I am 26 and was diagnosed 11 days ago. I'm still learning about how the insulin and food affects the way I feel, and I think I'm doing an alright job so far. However, if I'm out and about walking for 30-45 minutes, I start feeling a little hypo and need to eat a snack. I'd like to be able to walk around more and also start exercising, but have some fears. Any advice?
Hi, and welcome to Juvenation! :)
T1 has such a learning curve, and you've no doubt got a lot on your mind right now, so good for you for wanting to figure out exercise already. I think you'll find a lot of people on here to use as a resource and exchange information with. You may be interested in checking out the "Diabetic Atheletes" and "Exercise & Fitness" under the Groups tab. Lots of good info there, too.
30 minutes of walking will make most of us drop low, too. With a little bit of planning ahead (and a lot of trial and error), you can learn how to head off that issue. You may find that eating 10-15 grams of carb prior to your walk (maybe 15 - 30 minutes before), as a starting point, will help. The amount of, and timing, of your carb intake will vary by person, so you'll just have to play around with it a bit (and be sure to bring your meter with you on your walk, so you can test and see how you're responding).
The greatest enemy of fear is knowledge. If you're interested, here's a book that has really helped me figure out how different types and durations of exercise affect me as a T1: The Diabetic Athelete's Handbook by Dr. Sheri Colberg. The author was diagnosed with T1 in 1968, and is an Exercise Physiologist, so she really knows what she's talking about when it comes to this stuff.
Best of luck!
I wonder if i'll ever stop feeling newly diagnosed. It's been a year and a half, and i am still caught totally off guard by things.
exercise is really freaking hard. totally worth it. very hard.
Every body is different, and there aren't necessarily patterns even for your body, but here's the only advice i've got:
1. TEST. lots. my two hour run (which was half walking cuz i was low) today I tested 14 times. You will not be able to find patterns if you aren't testing.
2. adrenaline causes most of the low symptoms - the sweating, shaking, nervousness, fast heart rate. exercise causes the release of adrenaline. when you exercise you likely won't be able to feel your lows. test lots.
3. exercise makes your body more insulin sensitive both short and long tern. I'm guessing you're on MDI? try cutting the bolus for the meal before you exercise in half. You might also try lowering your basal insulin by a unit or two on exercise days. Also, over time exercise will make your body more insulin sensitive, so if you notice you are low a lot, start taking less insulin - both basal and bolus. CDEs are tremendously helpful in figuring stuff like that out.
3.5 You're probably honeymooning, or will be soon, and that can make diabetes super unpredictable, so always carry plenty of low stuff with you, and wear medical ID.
4. when you do strength training, so things like lifting and climbing, your body uses fast-twitch muscle fibers. when you do endurance exercise, your body uses slow twitch muscle fibers. fast twitch fibers are more insulin resistant, and using them has less effect on blood sugars. slow twitch fibers are very insulin sensitive, and get moreso as you use them, so endurance exercise is much more likely to make you go low. To combat that, you can lower your basal insulin and eat snacks. On my two hour run, I had 50g of carbohydrate. It barely kept me out of the 50s.
4.5 It helped me a lot to learn about the physiology of exercise in people w/ and w/o T1. I am a pretty hardcore physiology fan, so it might not help you as much, but being able to figure out what was happening in my body behind the numbers helped me feel a little less out of control when I was running.
5. Don't exercise with insulin on board. That means waiting 3+ hours between your last bolus and your exercise.
6. don't inject into muscles you're going to be exercising. Using muscles increases blood flow, which increases circulation of everything, including insulin, which makes you more likely to go low.
7. find other T1 folks who you can rant to about exercise. it's freaking hard, and I have had very little luck getting anyone who isn't T1 to understand it. Without my juvenation buddies and my other d-friends, I don't think I'd even bother to try. (I'm a great person to rant at, as long as you're happy to listen to me rant back!)
8. logging sucks, but it can really help you find patterns.
9. eat something with protein and/or fat in that meal 3 hours before exercising. they will slow your body's absorption of the carbs, and hopefully give you a steadier release which will make you less likely to go low. YMMV.
10. Don't let negativity take over for more than about two hours after a frustrating exercising experience. I'm nearing the end of my two hours allotment, so i'm sorry if the tone of this post is frustrated. Exercising is really hard and really worth it. I hope you can read through the frustration and find the advice!
11. Good luck. Keep me updated! Let me know what works for you, cuz I am definitely struggling to find what works for me! And congrats on taking this snarling bull by it's syringe-horns.
i'm 23, ive had diabetes since i was 7 and all through high school i was able to go out and not test and dance for hours without feeling low. for the past 2 years, i wasnt able to walk around a mall for 20 min without going low! if you wear a pump, the temporary rates are amaaaaazing for this! if i want to exercise, i put my temp rate on 50% for 2 hours. (so im getting half of my basal for 2 hours) you really have to experiment with it. sometimes i gotta eat a snack before i exercise along with my lowered temp rate. but its an awesome feeling to be able to run on the treadmill for 20 min without going below 100. i also test every 20 min when im exercising just to make sure im not low. once i got off the treadmill and tested for the heck of it and my sugar was 55! i didnt feel it bc my heart was racing from running. im all about testing often and staying at your target. it's perfectly fine to just stop and test while your exercising. just play around with what you got. you'll get it sooner or later!
Thanks for the quick replies! I will definitely start testing more, especially as I experiment with being more active. Thanks for the wealth of information. I'll try to incorporate the different stuff you guys are saying. I'm going to start off slowly and see how it goes. It sounds like an extension of what I've been going through with the insulin and diet, which is to say: experimenting, testing, and paying attention to what my body tells me. I don't know my insulin sensitivity or insulin to carb ratio yet either, so that makes things complicated. I'm taking 10u Lantis at night and 5u Humalog before meals. Does it make a difference whether I bolus less or eat more before a planned exercise?
Also, thanks for the advice on endurance vs. strength training and eating proteins/fats.
It's nice to hear from you guys, it definitely lifts my spirits as I embark on this journey.
To answer your question.....you just have to try and experiment...everyone is so different. The next time you plan exercise, try taking less of a bolus...then next time try to eat a little more....You should be able to find out pretty quickly what works and what doesn't...just remember to have sugar tabs with you at all times!!! Welcome to Juvenation! There is a lot of help and advice at this place! Your journey is just beginning.....best of luck to you! Take one day at a time! I have been T1 for 25 years....no two days are the same, usually:D
It sounds like you recognize that you're going to be doing a lot of experimenting. I think your experiments will be more successful if you only change one thing at a time. If you change more than one thing, and the experiment is not successful, you won't know which thing didn't work.
100,000 miles over 30 years on a road bike
hey, i know i'm only 16 but i've had T1D since i was 11 and i'm VERY active. trust me it took a while for me and my family to find out what i can eat and how much i can play sports, but we got the hang of it. Everyones different, and your always gonna have your high and lows so its gonna be hard at first.
I play 3 sports and exercise alot so i have a problem of being to low, so i usually bring snacks and drinks with me that i know will help. You also should test alot too. I guess you just have to see what works for you. Hope that helps man. Good luck!!!
This isn't always possible, esp if you're just walking around with friends or on errands, but I try to do my actual work-out at a similar time each day. It takes some of the guess work out for me. So, sometime between 2:30 and 3:30 pm EST, if you see me posting on here, tell me to get my butt in gear and go do my work-out. (;
Hope things are getting a little easier for you!
Good for you for wanting to keep exercising. My son was playing soccer within two hours of getting out of the hospital after dx. He had a bit of a tough time playing goalie as he was still suffering from blurred vision ( so he didnt know which of the three balls he saw was the one he was supposed to stop-lol) It was kind of scary actually --as we didn't know what would happen to his levels BUT it was so important as he is very athletic and needed to prove that he could still do things.
Like everyone else has said test - & take notes! Note when you have carbs, what time it is, what they are, how you feel, what activity you did and what your sugars are. You will be able to notice trends easier with things documented --as everyone does react a bit differently. Other things you may want to pay attention to is the temperature -- really hot or really cold tend to be more difficult for my son. ALSO he goes HIGH with adrenaline and LOW with exercise- for instance activity in a practice makes him hypo but the same level of activity in an intense game makes him hyper then follows with a quick drop. We take both regular and zero gatorade as he usually feels best when he has gradual intake of carbs if he needs them - so will sip on the regular throughout a practice or boring game. Not all exercise is the same - we found that with ski racing he tended to drop very dramatically afterwards, with soccer it is after the first half ( usually) and with biking it is almost right away.
Also ...since you asked for advice - always have a medical alert id on you (dog tag or bracelet. ) Good luck and sorry to hear about your dx.
Great research article on T1D and exercise. https://www.thelancet.com/journals/landia/article/PIIS2213-8587(17)30014-1/fulltext
It has a flow chart etc. aerobic ex decreases BG levels, anaerobic (weight lifting) increases BG levels.
I’m 22 and I’ve had T1D for 15 years. I know exercising can be crazy with blood sugars. I will get a little low after a 30-45 minute walk as well! Try talking with your endocrinologist about how different kinds of exercise affect blood sugars and what will be the best option for you.
Here is a link to exercise tips from The College Diabetes Network: https://collegediabetesnetwork.org/content/sports-exercise. I hope some this info helps!
I find that drinking a Glucerna shake before my walks helps. I also take glucose tablets as a backup.