High Blood Glucose, very fast correction

[SharpTail]

What I will talk about here may be inconsequential to some since the medication I am taking for meal boluses is only available in the clinical trial I am involved in. I have commented in past posts about how fast the action of the inhaled Technosphere Insulin is. I recorded on the weekend the use of the TI insulin for a correction I had to make.

We travelled from home to go to a restaurant and as it turned out I forgot the TI insulin. After an hour drive home my Blood Glucose measurement was 22.1 (390). I have always had no patience to wait to get that kind of number back into the normal range and have learned to treat it very aggressively. However, such a high number it has always been a struggle to get good action from my fast insulin (including Humalog before the trial), probably due to the increased insulin resistance referred to by others on this forum.

I took a bolus of TI insulin what would probably be the equivalent of 10U of Humalog for me. I then got on our treadmill and reached a fast walking pace to keep my heart rate between 120-135. Following are my BG readings during and after a 1 hour aerobic session:

Beginning BG 22.1 (390)
After 1/2 hour 8.9 (160)
After 1 hour 5.3 (100)

2 hour mark 5.2 (100)
(1 hour after exercise)

So in one hour I dropped my BG from 22.1 to a normal 5.3. A couple of interesting things happened. Most of the action of the insulin appears to have taken place in the first 1/2 hour. Also in the one hour after I finished the exercise session my blood sugar was stable, indicating that the action of the insulin was completed. In other words, it appears that I basically used up the entire dose of insulin in one hour rather than the 2-2 1/2 hours that it normally functions for.

I know without a bolus of insulin I can drop my BG level a bit with an aerobic activity. But with the addition of the TI insulin being rapidly used, I assume through increased blood flow to the lungs, the result seems to be very dramatic. The only other fast acting insulin I have used is Humalog and I could not expect to get this kind of result from it.

I would like to ask other members of the forum if they have used any other injected insulins to give this dramatic effect when combined with an aerobic activity?
Pat

[xMenace]

No Pat, not at all.

That is pretty impresive action. I'd be lucky to get down in four hours.

[Scratch]

I missed a lunch bolus last week and 2 hours after eating I was at 354 mg/dl. I was at work, so I couldn't hop on a treadmill, but I injected intramuscularly and high revved my left arm in a 4-minute set of tabata timed intervals.

http://www.diabetesforums.com/forum/exercise/25843-thread-diabetic-weightlifters-bodybuilders.html#post309585

I was down to 110 mg/dl in 1.5 hours and I estimate that the Novolog was all used up in about 2.5 hours.

[xMenace]

I missed a lunch bolus last week and 2 hours after eating I was at 354 mg/dl. I was at work, so I couldn't hop on a treadmill, but I injected intramuscularly and high revved my left arm in a 4-minute set of tabata timed intervals.

http://www.diabetesforums.com/forum/exercise/25843-thread-diabetic-weightlifters-bodybuilders.html#post309585

I was down to 110 mg/dl in 1.5 hours and I estimate that the Novolog was all used up in about 2.5 hours.

But is this a safe thing to do with such high sugars?

Tabata Anything - Four Minutes of Pain to Gain (http://ezinearticles.com/?Tabata-Anything---Four-Minutes-of-Pain-to-Gain&id=348486)

The Tabata workout is a high-intensity training regimen that produces remarkable results. A Tabata workout is an interval training cycle of 20 seconds of maximum intensity exercise, followed by 10 seconds of rest, repeated without pause 8 times for a total of four minutes.

[Scratch]

But is this a safe thing to do with such high sugars?

Tabata Anything - Four Minutes of Pain to Gain (http://ezinearticles.com/?Tabata-Anything---Four-Minutes-of-Pain-to-Gain&id=348486)

The Tabata workout is a high-intensity training regimen that produces remarkable results. A Tabata workout is an interval training cycle of 20 seconds of maximum intensity exercise, followed by 10 seconds of rest, repeated without pause 8 times for a total of four minutes.
Tabata timed. I windmilled my left arm for 20 seconds vigorously, then rested it.

I didn't go full out tabata interval.

[Scratch]

So I wasn't really trying to get my whole body pumping and knackered, I just wanted to stimulate a decent blood flow into my left arm.

[xMenace]

Cool. I'll try that next time.

[shiftzor]

Is that safe to do? It sounds a bit crazy to me. :D There is no fat on my arm or at least not a lot of fat, not sure injecting straight into my arm would help. Maybe I should inject into my stomach and do some sit-ups. ;) Might try it. It’s an interesting subject; I have found that if I eat lunch and go out to the shops on my bike, my bg sometimes drops like a stone. Usually by the time I return (an hour or so) I am back in normal ranges.

[Lizzie G]

exercise can give me that kind of drop without the bolus. in fact, i have found that when training intensively and starting with a high BG i feel amazing the entire workout whilst coming back down to earth. eg yesterday. after a day of oatmeal for breakfast, oatcakes and salad for lunch and BGs around 5-6 i had a mars bar at 4pm (no bolus) and at 6 started swimming with BG 13.6. i swam 180 lengths (4.5km) in 1.5 hours, felt strong and amazing the whole way through and finished with a 4.8. I have tried so many different ways of handling this kind of exercise, but this works great for my body, doing the whole 'start at 8 pop the glucotabs' thing really doesnt work for me strength and energy wise!

[RyanN]

This method is similar to what I do everyday.
(And it is sort of the cause of my higher A1C)

If my BG is high--say 280--I can usually take 1/2 to 3/4 u Humalog. I'll then check it after 30 minutes to see
if anything weird is going on just prior to its full entrance into my system. Then--if it is still the same 280--I'll take a walk (usually 30-45 minutes). It comes down really well, then it will keep working little by little once I rest.
(Ex. 280, dose 3/4 H, check at 30 min. (280), walk for 30 minutes, test=168, relax 1 hr, comes down to 120, 1 hr later, 90)

This works great for corrective doses; but I also do it for
my meal bolus' and here is where I run into problems.
I'll eat/bolus, check after 30min., if bg is high I'll take a walk, it
comes down, all is well . . . . until the 2 1/2 hour mark when
my body is still doing its final metabolizing, but my walk burned up all my insulin--which I naturally dosed a little lower
since the exercise would bring it down--and my bg goes up usually 80-100pts, then I have to do the above corrective dose.

So, I end up walking all around and wearing myself out and burning up all my calories and staying thinner than I want
to be (I've been trying to beef up the muscles, but stay
lean and grizzly instead).

I now realize this is not good (at least for the meal doses)

I do recommend the exercise corrective doses though, but BE CAREFUL!!! The power of exercise can be astounding.
I know from years of experience here; be careful because
that BG can shoot down REALLY quickly if you take
a lot of insulin as a corrective then do a lot of exercise. I NEVER take more than 1 1/2
u Humalog (and this is only for the very very rare big highs like 380) with exercise.
I usually only need to corrective dose 1/2 a unit if it is around 250. Please be careful!

Ryan

[ant hill]

exercise can give me that kind of drop without the bolus. in fact, i have found that when training intensively and starting with a high BG i feel amazing the entire workout whilst coming back down to earth. eg yesterday. after a day of oatmeal for breakfast, oatcakes and salad for lunch and BGs around 5-6 i had a mars bar at 4pm (no bolus) and at 6 started swimming with BG 13.6. i swam 180 lengths (4.5km) in 1.5 hours, felt strong and amazing the whole way through and finished with a 4.8. I have tried so many different ways of handling this kind of exercise, but this works great for my body, doing the whole 'start at 8 pop the glucotabs' thing really doesnt work for me strength and energy wise!

Yeah!! :D , I do that too. I even look at the BG meter and see that I have enough BG to burn and I will go and do some brushcutting in the back of my property so had 10.7 / 192.6 to start with and after I have 5.4 / 97.2 so I may skip the bolus and just take the bike for a ride instead. :biggrin:

[JediSurfer]

I alway beleived insulin resistance was due to cell damage and the carb dependent cells being unable to pick up the insulin from the blood stream because of this damage. Am I wrong?

[Subby]

Something like that, is the medical meaning of Insulin Resistance. This seems to be what leads to Type 2 diabetes.

But I think we type 1's tend to lump a few things in as "insulin resistance" as a practical, or unbrella term. The three things I can think of are:
- insulin resistance, as described, your cells are resistant to insulin. I understand this can be chronic but also change hour to hour, eg, you can improve sensitivity by exercise
- lowered insulin absorption, eg from injection site, whether localised problems (like scarification) or general issues such as the problem of injecting/infusing as opposed to natural release. Also less useful or potent insulin might fit in here
- temporary heightened insulin requirements - can happen through the effect of stresses, those hormonal releases, liver dump, etc etc

Often it's impossible to know what is what, and for better or worse, insulin resistance seems to be a natural umbrella term for "insulin not working as planned" :) I'm not sure on if it is useful or not to describe a process that acts like resistance but may not be. Not sure. Certainly worth trying to be more specific when we can, for diagnostic purposes.

In the case of driving for an hour, I would expect a wash of stress hormones being the cause. I don't know enough to say
if this stress problem would cause heightened insulin requirements, or instead, interfere with the body to utilise the insulin (ie, temporary, real resistance). Any smarties help with that one? This happens to me all the time, too.

As always, this is me blundering along in my thoughts and I am so happy to be corrected, I might learn something. I should put that in my sig.

[pari]

What I will talk about here may be inconsequential to some since the medication I am taking for meal boluses is only available in the clinical trial I am involved in. I have commented in past posts about how fast the action of the inhaled Technosphere Insulin is. I recorded on the weekend the use of the TI insulin for a correction I had to make.

We travelled from home to go to a restaurant and as it turned out I forgot the TI insulin. After an hour drive home my Blood Glucose measurement was 22.1 (390). I have always had no patience to wait to get that kind of number back into the normal range and have learned to treat it very aggressively. However, such a high number it has always been a struggle to get good action from my fast insulin (including Humalog before the trial), probably due to the increased insulin resistance referred to by others on this forum.

I took a bolus of TI insulin what would probably be the equivalent of 10U of Humalog for me. I then got on our treadmill and reached a fast walking pace to keep my heart rate between 120-135. Following are my BG readings during and after a 1 hour aerobic session:

Beginning BG 22.1 (390)
After 1/2 hour 8.9 (160)
After 1 hour 5.3 (100)

2 hour mark 5.2 (100)
(1 hour after exercise)

So in one hour I dropped my BG from 22.1 to a normal 5.3. A couple of interesting things happened. Most of the action of the insulin appears to have taken place in the first 1/2 hour. Also in the one hour after I finished the exercise session my blood sugar was stable, indicating that the action of the insulin was completed. In other words, it appears that I basically used up the entire dose of insulin in one hour rather than the 2-2 1/2 hours that it normally functions for.

I know without a bolus of insulin I can drop my BG level a bit with an aerobic activity. But with the addition of the TI insulin being rapidly used, I assume through increased blood flow to the lungs, the result seems to be very dramatic. The only other fast acting insulin I have used is Humalog and I could not expect to get this kind of result from it.

I would like to ask other members of the forum if they have used any other injected insulins to give this dramatic effect when combined with an aerobic activity?
Pat
Hello to All
I have been heard that excercise is not recommended for BG over 300.But you start with 390.please guide me that it could be a dangerous work or not based on your first BG?

[Lizzie G]

Hello to All
I have been heard that excercise is not recommended for BG over 300.But you start with 390.please guide me that it could be a dangerous work or not based on your first BG?

Hi - i was reading about this in a book the other day, without going into the science of it, you are basically ok as long as you arent producing significant ketones. when i was first diagnosed before i began insulin i continued to swim and it brought my sugars down. also, if i am doing endurance swimming i will deliberately start with sugars around that level. i think the key is probably how long they have been running high. its all very individual!

[pari]

Hi - i was reading about this in a book the other day, without going into the science of it, you are basically ok as long as you arent producing significant ketones. when i was first diagnosed before i began insulin i continued to swim and it brought my sugars down. also, if i am doing endurance swimming i will deliberately start with sugars around that level. i think the key is probably how long they have been running high. its all very individual!

Thank you very much indeed Lizzie.
I am a diabetic girl too .As I mentioned aboved is based on my own experiance.one day my BG was very high (over 500) and I staretd ecercise for loweing my BG.But after 15 minute I was in a bad condiotion that I went to emergency. Pysician said me that exercise with hyperglecemia is not recommended and it increase propability of ketoasidose and after that I don't this in hyper.

[ant hill]

exercise can give me that kind of drop without the bolus. in fact, i have found that when training intensively and starting with a high BG i feel amazing the entire workout whilst coming back down to earth. eg yesterday. after a day of oatmeal for breakfast, oatcakes and salad for lunch and BGs around 5-6 i had a mars bar at 4pm (no bolus) and at 6 started swimming with BG 13.6. i swam 180 lengths (4.5km) in 1.5 hours, felt strong and amazing the whole way through and finished with a 4.8.
Yes Lizzie, I have done the simular thing and it's achievable.
I was just out of a late cinema and just saw the last bus on my route home leave without me. :( Anyway I tested and see 22.7 / 408.6!! and said to myself "Power walk time" and did 6.5Km and that was done about 1 and a half hours work and no bolus!! too much to nibble on in the cinema. :eek: So when I arrived home it was a tolerable 7.4 / 133.2 and felt great. :D
I have tried so many different ways of handling this kind of exercise, but this works great for my body, doing the whole 'start at 8 pop the glucotabs' thing really doesnt work for me strength and energy wise!

Yes liz, I would know that in ballet there is talk about fueling the dancer and no fat was the topic and water as you will go though it so if you are about to do some exercise have a test as this will give you some idea what to put away in BG's.

I do recommend the exercise corrective doses though, but BE CAREFUL!!! The power of exercise can be astounding.
Indeed!!! take note. ;)
Please be careful!

Yes, Please take this as a warning as know you limits. :cool:

[Lizzie G]

Yes Lizzie, I have done the simular thing and it's achievable.
I was just out of a late cinema and just saw the last bus on my route home leave without me. :( Anyway I tested and see 22.7 / 408.6!! and said to myself "Power walk time" and did 6.5Km and that was done about 1 and a half hours work and no bolus!! too much to nibble on in the cinema. :eek: So when I arrived home it was a tolerable 7.4 / 133.2 and felt great. :D


Yes liz, I would know that in ballet there is talk about fueling the dancer and no fat was the topic and water as you will go though it so if you are about to do some exercise have a test as this will give you some idea what to put away in BG's.


Indeed!!! take note. ;)


Yes, Please take this as a warning as know you limits. :cool:

wow - thats pretty good about your walk. the key to a good workout for me is 1)to have had a meal with a decent shot of insulin within the last 6 hours to make sure i have a good glycogen reserve 2)not to touch insulin for at least 4 hours preceding exercise 3)to have a tasty chocolate bar about an hour before. best chocs i think are ones that arent just pure choc and contain something that raises the GI such as glucose (mars bars!) etc. this flys in the face of what i have been advised but works for me!

[ant hill]

best chocs i think are ones that arent just pure choc and contain something that raises the GI such as glucose (mars bars!) etc. this flys in the face of what i have been advised but works for me!

Gee I wish to have a BG meter when I was in ballet. :( and I had a jar full of jelly beans in class. the mars bar is an excellent energy boost I find as I get into some strenuous exercise. And I love the stuff as it's so designed to give you what you need!! :D

[Eddy]

Hi - i was reading about this in a book the other day, without going into the science of it, you are basically ok as long as you arent producing significant ketones. when i was first diagnosed before i began insulin i continued to swim and it brought my sugars down. also, if i am doing endurance swimming i will deliberately start with sugars around that level. i think the key is probably how long they have been running high. its all very individual!

At about what rate does swimming drop you? Granted, everyone is different... but... once I figure out land exercise and basals, I'd like to get back in the water. :)

[George83]

Thought I would add to an existing thread rather then start a new one, had indian for lunch yesterday, lots of starchy food and bread, and a indian dessert of some sort, misjudged my insulin, 2 hours post meal i was 14mmol or 250mg/dl, then incorporated the method Scratch used (post 3 of this thread)to lower his BG, 4units of rapid and an 1hr 20min later my levels has stabilised to a normal 5.4mmol or 96mg/dl, my 2hr result did not change.