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[IP] My first A1c and my exercise question

Hi, Arlie:

I'm not sure what kind of aerobic exercise you do or how often you do it,
but this has been my experience.  I am a marathoner and have been training
for the AFC Half Marathon in San Diego next weekend.  I run on average 30-35
miles a week.  Before going on the pump this past June, my blood sugars
would drop during the first couple of miles.  The more I trained and the
better conditioned I became, I built up bigger glycogen stores which would
then release and slowly raise my BG.  So, I could start a run with a normal
BG, ingest no CHO's whatsoever and end up around 250.  Even though I had
lots of glycogen stores, I didn't have that steady flow of insulin to keep
my BG in a normal range.  (This concurs, by the way, with what is said in
_Pumping Insulin_).

So the pump has been the perfect solution.  I definitely keep it on and, if
my blood sugar is normal, will have maybe 15 grams of CHO's for a 5-miler
and end up with a normal BG.  For a long run (10+ miles), I have approx. 40
grams of CHO's and will end up with a normal BG.  In other words, if you
exercise 3-4 times a week for 30-45 minutes and have a pretty intense
workout, you'd probably want to leave the pump on and have some Gatorade or
25 grams of CHO or so.  The more conditioned and fit you become, i.e.,
training 6 times a week for 45 minutes or one to two hours (of course I
don't know you -- you could be an Ironman competitor for all I know!), you
may experience exactly what I have been describing:  your glycogen stores
give you plenty of energy, but you don't have the insulin to keep in an
optimal range UNLESS you wear the pump.  My CDE said that sometimes it may
be necessary to increase the temporary basal rate, but thus far I haven't
had to do that. 

It was very frustrating before, since it seemed the harder I trained the
worse my control was (on MDI with Ultralente).  I hope this makes sense and
helps -- the pump has made a world of difference for me as far as training
goes (not to mention peace of mind).

Jeanne K., H-Tron, pumping since 6/01 
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