Hi guys! I am new to this site, but I have been a type 1 for about 7 years now. Recently, I have been struggling with my 6 am workouts. These workouts are more efficient for me because of my school schedule, but sometimes it is difficult to manage my blood sugars during this time. I am very sensitive to insulin and always have been,and my cardio sessions can sometimes drop me about 100-150 in 15 minutes or so with little to no active insulin on board. This is super frustrating! Then after my cardio session, my blood sugar rises rapidly! When I wake up with a blood sugar level at around 120 or less, I know that I will go low during my cardio session. I tried eating half of a powerbar the other day, and my blood sugar jumped up into the 300s. I need to find some sort of balance in order for me to have adequate numbers during my workouts. I don’t prefer to eat before my workouts this early because it never sits well in my stomach. I take Lantus at night, and depending on my blood sugar before my workout, I may or may not wear my pump at the gym because of my sensitivity to insulin. I would love to hear some suggestions on how to find a balance!
I think that mornings can be tough because people tend to have higher levels of stress hormones and tend to have more liver sugar dumping in the morning versus any other time of the day.
since you mentioned IOB… do you pump? if that’s right then why are you also using lantus? a lantus shot at night is IOB for a morning workout, have you talked it over with your endo about eliminating a lantus shot, and just use the pump basal rate?? if yes/you can try options like a temporary basal starting at about 1 hour before a workout, since you are doing cardio, temp basal rates might be like 0-10-or20% of your normal basal rate remember you have to change basal rates way before working out. I hate arbitrarily adding sugar because it’s just adding calories.
one thing I noticed with a change in activity that becomes the new norm; eventually you figure out what works best and eventually your body will react in more predictable ways - stick with it if you can. good luck!
Rylie, have you looked into an insulin pump yet? One of the great features is the “temporary basal”, where you can lower your basal (baseline) rate starting 30-60 minutes prior to exercise. If you do a 6am workout every weekday, you can set a particular basal rate to just automatically give you less insulin starting around 5pm, which will help keep you from going low. I just did a 90-minute bike ride on Sunday and my BG was stable throughout, and 109 afterwards!
From my experience, I concur with what both Joe and Angie have said especially about lowering your pump basal rate well before beginning exercise - when bike riding, I lower my basal to 20% 90 minutes before turning the peddles. On my pump, basal is not included in “Active Insulin” or IOB. And yes, Lantus provides you with background or basal insulin for up to 24 hours.
Another thing to consider is when aerobic exercise morphs into anaerobic exercise. For me, anaerobic exercise drives my BG levels very high within a very short time of finishing exercise. Before completing any anaerobic exercise, I test and give myself an appropriate bolus. At the beginning, that “appropriate bolus” was a lot of guess work.
Thank you all so much! This is great advice and I am going to put it into practice tomorrow morning. I do pump and I have been for some time now and it is so awesome to learn new things about it! I have been doing the untethered approach for years now which works best for me and my body, so I always take 5 units of Lantus at night along with the standard basal rate I have on my pump. I just made a temporary basal specific to my 6 am workouts, and I will play around with that, and I am also going to test my blood sugar after my aerobic exercise, before I begin my anaerobic to see if I can limit the highs. Again, I appreciate all of this feedback. It has been so helpful!
Another thought Rylie,
Does your pump model allow you to establish various basal rates for different times of the day, and also have the pattern feature so you may preset basals for days of planned activity?
The three different MM/Medtronic pumps with which I have had good experience allow as many as nine [I think] basal rates over the course of the day which I periodically validate by extended fasting on days when I haven’t planned anything other than “my customary” activity; the only bolus I take on these days is when I go too high.
Glad to see this post. I was just speaking with my Endo today and he advised that setting my basal 60 to 90 minutes prior to my scheduled workout is best and exercising in the AM is best. Also, he added that diabetics should never exercise less than 6 hours prior to sleep as we can experience low blood sugars at night. I use the MiniMed 530g w/Enlite sensor and I’ve had great experiences with it.
I drink coffee and eat a banana before morning cardio. That usually gets me through an hour of running.
Like others have mentioned, using Lantus and a pump could be giving you too much basal. Even if you shut the pump off you still have Lantus on board.
Don’t be afraid to experiment. You don’t need too many carbs, but they probably need to be from simple sugars. IMHO