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Re: [IPk] Stress, gym, basal levels and night-time blood sugar levels

I didn't really know about stress raising blood sugars but we had sort of
come to that conclusion because Charlie has found that if he has a major
concert or even a smallish solo, his levels are all over the place and he's
yet learnt how to predict what to do. Last night they gave a 2 and a half
hour concert and practised for three hours in the morning and again in  the
afternoon (all standing up) with football between rehearsal and in the
interval and he got higher and higher. He tests before a concert, during the
interval and straight after and usually has to give a correction bolus.


----- Original Message -----
From: "Melissa Ford" <email @ redacted>
To: <email @ redacted>
Sent: Saturday, May 10, 2003 5:01 PM
Subject: Re: [IPk] Stress, gym, basal levels and night-time blood sugar

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> Dear Graham,
> Yes, stress raises blood sugar when you get an adrenaline rush. It's hard
> know exactly how much your blood sugar will go up in every situation, so
> anticipating it is tough. Just the one day when you think you'll need 3 u.
> to prevent a rise and you give the bolus 10 mins. before the presentation,
> your blood sugar might 'decide' not to rise as much--and then you'll be
> stuck with a very inconvenient hypo! I have become discreet enough with my
> testing and bolusing that I've managed to do both whilst in meetings
> anyone noticing anything except the beeping of my pump. Even that's been
> ignored when everyone has assumed it was someone else's watch alarm,
> phone, or pager. When you're on just Humalog and you don't need to inject,
> programming a bolus on a pump is as antisocial as looking at your watch:
> one cares in most situations. Bonus: when it would be rude to look at your
> watch, you can check your pump (a MiniMed, at least, displays the time on
> the screen). You can say, 'It's medical equipment', and, unlike looking at
> your watch, checking the time on your pump couldn't be construed as rude
> As for gym sessions: if there's one thing that gets said every time the
> topic of exercise gets raised, it's 'your mileage may vary'. Bev, who runs
> considerable distances, needs more insulin when she exercises, but I tend
> reduce my basal to 30% of normal, or 50%, or even to suspend my pump when
> work out, depending upon a) my starting blood sugar, b) the activity I am
> doing, and c) how long I will be exercising. You will have to experiment
> see what you need. The best way to get a start when exercising with a
> I believe, is to start your workout (I mean every workout--starting a
> strenuous workout with a bg of 7 is like begging for a hypo) with a bg
> between 10 and 12. If you can plan it, reduce your basal rate an hour or
> before your workout to let your bg rise naturally and you won't need much
> a pre-workout snack. When you're trying to learn what your body
> does, try keeping your pump at 50% of the basal you'd normally have at
> time--if it would be 1.4, set a temporary basal for .7--for the duration
> the workout. Then test when you're cooling down. You'll probably not have
> gone hypo, but if you've seen your bg rise drastically, you probably
> more insulin during the workout--reduce your basal by 30% next time in
> case. I have found that sometimes my body burns a lot of glucose when I
> out and sometimes it seems not to do, but the 8-hour delayed hypo (glucose
> going back into muscles) is a constant. I like to exercise in the late
> afternoons so I am still up when it starts--then I can reduce my basal
> (sometimes by a whole unit per hour!) for a couple of hours just when I go
> to sleep and wake up with a lovely bg.
> About the night-time bgs: yes, it looks like you have a bit of the old
> phenomenon going on. Brilliant reason to get a pump as glargine is clearly
> failing you at night. Determining different basal needs during the day is
> indeed a matter of delaying (not necessarily skipping completely!) meals
> see what happens when you don't have any food or bolus insulin to obscure
> what is happening in the background. If you don't eat breakfast and you're
> quite high or hypo before lunch, you need a different basal; if you eat
> breakfast at 8, test at 11 a.m. and find you're fine, and then don't eat
> until 2 p.m., at which point your bg has gone very low, you probably need
> less basal insulin after 10 a.m. (point by which the dawn phenomenon
> hormones will have cleared out of your system for the day). Does that all
> make sense? Wish there were some on-line basal rate calculator for which I
> could send you a link, but we're all different and have varying
> requirements. We need to learn the strategies for finding the the right
> answers for us, not to collect simple, 'one-size-fits-most' solutions.
> When you're feeling muddled about things, just thank your lucky stars
> not a woman with monthly AND yearly hormonal changes too!!!
> Yours,
> Melissa
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