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The Law of Threes

October 10, 2007

Tonight, I returned to the gym after a two month absence.

My goal was to start off October with going to the gym, but for some reason that just never happened. Not sure why I decided not to, but I didn’t.

Then came this past Monday. Perfect opportunity really. Except for the fact my hip was incredibly sore from walking nearly five miles in Brooklyn on Saturday. So I thought, I’ll give it one more day.

Then came yesterday. Again, would have been perfect. Except for the fact I only had one test strip left in my meter case and I didn’t feel like driving all the way home and then all the way back to the gym. It was almost eight o’clock at night, I hadn’t eaten dinner and my blood sugar (using my last test strip) was 119 mg/dl. So I thought, I’ll do it tomorrow.

Which brings me to today.

After work, I drove home and changed into my gym clothes. Packed up my bag with a juice box, my iPod, glucose meter and test strips, a book and the latest issue of Us! magazine (trashy magazines are a gym staple).

Pre-gym blood sugar: 166 mg/dl.

Then I decided to do something revolutionary, something astounding, something incomprehensible!

I wore my insulin pump while working out.

GASP!

I know, I know, but it’s true.

You see, I’ve noticed something that happens to me when I work out. Some might even called it a trend. When I disconnect, and either eat a snack or skip it – it really doesn’t seem to matter much, my blood sugar will drop slightly over the course of the hour or so workout, and then promptly spike about twenty minutes after I stop. It’s ridiculous, honestly, and slightly infuriating when half the reason you’re at the gym is to help lower your blood sugar.

So I decided I needed to do some exercise testing. It’s the same concept as basal testing, only it’s with exercise. Rather than influencing my exercise with external manipulation such as temporary basal rates, disconnecting or additional food, I’m simply going to do nothing. I’m going to eat like normal and wear my insulin pump like normal. For three days. Just to see what happens.

I thought, how can I make adjustments for something when I don’t even know what’s going to happen?

I’m starting out slowly with this whole exercise testing, and I will do it for several days before I decide whether or not something needs to change – just like with basal testing, the first, and even second, test can sometimes be influenced by those other variables. You really need to do something at least three times to get a sense of trends.

Tonight was easy. All I did was about forty minutes of cardio, and some light stretching. As I said, my pre-workout blood sugar was 166 mg/dl. After the forty minutes of cardio, my blood sugar has dipped down to 118 mg/dl. I drive home, filling the gas tank on the way.

This would normally be the part where my blood sugar will then skyrocket. But when I get home and test, I find my blood sugar at a nice and easy 128 mg/dl. A perfectly reasonable rise, considering the fact most meter averages have a plus or minus average of a dozen points.

Am I expecting every night to be like this? Of course not. That would be insane. But I am curious to find out how an increase in physical activity at the gym will impact this. Maybe instead of disconnecting all I will need to do is lower my basal rate a bit beforehand or eat a small snack before heading in.

I suppose only time will tell.

12 Comments
  1. October 10, 2007 11:07 PM

    You should read “Pumping Insulin.” I’ve been pumping for 10 years, and it was only after reading this book that I finally understood the insulin / exercise connection.

    I always work out with my pump, even during bikram (hot) yoga. For intense exercise, you lower your basal rate by ~30% two hours before. You can supplement with carbs pre-, during, and post- depending on intensity, too.

    I highly, highly recommend ordering the book!

  2. October 10, 2007 11:08 PM

    Good for you! I’m glad you made it to the gym–that first step in is often the hardest. I plan on joining the gym here on the 15th (when I get paid!). Woo hoo!

  3. Allison permalink*
    October 10, 2007 11:13 PM

    Marina: I’m glad to know someone else keeps their pump on too! Almost everyone I know takes it off. I have “Pumping Insulin” – Jim Walsh actually gave it to me to give away for the OC New Me Challenge, but that project has obviously sunk quite fantastically this year (I blame The Move). I’ll eventually have to give it away just to clear my conscience, but maybe I will read it first!

    Amylia: Good luck!🙂 We should be “returning to the gym” blogging buddies.

  4. Sara permalink
    October 10, 2007 11:14 PM

    I am also a non-disconnector. I usually work out after work, pre-dinner. The only change I make is in my dinner bolus. I typically cut out a unit or two. Have thought about figuring out a temp basal rate, but it seems like so much work.😉

  5. October 11, 2007 1:06 AM

    I do not disconnect either. Most often my bg rises after exercise. However the most important thing is to test because each work out is always a little bit different and how my body reacts to exercise varies from day to day.

  6. October 11, 2007 3:57 AM

    I used to always disconnect for exercise, and now I don’t anymore (unless the thing is driving me nuts bouncing around/falling off my shorts while I’m running – I need to buy one of those handy exercise pump harnesses).

    The reason I stopped disconnecting was cuz of mine and my dr’s worries about ketones during longer or more strenuous exercise, since they can promote ketones if you already have them or have no insulin around. But I also find that i feel better with a tiny bit of insulin, I think. And I have fewer post-exercise highs.

    I do reduce my insulin pretty drastically though, 60-90 minutes before and during I use 10-30% of normal basal rate (except for anaerobic stuff like weight lifting or super strenuous stuff like a race).

  7. October 11, 2007 11:07 AM

    Allison

    The thing that surprises me most, is that you pumped gas on the way home. You really are changing girl. Don’t overdo it!

    Seriously though, I’ve seen the same problem in the past with exercise. Now that I’ve got a CGM device I can watch what happens during and after exercise. Though these days my exercise is typically only 20 minutes on a treadmill. I guess I really need to try this out with something more strenuous.

    Let us know what you find out. And best of luck with the gas pumping!

  8. October 11, 2007 12:02 PM

    Hi Allison, I second the recommendation on reading the exercise section of “Pumping Insulin”. Hey you could take that to the gym instead of “Us!” magazine🙂. The trick for me is to turn my pump down BEFORE I start exercising. I usually cut my basal rate by 50% for 1 to 1 1/2 hours prior and let that rate continue for a total of 2 hours. Yep, my pump is attached the whole time.

  9. Allison permalink*
    October 11, 2007 12:08 PM

    Bernard: Haha, no, sorry, not this time! You can’t pump your own gas in New Jersey either. The gas station attendant pumped it for me. But I will probably have to do it when I got to D.C. next weekend! Aaaaugh….

    Carol: I agree! Maybe I will post a book review when I’m done.

  10. October 11, 2007 4:08 PM

    Have fun experimenting. The great part is that just when you think you’ve got it, it moves. I’ve always wore my pump while exercising. After exercising I monitor my blood sugar very closely. I also reduce my bolus a few points at the next meal. I don’t like to adjust my Basal rate but if you’re using a MiniMed pump you can set a temporary rate for a specific period of time. I think the best way to stay on course is to exercise until you can barely move and then go out and eat a banana split. You can tone your muscles and get a great reward after. What a plan. I’ve never done it but it’s sounding better all the time.

  11. Sara permalink
    October 11, 2007 7:23 PM

    I didn’t see the Pumping Insuline recommendation before. I second that! I bought it about 6 months ago begrudgingly (I thought I knew all there was to know😉 ). Seriously, the book is great and I really learned a lot. As one of the OC New Me members, I think you should award it to yourself for your effort at organizing the program for the months it lasted!

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