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[IPk] Running and bg's


	First and foremost thanks for such a thorough reply - you have given
me lots of food for thought already.  
	I have answered your questions in the text.

	Have a good weekend.

	Audrey Sheal  
	IDDM 20 yrs+, minimed 508 6 months+

> Date: Wed, 18 Apr 2001 19:59:44 -0500
> From: "Melissa Ford" <email @ redacted>
> Subject: Re: [IPk] Running and bgs's
> Audrey,
> 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!  
	[Audrey Sheal]  I must confess that it is my choice not their's!
What I find is that if my bg 
	is above 11m/mol I have to give myself a small bolus before I
exercise or I go shooting up high.  
	I exercise first thing for a few reasons - it means I do it!!  I
have time!! and then I go home shower, 
	eat and get to work.  I also find exercising on an empty stomach
easier - for some reason, probably
	psychological!  I find that starting on a bg >6m/mol is ok and less
I would drink some fruit juice first.

> 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 [Audrey Sheal]  I always test before and immediately after, but
> have never tried during - good
	idea and will do it - particularly with the running.

> (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.... [Audrey Sheal]   My GP has never quibbled about
> the number of strips I use,
	which is a blessing and one less thing to worry about! 

> 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.  
	[Audrey Sheal]  I used to do 30 of other CV, and now I am doing 20
of other CV and then
	10 of running after that.  That in between would be a good testing

> 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! [Audrey Sheal]    I think
> part of my 
	problem is I have set up two basal profiles - exercise day, and
non-exercise day, and although I 
	use temporary basal rates during the day if I exercise, I would not
make any adjustment to my
	early morning basals when I am exercising.    

> 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." [Audrey Sheal]
> I love that quote,
	it is so true!  I think I should spend more time looking at
patterns, as I know they are there
	but I just am not being disciplined enough in identifying and

> 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
> pancreases. [Audrey Sheal]   You are not the first to recommend that book
> - does
	anyone know where to get a copy?? 

> I will stop writing now and go eat dinner!
> Melissa
> IDDM 7 years; pumper 5 years
> M.A. student, Theology
> The University of the South
> Sewanee, Tenn.
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