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Re: [IPk] Exercise

Audrey - plenty of advice seems to have come through :-)

If you must exercise in the morning, fine. You have your own reasons. I
personally don't like exercising then since that tends to be a difficult
time of the day for me bg-wise, so I don't exacerbate the situation by
throwing exercise on top of it.

When I do strenuous exercise, I cut my basal by 50% 30 minutes before I
start *and* I eat some carb when I start. And I restore my basal before I
finish. A temp basal is good for this, since I can set a 50% reduction for
90 minutes, and then forget about it. I don't claim to understand fully
what happens, but this seems to give acceptable results. The extra carb
hits the plunge that happens when I start - and for me it's more accurate
than an insulin cut.

It seems to me that exercise is very difficult to get right, as there are
so many variables and unknowns. What works for one person will not
necessarily work for another. It depends on your level of fitness, which
will change. And it depends on the type and intensity of the exercise. It
depends on how well stocked your liver and muscles are with glycogen (that
is glucose stored as a wax-like substance), which we often do not know,
since it depends on what we have been eating for the last few days, and on
what hypos we've had. In addition, in the person without diabetes, the
liver uses up most of the insulin that the pancreas produces. But in the
person with diabetes, the muscles and the liver get the same amount of
insulin, since we inject it into the outer circulation. This may explain
some of the choas that ensues: simultaneously the muscles are getting too
much insulin and the liver too little. Putting insulin into your fat does
not adequately mimic how the non-diabetic body works. That is one reason
why extra food (I find a Twix useful), rather than insulin adjustment, may

A very high bg after you exercise may be a delayed hormonal response to a
hypo while you were exercising. So prevention - eating before you exercise
- may be the best cure. I recorded my highest ever bg (27) an hour after
getting back from a days strenuous hill walking in the snow, during which I
had repeatedly tested hypo, and had eaten 2 complete packets of glucose. I
also suspect that on MDI, exercise may be trickier than on a pump, since
the act of exercising after several days of inactivity may cause unused
depots of long acting insulin to suddenly release insulin into the blood.
This *may* be why you have to look out for hypos after the event.

Ultmately it may be that the benefit of exercise with unstable bg's may be
better for your health than no exercise with stable bg's. But it's
unfortunate to have to make the choice.

But can anyone explain why my bg's plunge at the end of a long journey? Is
it the excitement of arrival? I was on a 6-hour train journey yesterday,
with son, and was met at the station by my wife at 10pm. 5 minute cycle
home. Checked bg: 3.2! I'd had a can of apple juice (15g CHO) and a largish
bag of peanuts 45 minutes earlier to counter this, but no luck!


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