Replies to This Discussion

Permalink Reply by Sheila Fitz on October 19, 2010 at 9:27pm

I agree that you should eat fewer carbs and more fat. Also, try reading Sheri Colberg, "The Diabetic Athlete". http://www.shericolberg.com/ Another good one is "Think Like a Pancreas." I am not on insulin yet (LADA), but I had a lot of problems exercising when I first started back to the gym. They tell me I was dumping glucose fromt the liver giving me high numbers after exercising. I'm pretty strict on the Bernstein diet, and now, I don't have problems exercising, but I still produce a little of my own insulin. Weight training is the hardest to regulate. I lost 15 quick pounds after I went low carb, and now, it is much, much slower, but I'm 57yo, and I'm lucky I'm losing weight. I keep going down sizes...Must be Zumba class. Oh, BTW, salad, especially with Romaine lettuce, gives me the highest bg levels. I cannot do salad unless it is Spring Mix without tomato or any of the other good toppings. I quit eating salad because it was so problematic. I don't eat fruit.

Permalink Reply by Baby Tee on January 6, 2011 at 11:07pm

I am perplexed on this issue, too. I don't have trouble with staying below the 30 g carbs, except that when I walk briskly for 30 min at lunch break, I need about 25 carbs to keep my bg from dropping. That puts me over the 30g for the day. I have dropped my insulin significantly, but I either go high, or I have to eat those extra cabs to sustain. I am on shots, so it isn't as easy as stopping the pump for a while.

Permalink Reply by Hana Rous on January 7, 2011 at 1:51am

I find i rarely need any carbs for exercise. My system seems to rum well on fairly high fats. I do a mixture of resistance and cardio exercise during the week.
Hana

Permalink Reply by Brian (bsc) on January 7, 2011 at 3:51am

Do you bolus for lunch? If you do, you may find that you need a markedly different I:C ratio for a meal followed by a 30 min walk versus a meal with no walk. And I guess I am just a bleeding liberal, I consider dietary carbs taken to sustain normal blood sugars during exercise as not counting towards daily totals (they are "free" carbs). Dr. B suggests that you use small amounts of glucose during exercise to keep your blood sugar at proper levels as needed.

Permalink Reply by Baby Tee on January 8, 2011 at 4:14pm

I haven't been bolusing for lunch. The problem is if I drop my long term any more (4 units levemir in AM), my bg goes up steadily all day. I am fine if I don't take that 30 min walk, but when I do, I have to eat at least 20 g carbs or I am really low withtin a half hour of getting back from walking. When I don't walk, I am crankier after lunch, so I prefer to walk to keep myself professional at work.

Do I just need to be low carb for a couple of weeks before I can exercize? This is still my first week, and I haven't really been low carb yet by Dr B's standards, because of that correction I take with exercize. I'd rather eat a piece of fruit before I walk than have glucose tabs when and after I walk.

Any more advice?

Permalink Reply by Brian (bsc) on January 9, 2011 at 7:44am

So, I'm still a little confused. But it does sound that you basically have a proper basal established. And it may take several weeks to become fully adapted to low carb, but your experience may just be something you have to work wiht. So from what you have said:

1) Lunch, 12 g carbs, no bolus, no walk -> no hypo
2) Lunch, 12 g carbs, no bolus, 30 minute walk -> hypo
3) Lunch, 20g carbs, no bolus, 30 minute walk -> no hypo

That such a small amount of additional carbs averts hypos seems so trivial. 8g of carbs gives you about 32 additional calories, hardly enough to fuel a brisk half hour walk that consumes perhaps 200-300 calories.

I suspect that what might be happening is that your brisk walk increases your absorption. In fact, there is some argument that some of the improved "insulin senstivity" from exercise comes from better circulation and absorption.

First, I am a liberal and consider any carbs consumed as part of sustain normal blood sugars during exercise are "freebees" and don't count towards daily total. So just eat the carbs that you need and don't worry about it. Secod, if I am correct, you are only eating 8g of carbs more, that is hardly much and is actually consistent with what Dr. B recommends which is to consume limited amounts of carbs during exercise as needed to sustain your blood sugar.

I hope that helps.

Permalink Reply by Baby Tee on January 9, 2011 at 5:02pm

Sorry. I could have been more clear.

1. Lunch, 12g carbs, bolus, no walk, no hypo
2. Lunch, 12 g carbs, bolus, 30 min walk - hypo.
3. Lunch, 20 - 25g carbs (depends how hot it is, etc), no bolus, 30 min walk, no hypo, no hyper
4. No lunch, no walk, no hypo.

Maybe I'll just eat a piece of fruit before my walk, and then eat lunch as planned. I can have a no carb lunch, other than the fruit. If I don't eat something before I leave, my bg drops and I end up eating glucose tabs while I walk, which just feels self distructive, as I am doing it. I'd rather eat a piece of fruit, or a "no no" vegetable.

Thanks for the help, BSC, I left the book behind at a relative's house when I traveled fro Christmas, but should have it back within a week or two.

Permalink Reply by Brian (bsc) on January 10, 2011 at 5:36am

Well, actually it is a bit strange that you can have a lunch without bolus, walk and be fine. But I guess my advice would be to just consider a lunch of 20-25 g carbs to be a freebee. It is carbs used to sustain your exercise.

In the scope of things, we all have to adapt. Optimally, you would like flexibility to chose to eat lunch or not and walk or not. You have that, depending on what you wish to do you. What may be easiest is to decide whether you are going to walk before eating lunch, then just eat your planned 12 g carb lunch. Then, if you wish to walk you can have something more to eat. Really, I don't understand why you think having sugar to sustain normal blood sugars is bad.

I don't believe sustaining blood sugar during exercise is self destructive. I actually believe that the benefit of exercise is not the calories you burn, but the post exercise benefits. And I am not convinced that sustaining normal blood sugars affects things, you will after all have to eat later to replenish depleted glycogen stores, so whether you eat a glucose tab now or eat more later doesn't matter. And restoring your body to a normal blood sugar won't stop fat burning. If you body is going to burn fat, that is going to happen whether you are at 50 or at 83 mg/dl.

Permalink Reply by Baby Tee on January 10, 2011 at 10:24am

I guess I have just developed a little bit of a "carbs are medicine and you don't want to OD." When you say it that way, I guess I was not looking at this in a healthy way. Great points, and thanks again, bsc.

Permalink Reply by Janie on January 10, 2011 at 4:30pm

I've been diabetic for a long time, but I have no ideal what it means to "bolus". Can you educate me?

Permalink Reply by onesaint on January 10, 2011 at 4:40pm

bolus and basal are the clincal terms for short dosing and continuous minimal dosing. They not only apply to insulin but other medial medicinal substances as well. Bolus is the short burst and basal is the long minimal dose.

Permalink Reply by Brian (bsc) on January 10, 2011 at 6:00pm

Dr. B developed the basal-bolus insulin regime in 1972. A basal is a slow continuous stream of insulin that keeps your fasting blood sugar properly under control. A bolus is a short burst of insulin as onesaint notes that either covers the glucose in a meal that you have eaten or corrects a high blood sugar.

It would be good to get Dr. B's book "Diabetes Solution." Other good books discussing insulin use include "Using Insulin" by John Walsh and "Thing Like a Pancreas" by Gary Scheiner.

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