# Swimming BGs



## Lucyr (Apr 12, 2021)

I went swimming for the first time in a while today, and found my blood sugars a bit odd so looking for some ideas. I used to swim in the evening but it’s only open in the mornings now, and I’m trying to lose weight so would rather combine meals into the routine than have extra snacks.

6:41am BG 6.0. Instant porridge with semi skimmed milk. 30g carb. 0u apidra (cautious first swim).

7:01am BG 6.0 poolside pre swim.
Swam half a mile at a gentle pace, a third slower than would previously take me as cautious first swim.

7:40am BG 5.6 poolside post swim

8:41am BG 11.7 didnt correct

9:32am BG 11.8 Did correction 2.5u Apidra

1:19pm BG 6.5 pre lunch.

I normally have toast for breakfast not porridge but thought porridge would be easier to swim on. Any ideas for why the spike later and how to stop it? Second question is how do I take this knowledge and use it for some kind of plan for evening swims when I am much more insulin sensitive then, or for swims when I swim with more effort and presumably will drop more.


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## helli (Apr 12, 2021)

Congratulations on getting one of the first swimming pool slots. 

I am not a swimmer but I do plenty of exercise. Morning exercise, for me, is very different to afternoon/evening exercise. I assume this is to do with Dawn Phenomenon/Foot on the Floor. 
IN the morning, my liver is extremely diligent in making sure I have enough glucose so will squirt out much more than later in the day. 
For example, I am on a pump - in the morning, I can exercise without making any changes to my basal and my blood sugars stay stable. In the evening, I need to suspend my basal completely to avoid hypoing. I have tried morning exercise before and after breakfast and it makes no difference.

The other thing to consider is that this is your first swim for a while which you have described as "cautious" so you may have been anxious and slightly stressed which will push your blood sugars up. 

If it was me, I would read nothing into this unusual swim (the first time back for a while) unless you see the same again next time, 
I would also be reluctant to make any adjustments to evening exercise based on morning exercise.


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## Lucyr (Apr 12, 2021)

I should have added, I got up at 6am. My bg was stable until after 7:40 so didn’t think it was foot on the floor or dawn phenomenon? I don’t normally get those as my Lantus holds my bg stable without breakfast usually.


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## Inka (Apr 12, 2021)

I agree with @helli I can exercise in the morning and don’t need to reduce basal or even top up with glucose much, but later in the day it’s a different story.


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## Lucyr (Apr 12, 2021)

helli said:


> Congratulations on getting one of the first swimming pool slots.
> 
> I am not a swimmer but I do plenty of exercise. Morning exercise, for me, is very different to afternoon/evening exercise. I assume this is to do with Dawn Phenomenon/Foot on the Floor.
> IN the morning, my liver is extremely diligent in making sure I have enough glucose so will squirt out much more than later in the day.
> ...


Do you mean to bolus as normal for dinner before evening swimming on the times it’s open in the evening? I don’t think that would work given I dropped without insulin before the spike? I was thinking of starting at the same process as for the morning, so 30 carb meal with no insulin. Just not sure if that would be enough, or whether to take some insulin given the spike.


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## trophywench (Apr 12, 2021)

@Lucyr - I reckon you are going to have to try it on yourself - and get your analytic head on after you remove your cossie!


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## Lucyr (Apr 12, 2021)

trophywench said:


> @Lucyr - I reckon you are going to have to try it on yourself - and get your analytic head on after you remove your cossie!


Shame there's no magic answer! Maybe i'll just try more carbs next time and still no insulin, since i dropped with 30g and test test test again!


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## Jaxieb (Apr 13, 2021)

I have also gone back to swimming yesterday and today, my blood sugars are high in the 9’s. I am a bit perplexed as I had brought them more under control with cutting my carbs. I do not eat anything before swimming as in pool about 6.45am and feels better to swim on an empty stomach??


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## Lucyr (Apr 13, 2021)

Jaxieb said:


> I have also gone back to swimming yesterday and today, my blood sugars are high in the 9’s. I am a bit perplexed as I had brought them more under control with cutting my carbs. I do not eat anything before swimming as in pool about 6.45am and feels better to swim on an empty stomach??


Hi Jaxie. Well done on going swimming, are your arms aching today? I don’t know if that could influence blood sugars if your body is recovering today? I’m only a small bit higher than usual today and slightly achey arms, 7.2 this morning compared to 6.0 yesterday.


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## Jaxieb (Apr 13, 2021)

Lucyr said:


> Hi Jaxie. Well done on going swimming, are your arms aching today? I don’t know if that could influence blood sugars if your body is recovering today? I’m only a small bit higher than usual today and slightly achey arms, 7.2 this morning compared to 6.0 yesterday.


I have felt achy and have a little cold and a bit stressed, so maybe these factors have impacted. Hopefully will regulate better soon


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## Lucyr (Apr 15, 2021)

I spoke about this in my recent appointment. The drs thoughts were that the lower bg after swimming was a bit odd, and that it may be I need some insulin but perhaps a half or a third of my usual dose. I gave my plan of trying the same thing again without any insulin to see what happens, and if I go up again then trying the same thing but adding a very small dose of apidra and incrementing up. I’ve booked swimming for Friday Saturday Sunday so plenty of opportunities to try it!


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## Lucyr (Apr 16, 2021)

So today my blood sugars were:

6:45 4.1, 40g carbs, 0u apidra (fruit toast)

7:03 5.1 (poolside)

40 minute swim, 50x25m lengths, moderate effort

7:51 6.6 (post swim and shower)

8:43 11.9 (corrected 2u)

12:01 5.2

So I guess I need some insulin with breakfast. Really nervous about taking insulin right before I swim though!


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## Lucyr (Apr 17, 2021)

Here’s today’s swimming blood sugars

2pm 6.1, 60g carb, 3.5u (half dose)
2:40pm 5.2 pre swim, swam 35 minutes, 1km (40 lengths)
3:20pm 4.2 post swim
4:30 7.3

Any ideas on stopping this dip after I finish swimming or rise after I finish? Looks like I need the carbs to fuel the swim, and need the insulin after I swim, but not sure how to get the timing right.


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## Lucyr (Apr 21, 2021)

Yesterdays blood sugars were
7am 7.5
7:30am 2.0

Swim booked for tomorrow. There is a theme of blood sugars dropping a bit when I swim so my plan is going to be lower carb breakfast of 1 slice toast with half bolus (if I haven’t taken much insulin it theoretically can’t go as wrong).

Then a small 300ml water bottle with 20g carb of pure orange juice and topped up with water, at the end of the lane to top up my bg half way through.


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## Lucyr (Apr 22, 2021)

So in good news I didn’t drown or need assistance or go low at swimming today. In bad news I felt sick through the swim (from the orange juice i think) and have no clue what to do to stop the post swim spike.

FBG 6.5. 1 slice toast with ham, 15g carb, halved bolus so 1.5u instead of 3u

Before swimming 7.1

During swim had 200ml OJ with 150ml water to dilute. 20g carbs. Had some before starting, stopped 2-3 times during my 40 lengths for a bit more and drank it all by the end.

Immediately after swimming 6.5 

When I got home half an hour later 12.9. Done my normal correction ratio for that plus for 10g carbs of a milky coffee and I’m sure it will come down, but really want to figure out how to stop the post swim spike!


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## helli (Apr 22, 2021)

My advice would be to enjoy your swim, dose for the spike afterwards and not worry unless it makes you feel unwell. 
Given the spike is for a short time and you handle it, I don't think it will have a major impact. 

If you are always high when you get home, could you preempt the rise and take a correction bolus immediately after your swim?

Do you have a Libre or are your finger pricking?
If a Libre, bear in mind it tends to be less accurate when high so your 12.9, may not be as high as you think.


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## Lucyr (Apr 22, 2021)

Thanks I might have to go with that. I use fingerpricks, I do occasionally use a freestyle libre but only when I can afford them. Whilst I’m on MDI and don’t particularly seem to be insulin resistant, more seems to be that I can’t produce enough insulin, im not eligible for things like libre/pump/dafne courses because I’m T2.

The reason the highs after frustrate me isn’t that they make me feel ill, and as you say, they do come down with a correction, it’s just that the correction takes 4 hours to finish working. So when I corrected the 12.9,  2 hours later I was at 9.0, and 4 hours later I was at 6.4. In the interim period my blood sugar has a couple of hours of being high that seem a bit pointless when my blood sugar was doing so well until I finish the swim.

Ultimately, I guess if the swimming is doing more overall benefit for blood sugars, weight, heart health, whatever else it does for you, than the 4hrs of being slightly high after does damage, then it’s probably a case of accepting that you can’t get perfect results and correcting as soon as I finish swimming.


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## Lucyr (Apr 24, 2021)

On Thursday night, which was the first swim after the hypo, I had a super long low bg. It must have taken 200g carb to fix, It wasn’t super low, 3-4s, but just wouldn’t go up. I had had an hour walk that evening but only a stroll and doesn’t usually affect my bgs. I don’t think I can have mixed up my basal and bolus as my bolus pen is a junior one that doesn’t dial up as far as my lantus dose.

I chalked it up as just one of those things and went swimming again on Friday. Only a short swim as I was late but BGs were fine and I did start to think I might be on top of this swimming stuff other than the odd dodgy day, and should start relaxing into my swims.

bgs were
12:00 pre lunch 6.2, 60g carb, 4u (half bolus)
2pm +2hrs and pre swim 8.5
2:50pm post swim 8.5
Spiked to 13 an hour later, but came down to 6.4 before tea.

As it’s the weekend and I don’t need to be back for work, I might experiment with a small bolus post swim, though probably accompanied with a little snack in the sun!


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## Lucyr (Apr 25, 2021)

The bgs still all seem a bit random, but from experience now today will be the 8th swim / 2 weeks of back to swimming, I should start to reach the point where swimming doesn’t affect my blood sugars.

For yesterday’s swim I had to get out as felt too low. Was in the 5s before getting in so had some carbs, had the orange juice at the end of the lane and drank after 20 lengths and again 1st 30 and then finished the bottle at 36 lengths when I felt my bg drop. I had a rest and tried another lap but felt too low for it to be safe continuing and got out, bg 4.3.

Had another low of 3.0 at 3-4 hours after dinner too. Not sure if it’s basal or bolus but lows most days this week mean I’m going to cut back the lantus and dinner apidra tonight to see if that helps even things out.


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## SB2015 (Apr 25, 2021)

Hi @Lucyr 

It sounds like you have got a good plan for your swimming.  Things will still vary with the weather and will need tweaks. I found that I needed to reduce my basal when I was doing a swim training session.  That is easier for me as I am on a pump, but you have already got your head round changes to make.

Like you I had my diluted juice at the end of the lane.  I also used a Libre sensor which helped as I was able to just swipe to see my levels (big enough numbers to see without glasses) and then decide if I needed more juice.

I still haven’t got back in the pool! Keep posting and you will get me there.


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## Lucyr (Apr 25, 2021)

SB2015 said:


> Hi @Lucyr
> 
> It sounds like you have got a good plan for your swimming.  Things will still vary with the weather and will need tweaks. I found that I needed to reduce my basal when I was doing a swim training session.  That is easier for me as I am on a pump, but you have already got your head round changes to make.
> 
> ...


Thanks, I think I struggle with it being so unpredictable? Some days it is fine and some days it isn’t and there doesn’t seem to be a pattern to which is which. I’m going again this afternoon and will probably try a protein/veg based lunch today so I don’t need to bolus and see how that goes, as the swims yesterday and today were 2hours after lunch ish, so a long time after to not bolus for it.

You should definitely get back to swimming, I’m only going 3-4 times a week at the moment and not doing much, only about half a mile a session, but will hopefully build it up a bit.  I already feel like I permanently smell of chlorine and feel much more energised, even if the bgs have been a bit scary some days!


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## SB2015 (Apr 25, 2021)

Lucyr said:


> I’m going again this afternoon and will probably try a protein/veg based lunch today so I don’t need to bolus and see how that goes, as the swims yesterday and today were 2hours after lunch ish, so a long time after to not bolus for it.


It is a juggling act manageing  this all, but just think what we save on not needing puzzle books to keep our brains active!!

I was interested in your not needing to Bolus for your protein/veg lunch.  I love a good veg stew, and I am always surprise when I tot up the carbs in them even without the obvious culprits of potatoes or sweet potatoes.  I find I still need to Bolus for these but no where as much as a potato feast.  When I was checking my insulin rates I found that if I ate just protein I still needed to Bolus a tiny bit , because in the absence of any carbs, my body tucked into the glucose it grabbed from the protein.  That sort of thing just keeps us on our toes, and I eventually find the patterns in my results, and then it all changes again!!

As you say if you are exercising a long way after the meal, adjusting those doses don’t help.  For me then it is only having the extra carbs which works.  For that reason I preferred to exercise after I had eaten, but it was not always be possible.

Keep at it.  Keep looking for patterns.  Your brain will get lots of exercise with this, which is such a benefit!!


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## Inka (Apr 25, 2021)

I used to swim after my meal too. I reduced my bolus for that meal, and also top up with carbs before I got in the pool. I tended to always swim at the same time because I knew that worked. I also stuck to the same meal (pasta) - again to try to add some consistency. My pre-swim snack was a sweet chocolate bar (a Fuse or Boost) and I found that sustained me all swim. I had Dextro by the pool if I needed more glucose.


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## Lucyr (Apr 25, 2021)

@SB2015 i haven’t actually tried not bolusing for a meal for a while, even veg contains carbs even if it’s only 10 or 20g etc so I usually bolus for everything. But where the aim is being slightly higher before swimming whilst minimising extra calories I thought worth adding to my experimentation pile.

@Inka it would be so much easier if you could pick what time you swim to just have the same time every day! Not how it works with Covid restrictions and prebooking though. I do roughly have the same times now though of 7am Monday to Thursday and 2-2:30pm start for Friday to Sunday sessions, each session lasting 45 minutes, though I’m only doing about 30 till I get settled into it.


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## trophywench (Apr 25, 2021)

Remember - exercise you did 48ish hours ago can still be affecting your BG.  Trial and error ......


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## Inka (Apr 25, 2021)

Yes, my regular swim was pre-Covid @Lucyr I should have clarified that. I’ve not been for ages now due to Covid, and also being a single parent now, my swimming sessions usually involve children and are far less predictable!

I did find the reduced bolus and after-meal thing worked best for me though. I left it long enough after my meal to not be uncomfortable but went as soon as I could after taking that into account. I reduced my bolus by 1/3 normally, but depending on circumstances it could be between 1/2 to 1/3 reduction. I felt having the food and some insulin on board helped my swimming too, but I’m Type 1 and it might be different for Type 2s.

Out of interest, are there any restrictions or changes in the pool? Reduced numbers I presume, but any other changes?


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## Lucyr (Apr 25, 2021)

Inka said:


> Out of interest, are there any restrictions or changes in the pool? Reduced numbers I presume, but any other changes?


There are a lot of changes! Only one thing happens at a time, for 45 minute sessions with gaps between the sessions, no more family swim or lessons over one side with lanes roped off for lane swimming etc, it's either family swim, or lane swim, or lessons. The lanes are double-width, 10 spaces in each at mine and you need to prebook, i quite like this as theres more space and you know in advance how busy it will be, but it is more restrictive with not many sessions available for swimming. There are penalties if you cancel short notice which is good for discouraging people to book everything up.

When you get there, you cant use the changing rooms before swimming or use the lockers. You arrive pool ready, take shoes off at the door and walk barefoot to an x marked spot round the poolside, take clothes off on your spot (i just wear shorts and a jumper over my costume) and leave your belongings on your x whilst you swim. 

During your swim you cant overtake, or swim splashy strokes like butterfly, or strokes where you may bump into someone like backstroke. If you need a rest you're supposed to wait till no one else is resting so that you keep distance at the lane end.

After your swim, you need to leave as soon as possible. drying as best you can poolside then shower and change at home. My pool have now opened changing rooms for anyone who does need to get changed (e.g. if swimming on their way to work), though these are discouraged.


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## Inka (Apr 25, 2021)

Oh, blimey!  Lots of changes indeed! I was thinking about the logistics of taking the children, but I think I might leave it a little longer!


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## Lucyr (Apr 25, 2021)

Inka said:


> Oh, blimey!  Lots of changes indeed! I was thinking about the logistics of taking the children, but I think I might leave it a little longer!


Every pool has different rules so you should be able to find them for your pool on their website. For kids swimming at mine the rules are the same as the lane swimming rules above - come ready to swim etc, but the added rule of bring your own toys they won't be provided, don't share them with other families, keep distance from other families etc. Personally i'm not too concerned about using the changing rooms, but there are less of those too as even though theyre open a lot of cubicles are closed for distancing. I just get out 5-10 minutes before the end to grab a shower and a changing room, but the majority at my pool do just change poolside. They aren't as concerned at stripping off in a glass walled public place as i am!


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## Inka (Apr 25, 2021)

Just had a look. My pool sounds very similar. Pre-booking only, less changing rooms and showers, less and wider lanes, no flume, and arrive ready to swim if possible.

It’s a bit stressful at normal times with the annoying D and excited children, so I think I’ll need to psych myself up to have a go with the new restrictions I’m slightly concerned about the air quality there too, so might wait until I have my second vaccination. It’s weird trying to get back to a semblance of normality.


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## Lucyr (Apr 25, 2021)

I think the answer to all this is that confidence is the most important factor. My blood sugar dropped quite a bit (from 7.7 to 4.3) during the swim today, perhaps as I had had a small chicken salad beforehand and not any carbs so a bit more would be good, though I drank my orange juice during it.

Today I found knowing and reminding myself that I didn’t have any apidra on board, and that I was drinking orange juice during to help keep my levels from dropping too much, that there was lucozade in my bag if needed, and that the lifeguards know how to recognise and treat a hypo, all combined together to help me relax into the swim a bit and I swam better than previous days (though I still had to get out early as I felt low).

I think I’ve finally settled on a plan! Not more than a couple of units apidra in the 4 hours beforehand, diluted juice at the end of the lane with at least 20g carbs, lucozade in my bag, and do some kind of waving my medical id at a staff member if a low is feeling serious...


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## Lucyr (Apr 27, 2021)

Well today was a weird one. Didn’t sleep much last night so went swimming early as I was up anyway, but forgot the impact lack of sleep has on muscles and didn’t swim well so kept it short. I did feel like my confidence is growing though.

7.3 before breakfast (small banana 20g carb, 2u half bolus)

Only did 20 minutes swim, drank 35g carbs of orange juice during in an attempt to get some energy into my swim. 

Post swim 7.3. Bolused for half of the OJ (3.5u) as know I had more than I needed.

1hr post swim 5.8. With most of the extra 3.5u still to go on top of the 2u from earlier.... I’ve had some toast as that’s like 4u left. Stick to a 1-2 units correction post swim next time!


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## Inka (Apr 27, 2021)

Getting the right balance is one of the hardest - and most frustrating - things about diabetes and insulin. It sounds like you’re doing well @Lucyr Often it is just a case of a nudge this way (carbs) or a nudge back that way (insulin), and sometimes more than one nudge of each!


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## trophywench (Apr 27, 2021)

Trial and error - and if you're like me - the errors certainly still sink into the recesses of my cranium much more lastingly than the successes!


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