Category Archives: diabetes and exercise

Exercise and Play…the diabetes way

The next two prompts for Diabetes Awareness Month Photo A Day are exercise and play.  When you live with diabetes, both require special preparations.

Last winter my son decided to begin working on his body.  He “found” exercise in a way that only a teen can.  He picked up the Body Beast exercise videos and began to tone his muscles.  This presented new challenges for us.  We had to learn how to tailor his insulin needs and extra carbohydrates depending on the intensity and length of his workouts.
body beast
 
 
 
 








Play also presents challenges…We must make sure that a glucometer and glucose are always with him no matter what he is doing.
skidoo day March 5 005skidoo day March 5 030

Diabetes and Exercise…What I learned last week

In the past few months my son has really gotten into body building.  I am not talking on the competitive Mr. Universe scale of things, but simply getting fit, building muscles and looking “buff”.  He was following the George St. Pierre workouts and is currently working out to the “Body Beast“. I am excited to see him taking an interest in his health.  I am impressed to see the muscle tone and the dedication that he is giving these efforts but it is also presenting new challenges to us–how to manage diabetes and exercise!
I was therefore overjoyed when I saw a poster from my Animas rep stating that she would be bringing two people into our area to speak on just that topic! I was dying for my son to actually attend and learn himself.  He was equally sure that I could go and bring him home the Coles Notes version!  In the end, he won with the valid excuse of having to study for final exams.
The night’s two speakers were Sebastien Sasseville and Heather Buckle. Both of these people are extremely athletic and living with Type 1 diabetes.  You may know Sebastien from his mountain climbing expedition to the top of Mount Everest, his recent run across the Sahara, or perhaps his many IronMan races. His motivational talk incorporated how important his diagnosis of diabetes has been in his personal growth as well as to his development as an athlete.
He explained how vital it was to have dreams and actually work towards them! With or without diabetes, it is important that we refuse to be still and we continue to evolve at all times. He refers to diabetes as a houseguest that is now your roommate and how you must learn to live with him/her in order to get the most out of your life.  He reminded his audience living with diabetes that it is not about the A1c, its about the journey to get there.  As a personal life coach, it was great to hear him reiterate some of the same things that I had recently talked about in my “Normal is Just a Setting on the Dryer” session!
Sebastien also spoke a bit about his control and how he handled his diabetes care. I was surprised (although I should have intuitively known this) that the same exercise at different times of the day has to be handle in different ways.  This was important to bring home to my son who may workout at 8pm on a weeknight but 2pm on a weekend.  I tend to worry about workout times more in the terms of “let’s make sure he is not low during the night” and that is where it ended. This was a great talking point to use when I got home.
Heather continued the discussion on how to handle exercise and diabetes care by giving some great information on physiology.  She has been living with diabetes for 27 years and is an athlete as well as a physiotherapist and Certified Diabetes Educator.  She offered tips that my son and I had not even considered!
She noted that basal rates should be dropped by even a small bit up to two hours BEFORE exercise, the importance of eating within 15 minutes of exercise, and keeping an exercise diary.  She is the first person to show me real guidelines for when you can and cannot exercise when dealing with a high blood glucose level.  Its a question that parents often ask me when writing up plans for school–when is my child too high to participate in gym class? It turns out that the magic number–with or without ketones, is 17mmol (306mgdl).  Even without the presence of ketones, after 17, you will go higher with exercise! Fabulous to know for real world application!
Heather also showed us scenarios of why you may go higher after prolonged exercise even it you managed to stay in range for the entire period of exercise as well as how to fix this!  She talked about supplements, as well as the effect of temperature on insulin absorption.  Another light bulb moment for many people was when she discussed using multiple basal rates for one exercise time period! If you were doing an activity that required various levels of intensity, use various temporary basal rates.  This made many audience members go “Of course!” A final tidbit to remember–injuries will raise blood glucose levels. Duh! but still how often do we really think about it?
There was a lot more that both Heather and Sebastien had to say but those were some of the key points that were important for us.  Exercise is vital and as important as insulin when living with diabetes.  Attitude is everything–diabetes is not going away anytime soon so make it a positive part of your life!  Enjoy taking care of yourself. Enjoy being active and be the very best that you can be. Great messages from wonderful people!
exercise and diabetes animas

D-Math Muddle

There should be a warning in life to prepare you, some sort of course you could take, or as my son would suggest–an app that would do all of your diabetes related math. I can handle adding up carbs in a meal. I can subtract fiber.  I can even follow the formula for an extended bolus.  I can establish the carb factor for many homemade meals.  Figuring out how much basal my son needs at certain times can however be a nightmare!
Last night he had the brilliant idea of taking off his pump before a workout.  He planned to use the “disconnect” feature which gives him part of his missing basal upfront and then the rest at a specific time so that there is no basal missed when the pump is off. Smart kid! The only problem was he was high before disconnecting.  Do we correct the high? Probably not because he is exercising.  He has a cold.  His body is fighting germs.  Exercise may not be enough to cut it.  The pump of course gave a suggestion for the correction but it hadn’t factored in those two key details.  Mom had no mathematical formula to do this with so my solution? Wing it! Take a smaller correction and hope for the best!
The next question came in the form of how much basal to you deliver before exercising? He figured he would be untether for about 45 minutes but the pump would only allow 50% of the basal rate.  Was he going to need all of his basal rate when he was going to be exercising anyway? Probably not. Where is that calculator that will tell me how much he will burn while exercising to the Body Beast as well as completing his own routine? Oh yeah, its more of the “Mom Guess” formula. Joy!
I assume my guesses did okay.  He was 7 (136) at 3am and woke up at 4(72).  My pancreatic skills sufficed for that round of exercise.  Let’s hope I am as brilliant for today’s battle. Math-problems-