How does exercise affect you?

[MarkMunday]

Hi,

I am using Lantus before bed and Humalog before meals. I have got the highs under control. But I am still having problems with lows. Mainly because of the effects of exercise.

I find that exercise brings down my blood sugar for up to two days. I am able to reduce the Humalog injections to take this into account. But Lantus is not that flexible. The end result is that the goalposts are always moving and my blood sugar fluctuates widely.

How does exercise affect your blood sugar and how do you deal with it?

Cheers,

Mark

[Mick]

Mark--

I've been using Lantus for over 3 years now. I take 17 units before bed, and bolus Novolog as needed with food. Here's the deal with exercise--and I exercise a LOT--if I have no active Novolog in my system, exercise has NO effect on my glucose whatsoever. IF, however, I exercise within 3 hours of bolusing, I can get wild and unpredictable results. SO--I never bolus before exercise, and never exercise after bolusing. Very simple scheduling solution. The one thing (besides Bolus doses) which could affect your sugar in regards to exercise is if you were taking too lage a basal dose. THAT is a potential issue if you determine it's not your Humalog. Remember the formula: weight in kilos times .6 = TDD of insulin, 60% of that should be Basal, 40% bolus. If your Basal dose of Lantus is substantially more than that, reconsider your dose--you may be using your Lantus to cover some of your meal needs, which will mess you up other times of the day--especially during exercise.

Michael
T1 since 1965
Cycled 20 miles Saturday--didn't even need a snack!

[rzrbks]

MarkMunday.

Mick knows whereof he speaks, you'll just have to tweak the info for you tho and as your level of exercise changes so will your insulin needs-----in the Spring and Fall, walking the Miniature Alps where I play golf is no big problem but when summer hits, whoo Boy, I watch myself much closer


Cycled 20 miles Saturday--didn't even need a snack!

Yeah, but Mick, you're way up there by the North Pole, for pity's sake:-

Come down here where it's 105-110 F. and humidity runs 80-90%

[MarkMunday]

Thanks for those comments. This is interesting. I can't be having too much Lanus. I weigh 75 kg. So, theoretically, the insulin dosage should work out something like this. See comparison with how much I am actually using :

Theory Actual

Total daily dose .6 X 75 = 45 35
Lantus .6 X 45 = 27 9
Boluses 45 - 27 = 18 26

Looks out of whack. And the fact that I am going low at night (3-4 am) doesn't make sense. I can't reduce the Lantus much more. And it can't be because of the Humalog.

5 years ago, I took 20 units of NPH at night and 10-12 units of Humalog before meals. But I have been reducing it steadily to avoid hypos.

I am not particularly fit and and I have only been doing moderate exercise. It almost seems like my body is producing it's own insulin. Which is very unlikely. I have been T1 for 26 years.

Any other suggestions?

Cheers,

Mark

[rzrbks]

As you become healthier doesn't your body become more efficient/effective at everything?

Including, using the insulin you inject?

I'm a Type 1.5 and I assume that means that since I have to change dosage according to exercise that both other types do as well.

[Mick]

A couple of comments on these interrelated issues.

#1) We actually use insulin more efficiently, and therefor require less of it, the higher our lean muscle mass percentage is. One body fat drops below 15%, insulin sensitivity goes way up--muscle being a much more efficient user of insulin that fat. When my body fat% went down to about 12% (that of a pro athlete), my insulin requirements dropped, for a time, to almost nothing. Until I researched and understood this phenomenon, I was dumbfounded--I'd been insulin dependent for over 30 years at the time! I went from taking a TDD of over 70u to less than 20u. After weeks of whacky readings, I finally stabilized at the TDD of about 30u I take today, depending, of course, upon what I eat.

#2) Sometimes, for no reason, my insulin requirements just seem to change for a time--either become significantly less or more. No explaination has ever been offered to me on this one. I know of many other type 1's who have, thru the years, had this same occasional experience. It has been suggested that, from time to time, our islet cells might actually manage to regenerate sufficiently to begin producing "endogonous" insulin in quantities which impact on our glucose levels enough to reduce our need for exogonous insulin. However, the original autoimmune reaction which killed our islets in the first place eventually destroys these new ones attempting to set up shop, and we're eventually back to where we started. this is a plausable, if far-fetched explaination, but one which does fit several emerging theories about our disease process. Who knows...?

Enjoy life's weirdness,
It's more fun that way...
Michael