# Weight training



## Jess810 (Mar 11, 2015)

Hi all,

My husband was diagnosed with Type 1 yesterday and I have a few questions about his exercise regime.

He weight trains 4 times a week, should he be eating a chocolate bar or something similar prior to working out to keep his levels up? It's quite an intensive work out for around 2 hours at a time.

Should he be checking his blood glucose levels during the exercise? Should he modify his insulin intake before or after his workout?

This is all very new to us so any useful tips would be most gratefully received.

Thanks in advance.


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## Northerner (Mar 11, 2015)

Weight training can have quite an effect on blood sugar levels, but it is very difficult to predict and can vary greatly from individual to individual. It's therefore important to establish how HE reacts to exercise by following a methodical testing regime. He needs to test prior to exercise, to make sure his levels are appropriate at the start (not too low and not too high - I prefer to be in the 7-10 mmol/l range), and then test frequently to see which way his levels are going. They may go up initially and drop lower later - again it is a personal thing. He should also keep a good supply of fast-acting sugar close by - something like lucozade or full sugar Coke, or my preference, jelly babies  Chocolate is not ideal as the fat in it slows the digestion and therefore can take longer to raise the blood sugars if they drop low.

He might want to take a look at the Runsweet website - it has all sorts of information about exercise and diabetes (founded by the person who helped Steve Redgrave to his fifth gold medal after his diagnosis!):

http://www.runsweet.com/

Also, I found the Diabetic Athlete's Handbook immensely useful in understanding how different forms of exercise affect the body, so could be worth investing in


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## Jess810 (Mar 11, 2015)

Thanks Northerner. It sounds like it is going to be very much trial and error to begin with to see how his body reacts to different activities. He's not a big fan of sweets so I think we will get stocked up with lucozade and full sugar drinks 

I'll make a note of the website and have a look at it with him tonight.

We have a lot of reading to do over the coming weeks


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## Northerner (Mar 11, 2015)

You do need to be patient to begin with. The events leading up to his diagnosis will have affected his body, and he needs to recover from this also. I lost about 18 pounds in 3 days prior to my diagnosis. I remember that I felt absolutely terrible before, but as soon as they gave me insulin I was raring to go - even thought I might make it to my marathon just a few days after! It took a while to dawn on me just how ill I had become, so tell him not to overdo it!


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## Copepod (Mar 11, 2015)

Welcome Jess810. Do try to get your husband to join himself, too. 

To help you target your reading a little, these pages of Runsweet website are particularly relevant: 
http://www.runsweet.com/StartingSports.html [introduction to exercise physiology, differences between aerobia and anaerobic exercise etc]
http://www.runsweet.com/Gym.html [anaerobic gym work eg weight lifting machines; not specifically free weight lifting, but I'm not sure if that's what your husband does?]. 

As you mention your husband isn't a fan of sweets, one source of sugar he might like, but wouldn't think of, are pureed fruit sachets. Much less sweet & sickly taste than full sugar soft drinks or sports energy drinks or gels. Not as quick acting, of course, but good for maintaining blood glucose levels through extended periods of aerobic exercise - I mainly run / orienteer over long distances, absolute minimum 5km, but up to 3 consecutive days of 20 miles over Lake District hills, for example.


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## Jess810 (Mar 11, 2015)

Hi Copepod, thank you for the warm welcome  I will certainly suggest it to my husband to join, I have found everyone so helpful and friendly and I have only been a member a few hours!

Thanks for the links, I will have a look at them tonight with my husband when I show him this forum

Great tip! He loves fruit so I think he would much prefer to try the pureed fruit sachets to help maintain his levels during exercise. I must say, it's such a relief to read all of the threads and see that people's lives haven't really changed since finding out they have diabetes, I feel a lot more positive than I did yesterday


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## HOBIE (Mar 11, 2015)

Welcome jess & well done hubby for keeping active. Once you have tested & know what is the "Norm" on a workout its hard to know.  But good luck


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## KookyCat (Mar 12, 2015)

Hi Jess
I use nakd bars when I'm exercising, they're dried fruit and nut bars between 13 and 17g of carb depending on the flavour and mix of dried fruit.  They're not quick enough for a hypo but they help me avoid hypos when doing anything physical, and they're convenient.  I also use dried fruit (sultana, mango etc) as a top up which works well.  I really don't like sweets, and can't stand fizzy drinks or juice generally because they're too sweet so I make my own juicy water for exercising where stopping to nibble isn't an option.  I mix natural Apple juice with fresh lime (just a snit) and then dilute it with cold peppermint tea, chill nicely and bingo a refreshing and not horribly sweet drink.  I make sure the apple juice content roughly approximates 15g of carb but that's because I know that will do the trick for me.  Just some ideas for when he's worked out the impact excercising has on him .


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## Jess810 (Mar 12, 2015)

Hi KookyCat,
Thanks so much for the hints and tips, he does like those types of bars so I will add them to the shopping list  He was at the gym yesterday morning (9-11), ate some porridge at around 11:30 and when he checked his levels at 3pm (when he was due to eat again) he was at 4.4 mmols so he was very stressed out and physically shaking from worry. I think I'll suggest he has one of those bars just before he exercises and check his levels more frequently when exercising.


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## Northerner (Mar 12, 2015)

Jess810 said:


> Hi KookyCat,
> Thanks so much for the hints and tips, he does like those types of bars so I will add them to the shopping list  He was at the gym yesterday morning (9-11), ate some porridge at around 11:30 and when he checked his levels at 3pm (when he was due to eat again) he was at 4.4 mmols so he was very stressed out and physically shaking from worry. I think I'll suggest he has one of those bars just before he exercises and check his levels more frequently when exercising.



4.4 is OK if he was due to eat  He may actually have been shaking due to a 'false hypo' - this is when you get the symptoms of a low (below 4.0 mmol/l) blood sugar even when it isn't strictly low, because your body is used to running at much higher levels in the weeks, and possibly months, prior to diagnosis. As you adapt to numbers in the 'normal range, the symptoms should then appear only at lower levels. Having said that, at this early stage it's probably better if his levels were a bit higher than the 4s after exercise, as that is a bit close until he gets a better understanding of his reactions.

Most hypos, by the way, if they are in the upper 3s, are easily treatable with a jelly baby or two, or 10-15g of fast-acting sugar of preference  In the 'olden days' they actually used to deliberately induce hypos in a patient in hospital so they could experience and understand how it felt in a controlled and safe environment. I had my first hypo whilst gardening!


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## Jess810 (Mar 12, 2015)

Ah ok so he may experience these false hypos while his body is adjusting to his "new" levels? He thinks he may have been a bit too ambitious going to the gym yesterday so he is going to give himself a break for a few days until he is feeling 100% up to it.

Do you experience hypos very often? I know everyone will be different but just to give me an idea of what we could expect.


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## Copepod (Mar 12, 2015)

It's impossible to say how many hypos each person using insulin experiences. The key factors are:
[1] Always have something sugary within reach eg sweets in trouser pocket at all times, or fruit puree pouch in rucksack waist belt pocket or bumbag when running or beside weight machine / tread mill / rowing machine etc in gym or on bedside table when sleeping. Then person can treat their own hypo quickly, easily and discretely. 
[2] Always try to work out why a hypo happens eg too much exercise / too much insulin / too little carbohydrate / unusually hot or cold or windy weather etc.


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## trophywench (Mar 12, 2015)

The effects of exercise can last up to 48 hours.  Exercise causes insulin to be absorbed more easily and usually, people need less when they are doing it.

Frankly at the mo, he'd be far better off spending some time fathoming how the insulin he's taking affects his body when it's just being 'normal' - and it's so very very new it could easily change nearly everyday.

Not that doses and routines ever stay exactly the same for massively long periods anyway, but right now when he's still going to be in his 'honeymoon' period, and until the doses and timings can be sorted out accordingly to last him a while it seems far more sensible to not put the body under too much avoidable stress.

Don't stop taking exercise of course - but something a bit less intense maybe?  How long since you went for a walk together?


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## Jess810 (Mar 16, 2015)

Thanks for the advice Jenny, I will pass it on.
My husband saw a dietician on Friday who advised to reduce his morning dose of 4 units to 2 units on the mornings he visits the gym. So today he did that and expected his levels to be low but not too low however, when he got in from the gym and tested his levels they were 17 so obviously much higher than anticipated. He tried calling his clinic for advise but no one was answering (and still haven't) so he started to get very anxious and upset as he had no idea what to do.
We have spoken to someone who knows a bit about Diabetes who suggested he have either 2 units and not eat or have 5 units (an additional 1 to his scheduled dosage of 4) and eat as normal.

Any advice or suggestions on what others do when their levels are higher than expected would be really helpful as we're still feeling quite anxious. Thanks.


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## trophywench (Mar 16, 2015)

Sorry - not enough info there for anyone to make a guess - and it is all guesswork at the moment anyway.

What was his exercise yesterday, what was his BG before he went to bed last night, what was his fasting if he did it, what was it before he ate, and EXACTLY what did he eat?


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## Northerner (Mar 16, 2015)

Jess810 said:


> Thanks for the advice Jenny, I will pass it on.
> My husband saw a dietician on Friday who advised to reduce his morning dose of 4 units to 2 units on the mornings he visits the gym. So today he did that and expected his levels to be low but not too low however, when he got in from the gym and tested his levels they were 17 so obviously much higher than anticipated. He tried calling his clinic for advise but no one was answering (and still haven't) so he started to get very anxious and upset as he had no idea what to do.
> We have spoken to someone who knows a bit about Diabetes who suggested he have either 2 units and not eat or have 5 units (an additional 1 to his scheduled dosage of 4) and eat as normal.
> 
> Any advice or suggestions on what others do when their levels are higher than expected would be really helpful as we're still feeling quite anxious. Thanks.



What level was he at before the gym? The problem with exercise is that, if you have insufficient insulin circulating, then levels will increase because the muscles can't use the glucose. So, you have to find a happy medium. I don't think that I personally would reduce by 50% in one go like that - if I thought a reduction was needed then I'd probably just go for the smallest decrease and work from there - does he have a pen that will deliver doses in half units? How long after injecting was his gym session? I've found that very small doses don't 'last' anywhere near as long for me as larger doses (e.g. small dose = 2-3 units, larger dose 8-10 units), so it's possible that the insulin is 'spent' before the exercise is finished.

I wouldn't exercise with insulin but without food. In the mornings, insulin resistance tends to be greater, plus the liver tends to release more glucose, so getting levels right at that time of day can be tricky. As we vary so much it's very difficult to give recommendations, but when I was working it out I decided caution was the best way forward, just making small adjustments, sticking with the same pre-exercise food, and doing the same exercise in order to reduce the variables. Then I would adjust up or down and take note again. 

You need quite a bit of patience, but it is worth it in the long run. For example, this morning I went out for a run: I injected when I got up, ate a slice of toast about 40 minutes later, then went out for the run about 50 minutes after eating. This gives the food time to start digesting and the insulin to get working. I ran 7.5 miles without needing any extra food and my post-run level was pretty much the same as my pre-run level. This is what I have found works for me. Actually, I rarely test pre- and post-run these days, because I know that I'm going to be OK, although I still take a few jelly babies along with me to be on the safe side!


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## Copepod (Mar 16, 2015)

Also need to know if the exercise he is doing at gym is aerobic or anaerobic or a mixture. See runsweet pages I mentioned earlier in this thread for explanations of effects of different types of exercise on insulin resistance / glucose tolerance.


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## Jess810 (Mar 17, 2015)

Thanks for the replies all and apologies for the lack of information.

His fasting level before the gym (at 8am) was 9.3, then he had a bowl of Crunchie Nut cereal with 1% milk straight after his 2 units of Novorapid, he was at the gym at 9am for two hours doing weight training, which from what I have read on those links you sent Copepod is anaerobic, he said he had taken it easy compared to normal.

His pen does deliver half units, this morning he has taken 3 units before the gym. His level was 6.7 this morning. So if it is high again after the gym, I will suggest he takes 3.5 units tomorrow before his gym session - thanks Northerner.

The course of action he took yesterday was to take 5 units (instead of his usual 4) after the gym at 12pm and have his usual food which was scrambled eggs on a wholemeal thin. When he checked his bg level again at 13:00 his level had dropped to 10 and he checked again quite frequently for the rest of the day and his level was between 6-7 so he was a lot happier and more relaxed.


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