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Re: [IP] exercise....


In my case, exercise involves trying to balance a number of variables, and 
trying to reduce the overall impact of a single variable on the others as 
much as possible:

1)  BG levels - before, during and after exercise
2)  Duration of exercise
3)  Intensity of exercise
4)  Recovery period
5)  Murphy

I never disconnect for exercise, regardless of the intensity and duration. 
I've had days when I changed my "normal" basal rate to .1 / hour, then 
reduced that by 90 % for 8 hours (kayaking, snowshoeing, etc.), giving me 
an effective basal rate of .01 / hour. It seems my body does need some 
insulin during this time. I sometimes supplement with carbs, but it's not a 

If I eat a meal just prior to intense exercise, I'll adjust my insulin / 
carb ratio. The actual change is based on items 1, 2, 3 above. The more 
intense and longer duration the exercise, the greater the reduction in 
bolus. If I normally use a 1:15 ratio, I might change that to 1:20. This is 
very much a YMMV area.

If my meal is several hours in advance of exercise, I typically don't 
reduce my bolus at all. I try to avoid a heavy / large meal, though, so 
there isn't a lot of insulin and / or carbohydrates hanging around when I 
start exercise. This makes maintaining good BG levels during exercise a bit 

I use Humalog, so I begin my temporary basal reductions 1 hour in advance 
of my activity. The actual % reduction is based on the type of activity. I 
don't reduce for ballroom dancing - if you ever saw me dance, you'd know 
why. I use very little energy bumping into other people and tables <vbg>. 
When I used Velosulin, I started basal reductions 2 hours in advance of 
exercise. If my BG is higher than target (I aim for 150 pre exercise), I 
may start the temp basal closer to the start of the exercise - 1/2 hour in 
advance, instead of 1 hour, for example. I try to avoid chasing a high pre 
exercise BG with extra insulin - it usually leads to a low during the 
exercise session.

I'll often return to my normal basal rate 15 to 30 minutes prior to the end 
of exercise (sometimes not possible, so I'll wait till finished). If the 
exercise was extremely intense, I'll maintain my basal reduction for some 
time after - the recovery variable I cited above.

This type of routine works for me for: golf (no cart), kayaking (calm 
rivers, lakes), fly fishing (much less basal reduction), ice skating, cross 
country skiing, snow shoeing, curling.

Generally, I bolus as normal for any post exercise food, but again, YMMV 
(mine does). I try to be conservative with the carbs and the insulin, so I 
don't end up juggling each.

My overall rule of thumb for exercise is to be conservative with insulin. I 
find it much easier to adjust for a high BG during or after my exercise, 
than trying to crawl back with a BG that's too low. I'd rather be a little 
high going in, than too low during.

Oh, and variable #5 - that's Murphy. When I've got all the other 4 things 
figured perfectly, Murphy jumps in, surprises me with one of his "laws" and 
gets me grinding my teeth in frustration. Murph shows up far less often 
when I pump :-)

Bob Burnett
mailto:email @ redacted

Jess wrote:

>to confuse the issue....  so now i'm going back to dancing...  usually
>done in three hour long sessions.... there are breaks from time to time,
>as i don't know all the dances, and sometimes i get tired....  so this is
>my current plan...  for those of you with more experience, let me know if
>this sounds sensible:
>eat dinner before dancing and bolus for only 1/2 of the carbs... (this is
>what i was doing on MDI and it worked well...)
>an hour before dancing starts drop basals to 60% of normal for the
>after dancing go out with friends for food... (usually ice cream  ;-)  and
>bolus for some percentage of the carbs...  (help?)  and set my basals back
>to normal...
>and of course test, test, test....

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