need advice cuz my dr. sure isnt helping!!

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Permalink Reply by Michael Bjorkman on May 4, 2009 at 12:50pm

protein helps to stabilize your blood sugar, so maybe have a protein shake, or a peanut butter sandwich after the workout to avoid the lows.

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Permalink Reply by heather turek on May 13, 2009 at 1:43pm

thanks ive started eating protein afterwards and it's helping!

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Permalink Reply by Eric Rizzo on May 4, 2009 at 5:30pm

Are you on injections or a pump? This is one (of many) areas where a pump can make a big difference, because you can tell it to reduce your basal delivery around a workout.
If you're using injections, I suggest a healthy snack like fresh fruit right before you start working out. When I was still injecting I always had a banana or granola bar or similar if I was going to work out for more than 1/2 hour. Even now, on a pump, I still keep something like that in my gym bag at all times just in case.

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Permalink Reply by heather turek on May 13, 2009 at 1:47pm

thanks!
i do injections b/c i dont want something hanging on me all the time!
ive eaten bananas before workouts and then ended high afterwards so i assumed it was from the banana. so then i quit that. i ve been doing some research and heard on this site that intense exercise raised hormones which raise your blood sugar too so maybe that's part of it???

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Permalink Reply by Eric Rizzo on May 13, 2009 at 5:20pm

Bananas are pretty high in carbohydrates (higher than I expected before I first looked it up), so maybe you should try something a little less sweet (peanut butter is a good one because it has some carbs and some protein; chocolate milk is also a good mixture of the two as long as you don't drink too much).
As for having "something hanging on all the time," I was turned off by pumps for 20 years because of the same mentality. Then I discovered the OmniPod and now, a year later, I can't imagine how I had any control of my diabetes without it! Going on the OmniPod system has genuinely changed my life, no bull. Because you are having lows so much later than your workout, you might be a good candidate for a pump; it's "constant drip" basal delivery is much more reliable and closer to a healthy pancreas than the long-acting insulins like Lantus or Levemir. As a result, hyopglycemic episodes are often much less frequent for pump users. I know that is definitely the case for me; and my overall control is much, much better (not that it was horrible before, my HbA1C before the pump was below 7.5).
It's a big, personal decision, I'm just offering some personal experience to give you something to think about.

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Permalink Reply by Tom Gohl on September 14, 2009 at 4:03pm

Heather-
In all this, I'm not sure I've heard what sort of workouts you do. Are you doing lots of cardio? Are you going beyond 90% max heart rate and getting into an anaerobic zone? I've found that if I go hard enough to be anaerobic - either cycling or running - I will always have a post-workout high. After running races, it is particularly a problem, and lasts for a good hour or so after the race.

I will second Eric's encouragement to consider pumping. It takes awhile to figure out the quirks of that system as well, but most of the quirkiness is visible - unlike the variability of the long-acting insulins which is largely an invisible phenomenon. The pump can really be a great tool for long workout situations. Biking on the open road for 5+ hours, I can disconnect completely. The basal insulin is gone from my body in 2-3 hours after disconnecting, and the working muscle completely compensates for the lack of basal insulin. Then, I can reconnect after the ride and gradually bring the basal rate back up to normal to avoid the post-ride low problems.

Sorry - more pump preaching!
-Tom

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Permalink Reply by Anne Findlay on May 4, 2009 at 6:52pm

One is your current approach? Like Eric asked, are you doing injections or pump? If injections, when are you taking them in relation to when you are exercising?

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Permalink Reply by heather turek on May 13, 2009 at 1:49pm

i rarely take injections after 3p or occasionally at 5p. My workouts last from about 6/7 to 10p and i'm getting my low blood sugars anywhere from midnight to 2a and then again at 4a
i need some sleep!!!! :)

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Permalink Reply by Anne Findlay on May 13, 2009 at 2:02pm

what basal insulin are you taking? It sounds like you may need to reduce your overnight basals or long-acting insulin when you plan to do long evening workouts. Eating a well-rounded meal can also help. If I skimp on my post-workout meals (especially for long workouts), I am more likely to have delayed-onset hypoglycemia. Keep in mind that short-acting insulin peaks about an hour post injection so you would start reducing about an hour before you are going low. Of course, you will have to fiddle around to see what works.

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Permalink Reply by Eric Rizzo on May 13, 2009 at 5:25pm

Not to repeat myself, but these kinds of adjustments are exactly what a pump makes so much simpler. You can easily adjust your basal any time based on what you're doing and what/when you're eating, which makes an enormous difference in overall control. Heather, I know exactly how you feel about pumps (I felt the same way for a long time), but it might be worth taking a look if these kinds of issues are important to you.
OK, I'll shut up now about pumping insulin... ;-)

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Permalink Reply by heather turek on May 18, 2009 at 8:51am

hey eric thanks for talking about the benefits of the pump- i'll prolly break down and do it one of these days. i'm willing to listen to your thoughts on pumps... however i prolly wont get one soon :)

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Permalink Reply by heather turek on May 18, 2009 at 8:36am

Hey anne!
I was taking 20 units of Lantus and then when i started having all the lows i dropped it down to 15. it has helped!
I actually quit taking humalog after my workouts even if i ended up high. It has helped a bit.
thanks so much it's good to hear you're thinking the same thing... good affirmation!

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