# Exercising BG goes down



## James B (May 9, 2020)

Hi I’ve recent started to get back into walking and have been on two walks this week. I’ve found my BG goes down if I walk longer than 45 mins so I take jelly babies with and have four to bring them back and also take a bag of crisps but I’ve found no matter what I do the BG goes back up and then comes hurtling down which means I eat a lot more carbs to bring them back up which kinda defeats the purpose of walking to lose weight. Does anyone have any ideas on how I can keep the glucose up after the jelly babies and bag of crisps? I’ve also tried fruit a banana and an apple and it just doesn’t seem to want to go back to being steady it’s really demoralising me as I’m desperately wanting to get back into being fit and healthy. I used to before the diagnosis walk 15km a day now I can just about do 10000 steps before my legs are jelly and walking is the one exercise  I enjoy doing for fun


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## Inka (May 9, 2020)

Hi @James B Yes, it’s annoying to have to eat when you do activities. It always used to make me feel strangely guilty. 

It depends when you walk. I have a pump so can set a temporary basal rate for exercise, but when I was on injections, if I was, say, walking after lunch, I’d slightly reduce my lunchtime bolus or/and eat more carbs for lunch. I then topped up on my walk as needed with glucose tablets and extra carbs. I always find flapjacks good as they have a mix of fast and slow carbs.

If you’re able to walk at the same time each day to start with and may end even do the same walk, you can get an idea of what works for you.


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## James B (May 9, 2020)

Inka said:


> Hi @James B Yes, it’s annoying to have to eat when you do activities. It always used to make me feel strangely guilty.
> 
> It depends when you walk. I have a pump so can set a temporary basal rate for exercise, but when I was on injections, if I was, say, walking after lunch, I’d slightly reduce my lunchtime bolus or/and eat more carbs for lunch. I then topped up on my walk as needed with glucose tablets and extra carbs. I always find flapjacks good as they have a mix of fast and slow carbs.
> 
> If you’re able to walk at the same time each day to start with and may end even do the same walk, you can get an idea of what works for you.


I keep hearing that word bolus... what does it mean? So you think by increasing my lunch time carbs and still count the carbs eg 43 taking the correct insulin 4 units it should help?


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## Inka (May 9, 2020)

James B said:


> I keep hearing that word bolus... what does it mean? So you think by increasing my lunch time carbs and still count the carbs eg 43 taking the correct insulin 4 units it should help?



Sorry! A bolus is an injection of your fast acting insulin for food. So if you have 4 units before your lunch that’s your lunchtime bolus. 

If it was me, I’d try eating the same lunch (ie same amount of carbs) but having less insulin. So, if you normally have 4 units for 40g carbs j_ust as an example_, then I’d try having 3 units and the same 40g carbs. If that works out almost right with your blood sugar but not quite because it still a bit lower than ideal on your walk, you could then add a few more carbs eg take the same 3 units but have 45g carbs rather than the 40g carbs.

Again, all those figures are just examples. The basic idea is to reduce the mealtime insulin before your exercise session. As I said, you can opt to keep the mealtime injection (bolus) the same and up the carbs as that will have a similar effect. You can also do a combination of the two - a little less mealtime insulin, a few more carbs. You should then find you need less ‘top up glucose/carbs’ on your walk, but you’ll probably need some. Always take more glucose and carb snacks then you think you’ll need.


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## James B (May 9, 2020)

Inka said:


> Sorry! A bolus is an injection of your fast acting insulin for food. So if you have 4 units before your lunch that’s your lunchtime bolus.
> 
> If it was me, I’d try eating the same lunch (ie same amount of carbs) but having less insulin. So, if you normally have 4 units for 40g carbs j_ust as an example_, then I’d try having 3 units and the same 40g carbs. If that works out almost right with your blood sugar but not quite because it still a bit lower than ideal on your walk, you could then add a few more carbs eg take the same 3 units but have 45g carbs rather than the 40g carbs.
> 
> Again, all those figures are just examples. The basic idea is to reduce the mealtime insulin before your exercise session. As I said, you can opt to keep the mealtime injection (bolus) the same and up the carbs as that will have a similar effect. You can also do a combination of the two - a little less mealtime insulin, a few more carbs. You should then find you need less ‘top up glucose/carbs’ on your walk, but you’ll probably need some. Always take more glucose and carb snacks then you think you’ll need.


That makes perfect sense as carbs bring BG up and Insulin brings it back down so by taking less _bolus_ insulin it will mean your BG will be higher for the walk and won’t drop as low and keep it more steady. Thank you for making it simple to read I’ll give that a go later today and come back with results, Cheers Inka!


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## Inka (May 9, 2020)

Good luck   As with most things, it’s a case of trial and error.

I also forgot to say that ‘liquid glucose’ in the form of a sugary drink eg regular sugar coke, can be good if you’re fed up with the eating. I often take a bottle with me on longer walks, especially in hotter weather.

Swig as needed!


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## Robin (May 9, 2020)

I had to give this some thought, as OH and I have been going out for walks after lunch regularly over the past 6 weeks. As you say, exercise for losing weight doesn’t work if you have to eat more!
 I find reducing lunchtime insulin works, but I get a spike higher than I’d like before the start of the walk if I then eat my usual amount. I’ve adopted the strategy of reducing the lunchtime insulin, reducing the amount I eat, but taking with me something like a banana, to replace what I would have eaten at lunchtime anyway, then eating half of it after 40 minutes, and the other half after another 40minutes. Seems to keep me level, without any up front spike, and with no extra overall food consumpton. (I may be a bit slow, it took me a week of hypoing after 40minutes, followed by a week of spiking too high before the walk, to work this out!).


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## SB2015 (May 9, 2020)

It is indeed irritating to have to eat to deal with lows when exercising.

My plan is the same as @Robin. I tend to eat after a meal.  I reduce the carbs a bit, and also reduce the insulin for the amount of carbs that I am actually eating.  I then take extra carbs whilst I am walking.  Usually an apple as I set off, then a trickle of Wuthers during the walk.  I am using a Libre so I get a picture of what is happening to my levels and head off lows.  I am also using a pump so I am able to turn down my background insulin so need less additional carbs.

It was this issue that was my main reason for wanting a pump.  On injections if I was wanting to walk for the whole day I would reduce the background insulin at the start of the day.  For shorter walks I went after a meal and followed the plan above.

I hope that helps


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## James B (May 9, 2020)

Hi Guys. So i tried a couple of different things on today 12 KM walk. I didn't have a lunch today because I woke up way to late so had leftover starry about 11am and took correct _bolus. _Went out for the walk about 15:50_. _I drank a 150ml coke which sent my BG up to 9.1 when i got to the park to start the walk, about 35 mins later i could feel the BG dropping and i was at 5.3 so I had an apple, this didn't work at all and the BG continued to go down to 4.1 about 20 minutes later so I took Inka's advised and drank more coke which took me up to 4.3 20 mins later so i finally had a piece of flapjack and then it was time to go home and I've just arrived home about 10 minutes later and im at a steady 5.0 probably gunna eat a banana now. But thanks everyone for your suggestions!


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## James B (May 9, 2020)

SB2015 said:


> It is indeed irritating to have to eat to deal with lows when exercising.
> 
> My plan is the same as @Robin. I tend to eat after a meal.  I reduce the carbs a bit, and also reduce the insulin for the amount of carbs that I am actually eating.  I then take extra carbs whilst I am walking.  Usually an apple as I set off, then a trickle of Wuthers during the walk.  I am using a Libre so I get a picture of what is happening to my levels and head off lows.  I am also using a pump so I am able to turn down my background insulin so need less additional carbs.
> 
> ...


How would I go about altering my background insulin I'm on 24 units on a normal day, I plan to walk 10km everyday would you advise going down to 22 and see if this helps or would you start lower? My understand is background insulin keeps you steady throughout the day current 24 units keeps me around the 5.4 - 7.2 mark throughout the day I feel this may be a question for the diabetic health team though.


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## Inka (May 9, 2020)

@James B That’s a brilliant result   Well done! It’s so hard to start with and fitting diabetes into your life isn’t fun, but it can be done

(And you get to pick up exciting vocabulary like ‘bolus’ too  )


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## James B (May 9, 2020)

Inka said:


> @James B That’s a brilliant result   Well done! It’s so hard to start with and fitting diabetes into your life isn’t fun, but it can be done
> 
> (And you get to pick up exciting vocabulary like ‘bolus’ too  )


I think I took food and exercise for granted before the diagnosis! There is so much more to think about now just make sure I'm well enough to function and enjoy what I'm doing. But I don't want it to stop me from doing things I enjoyed prior to the diagnosis there's no point as I have it for life now I can either be scared and totally change who I am or embrace it. My next questions will be about alcohol I've not had a drink in 13 weeks and once lockdown ends I am very sure I'll be have a few/a lot of beers to celebrate! So get ready for that one Inka!


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## James B (May 9, 2020)

Inka said:


> @James B That’s a brilliant result   Well done! It’s so hard to start with and fitting diabetes into your life isn’t fun, but it can be done
> 
> (And you get to pick up exciting vocabulary like ‘bolus’ too  )


Also it's pretty stressful checking the BG constantly and before I wouldn't do it in front of anyone but doing on the walk past few days no-one really notices so the next hurdle will be taking _bolus_ in front of people but again I'm pretty confident no-one will say anything cuz they'll find it awkward, best thing I can do is act like its natural to do so, as it is normal for me!


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## Inka (May 9, 2020)

Like all things with diabetes, having a drink or two is fine   You just have to give it a bit more thought and always have the diabetes in mind.

Most people think my blood sugar meter is a phone so that’s ok. I’ve had Type 1 for years but I do remember the early days and being very, very shy about doing my injection in front of people. I got over that gradually. People have never said anything to me (apart from one nasty person at work, but she was soon told off by management) The only time I heard a comment was from a young child and that was just them asking their parent out of interest. Most people either don’t notice or aren’t interested. If you think about it, you’ve probably been in public places with Type 1s before and they probably tested and injected - you just didn’t notice 

Once you get smoother and quicker at doing the injections, it’s easy to be swift and discreet. And if people do ask about it, it’s usually out of interest and that’s ok because it’s an opportunity for them to learn more about Type 1 and diabetes in general, so that’s a good thing.


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## SB2015 (May 10, 2020)

James B said:


> How would I go about altering my background insulin I'm on 24 units on a normal day, I plan to walk 10km everyday would you advise going down to 22 and see if this helps or would you start lower? My understand is background insulin keeps you steady throughout the day current 24 units keeps me around the 5.4 - 7.2 mark throughout the day I feel this may be a question for the diabetic health team though.


If you are using a background insulin that is once  a day, you cannot use that to account for any exercise.  I only used this option once I was using a split dose of Levemir. With a morning and evening injection I was able to adjust the day time without impacting the evening dose.

Your only option is to juggle reductions in Bolus (quick acting) insulin and eating additional carbs.
It will then be easier if you are able to time your exercise to be after a meal.  That is no bad thing as it can also help to reduce post meal spikes.  As with all things to do with Diabetes it is a case of trial and improvement, to work out what suits you.  It may be worth asking your DSN if you could look at switching to Levemir and split this.

As I said before it was issues around exercise that was a motivator for me to switch to a pump, which gives so much more flexibility.  We were asked to switch to the split Levemir fro a while before going on to our pumps as this was the closer match to the behaviour of the pump.


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## SB2015 (May 10, 2020)

James B said:


> Also it's pretty stressful checking the BG constantly and before I wouldn't do it in front of anyone but doing on the walk past few days no-one really notices so the next hurdle will be taking _bolus_ in front of people but again I'm pretty confident no-one will say anything cuz they'll find it awkward, best thing I can do is act like its natural to do so, as it is normal for me!


As you say if you just get on with it no one seems to notice testing and injecting.  The only time someone  noticed me doing it in a pub was when she was doing exactly the same.  We just exchanged a smile.  

It will soon become your new normal and you will start to do it automatically.


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## James B (May 10, 2020)

Just to add to this I found a really helpful chart for exercise i've attached it if anyone else thinks it may be helpful for the future!


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## Inka (May 10, 2020)

Good point about ketones in that chart there. I was told not to exercise if 13 or above. It also gives a good guide to how much to eat. I tend to swig or nibble as I go along if I’m only taking moderate exercise, but for anything strenuous I eat more in one go. 

As with anything Type 1, it’s getting that balance right between going too high and going too low. You might also find some forms of exercise push you high. I don’t find this really, but I know some people do. But I do find exercise early in the morning has a different effect than later morning and during the day.


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## Deleted member 25429 (May 11, 2020)

I’ve started counting steps , my target is 12,000 a day . Yesterday sugar levels were a pain as they kept dropping reducing my lantus and much better today . Early morning exercise means no novarapid for me at breakfast or lunch , just need some in the evening


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## SB2015 (May 11, 2020)

Freddie1966 said:


> I’ve started counting steps , my target is 12,000 a day . Yesterday sugar levels were a pain as they kept dropping reducing my lantus and much better today . Early morning exercise means no novarapid for me at breakfast or lunch , just need some in the evening


As with all things Diabetes, it is a case of finding what works for each of us, and then monitoring that and watching for any changes needed.


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