It won't always Workout

Happy Monday and here’s a quick update on recent happenings here . . .

I’m not about to start writing about how to control blood sugars when exercising. I’d need a rather large book and more than a level scoop of patience to start exploring this mystery. Please speak with your diabetes medical team on how to get started on that road of discovery. It can be super-easy or super-complex and Your Diabetes Most Certainly Will Vary. This should be a new acronym. YDMCWV. Or maybe let’s just stick with YDMV for simplicity.

If you have T1D and have been exercising for a while, then you’ll likely know about the many considerations you need to make, such as reducing basal rates, snacking, trialling different meal boluses / timings, types of exercise …… yada, yada . . . list goes on.

Often it takes a lot of time, experimentation and observation to get exercise and blood sugar control right. And there’s nothing to say it will work out the same the next time you decide to hit the gym. There are simply too many variables in any given day for this to be a reality.

Welcome to the maddening reality of T1D.

Working Out when it doesn't Work Out

It doesn’t always work-out and that’s okay. As long as you learn something and can try something different next time, then working out is still worth your time and effort. For me, the physical and mental benefits of exercise outweigh the difficulties I face in blood sugar management.

Here’s what a recent trip to the gym looked like for me:

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All good pre-workout sessions start with thinking about how you plan to stabilise blood sugars. This involves sporting an intelligent, slightly confused, contemplative face.

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I had made changes to the exercise blood-sugar level targets on my Closed Loop System (DIY Artificial Pancreas) the day before. The changes involved keeping my targets set higher to help prevent hypos during workouts.

Serious weight training face on. Check.

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Very soon after my cardio warm-up and only about 10 minutes into weight training, I started to plummet. Even with a reduced basal rate for 2 hours prior, a pre-workout snack and avoidance of other insulin / meals for 4 hours prior.

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And so, juice time! There’s no choice when it comes to hypos and working-out—you have to act fast. Juice is not the quickest rescue remedy out there, but it’s a portable remedy which is easy to chug down.

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And eventually on with exercise. Even though my Dexcom was still LOUDLY alarming everyone at the gym to let them know my blood sugars were low. Which, of course, just sounds like an air raid siren in reality. Nothing too serious.

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Even though my blood sugars were still struggling to stay above normal, I had some Carbs on Board (COB) in the apple juice and biscuit I’d eaten and wanted to visit the steam room and pool. I’m super-lucky to have a Continuous Glucose Meter (Dexcom G6) so I can see my blood sugars on my wrist watch. Surreal, I know, but that’s technology for you nowadays.

However, the CGM relays my blood sugar to my phone. The phone then relays it to my watch. So I need my phone on me at all times if I want visibility of my blood sugar levels on my watch. Dexcom are apparently working on a direct to Apple Watch relay. But for now, iPhone’s are not waterproof and I’m not confident just leaving it poolside. Apple Watches can be waterproof dependent on the model you have.

So it was into the pool with zero blood sugar visibility.

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There was NO ONE at the pool that evening. So after about half an hour, I went to grab my DIY Artificial Pancreatic Parts:

  • iPhone

  • Riley Link

  • Pump

I was still hovering around the 4mmol/L mark and feeling a little hypo, so . . .

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Thankfully our Gym brings food poolside, so we had a rare treat and grabbed a cuppa. This time I even ate the biscuits!

From here, I’ll make some tweaks to see if I can improve things. Such as:

  • Change my Workout Mode targets again, setting them slightly higher so my Loop is aiming for higher blood sugars before and during workouts. This is effectively a percentage reduction or total elimination of basal insulin in the hours before working out, dependent on what Loop decides when looking at current and predicted blood sugar levels against your set thresholds.

  • I usually avoid eating meals in the 3-4 hour period before working out anyway because having any insulin on Board (IOB) spells huge trouble for me, especially if that insulin happens to be hitting it’s peak action time when I start my workout. It’s worth checking with your Hospital on when your particular insulin starts to peak and taper off. I’ll be double checking mine again to make sure I have as little insulin as possible on board.

  • I’ll try different snacks out. Although snacking is not ideal, it is sometimes necessary when working out with T1D. For me, it’s always been a MUST. Basal reductions are there to help prevent excessive snacking. Faster acting snacks or slower acting snacks can be used to treat hypos or help keep blood sugars up for longer periods respectively. Bananas are the most common recommendation I hear for a pre-workout snack, possibly they have both fast and slow acting sugars. Who knows, but worth a try!

  • And speak with my Hospital Team at my next appointment about anything I may be missing.

We will see if it works-out next time.

Have a wonderful day and I’d love to hear how you get on with exercise and blood sugars if you have T1D.

Comments are open, so please let me know below . . .