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Re: [IPk] Running and bgs's


First, congrats on keeping a regular exercise routine.  Keep it up and the
long-term benefits will rock.  I never exercised enough until I had a pump.
I've maintained a healthy weight because I don't have to eat a lot in order to
avoid getting low while working out.  However, you may want to consider
exercising after you've eaten breakfast if you can bear to do so.  You are
exercising on a *fabulous* waking-up bg.  It's not a fabulous working-out bg,
however.  It's not a happy thing to set your basal rate so that you wake up
much above normal, but you must have sugar to burn in your system before you
break a sweat.  Remember that exercising burns glucose at a pretty good rate.
I normally exercise with a bg of at least 9 mmol/L, but I take 1.5 units of
insuin first if I'm at 16 mmol/L.  When I was a new pumper, I was not to
exercise until my bg hit 11 mmol/L.  That's a general recommendation--if your
MD or diabetes care team has told you to exercise before breakfast, on a bg of
ca. 5-8, you have a choice about whether to listen to them!  You need to
listen to your body first and tell your care team what you're doing.  You
might want to try testing your bg before, during (1/2-way point), and
immediately after your workout one day per week for a few weeks to see what's
happening (I bet you have to watch the number of strips you use...which is
AWFUL because pumpers should feel free to test 6-8 times/day. Grrr.).  With
that out of the way....

You didn't mention if you're tacking the 10 minutes of running onto the 30 of
something else that you usually do or whether you're substituting the 10 min.
run for the usual 30 minutes of cardio.  That is a VERY important bit of
information; please let me know.  I have some guesses about why your bg is
spiking up by 5 mmol/L (a significant amount), but I can't say anything until
I know just how much you're exercising.

With regard to how you ought to adjust your insulin for exercise, the general
rec. that I follow if my bg is above 11 mmol/L is to reduce my basal rate by
half (so if I'm on a 1.3 u/hr rate, I make it .6) about half an hour before I
plan to exercise, and I let that run for a half-hour after my workout.
(Example:  I want to go to the gym at 5:30.  I test my bg at 5 and set my
temporary basal rate to last 2 hours.  I change clothes, eat a snack, etc.  I
work out from 5:30 to 6:40. Then I check my bg.  If I'm above 8.8 mmol/L, I
take a little insulin, but not what I'd take if I hadn't just exercised--I
take about 30% less because my body's metabolism is going to be running higher
for the next several hours.).  I always exercise in the late afternoon or
early evening, after I would normally want a little snack anyway.  If my bg is
between 7 and 8.5, I usually eat an apple or some raisins first to make sure
I'll have enough glucose to burn.  If my bg is low for exercise (ca. 5-6
mmol/L), I often a piece of bread with honey on it and a few raisins.  (Wait!
You people call them sultanas.  Give me a break: I am going back and forth
between this e-mail and a tool that converts mg/dl--how I measure my bgs--to
mmol/L [http://people.ne.mediaone.net/dclc/convert.htm]) Honey is more
effective and much tastier than a glucose tab!

PLEASE let me know just how much you're exercising and we can work on the
spiking you're experiencing.  Perhaps having this conversation on-list will
help other readers too, but if you'd prefer to communicate privately that's
okay too.  One more thing that I'll throw out before closing: be attentive to
how your hormones are affecting your body and adjust your basal rates as
necessary.  If you've only been running on the new schedule for about a week,
perhaps your hormones are playing a part in the spiking--you'll know if that's
the case.  I generally need .3 u/hr. more than normal for about 10 days every
month.  I used to be scared to raise my basal rate by that much all by myself,
but with time I have become more confident.  If you see the need to increase
your basal, start with .1/hr for all profiles during which you're running
high.  Stick with that for 2 days and increase by another .1/hr if every two
days until you see improvement.  Write down what works best and just use it as
soon as you think you need it the next month in order to fine-tune the system.
Also beware that the rules under which the "system" operates are subject to
change without notice.  As my very wise (now-retired, unfortunately) diabetes
educator used to say, "Diabetes is an art, not a science."

The reward for anyone who read this whole e-mail is a book recommendation:
Outsmarting Diabetes by Richard Beaser.  It's out of print and surely a little
out of date now, but Beaser's approach to intensive therapy got me started in
learning to pay more attention to my body than to standard-issue medical
recommendations developed by well-intentioned people with fully funtional

I will stop writing now and go eat dinner!

IDDM 7 years; pumper 5 years

M.A. student, Theology
The University of the South
Sewanee, Tenn.
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