The Highs and Lows of Type 1 Diabetes: Exercise and Blood Sugar Management (Not as easy as it may seem)

Tuesday, January 21, 2014



I can still remember being seven (the year I was diagnosed with diabetes) and hearing my Dad yell to me in the middle of my soccer game, "ARE YOU LOW?!"  I would shoot him a quick annoyed "I'm okay" look and roll my eyes because I thought he was being over paranoid.  There were a few times though where I was actually low in the middle of a game and my Dad would run out on the soccer field with my blood tester and an already opened juice box, which he told me to drink right away.  I remember feeling embarrassed because everyone would look at me but looking back I can only imagine how terrifying it must have been for my parents to have to solely rely on me recognizing my low or high symptoms.  I also think my parents are amazing for caring as much as they did.

Being active has always been a huge priority in my life.  It not only makes me feel great both physically and mentally but it makes a huge difference when it comes to having tighter control with my diabetes.  But with all that said, having type 1 diabetes can make it quite frustrating at times.  Different activities do different things to my blood sugar and trying to figure out how my body is going to react to certain things can be quite challenging.  Sometimes it seems like no matter what I do, my blood sugars have a mind of their own.  To this day I do not have the whole exercising while maintaining perfect control thing down to a science, but I have figured out what works best for me most of the time.

A few things I do when working out:
  • I prefer to have my starting blood sugar around 160 before starting a workout.  This might seem a little high to some but if I start any lower I drop really fast.  If I am on the lower end of the blood sugar spectrum before working out I will have a small snack, such as half of a Larabar to help raise it a little.
  • I almost always take off my pump and put it on suspend if I am doing an intense workout.  If I am doing a low intensity workout like Yoga or weight lifting I will put my pump on a 50% temporary basil rate. 
  • Running, swimming, dance and spin all make me drop about 30 minutes in, so at the 30 minute mark I stop for a minute and check my blood sugar.  If I have dropped significantly I will eat a couple Cliff Shot Bloks
  • I have noticed over the years that outside activities on a hot day make my blood sugar drop at a faster than normal rate compared to days where it is cooler outside.  Does anyone else notice or experience this?  So for days where it is hotter than normal I make sure to pay extra attention to my pre/during and post workout blood sugars. 
  • I bring my blood tester with my wherever I go.  If I am running outside I will carry it in my hand.  I need a better system for this now that I think of it. 
  • If I am running long distances (outside) I always bring a juice box with me as well as another back up source of sugar. 
  • I have gotten over the feeling that people are going to think I'm weird if I stop in the middle of spin to check my blood sugar if I feel low.  I know how important it is to take care of a low right away and that is always a priority for me no matter what the situation. 
  • If my blood sugar goes high during a workout, I usually will do a small correction and then continue my workout since exercise will naturally bring it down faster. 
  • I always check my blood sugar post workout and drink a protein shake to help keep me stable the few hours following.  My favorite protein powder is Joy Rob Whey Protein.  I am the queen of buying crappy protein powders and I am so happy to have finally discovered this one.  I will never switch and it is beyond delicious. 
If you have any questions regarding this specific topic you can leave them below and I will do my best to answer in the comment section.

*If you are thinking of changing anything regarding your diabetes management, it is always best to talk to your doctor first.

See also:
The Highs and Lows of Type 1 Diabetes: How I Prepared for Pregnancy

23 comments:

Sarah said...

I usually find a lot of differences between myself and other diabetics when it comes to how to manage exercise, since each body is SO different. I can relate to most of what you do though.

I lower basals or remove pump, try to start off with a number between 100-150 (might need to snack), and ALWAYS have dexcom or my blood sugar meter on hand. I have a folded fruit strip in my dexcom cover from Tally Gear (http://www.tallygear.com/), I can clip this to my water bottle, the dog's leash, my key chain, and I have my mini one touch meter nearby.

I usually run with a small Camelback to carry my meter, juice or fruit strip, and water. It's like heaven though when I don't have to run with the pack though (i.e., when my husband runs with me and he carries it or throws my stuff in his pockets!). Different style workouts affect me differently. I've noticed if I don't warm up before doing weight lifting my blood sugar actually goes up instead of down, whereas any cardio makes it plummet if I don't plan ahead. I even drop when running errands and have to have a snack before or during!

My basal, bolus rates, and blood sugars are all lower with warmer weather. Sometimes I even drop sitting in a hot tub. Insulin absorbs faster in a warm blood stream!

I stop in the middle of classes to check all the time, I'm over the on-lookers as well, but I always wonder what people are thinking of the person eating a snack during a workout! It's definitely not an exact science and I find myself always asking doctors/dieticians for new ideas. I find consistency makes it easier. For example, if I do intense workouts or a lot of cardio it has to be in the morning or I have too many problems with going low at night!! If I can keep my workouts at the same time everyday and eat relatively the same thing my blood sugars tend to be more stable. Easier said than done!

deanna said...

Yes! Heat makes me more insulin sensitive. Swimming is something I'd love to master - going to try fruit before a swim because I just can't seem to get that one to work for me. I am beyond caring if anyone is bothered by me checking my bg in public - I do it all the time. More awareness is not a bad thing! I'm working out the kinks in the new Enlite sensors and 530G pump - a vast improvement over the old sensors that I could not get to work. Have you tried it??

Lindsay @ Delighted Momma said...

Sarah- thank you so much for all the wonderful feedback! I love hearing what others are doing!

Lindsay @ Delighted Momma said...

Deanna- I actually just switched to the newest pump (530G) with the sensor and to be honest so far I am not loving it. I am just not a huge fan of wearing two separate devices 24/7. BUT I do think I will use the sensor for things like marathons or maybe I I am having a few weeks where I jut can't figure out my blood sugar patterns. Hoping they come out with a 2 in 1 pump soon! That would be so awesome.

deanna said...

Truth is, I'm a little too brittle for a CGM, and it's taken some time to figure this one out. That being said, Medtronic has been super, they have replaced all of my sensors that have not lasted the 6 days (that would be ALL the ones I've tried!) and my inserter. I'm self pay for CGM and sensors as Kaiser "doesn't do" them, so if I can't get them to work, I won't be buying any more! Like you, I will use them at times when I feel a little extra data will help fine tune, and exercise is one of those things...I just wish the pump/receiver was waterproof. Don't need the insulin when I swim, but I sure would love that data!!

Alexa said...

Oh Lindsay I can only imagine what it must have been like for your parents. As parents now I think we know that worry, that concern. The reality that we would do ANYTHING for our little ones and being on 24 hours a day without taking a second thought. I've been passing along these little diabetes posts to my little cousin (who's 9 and was diagnosed when she was 7). :)

Stephanie May Anderson said...

thank you for your recent posts about diabetes. I currently have gestational diabetes, so I have had a VERY SMALL glimpse into the world of diabetes. I never knew how much something could impact your life! Since starting insulin, I've had multiple nights of waking up with a blood sugar of 50, being drenched in sweat, and feeling so sick and hungry and delirious all at the same time. I too love being active and first found that exercise made me drop way too low, but after several insulin adjustments, I am doing much better. I use a lot of your recipes and have found that the more "paleo" I eat, the better my blood sugars are, so thank you for all your recipes and posts about diabetes! They are very helpful

Ashton said...

I really need to get better at exercising consistently because it makes such a huge difference in my blood sugars. I enjoy biking but can not (for the life of me!) get into running. So, I have been tempted to try spinning as an alternative to that.

I definitely need to start my workout a little higher in the BG range as well. I tend to drop quickly the more cardio that I am doing.
Also, I can completely relate to the heat dropping my sugar rapidly. Summer activities become more tricky because of that.

I too, just got the newest Medtronic pump (even though I don't have it hooked up yet) with the new sensor system. I just can not get into wearing two things as well. Especially because the last CGM sensors were a little too brutal to my stomach. Did anyone else find that to be a problem?

Lindsay @ Delighted Momma said...

Ashton- The old sensors were pretty brutal on my stomach too. Half of the time they would really hurt and the other half of the time they would bleed and leave all kinds of weird reactions when I would remove them. The good news is I have tried the newest sensor and it is basically pain free and the needle is SO much smaller! With that said I still don't like to wear it all the time.

Tiffany Smith said...

Laughing at Sara's comment because just this week I was guilty of eating candy in Yoga class and couldn't help but wonder what others were thinking;) Lindsay, do you ever do Hot Yoga? I'm finding it VERY hard to keep my sugars up in Hot Yoga, even when decreasing my basal by 60%. After reading your post and the other comments, I see that the heat is prob a huge factor. I hadn't made the connection. Also, thanks for the protein powder rec. Definitely going to try it!

smilemilegirl said...

I can relate!! (: I have to be at least 160 as well. When I run, I don't carry my meter, but I am usually wearing my sensor, and I always have sugar on me. I have to eat 20g carbs uncovered with a bit of protein (like rice cakes, etc) an hour before my workout. I temp basal an hour before hand too, but sometimes just during the activity. My endocrinologist hates when I suspend my pump, but when it's really cold and the insulin will freeze if I wear it running, I have no choice. I think I need to try Larabars before running! That sounds like a great idea. Thank you for doing this series. I love reading about other people's diabetes, especially those who have more experience than I do.

Jill said...

Hi Lindsay, Have you ever heard of the rehabilitative exercise program called T-tapp? I have used it with great success, and I know of others who have had incredible results controlling their blood sugar levels with just 15 minutes of exercise a day. You might want to check it out at www.t-tapp.com, and here is also one of the success stories I thought you might be interested in: http://t-tapp.com/successstories/aimee/default.html

Mary said...

What are the two separate devices with the new Medtronic pump? Are you referring to the pump and the cgm sensor or is there something else I'm missing?? Had an appointment with my endocrinologist today and he wants me to switch. I was adamantly opposed but he is still pushing it!!

Lindsay @ Delighted Momma said...

Jill- Thanks for the heads up. I have not heard of that program before.

Lindsay @ Delighted Momma said...

Mary- I was referring to the insulin pump as well as the new Enlite sensor. The sensor is awesome and you may want to give it a try! I personally just don't love wearing it all the time.

Mary said...

Gotcha! I had to wear the dexcom sensor along with my pump for a few weeks a while back. That was miserable carrying that monitor around and having my pump on me!! I just wasn't sure if it was something like that and I missed something. The lag time for the cgm was a HUGE issue for me because it would alert me of a low and I would test at be at like 95! So annoying especially in the middle of the night...

Rhiannon said...

Your posts about your life with diabetes make me realize how strong you are! So many people don't take good care of themselves and would probably give up on so many things with all the "extras" you have to take into consideration. As someone who doesn't have diabetes, it makes me see how fortunate I am to be able to just go for a run and not test sugars or make sure I have enough snacks to get me through. You're an inspiration for everyone! Thanks for writing such a personal series.

Sugar baby said...

Thanks Lindsay for these posts on Type 1. I have only had it for 7 months but am finding that exercise can be a pain too. I'm on MDI still so I just eat a banana or some fruit before doing workout. If I do an intense workout I go higher during it and the let it drop after. I have been doing a lot of weights and hard workouts which mean I stay up. I think if I just do cardio I go lower quicker too. I need a better system of taking my kit around too, I run with a small bag in my hand so annoying! I'm thinking of getting something I can clip around my waist even though I hate how they look! I was wondering if you try and keep your sugar pretty perfect throughout the workout or if you don't mind a small spike? Also how far are you running and how often do you have a low? Thanks x

Lindsay @ Delighted Momma said...

Sugar baby- I try to keep my blood sugar somewhat stable during exercise but if I do have a higher than normal reading I will keep going after a small insulin correction. I run about 5-6 miles a day. I love running :) I don't have too many lows from running because I think my body is used to it.

Honor Youngs said...

Thanks for the post!
I so appreciate this whole conversation, It's helpful to see how everyone deals with exercise, and It's definitely nice to know I'm not the only person in the world who carries their blood tester with them when running. I do use a running belt by Nathan when I go for longer runs - I keep my tester and stinger gels (for lows,) in there and it helps a ton. It's not the most attractive thing to wear, but with my supplies, it does keep me going and feeling confident that I won't bottom out.

I have had issues on some occasions where I gave myself too little insulin while running and ended up with a seemingly normal reading after getting home - around 120, but about an hour later I'll feel ill and sometimes I've ended up with ketones. Has anyone else experienced this? I find it frustrating because I'd like to try and train for a marathon but running for longer than 2 hours has proven difficult in these regards.

superhumanradio said...

Wow, what great information. I am sure the info on your blog will help others, as I am trying to do as well.

Anonymous said...

This is awsome information. I'm the Mom of a 14 year-old son, a fairly recent Type 1 diagnosis, about 7 months. We too have had issues with the new MDT pump but it has gotten better. My son swims competitively and practices 5-6 days a week. For swimming he has it down to a science; he tests about every 30 minutes, likes to be at 160 when he gets in, and sips Gatorade betweeen sets depending on the intensity of the work out. This is good info on running as he likes that too and biking. We have definitely noticed a connection with warmer weather and lower bg readings. A recent trip to Mexico was very enlightening that way and we were lucky no bad lows. But helps us as we prepare for the first summer with Type 1. He also will be sailing every day for at least six weeks. We are trying to figure out what to do with that? The pump isn't waterproof and it's a long time to unplug? Anyone have strategies for sailing with Type 1? Use Lantus again and the pump for just food bolus? Any thoughts greatly appreciated!

Rocky M said...

People says that diabetes cannot cure. it is right. but we can control diabetes with simple yoga exercise. Watch more videos here - yoga for diabetes

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