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Re: [IPk] Excercise causing high BG level

Hi Suzanne
When you say you dropped your bolus to 90%, do you mean you decreased it 
by 10%? Just checking that's what you meant, not that you dropped it by 
90%. It doesn't seem much of a reduction, that's all. Did you touch the 
basal rate at all?

Either way, what you may find is that once the exercise has finished, 
you still have carbs left in your body from your meal that aren't 
covered by the insulin, given that you reduced it.

Here's a more extreme example. On Wednesdays I do a spin class at 2pm. I 
eat lunch at 1pm (60g carbs) and don't bolus AT ALL for it. My BG is 
usually around 7-8 immediately before the class at 2pm, and around 5 at 
2.45pm when I finish. Sounds perfect. But I actually still need some of 
that missing insulin to cover the carbs for lunch, which continue to 
have an effect on my body for the next few hours (since the action of 
the carbs is several hours, not just 2 hours). So I have to then bolus 
1-2 units when I finish the class, to cover that missing insulin I 
didn't take with my lunch.

It might be the same thing happening to you. The mistake people usually 
make with exercise is to not reduce their insulin early enough, and/or 
to end the reduction of basal rate too late (after you've finished the 
class is already too late - usually putting the basal back to normal at 
least 30 minutes before the end of the class is better).

Alternatively, you might just be one of those people for whom some types 
of exercise raises your BG. You could try next time not reducing your 
meal bolus and see what happens (you may find that because Pilates isn't 
very energetic, you don't actually need to reduce your insulin - this is 
what I find personally).

If you do find you need to reduce your insulin pre-Pilates, as you did, 
my suggestion is to take a small amount of insulin immediately after you 
finish the class. I find it better to do this as a square wave over 30 
minutes or so, for the simple reason that if you find you don't need it 
after all and start going low, you can at least cancel the rest of it.

There's no correct answer, it's just about finding what works for you, 
so it'll take a bit of experimentation. It's taken me a long time to 
figure all the different food and insulin requirements for the various 
different sports and exercise I do, and it's different at different 
times of day.

On 22/01/14 16:18, Suzanne Allen wrote:
> Hi,
> I wonder if you can help me with this please?  I have just started Pilates
> classes and as per the advice in "Think like a Pancreas", I have dropped my
> bolus rate at dinner time to 90% of the recommended food dose.  I then
> attended Pilates class about 90 minutes later.  Last night my BG was 7.2 at
> the end of the hour long class i.e. 9.30 p.m, which I thought was OK, but
> was perplexed to see it rise later to 11.4 at midnight.  I was expecting it
> to fall, not go up!  As I am trying to tone up and lose some weight, I am
> disappointed that I may have to give myself more insulin, not less.  Can
> anyone explain to me what is going on please?
> Thanks.
> Suzanne Allen
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