[Ginny27S]

Hi. I am 22 and have been a type 1 diabetic since I was 19. I haven't really taken care of myself lately, a1c's are usually around 6.8-7.0. I've found it so hard to deal with the diabetes. However lately I've decided that I want to take control and watch my diet and lose some weight so I've been doing some intense work outs such as high intensity boot camp, Zumba, and other cardio exercises. I thought all this exercise would help with my bg levels but it's done the opposite!! My levels will sometimes reach 300 post workout! Then when I account for it at night my sugar drops pretty low. It's crazy. I don't know what to do about the post workout highs! Any tips? It's frustrating because exercise is supposed to regulate ur levels.

[zanecohen1]

My son is type 1, extremely active and we have the same reaction when he plays most if his sports. We typically plan before his sports to keep him higher by doing half of whatever his insulin dosage is prior to the sport. He ends high but then drops naturally from the effect if the exercise. Not too low however but about 100 pts the first hour. Sometimes the effect of the exercise can be up to 14 hrs later. We don't correct if he's high after sports and we make sure before bed he has a carb/protein snack (like a sandwich-complex carb which prevents the overnight lows.

[type1rachelle]

Hi there! first of all, an A1c of 6.8-7.0 is hardly not taking care of yourself, but I understand the frustration with the volatility of your BGs.

I'm 31 years old, T1 for the last 14 years, and I am very active and compete in endurance sports.

I would recommend this book for you:

http://www.amazon.com/Diabetic-Athle.../dp/0736074937

It was a real eye opener for me when I began cycling and running. Basically, if you're engaging in high intensity stuff, you're releasing stress hormones which block the absorption of insulin and glucose. Before a race, it's not uncommon for me to see BGs in the 300s and even 400s! This is the nature of T1 diabetes - extreme volatility from time to time.

What I would recommend is this - engage in lower intensity but longer efforts. So instead of a 20min sprint, go for a 40min jog. If that's too tame for you, try long drawn out efforts with "pick ups" mixed in there (periods where you speed up for short intervals). With less stress hormones, your BG should be lower.

Also, are you on an insulin pump? Insulin pumps are great because you can keep them on during exercise and just decrease your basal rate. So when I run more than a half hour, assuming I'm within range with my BG, I run with my pump at -50% of my normal basal. If you're out there with NO insulin in your system, your BG is going to sky rocket as soon as you stop exercising.

I even go as far as to give myself a couple of units to cover a post exercise snack about 15mins before I stop exercising. It might seem scary to give yourself insulin while exercising, but that recovery meal isn't doing anything for you if the glucose is just going to sit in your blood for an hour after your workout - to fully recover, you need to eat something within that 30min window following exercise. Don't let diabetes hold you back from this, because you'll only be gaining partial benefits of exercise - you get stronger in recovery, not during exercise.

If you're not on an insulin pump, consider giving yourself a quick injection 10-15mins before the end of your workout and then eat something. I opt for something around 200-300 calories with a 1:4 protein to carb ratio. Something like a protein shake with very little fat works really well.

Yes, exercise increases insulin sensitivity... so while you shouldn't go insulin free, it's important to keep this in mind when bolusing (either correction or meal boluses). You'll have to play around to find out what works for you, but I know for me, I typically only give myself half the bolus, no matter how high my BG is, because I know it WILL come down, and usually FAST... then I'll be having to play "catch up" with my BG - and if I'm in the middle of a race or something, it's VERY hard to recover from a low BG. Depending on the exercise, my insulin sensitivity can last up to 6 hours POST exercise (after a long 4-5 hour bike ride, for example). And after a long endurance race (>5 hours) I can be more sensitive to insulin for a good day or two!

Don't be afraid to experiment - keep detailed logs so you know what works and what doesn't... only change one thing at a time so you can isolate what works and what doesn't, etc.

We eat, sleep and travel with diabetes - exercise should be no different... everything is just trial and error when it comes to this and finding out what works for you - but I do recommend the book, it was really informative for me.

Exercise and diabetes is something I'm very passionate about, so I've spoken at various events and have been interviewed as well... here, if you're interested in checking out what I have to say:

http://thesmartwomansguidetodiabetes...chelle-glantz/

or you can always PM or email me directly.

good luck and have fun!

[Ginny27S]

Thank you both for the advice! It was really helpful and relieving to know that it's common for this to happen. I'm not on an insulin pump however I did take a very low dosage of insulin after my workout with my snack, half the dosage as suggested and noticed that I barely had any overnight lows these past couple nights. It really is just a guess and check kind of disease and I have to play around with it to see what works and what doesn't lol. I wish there was a handbook on all this stuff and guessing wasn't needed! It's frustrating and stressful trying to figure it all out lol.

[brauschenberger]

I have had type 1 for 39 years. I have always been active, I am a distance runner and also a biker. The high bg readings after intense exercise are common; be careful not to over correct. I find the effects of intense exercise can last a good 24 hours. Remember that you tend to be dehydrated to some extent after hard exercise, this makes your bg readings appear higher (blood is more concentrated).

[type1rachelle]

yep yep - trial and error, and try to learn in the process and retain for next time.

REALLY interesting to learn about dehydration and higher readings, thanks for the info! I have noticed that when I check during swimming, if my hands aren't completely dry, I might get a lower number (then I dry my hands completely and it's higher) - probably same concept.