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Re: [IP] exercise


Welcome to the list. I think you'll find a lot of good people here.


>How do you handle exercise?
>1)  For long term (all day) exercise-- such as a mountain hike I took
>recently, in which I hiked for 6-7 hours, I used a temp basal rate--
>about half of my regular basal rate-- and still had some hypoglycemia,
>then had some hyperglycemia later on.  I realize this is due to the
>increased need for insulin later on, but at nighttime, I forgot to
>adjust my nighttime basal, and had a severe hypoglycemic episode in the
>middle of the night!  I guess this was good information for next time,
>but dangerous!
I find it's generally safer to start exercise with a BG that's a bit too
high, rather than one that's "right on the line" or too low. It's generally
easier when exercising to correct a high, than it is to correct a low. When
I started pumping, this was a challenge for me. Now, I start exercise with
a higher target BG than I would aim for during normal activity (perhaps 150
- 170, depending on the exercise. Note: this works for me, may not work for
you. YMMV).

You do need to watch the basal rates later on. As you probably know,
exercise can increase your metabolism for some time after the activity,
resulting in reduced insulin requirements. For me, the "trouble time" is
generally mid morning to noon the following day. Mistakes happen, but if
you try to learn from them, you'll have quite a catalog of useful
information some day :-)

>2) I found for shorter term exercise 30 min to two hours or so-- a temp
>basal rate is not so helpful, nor suspending the pump, as I have to plan
>ahead and make adjustments one to one and a half hours prior to
>exercise, and the timing doesn't always work out very well.
The timing can be a hassle. Are you using Humalog or Velosulin? I'm on V,
and I need to plan basal rate reductions 1.5 to 2 hours in advance of the
exercise. It stinks, but I can generally deal with it. Humalog was much
easier for me, when planning exercise. Whenever possible, basal rate
reductions are my preferred way to deal with exercise / physical activity.
When advance planning is not possible, I resort to extra carbs - adjust
based on experience.

>3) What seems to work best is to exercise after a meal, and recently
>I've halved my pre-meal bolus, then exercised and that worked out well.

I use this trick also, and find it works well. I am surprised at times,
though, by how much I can reduce my pre meal bolus. Sometimes the 50 %
reduction is not enough. Adjust based on experience. Again, for me, it's
generally better to be a little higher than desired before exercise, rather
than suffer a low while exercising. Lows are not fun when you're 10 miles
from home on a cross country ski trail, or halfway down the river.

>4) And lastly, when I exercise between meals, I eat some carb and
>sometimes add protein snack.

This works for me as well. I've recently tried things like Power Bars for
activities such as kayaking or golf - long duration, moderate to high
moderate activity level. The results have been very good.

There are some people on the list who are much more active than I am, and
undoubtedly can add a lot of good info to this thread.

Keep asking questions - that's what the group's here for :-)

Bob Burnett

mailto:email @ redacted

Insulin-Pumpers website http://www.insulin-pumpers.org/