One of the questions I get asked the most from non diabetics with regards to exercise is, "How do you do it?"
My first response is always, "Very carefully."
Which I then follow up with, "Trial and error."
Every diabetic knows that diabetes is entirely unpredictable with a zillion factors that ultimately effect the outcome. We also know that no two of us are alike. (Like a beautiful snowflake? *gag* ha). Basically what works for me, is highly unlikely to work for someone else.
This week I spent a bit of time trying to analyze some blood sugar outcomes. Since having to switch my workouts to the evenings again I've been struck with so many issues that I was happy to not have to deal with for awhile. My insulin sensitivity in the morning is absolute crap. I take 3 times more insulin in the morning than I do for the rest of the day. This means that I can easily work out without having to lower my insulin or make any special requirements. It's pretty awesome. Makes me feel like a normally functioning human being.
Three days in a row I did the exact same workout at the exact same time on my trainer at home.
Day one I set my temp basal for -70% 1.5 hours ahead. I went low mid-way and again at the end. I treated my low with only 10g of carbs because I knew if I had any more than that I would rebound. I set another temp rate at 160% for 3 hours as soon as I was done. Later in the evening my blood sugar jumped up to an 18mmol/l (325mg/dl). I chased highs all night.
Day two I set my temp basal for -80% 1.5 hours ahead. I finished a bit higher than expected. I then set another temp rate at 180% this time for 3 hours. I hit 16mmol/l (288mg/dl). I chased highs all night.
Day three I didn't want to do the same workout again but my desire to see some results trumped my boredom. I set my temp rate for -75% (in between the previous two days). My blood sugar stayed mostly steady during the ride and I finished with a perfect number. I immediately set a temp at 200% for 3 hous and at the same time bolused 2 units. I didn't chase highs all night :) I went to bed with normal blood sugar.
The biggest thing I learned? I have a SERIOUS problem with post exercise highs. This frustrates me because I feel guilty when I am hungry after a workout because I know it will never end good. It also concerns me that my body requires SO MUCH insulin after supposedly working out. I mean, that much insulin means that there is glucose in my blood that needs to get into my body. Glucose = calories that I just spent an hour burning off.
I know from experience that I can go very low and often during evening workouts because I am very insulin sensitive at that time. But whatever I'm doing right now just doesn't seem to be good enough.
I thought about trying to NOT use a lower pre exercise temp basal, or maybe half the reduction. I am really interested in trying some other way of managing this. I am wondering what would happen if I eat something an hour ahead and not set a lower temp basal rate. I question if the food would sustain the exercise and maybe I won't dump so much glycogen and end up with those evil post exercise highs?
Are there people out there that are able to maintain normal blood sugar before, during and after exercise?!