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dunkers7 DAFNE Graduate
NHS Lanarkshire
24 posts

Is there a place you can feedback on what you find useful to manage BGs during exercise? Hopefully by posting here it will help someone...

I was used to seeing a very big drop in blood glucose levels when going out running, starting exercise on a blood glucose of 15 mmol/l and finishing on a blood glucose of 5 mmol/l was not uncommon. Eventually got to the point of actually accepting that the pre-exercise blood glucose had to be a higher than desirable to avoid hypo, just couldn't seem to start off under 12 mmol/l and NOT hypo, I was already reducing insulin and maxed out on how many carbs I could take on during the run.

Now I'm trying a different approach which is over and above the usual advice of reducing insulin and taking on more carbs.

If exercise is close to a meal time, I've started doing the exercise before the meal instead of after it. At first I'd expected going out for a run on an almost fasted BG would be a recipe for a hypo, but it wasn't. It actually seems to help because it (at least partially) isolates one of the things likely to cause a blood glucose drop: the QA insulin.

I initially found out when deviating a little from my normal routine by running before dinner. My blood glucose didn't drop as much as I expected it to. Tried it a number of times now, and consistently I've found the same pattern - the blood glucose drops are less. Basically it means I'm finally able to start exercise on a lower blood glucose, and with less risk of a hypo.

Readings around a 45 min run last night were:

Before - 6.9 mmol/l (took on 2 CPs)
After - 8.1 mmol/l

Maybe it's unconventional, and not quite DAFNE, but it seems to work!

dunkers7 DAFNE Graduate
NHS Lanarkshire
24 posts
Time 08:00 12:00 18:00 19:00 23:00 [18:00] Before 4.5 mile run, took 1 CPs for exercise
[19:00] Test after exercise
CP 5 3 1 5 5
BG 7.0 4.3 7.8 5.0 5.2
QA 5 3-2 - 5-1 5-2
BI 13 - - 14 -
Ratio (QA:CP) 1:1 1:1 - 1:1 -
QA Site Stomach - - Stomach Stomach
BI Site Left Thigh - - Right Thigh -
Ketones - - - - -

Figured that an example should be included to put the above in context. So here's the diary for today.

Rafa DAFNE Graduate
St Vincent's Dublin
99 posts

Trial and error for myself. Eventually found that i need to reduce my morning BI by 2 units and make sure I have no novorapid still in my system when starting my run at 5.30pm. Has worked fine since then. Previously with novorapid still in my system I could be 12.0 starting out but within half an hour I would be down to 5.0

JamesW DAFNE Graduate
Norfolk and Norwich University Hospital
24 posts

@dunkers7, how do you find your levels the next day/24 hours?

dunkers7 DAFNE Graduate
NHS Lanarkshire
24 posts

JamesW, I do find I need to reduce QA and BI after running to avoid hypo during the night. In the example I posted, I reduced QA by 1 and BI by 1 for the exercise. (apologies, should have posted that BI dose as a negative correction)

Have also found that a general increase in physical activity after a long layoff from training has improved my insulin sensitivity a lot in a short time, even on days when I'm not training and well after the 24 hours. That evening BI is now down to 10!

Have done a few basal tests since last week, yet to find out where the BI doses are going to bottom out.

JamesW DAFNE Graduate
Norfolk and Norwich University Hospital
24 posts

Thanks for the further information. Hope the training and dosing continue to stay to form.

Warwick DAFNE Graduate
Diabetes Australia-Vic, Melbourne, Victoria
389 posts

Hi Dunkers, yes I find the same. Exercise in the morning before breakfast will see steady BGs, sometimes even higher BGs when I come back if it has been a long session and my basal has started to run out.

I find that exercise with any QA in my system will almost always lead to hypos, so I try and exercise at least 4 hours after injecting my Humalog.