredictable.
I don’t typically eat anything after a workout, but I will drink a Nuun water to replace electrolytes. It really helps me feel better post-run! Nuun is calorie and carb-free, so it’s a great way to replace some nutrients without spiking my blood sugar. Occasionally I will eat a snack, if I’m hungry, and in those cases I usually bolus normally unless I’m low (always test after exercising!).
Finally, my big post-exercise headache is the morning-after low blood sugar. When I exercise in the evening, I switch over to my Exercise basal profile which lowers my basal in the early morning hours. For some reason, that’s when I go low and changing my basal keeps that from happening. I change it back to my Normal basal setting in the morning, or even the next evening, since the daytime basal rates are the same for both profiles (so I have a big window of opportunity for remembering to switch). Of course, if I exercise two days in a row, then I just keep the basal profile the same.
So that’s how I do it! Or at least, how I try to do it. How do you combine diabetes and exercise?