# Hello



## NatB (Mar 17, 2012)

Hello All, I have type one diabetes which I have had for several years. I am currently using an insulin pump. I am experiencing frequent hypos during and after exercise. Have found it very interesting that I am not the only one in this situation. I have tried everything that I have been advised to do including dropping my BG insulin before and after exercise, having fresh orange and a snack afterwards but I just can't stop the hypos. Sometimes it can be the next day after exercise. I am running twice a week doing four miles and body pump once a week. I have also tried increasing my carb intake but nothing works. Any ideas would be really appreciated. My kind bro has ordered me the book that some of you have advised. Can't wait for that to come! 
I am so pleased I have found this forum as I feel somewhat normal again .
Thanks


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## Northerner (Mar 17, 2012)

Hi NatB, welcome to the forum  By the book, do you mean The Diabetic Athlete by Sheri Colberg? If so, it is very good. Exercise can make you extra sensitive to insulin for up to 40 hours afterwards (well, it does in my case!). Are you adjusting your basals as well as your meal bolus? ome people find that they need no insulin at all during exercise, but I'm the opposite to that! I once read about a Swedish Type 1 marathonrunner who would take no insulin at all diring a race, I would just go high! It's a very individual thing so you need to be very methodical, do lots of testing and try not to change too many things at once. 

I look forward to hearing more from you!


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## margie (Mar 17, 2012)

Welcome to the forum Nat. There are quite a few pumpers on here - so hopefully one or more of them will be able to come up with a strategy that will help you.

Hope you enjoy the forums.


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## Pumper_Sue (Mar 17, 2012)

Hi Nat,
welcome to the forum 
There's a website called run sweet which might be of some help to you, plus the book pumping insulin by John Walsh.
Have you also looked into how long before you exercise you drop your basal?
Do you have seperate basal patterns for exercise days as well?


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## HOBIE (Mar 17, 2012)

Hi Nat B. Good luck with book. How low are bgs ? & what is before & after ?


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## NatB (Mar 17, 2012)

*Thank*

Thanx for the quick replies! I have been on the run sweet website and have tried some of the advice on there. I have dropped my ratios 10% at meals. I also drop my BG two hours before I exercise and double the amount after the exercise. Thought I had sorted it Thursday evening But Went to body pump Friday at 9.30 am  and ate carbs at breakfast. Level was 8.7 before workout and when I came out it was 2.7. I had also had two dextrose tabs before workout. I ate a banana and had a couple of dextrose tabs and it was 11.2 after an hour. Feel frustrated with it all at the min. Going back to see the diabetic nurses next Thursday. The book my bro has ordered me is The Diabetic Athlete by Sheri Colberg.


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## trophywench (Mar 17, 2012)

How do you mean drop your BG before exercising?  do you mean your insulin to carb ratio?  

And have you tried testing halfway through exercising? - how high do you go? - am thinking reactive hypo here ? ? ?


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## NatB (Mar 18, 2012)

*B G insulin*

Hi I drop my BG insulin on my pump 70% for two hours before my workout and if I workout for an hour will drop it again for another two hours. When I have my lunch I take 10% off My food ratios. Levels usually drop to 2.0 or 3.0. I have tried dropping my BG 10% all day but woke up the next day with a level of 15.0.


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## Steff (Mar 18, 2012)

Nat hi and a warm welcome to the forum


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## HOBIE (Mar 18, 2012)

On the face of it i think you are doing to much with pump ?   I did 2.5mile in 15 mins on mountain bike up & down hillicks. Had a choclate bicky for reward a little bit lower bg but nothing to worry about. Keep at it


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## gail1 (Mar 18, 2012)

hi and wellcome to the forum


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## Pigeon (Mar 18, 2012)

Hello Nat!

I do a lot of exercise too, I'm on injections though not a pump. Just thought I'd say that if I exercise within about 3 hours of a meal I would halve my insulin with that meal, as I find on board fast acting insulin has a massive effect when you exercise. So I would suggest you are doing the right thing, but need to drop your insulin with your meal beforehand by more than 10%!


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## Mark T (Mar 18, 2012)

Welcome to the forum Nat


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## slipper (Mar 18, 2012)

Hi Nat, welcome


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## Julia (Mar 18, 2012)

Hi Nat, welcome to the forum!
I have a pump too as I was really struggling with levels during and after exercise. I completely agree with Pigeons comment. I do exactly as you do, reducing basals 60-90mins or so before start of exercise, but I find I really have to be conscious of when I last bolused. 
Does you pump tell you "bolus on board" ie extra insulin kicking around from when you last bolused. If there is any left ie you bolused within last 4-ish hours, that extra insulin works extra well during exercise.
If I bolus within 2 hours of starting a run, I'll reduce my bolus by at least 50% (ie a lot more than your 10%). 
If I've had a meal 3-4 hours before it's more problematic as don't want to go high by not covering all carbs, but if still some bolus on board when start exercising tend to drop, so see what extra insulin is still on board and cover it with extra "free" carbs. Sorry if that sounds really complicated but I wanted to tell you what I've found that (sort of, mostly) works for me.
I would say start experimenting with reducing your bolus more, if eating close to exercising. And the book is definitely worth a read.
Let us know how you get on.


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## HOBIE (Mar 18, 2012)

Hi Julia, i am on same pump as you for more than 2 years aswell.  Yes you have to adjust but i never really sit still for long normally.


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## NatB (Mar 18, 2012)

*Low BG*

Hi all, many thanks for all your advice going to give it a try on Tuesday when I go for a run. Will let you know how I get on! Really appreciate all your help. Nice to know I'm not the only one in this situation. 
Sometimes feel like giving up on the exercise which I know isn't the right thing to do!


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## Pumper_Sue (Mar 18, 2012)

NatB said:


> Hi I drop my BG insulin on my pump 70% for two hours before my workout and if I workout for an hour will drop it again for another two hours. When I have my lunch I take 10% off My food ratios. Levels usually drop to 2.0 or 3.0. I have tried dropping my BG 10% all day but woke up the next day with a level of 15.0.



When you say you drop 70% are you actually then only dropping your insulin by 30% as in the pump is saying 70% basal? I know so many people make this mistake so just checking 

Have you thought about perhaps running a 50% basal for 4 hours before your run plus reducing your insulin for meals?


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## NatB (Mar 18, 2012)

Hello there, yes I meant 30%. Sorry i didn't make that clear. I have tried more but had highs later on. Will try 50% instead like you advised. Do you think it will stop the lows later on or should I eat extra carbs at supper? 
Sorry for all the questions but it's great to be able to speak to people who are in the same situation as me. I am going to stick to the same exercise for a month to try and sort myself out. I have also tried rice and pasta before a workout as thought that might be slow releasing. 
NatB


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## NatB (Mar 22, 2012)

*Gym and hypos*

Hi All,
Well I thank you all for your advice. Worked a treat on Tuesday. Was a high before my workout but was normal range when I came out and no hypos.
Went tonight and was a different story was 3.3 after an hour and resorted to taking my pump off for the remainder of my workout. Not sure if that was the right idea but will see.
Received my diabetic athletes book today so I will read that tonight.
I hope you are all well. 
NatB


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## Phil65 (Mar 23, 2012)

Hi Nat,

I often take my pump off when exercising...depending on the type of exercise, gym work definitely. Walking the dog or playing golf (4 miles over 4 or 5 hours, carrying a golf bag) I put a TBR on and I reduce my basal by 90% over the 4 hour period!  I still have jelly babies whilst playing! It is difficult to get right and often I don't but I still find it easier on my pump than MDI.


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## NatB (Mar 23, 2012)

Hi Phil and thanx for your help. 
I keep thinking I have sorted myself out but then the next workout I'm either too low or very high. 
Last nite I did a four mile jog and kept dipping. I decided to take my pump off but later on I was 15.4. When u take your pump off do u give a correction later ? I much prefer the pump and wouldn't go back atall. It's just the exercising that I'm strugging with.


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## Pumper_Sue (Mar 23, 2012)

Hi Nat,
may sound a daft question but have you done any basal tests lately?
If not it might be worth considering doing them and then reviewing your carb ratios and correction factors.
Then once you have them sorted start a plan of action on your exercise aproach.
Each thing you then do write down the results and what you did about them. This way you can then build up a picture as to whats going on. As we are only getting half of what you are doing it's very difficult to even second guess a solution or idea to help you.


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## NatB (Mar 23, 2012)

Hi sue, 
I have done basal testing and my levels are usually ok when I'm not working out or poorly. I think I'm probably trying too many different things with my levels. Am writing everything down and trying to stick to the same exercise to try and see what's going on. My husband says I'm never going to get them level when working out as my levels aren't consistently the same. I will keep at it.


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## Pumper_Sue (Mar 23, 2012)

NatB said:


> Hi sue,
> I have done basal testing and my levels are usually ok when I'm not working out or poorly. I think I'm probably trying too many different things with my levels. Am writing everything down and trying to stick to the same exercise to try and see what's going on. My husband says I'm never going to get them level when working out as my levels aren't consistently the same. I will keep at it.



Would it be poss to do your exercise at the same time each day?
If so then you can work on what happens and why. Then perhaps exercise at a different time and see what happens then. It's more than likely you need different tactics for dif times of the day. Perhaps PM HelenM as I believe Helen does distance running and uses a pump.


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## NatB (Mar 24, 2012)

Thats a good idea. Went to gym for an hour today and didn't have breakfast just a creal bar and had my breakfast when I got back. My level stayed the same all the time I was there. I read it in my atheletes book. I will try your advice too. Thanx so much.


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## Northerner (Mar 24, 2012)

NatB said:


> Thats a good idea. Went to gym for an hour today and didn't have breakfast just a creal bar and had my breakfast when I got back. My level stayed the same all the time I was there. I read it in my atheletes book. I will try your advice too. Thanx so much.



That's great news Nat!


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