Exercise, the lows come too quickly and easily!
Just wondering if i could get some advice and opinions. I am finding im getting low rather easily and quickly when i train in cycling, sometimes running and ALWAYS when swimming. I have tried numerous combinations including:
1) 0.5 unit bolus (and minor basal reductions the night before exercise) for breakfast/lunch or whichever prior to exercise. The result= no power and didn’t train well. Its as if i need my normal 1 unit bolus to shuttle that glucose into muscles. (1 unit is what i have at lunch and breakfast because both meals have 30gms of carbs)
2) I have tried low GI carbs and waiting around 1-2 hours prior to exercise. I have also tried high GI carbs about 15mins prior to exercise. The result= Still get very sharp drops in bs within 30 mins.
What was worked for my triathlon races is this: 1 unit bolus in the morning 2-3hours out from the start to cover around 55gms of carbs. It usually gets me to around 10mmol which is great (if it doesnt i just have to have a few jellybeans to top it off). I do a 300m swim (yes, 300m only!) and have a Gatorade prime in the first transition (30gms of quick acting carbs), ride 15km while drinking a powerade along the way, and finish the 3km run. I finish back on 10mmols. It goes down after that over a fairly short time, if it doesn’t i bolus but usually don’t have to. Anyway for an event that lasts all of about 45 mins, i need 55gms carbs for breakfast + 30gms in transition + 15gms on the ride. 45mins of exercise and i need around 100 grams of carbs just to get through! These feels crazy to me. I feel like im sucking down carbs just to stay afloat.
Ill give you another example. Today i got up, had a banana and 30gms of oats and 1 unit (to cover the oats, the banana to try and spike me a bit). I got to 7mmols before i took off for a run (in about an hour after taking food and insulin). Now perhaps i needed to wait more because i had full effects on insulin on board. But in only 4kms i was down to 3.1. I took glucose tabs and jelly beans to see out 10kms. It was at moderate pace. At lunch i had 1 unit to cover lunch (30gs of carbs), 2 hours later went to the gym and lifted weights. Finished that about 2hrs later with bloods at 5mmol (weights slightly spike me then level out). I then had a powerbar with 40gms of carbs in it before i went for a swim after weights. I waited about 15 mins and my bs got up to 7.5mmols. The powerbar was working and my sugars were seemingly on the way up. I swam 35 laps of a 25m pool and lost my power and technique went to crap so i knew i must be getting a bit low. Jumped out and i was 3.3mmol.
Does anybody else feel like their really sucking down alot of carbs to keep afloat with exercise? Sorry for the long post, but does anyone have any suggestions. I have tried to spike with larger amounts of most things from brown rice to energy gels, often with insulin still ‘fresh’ in the system and often when its well out (eg 4 hours like my swim today). Im at a bit of a loss in trying to maintain high bsugars for any length of time during exercise, intense or not, stopping short of becoming a carb addict. I assume the honeymoon period may have something to do with it. I think when im off my honeymoon and my insulin needs increase i think i might get a pump.
Replies to This Discussion
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Permalink Reply by acidrock23 on -
I have been in that situation, before I got my pump, the Tae Kwon Do classes I was taking would drop me 80-150 points. We had a Friday evening class, at which I'd lose 4-5 lbs (water weight, I know but still...) and have pretty much an entire Gatorade for.
I don't swim much but the last time I did, maybe 2007 or 8, when MrsAcidRock had a broken toe and couldn't do any impact workouts, I noted that it killed my BG too. I haven't exactly avoided it but it doesn't come up that much. Eventually, the up and down of TKD (not to mention my A1C had drifted up into the 7s, at least partially from running up to 180 6 days/ week to work out...it adds up I think?) made me decide I want a pump.
It sounds like you are working out a lot more than I am as well. There's a few people at the "diabetics who run marathons" who do a lot of workouts. Do you know Heidi Jane James? She's from NZ and is an avid competitive triathlete. http://www.t1trigirl.org.nz/
She's a member and, while I don't see her around all that much I'm friends w/ her on FB so I follow along w/ her considerable exploits and occasionally check out her blog. Maybe some of her posts would offer some solutions, although one mentions "a handful of sugar from the yacht club" which won't help if you don't have a yacht club handy!
It sounds like you are doing all the "testing" and "science" stuff that you need to do and that it's just hard.I think the only solutions are to log and test a lot. Swimming is a big barrier for me as to me, it's not worth the bother. One of my buddies has suggested I join him for a local tri (sprint I think? 400 yard swim at the giant municipal pool made out of a quarry by a WPA project+ 10K run+ 14ish mile bike ride?) The run and bike ride don't intimidate me at all, except for managing the BG in the toilet while I'm transitioning and I'm sort of ambivalent. Sure it would be fun but running 16 miles or whatever's on the marathon training schedule for that weekend will be fun too. I know there's lots of people, with and without diabetes, who manage to do multiple tris and marathons all the time however I am sort of ambivalent about dealing with swimming.
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Permalink Reply by timmy on -
thanks AR. I will have a look at the links, im always looking to see how others manage it. sounds like a pump makes all this easier. I can get away with needles come race time because they arent long races, but training is a different story. And i do get concerned because im having to spike my sugars every day before training to compensate. It would be nice to flatline a bit more!
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Permalink Reply by acidrock23 on
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Another good thing about diabetes is that races are ***ALWAYS*** easier because there's carbs all over the place. I have a stack of Gu I get since they are always passing it out. I don't usually use the stuff but figure "well, as long as it's there...". Lugging stuff along on training runs can be tedious and, for the longer runs I've had a few where I'd eaten most of what I lugged along! A pump makes thing a lot easier, both from the data collection standpoint and in terms of being able to turn your basal rates where you need them.
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Permalink Reply by Super_sally on -
Hi,
I don't yet have personal experience on this - but hope to soon. My last experience with triathlon was prediabetes...Anyway, sounds to me like your insulin is not the problem, but rather the timing / amount of carbs that you need to keep things where they should be.
First thing I noticed is that you seem 'reluctant' to be slurping down so much carb... though of course you know you need it....
I'd say keep experimenting with the type and amount of carbs (plenty of gels out there, which would be easiest to work with and which can theoretically give you a pretty steady supply (yes, you would be sipping sugar every 10 - 15 mins or less?) to try to match your output.
There is also another confounding factor which is the fact that your peripheral blood sugar (at the finger tips) lags behind the central blood sugar).... How you feel energy wise / do you feel low will also tell you something...
Will be interested to see what you find out and how this develops for you.
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Permalink Reply by Michael McClure on -
Hey timmy. I'm tracking your progress. AR and the others give great advice. Anecdotally, I had to throw the towel in this evening. I've been cleaning house all day and really (REaLLY) wanted to end the day with at least an hour and a half on the bike, but I've not been able to get my sugars above 75 mgdL all friggin' day! Man! I've been carving up every time my Dex buzzes at me, and get nowhere. Others days I just look at a cookie and I'm ascending. Today, not so much.
It's true that your lovely honeymoon is at work for you, but my point in telling you this is that after even 30 years it can be a day to day crapshoot. As AR sez, it's hard. Just try to do your best (as you are doing).
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Permalink Reply by acidrock23 on
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It's a LOT easier to lug carbs along on your bike though! I could easily fit 2 sleeves of Girl Scout cookies in the pouch under my seat!
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Permalink Reply by Michael McClure on
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You have no idea. *_*
My riding bubs are always amazed at what I haul along on rides in my backpack, not the least of which is my DSLR with 12-24 lens and my strobe flash. Along with nearly an entire bike shop of tools, tubes, twisty ties, leatherman, poncho, space blanket, med supply kit and all my diabetic b*******. Those guys are forever trying to weight weenie their bikes down to the mid-20 pounds region. I'm not so concerned with that as any weight loss in my bike will definitely be offset by my 20 pound pack of shtuff (yes, including food!).
/\/\
P.S. Here's a shot from a recent ride with my son...
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Permalink Reply by timmy on
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hi sally :). lol@slurping carbs, yep it does feel like that sometimes. I have no problems having to carb up, but my concern is a) putting on weight (hasnt happened yet, but sometimes im chugging a 100cal gel every 15mins which from a weight loss persepctive defeats the purpose!) and 2) the danger of spiking myself daily to manage the exercise. Sure its a temp spike, but i still feel guilty doing it.
I have a container full of gels, some are ok, some dont do alot for my sugars at all. But i will keep going, i think a pump will be good for me but i will perhaps wait until im not honeymooning so much.
Thanks also Michael, glad to see someones keeping an eye on me haha :) Its funny, i read info and books like the athletes diabetic handbook, and there are suggestions of 15-30g,s of carbs per hour for some exercise such as swimming. Some even have to hit themselves with insulin because they spike when they swim! I feel like im pacman underwater with glucose tablets just to keep going!
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Permalink Reply by Super_sally on
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As far as carbs, it takes what it takes. Don't worry about weight if it hasn't happened yet.
Maybe just like insulin there is some sort of "curve" for how much sugar you need when for different types of exercise. Assuming you are well fueled before starting with longer slower acting carbs. Maybe the sugar needs to be less at the beginning and then more as the activity progresses or vice versa. Frequent testing and experimentation.... a bit of a pain, but then that's part of training....
I think your case is harder as you are racing shorter races where stored glycogen / readily available sugar plays a bigger role than fat(aerobic zone training). I like longer distances (and I'm pretty slow anyway) so I think I will be more able to use fat for energy.
There are some discussions in the bernstein group about training / triathlon and low carb high fat diet. Maybe worth a look. They also mentioned some professional triathletes that use this approach.
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Permalink Reply by Super_sally on
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Oops.... that was your post in the bernstein group. Sorry, am a bit dense at the moment....
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Permalink Reply by acidrock23 on
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One thing about the gels is that I've noted a lot of them use maltodextrose which I think is absorbed more like "food" (like a couple of hours later, I'll see a spike...) rather than "sugar"/ candy/ glucose/ gatorade, that will show up 15-20 minutes, while you are working out. During the Chicago Marathon, I hit almost every Gatorade stop, I think I ran by one of the first ones, but didn't see much on the CGM running > 130. I had one spot where I decided I wanted Gu w/ caffeine as I was having excruciating cramps and wanted to do something, so I bolused for the 30G of carbs (gatorade+Gu...) but cut the bolus to 33% of what the pump recommended. That worked fine BG wise (although it didn't do anything for the cramps...) and I was down to the 60s or 70s w/ a couple of miles to go, which is sort of where I'd want to be, anticipating a spike when the tort...I mean race ended?
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Permalink Reply by Michael McClure on
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It's actually maltodextrin. Good stuff -- long chain carbs. Not so spiky.
Hammer Nutrition uses maltodextrin in all their sports-related gels and such. I've been using it for years (especially their Perpetuem for 12 hour races...). Here's a very concise description from their Hammer Gel page:
"The staple of any energy drink, bar, or gel is carbohydrate, and Hammer Gel stands alone in today's glutted market of energy products. A look at the ingredient list on the label will tell you why: we use long-chain complex carbohydrates for smooth, consistent energy release. There's only a trace of sugar, so Hammer Gel doesn't set off wild insulin spikes causing "sugar high" and "sugar crash." You won't find our products saturated with cheap, ineffective, commercial-grade sugars, which can ruin health and performance. Hammer Gel is an easily digested, concentrated source of complex carbohydrates with four amino acids added to enhance performance and prolong energy levels during intense training and competition. Hammer Gel has a syrup-like consistency that mixes easily with water if so desired. You can drink it straight, dilute it, or use it to flavor other components. Use it before, during, and after exercise."
See Hammer Nutrition
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