Replies to This Discussion

Permalink Reply by miketosh on December 22, 2011 at 6:48am

Trial and error. You may want to consider stopping the pump, or setting your basal down to 50% or less, before you start running.

You can NEVER discount the usefulness of a CGM for this situation though. Of the three people I see daily who have gotten a CGM, all three say they could never live without it. I feel the same way. Getting over 17000 BG readings in a day gives a whole new perspective on how food, insulin, and activity affect sugars.

Permalink Reply by Mike W on December 22, 2011 at 6:51am

I love the idea of a CGM, just not sold on the cost/accuracy yet. If I can keep up the running/work outs for a while I could probably justify the cost.

Permalink Reply by miketosh on December 22, 2011 at 7:07am

Yeah, you need to accept that it won't be accurate. Even the newer ones. My accuracy is affected by water consumption, (dehydration makes it less accurate,) how quickly my sugars are dropping or rising when I calibrate, and how long the sensor was sitting on the shelf before I started using it.

Thankfully, Aetna covers it at the same rate as Pump supplies, and Minimed only bills me for the coinsurance portion, not the deductible. The Minimed sensors are marketed for 3 day use, but I find mine work best on days 3 through 7. So I use about 45 sensors a year, and don't pay much for them.

Permalink Reply by Mike W on December 22, 2011 at 7:12am

i wasn't aware of the dehydration thing, thats good to know.

I'm a federal employee and while my insurance (BCBS) is good for most things it only covers 70% of my pump and cgm (if i had one). I think I figured it to cost me roughly $1k for the first year which included the unit. Price isnt really the issue though, if it is going to meet a need I'll get it. Before working out and running I didn't see the need, i just checked 10 times a day.

Permalink Reply by Sheila Fitz on December 22, 2011 at 7:31am

My husband is a Federal employee with BCBS. I became LADA (Type 1) three years ago, too. You saved me from figuring out the potential cost of a cgm. Thanks! That was good info to know. I don't do insulin, yet, and eat <30 carbs per day. I do intense Zumba classes for one hour. I never go low, though. I consumed FAGE full fat plain yogurt with some sunflower seeds and truvia before I exercised and only went down to 90 last night. I think I'm stil eaking out a bit if insulin. Right now, extra vegetables seem to work for me before Zumba or something like cardio kick boxing, too. I''m thinking of asking for insulin only because no matter what my intentions are, I cannot make the gym more than 2-4 times a week.

Permalink Reply by Mike W on December 22, 2011 at 7:34am

Just an FYI, theres two levels of BCBS and I have the lower one.

What are you taking if not insulin?

Permalink Reply by miketosh on December 22, 2011 at 7:59am

Not to jump on Sheila's toes, but (AFAIK) often times, LADA takes a while to fully wipe out the beta cells, so with exercise and diet, LADA individuals can postpone taking insulin for a few years.

My uncle recently was DX'd with LADA, and my aunt thinks she is some witchdoctor, so she comes to me and says, "He can keep his sugars around 175 by using my special formula of vitamins and this special fruit juice. You should try it too, you could stop taking insulin." I feel bad for the guy, when he finds out that he can't keep 175's forever. All I can do is keep my distance I guess. Some people get so into alternative medicine that they can't recognize when it isn't working.

Permalink Reply by miketosh on December 22, 2011 at 8:00am

One of my coworkers is a fed for the FAA (I'm a contractor) and she just got the Dexcom 7. She's had it less than a week and already says she can't live without it.

Permalink Reply by Sheila Fitz on December 23, 2011 at 7:15am

Nothing. I eat low carb and exercise, but my low carb is following Dr. Bernstein, who is stricter than most. I don't eat any fast acting carbs, ever. I started doing this as soon as I thought I may be diabetic, before the tests came in. It seems to have preserved some pancreatic function. I've been doing this 2.5 years. It is just a matter of time before my pancreas loses all function. I know that. I tried taking Glucophage XR, but it does absolutely nothing for me. I'm going to ask for a small amount of insulin in a couple of weeks. Yes, exercise can keep me at a waking fasting bg of 90, but I am needing to skip days between workouts because of the arthritis. If I consumed readily available carbs before working out, I would get so thirsty, that I would spend half my time grabbing my water bottle.

Permalink Reply by Sheila Fitz on December 23, 2011 at 7:27am

Oh, for sure, miketosh about the LADAs - latent diabetes of the adult. They understand it so poorly because we don't have large numbers to study - and many are misdiagnosed as Type 2 until it is too late to preserve their pancreatic function. I was lucky. I argued with my Endo that I thought I was diabetic. He tested me to prove me wrong. My antibodies said it all. LADAs have great variability. I have comorbid autoimmune thyroiditis, Hashimoto's, and have antibodies that suggest I'm brewing RA. I did not become LADA until I was 56yo. It is not as aggressive in the destruction as someone who gets it at 5yo.

Permalink Reply by Jerry Nairn on December 22, 2011 at 8:20am

You've said what you do with your carbs, but not what you do with your insulin. Are you on injections or a pump? If injections, which insulins and when?
This is a very important part of managing exercise.

You may want to take a look at this article for information about figuring out a specific carb/exercise ratio, but remember the equation really has to involve at least carbs, exercise, and insulin.
http://www.diabetesnet.com/diabetes-control/exercise-and-diabetes/e...

As an example, with a pump, I reduce my basal rate by about 50% an hour before a long run, then take in about 20 grams of carbs an hour.
If I was on injections, I might reduce my long-acting insulin on the days of a run of 18 miles or more.
For all runs, I'm very careful with mealtime insulin. I try not to have a meal close to a run. If I have to eat within a couple of hours of a run, I reduce the insulin to carb ratio.
If I find myself starting an unplanned run, with more insulin than I would like in my system, then I eat right before I start.
I no longer drive my blood sugar way out of range just to keep from going low. I understand the fear. I used to do that. But it's really not necessary. Have some juice or a gel or even glucose tablets before starting, then carry and use more food on the run.

Permalink Reply by Bob on December 23, 2011 at 3:00am

This am I woke with a BG of 86. Took my regular daily basal Lantus (18 U) and 2 slugs of OJ and went out for a 2 hr 60 Km ride (flat, minimal wind). The only fuel during the ride was 8 baby carrots. When I got back BG was 63. Which is what I would have figured as I typically drop 10 pts/hr of riding for at least the first 2 hrs. Beyond that time/distance I'm not sure yet as I haven't done longer rides. Carrots were a poor substitute for a banana but it was all I had available at the time and was curious if it would bump my BG at all which it obviously didn't.

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