What to do to keep sugar from droping during exercising

Exercise
1

My problem is that I have a bit of problem in keeping my level from droping during practice

I am a type one only since 2.5 years and I still get upset when I have to stop in the middle of training because my sugar is low.

ex.: last thursday we paddle 8 times 90 secondes at 95% with 40 secondes active rest (meaning that we keep paddling slowly) my sugar dropped to 3.2 (I started 11.5 (i brought my sugar up to that level) and within not even half hour it dropped

yesturday we had a 20km competition and every half hour I would check my sugar and it was between 8 and 10 all the way until the end (1hour 35 min all out )

what can I do. Thanks

2

Since you're doing an aerobic exercise, you should try to eat something with carbs prior to it and not bolus, or not bolus as much since aerobic exercise tends to cause your glucose to drop. As compared to anaerobic exercise (sprinting, high intensity workouts), that typically causes a rise in glucose. Try a power bar or something with about 20-30g of carbs before your next practice and see if that keeps your glucose in check.

Hope that helps :)

3

You can also try drinking Gatorade/Powerade throughout the workout. (Keep the bottle beneath your seat or near your legs?) You will of course need to keep checking your blood sugar to see how you are doing.

If you have been doing the workouts for a while, and the workouts tend to be at the same intensity, your body should eventually adapt and therefore not go low anymore. However, if the reverse is true, it may be a wild ride.

You might also want to consider not bolusing 3 hours before working out (so there is just a low level of insulin in your body). This will take some meal planning, but I'm sure you can figure it out!

I highly recommend getting yourself a copy of The Diabetic's Athlete's Handbook:

http://www.amazon.com/Diabetic-Athletes-Handbook-Sheri-Colberg/dp/0736074937

Keep up the good work!

4

I do eat  45 minutes before training and put my pump at -80% 2 hours before training and put it back  to normal the minute I finish training, I dragon boat so we do paddle at very high intensity and some times we paddle 15 to 20 minutes non stop, my problem is at high intensity with active rest it is then that my bolus drops. I check my sugar before getting on the boat and normally it is at 10 or 12 then 15 to 20 minutes into the exercise it drop sometime at 4 or  under, maybe I should eat again before getting on the boa??

 

 

5

[quote user="Lia Hollander"]

You can also try drinking Gatorade/Powerade throughout the workout. (Keep the bottle beneath your seat or near your legs?) You will of course need to keep checking your blood sugar to see how you are doing.

If you have been doing the workouts for a while, and the workouts tend to be at the same intensity, your body should eventually adapt and therefore not go low anymore. However, if the reverse is true, it may be a wild ride.

You might also want to consider not bolusing 3 hours before working out (so there is just a low level of insulin in your body). This will take some meal planning, but I'm sure you can figure it out!

I highly recommend getting yourself a copy of The Diabetic's Athlete's Handbook:

http://www.amazon.com/Diabetic-Athletes-Handbook-Sheri-Colberg/dp/0736074937

Keep up the good work!

[/quote]

 I just order the book you suggest I let you know how it goes then,  I do bring my pump down at -80% 2 hours before training and eat 45 minutes before without bolus  (it is just a 45 weeks that I train at this intensity, when I used to train like that I was not type 1 diabetic now I am and it is so different I do get scare since I don't know what can happen or how I will feel if something is happening, an hypo when I am not training I feel it but in training I don't

that is what scares me, but it does not stop me, I just don't want something to happen and I did not see it come

6

@Manon Lalonde

I'm glad you ordered the book, it really is an incredible resource. It even has a "rowing" section (I know this not exactly the same as what you are doing, but it should be a good starting point). Since you are getting the book, I won't go over more technical stuff.

However, it sounds like you are worried about going really low during practice and either 1) not knowing it or 2) not knowing what to do. Believe it or not, you have complete control over this. How? By planning.

1) Your teammates need to know that you have Type 1 diabetes, what a low blood sugar (insulin reaction) looks like and what they should do in case it happens (help you get some Gatorade, squish the glucose gel in your mouth, give you a glucagon shot, etc.)

2) Exercise stimulates a lot of the same feelings that a low blood sugar does (heart pounding, sweating etc.) so it can be hard to know if you are going low while you are exercising. This is why testing before and during is so important. Everyone has different low blood sugar symptoms, but for me, I get this panicked feeling along with the heart pounding and sweating (that doesn't happen when it's just me exercising). I've also found that I have a hard time concentrating, not even able to do a 2 + 2 math equation. So if this feeling comes on, I try and quickly assess, is this just exercise related or is it a low blood sugar?

3) Sometimes bad stuff happens no matter how well we plan. Kris Freeman, U.S. Olympic Cross Country Skier had the best coaches, tightly controlled everything he put in his mouth, his workouts, and his insulin plan. He had a extreme low blood sugar in the final stretches of what could have been a winning race for him. And he lost his chance for a medal.

http://www.post-gazette.com/pg/10202/1074042-114.stm

Diabetes is a marathon, not a race. Knowledge & strength are our tools.

7

you are so sweet, thank you so much

I did not know how to talk about my problem since most people I know have diabetes since they are young and I just got it and felt kind of out of place.

the thing is, bad things happens but I don't know what it is since it never happened.  I'm asked but I have no idea what to say since it never happened to me

 I do have the pounding and the sweating feeling  and I speak slow when I don't exercise and my sugar drops but during exercises I found out my sugar is lowwhen I test and sometimes I have to stop paddling because I have to bring my sugar back up (at least 15 min.)

thank you so much again

 

8

As much as they might want to, our doctors, nurses, and nutritionists will never know enough to truly help us with our diabetes. That is why we must learn it all ourselves.

Let me let you in on a little secret: no matter when or how you are diagnosed you are always going to feel out of place. Everyone has a different story, everyone's bodies react a little differently. You can often find a common ground, but you will never find another you. And that's O.K. :) And in case no one ever bothered to mention this: it's not your fault that you have Type 1 diabetes. (I struggled with this feeling of guilt for years.)

As for "bad things", I believe we only have a menu of 3.(This does not include long term complications.)

1) low blood sugar (hypogylcemia) -which it sounds like you have experienced and know how to treat! [VERY COMMON-ONLY DANGEROUS IF IGNORED].

2) extreme low blood sugar- you pass out [RARE-DANGEROUS-NOT NECESSARILY LIFE THREATENING]

http://en.wikipedia.org/wiki/Hypoglycemia

3) extreme high blood sugar (hyperglycemia) with DKA (diabetic ketoacidosis) [COMMON-VERY DANGEROUS-LIFE THREATENING]

http://en.wikipedia.org/wiki/Diabetic_ketoacidosis

See, it's not that bad! :)

As for educating your teammates/friends, I would take the time to

1) Explain what Type 1 diabetes is (they will comment with horror stories of how their aunt's sister's uncle's roomate died from diabetes, but just try to ignore them, they are just trying to help)

2) Explain the symptoms of a low blood sugar

3) Come up with a code word to let them know that you need help (help=giving you food, drink)

4) Show them when and how to use a Glucagon shot to revive you

I hope this continues to help and I hope that knowing what the worst case scenario is makes it all a little less scary for you.

-Lia

9

Thank you so much for your advice on this subject.  My daughter, 14,  is a type 1 dx 1.5 years.  She has been active in volleyball and will be starting basketball soon.  She was put on the pump in April of this year.  We spent most of  the summer adjusting her pump, boluses, basals, and foods.  We've tried different things and are still fine tuning, especially for tournament play.  I googled this book and ordered it right away.  I am confident that it will give us good advice.  Her primary problem is the exercise lag, in which her blood sugar drops 6-8 hours after volleyball.  However, when she runs, her drop is much sooner, within 3-4 hours.  When swimming, she seems to be most consistent and her bs hoovers around 100 which is awesome.  So, we know that different exercises affect her differently.

Currently, with just practice and or a single game, we 1/2 bolus within 2 hours of activity.  Then, we eat about 15 carbs per 1/2 hr of activity.  Then, if it is withing 2-3 hours of bedtime, she eats a 30 carb snack with no bolus.  Of course, we still check her at about 230 in the a.m.  Tournament play is different because we found out (the hard way) that the lag is escalated.  After playing 1 hr on/ 1hr off for about 4 hours, her bs dropped and we had to play catch up.  We dropped her basal rate by -30%. for the next 12 hours.  This seemed to help.  But she was still eating alot to keep her bs up.  The most recent tournament, we 1/2 bolused breakfast.  She had her first match.  Then 30 minutes before her 2nd match, we temp basal -80% for 15 hours.  This seemed to be o.k., but, it seemed like she was still eating alot.   However, we stopped the 4 hour lag drop and were able to maintain in target.

We have another tournament tomorrow, but it won't be as intense as the other two.  We are learning as we go, which I think will be a fact of life for her.

Basketball will be a different story.  I will have to begin monitoring her at the practices to see how she does.  I look forward to getting my book and getting some additional wise advise.

Thanks again.

 

10

I have had type 1 for 25 years and just completed my first half marathon here in Sydney. I carry a BSL machine in a slim bag around my waist and use Gu gels for a sugar hit. It is very easy to take with a drink of water and gives you around 20 grams of carbohydrate. 

Also some low GI carb before you start, such as some multigran bread will help your sugar not fall while training.

While training I use the formula of half a unit of insulin per Kg of body weight per day as the total daily insulin requirement. Any more and your sugars will drop. Anyway works for me. good luck

11

If you are not on a pump, you need one.  Unfortunately with diabetes you will need to eat something every hour with intense exercise. I temporary basal rate myself to about 1/3 of my normal basal rate and eat Cliff Shot Blocks.  They are the best mixture of simple and complex carbs and are easy to carry and pop in your mouth.  Your athletic performance will be so much better if you eat a bit than having to feel bad and treat a low.  Staedy blood sugars with constant sugar flowing to the muscles = high performace.  Remember it is a science experiment but you will get it dialed.

12

Try drinking gatorade when you are taking your brake it helps me.

13

I have been low when exercising for 40 years until last month I spoke with a Diabetic Dietician and she told me my problem was not eating enough fat so now before exercise I eat about 7 grams of fat  3 grams of protein..if you are needing more check with a dietician. First time I am not low nowadays from exercise. I guess we burn fat and not having enough no matter how many carbs kept me low. Hope this helps

14

Drink gatorade or eat shot blocks or anything that is high in sugar even if running around a lot!!

15

My diabetic dietician who works with my Endocrinologist finally suggested something that works for exercise. She said fat/protein is the glue to keep blood sugar from dropping and jumping around. I eat 1/8 cup of peanuts which has 3 grams of carb and 3 grams of protein and 7 grams of fat. I teach exercise classes all day and I was packing in the carbs and it was not working either still low or too high.. Thi the fat/protein works for me after 40 years finally found a cure I am extremely active . Hope it helps you. You may need to up the protein.

16

My Dexcom CGM is really helpful when i exercise- i can pretreat a low if necessary so that i can keep exercising. Also- i tend to be easily effected by exercise so  i turn my pump down to a temp rate of 50% for an hour before exercise then to only about 10% while i exercise otherwise i drop. The dexcom is great because it lets me track when i drop or go up so that i can adjust my temp rates accordingly- before i would have to jack my sugar up in order to exercise which we all know doesn't feel good and which ruins a day of good control- now i can stay within target range even exercising every day. for me is also helps to not have eaten/bolused for atleast 3 hours before i exercise- that helps to keep any leftover insulin from the bolus from dropping me. Just adjusting my pump and not having to eat my way through my workout helps me to keep from gaining weight/ actually lets me lost weight when i exercise.

But i agree with what someone said above- you definitive have to play around and see what works best for your body- no doctor or dietitian can tell you exactly what will work for you.

Good Luck! (i hadnt heard about that book! im excited to check it out!)

17

For Lacrosse i usually eat a cliff or a power bar before practice and drink water during the practice

18

I know exactly how you feel.  I play in a lot of softball tournaments and it's hard becuase depending on if we win or lose depends on how many games we play.  I can play anywhere from 2 games to 8 in a day.  I always lower my lantus dosage the night before a tourament but you are on a pump so a little different.  I would recommend eating before and not bolusing.  When i played ball in college I had the team trainer carry glucogon emergency kit if you are worried about anything happening.  Its difficult to keep your glucose level up when you are excercising once it gets low becuase more excercise will not help.  I have had to come off the field before and usually have to sit out a couple innings it's very annoying and I hate doing that to the team. 

19

I drop when running a mile two times a week. I am only ten had to say i was thirteen to get on the site

20

I am also low every night