Night Lows After Exercise

My daughter, dx September 2008 and still in her honeymoon period, has just joined the cross country team at school -- she is running 1-3.5 miles at practice and we are finding that she is experiencing nighttime lows, into the 50s.  We ahve tried lower basal before her exercise, suspending the pump while she exercises, post exercise uncovered carbs and lowering her basal by 40% following exercise until midnight or one in the morning... even with all these steps she is often 55-65 at midnight or one in the morning.  Does anyone have any tips/suggestions for what else we might try? Do you think this is related to the need to replenesh her glycogen or insulin sensitivity from exercise, or both? Thanks. 

Hi Rosemary, I get these also after exercise, especially when exercising in the evening (run or bike).  One thing that I do is have porridge before bed.  Make sure it is lower sugar stuff, but the high complex carbs sees me through the night.  If this is post exercise, I take no fast acting with this food and keep my basal dose the same.  I know some people don't like to eat before bed, but it works for me.

Hi Rosemary.  I have had some of the same issue in the past.  It does help to replenish glycogen levels following workouts but from what I've been told by my endo as well as her team is that exercise can effect bg levels for up to 24 hrs following exercise.  It has taken me a while to get my particular basal rates in check, however, it is possible.  I am not sure what pump your daughter is using but the one I use allows for different patterns, one of which I use for exercise.  Having the lower basal rate for a longer period of time and through the night worked for me.  Keep following up with the endo - he/she should be able to work with you during this period - including e-mailing bg results so that you don't have to do more office visits and be able to adjust on the fly.   Also, someone recommended a book to me a while ago and seems to have a good following among type 1 diabetic athletes - here's a link for you can see what the cover looks like  Best of luck! 

Hi Rosemary,

Two great answers already, so I'll just reinforce them and add my personal experience. I played college football with diabetes, and at the time I was on Humalog and Lantus. My Dr and I worked on it for some time until we figured out how to keep me from dropping during sleep. Intense exercise can in fact affect your blood sugar for up to 24 hrs, and for me, we cut my lanus (basal) by 50% on workout days. I also adjusted from just drinking gatorade before my workout to eating something with more complex carbs, such as nutrigrain bars. Lastly, we finally figured out that I had to also cut my post-workout meal's humalog (bolus) by 50%. Of course, none of this stuff is fool proof, and we will always have highs and lows that are unexplainable. It's no secret that it takes more to be an athlete with diabetes, but it should never be something that stops you from doing ANYTHING that you want (except drive tractor trailer trucks...we can't do that). Good luck!!

Oh, and the Diabetic Athlete (I have the older version of the Diabetic Athlete's Handbook) is indeed a great book!!