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Hitting the Wall.

January 15, 2010

Today, I completed my fourth workout in two weeks, which means I am halfway to meeting my January goal of working out four days a week.

I’ve also hit what is known as <deep voice> The Wall. </deep voice>

From what I can tell, I haven’t lost any weight. Not even an ounce. My clothes, for what it’s worth, fit exactly the same as they did before I started working out. I am optimistic this shall change, but I am not holding my breath (which is good, because that would make working out rather difficult). My blood sugars on the other hand have dramatically improved already. While I haven’t lowered my insulin intake just yet, I am overall having less highs throughout the day, and find myself holding steady more often and flat-lining on my CGM throughout the day. I am in general taking less insulin than I was before because I’m having less frequent high blood sugars. I’m correcting less and enjoying ringing in at lunchtime at 110 mg/dl. Deviation and variation in blood sugars is just as dangerous as the blood sugar itself; the more often you jump around, the higher chance of getting complications even if  you’re A1C or glucose meter average says you’re a-OK. Pay attention to your standard deviation because it means more than you might think.

I am still finding myself with my classic conundrum though. I’ll start working out at a reasonable number, and slowly drop a few points, maybe thirty or forty. I come home to a really great low-to-mid 100s blood sugar and think I’m Superwoman. And then, about two hours later, POP! goes the blood sugar. And I spike to a lousy mid 200s blood sugar without doing a damn thing. And here’s the thing: I wear my insulin pump while I work out. It’s not like I’m missing basal rate. I usually work out after I eat dinner though, but if I take my full amount of insulin at dinner, I sink like a rock. If I don’t take a full amount of dinner, I hold steady, maybe drop a little which is normal, and then POP!

The mid-workout calm before the post-workout storm.

This, my friends, is why I avoid the gym. It’s not the lows that kill me – it’s the lousy highs that plague my post-workout and make me feel like a gym failure. The next day, of course, the after effects are great. It’s just that post-workout high that won’t seem to budge. Suggestions for how to kick that 268 mg/dl into submission would be greatly appreciated!

Today marks the beginning of Week Three (my weeks are Friday thru Thursday to coincide with the start of the year since my first workout was on Saturday, January 2). I plan on attending another ballet class on Sunday (my fifth!), workout on Monday since I’m not working due to MLK Jr. Day, and then twice later, probably Wednesday and Thursday. I have them written down on my new Anne Taintor calendar and I’m trying to make sure I stick with it!

I may have it the proverbial two week Wall, but I plan on kicking right through it! Hi-YAH!

24 Comments
  1. January 15, 2010 10:36 AM

    I get a similar pattern when I work out, but have sort of figured a way to manage it. I usually exercise either about 90 minutes after eating (in which case I do as you do and reduce my bolus) or I exercise before eating (in which case I lower my basal quite dramatically for a couple of hours before). In both cases, whatever insulin I did not take ahead of my workout, I take as soon as I finish. So for example if I go for a run when I get home at 7pm, I reduce may basal between about 4.30pm and 7pm (basal is at normal during my run) My basal at this time is around 0.7u/h. I knock it down to 0.2 and take about 1.2 units as soon as I finish. I do also sometimes have some supplementary uncovered carbs before or during exercise, but this is dependent on blood sugar. I also need to reduce my basal rate again a few hours later to account for muscles rebuilding their glycogen stores!

    It is complex, but I’ve definitely found that the more you do it, the easier it is because it just becomes normal. Just think, if you go to the gym every single weekday, you can build the necessary changes in to your basal rate pattern, and only change them if you skip a day.

    Good Luck with sticking at it – you go girl!

    • January 15, 2010 10:44 AM

      I never even THOUGHT of taking the insulin I was skipping *after* working out. Wow! Thanks, Caro. I may have to give that a try.

  2. Rob permalink
    January 15, 2010 11:09 AM

    I’m not sure how you’re adjusting your basals while you’re exercising, but I generally dial mine back 20-50% depending on the intensity of the workout. To prevent a post workout high, I’ll return to my regularly scheduled basal rate with about 20 minutes left in the workout. Also, a snack with a bolus to cover it after you finish working out will usually smooth out that CGM trend (at least it seems to for me).

    • January 15, 2010 11:13 AM

      I don’t typically lower my basals at all, actually. When I’ve done that in the past, I tend to end my workout high right away, rather than a delayed high later. I only lower my basal if I’m entering my workout at a lower number, like 130 or 140. I don’t drop enough during an average workout to need a lower basal rate. A snack afterward might help, though. I was never able to get lowering my basals to work for me when I was in college. Like I said, I don’t usually drop that much during my workout, or even right afterward. It’s always like an hour or two after working out that I start to skyrocket.

  3. January 15, 2010 11:46 AM

    I love how determined you are!!

  4. tmana permalink
    January 15, 2010 11:58 AM

    The ongoing T1 dialog about bonking mid-workout and spiking afterwords has me extremely curious about how T2s’ (whether or not on insulin) and “normal” folk’s blood glucose levels react during, and after, exercise. (I generally don’t notice a measurable drop or spike, but I’ll find my ability to perform is dependent on hydration, electrolyte management, and carb intake/management during exercise… but without a CGM, I don’t know if what I’m responding to is changes in blood glucose levels or something else.)

    • January 15, 2010 12:05 PM

      You could try getting a trial of a CGM from your endo if you think it might help you answer some questions. You don’t have to purchase one, but you can see if it’s something that would help temporarily.

  5. January 15, 2010 12:48 PM

    It is normal not to need to drop your basil rate if you are not working past a specific threshold (it is different for everyone–Aerobic versus Anaerobic). At some point you may need it. For a day of downhill skiing I would not need a temp rate, but if I was hiking and skiing I would.

    It is also quite normal to have post workout highs. It can occur for about a dozen different reasons. I would start with everything you put into your body up to 4 hours before working out (food, carbs, sugar, fats, liquids, insulin, walking, etc) and find out what you have ON BOARD during your workout. The other effect of exercise is that your body DUMPS naturually occuring glucose into your system as you workout because it is trying to refuel itself. Try a temp of 115% as you end your workout. Once your body is used to the exercise, you may no longer need it.

    Your milage may vary. I’m not a doc or medical pro — just been doing it long enough to know my way around.

    -T1 Athlete

    • January 15, 2010 12:58 PM

      Thank you! Again, very useful info. I never thought about raising my basal either… Both yours and Caro’s options sound like they could work (taking a little bit more insulin post-workout). I’ll definitely report back!

  6. January 15, 2010 1:09 PM

    Here’s my pattern:
    1. Work out after eating – wait for BG to start climbing so I don’t tank
    2. take extra uncovered carbs with meal if starting on low side
    3. about 2 hours AFTER workout, do a temp basal of plus 70% (that’s 170% not a lower basal).

    It’s a pain to remember step 3, so what I try to do is normally have my basals set for my post-exercise spike. Then, if I don’t work out, I do a temp lower basal. Or, if I don’t work out because I’m too stressed, I get to eat some cookies to avoid a low🙂

    • January 15, 2010 1:59 PM

      I love that last part, Val. I didn’t work out so I need to eat cookies! LOL!

  7. January 15, 2010 1:52 PM

    Hey Allison
    actually I don’t know if my advice here would actually work since I am a type 2 or oral meds but I think a few things overlap so I hope I might put in my 2 cents.

    I have been doing a diabetes management solutions project on my blog and one of the things I was earmarking is exercise and some of it effects.
    one thing I do is that I workout on a daily basis just because my plan of doing it for 5 days kinda fizzled out when my sugars went back to popping up on my rest days, I think once you have the control and your body has adjusted then it can manage the 2 days off, but for now 7 days it is, am at day 17 by the way.
    another thing was I always figured, you know work out and your sugars drop, boy was I wrong, a few times my sugars were actually higher after workout . So I posted the question on tudiabetes and the responses were overwhelmingly towards adrenaline making your glucose levels higher.
    A few great suggestions were reducing to a moderate exertion level about the last 15 minutes so your heart elevation goes down improving your sugars.
    2. because you are eating before workout, could the pop up could be because that’s the time the food is getting digested and the glucose is being released.
    Finally for the wall, its just too early, your body has not fully adjusted to the new fitness level, the first few pounds that you loose when you start working out is just water so give it sometime and don’t give up.
    here is the tudiabetes thread maybe it can shine a spotlight on your highs but like I said we are type II’s so there is some philosophical differences.
    http://www.tudiabetes.org/forum/topics/have-your-bg-numbers-ever-gone

    • January 15, 2010 2:02 PM

      Thanks for the link! I don’t think it’s digested food being released because the spike is usually 1.5 to 2 hours after I’ve eaten, and the food has definitely already hit my system by then, based on my knowledge of how quickly food works. My exertion level really isn’t that high to begin with so I’m not sure I could go any lower.

      It is true that I’m still new to work out – hopefully the results will materialize soon! I’m impressed by your 17 day streak!

  8. January 15, 2010 5:15 PM

    I’m not sure what to tell you r.e. your blood sugar as I know nothing about that BUT I will say that even though you haven’t lost any weight or your clothes don’t fit better THEY WILL so keep at it!! Once you’ve worked up to 3-4 workouts a week and have been doing it regularly for 3-4 weeks you will start to see changes in your body so don’t give up now🙂

    • January 15, 2010 6:01 PM

      I know – I am just impatient! And I know that most of my 20sb readers won’t know a thing about blood sugars but I am hoping that by combining my diabetes writing and my twentysomething life writing, I will be educating more people. It’s how my friends in high school learned. Just by being around me.🙂

  9. January 15, 2010 11:50 PM

    Hey Allison,
    I’m not sure if this has been addressed yet, but here are a couple thoughts.
    1) weight loss… It can take time to kick in. Also, it is really easy to over-compensate for the calories you burn. Even when I have trained for an Ironman, logging upwards of 20 hours per week at some points, I have not always lost weight. (I may not always be focusing on that goal however.) For some people exercise will cause the weight to come off without effort. For me, I have to be very cognizant of my eating. I will eat a snack (about 20-25 g) immediately before beginning exercise over an hour, or if my BG is <130 or so. I may wait to eat the snack until I have started exercising sometimes. Usually what I do is time my workouts right before a meal.

    Which brings my to my second point…
    2) I try to avoid any significant boluses right before (<2.5 hours) a workout if possible. Usually I either workout first thing in the morning, or right after work & before dinner. I might have a snack beforehand of 20-25 g (banana, GU, etc.) unless my BG is high. In the case that I do eat something a couple hours before, I will keep it small and bolus maybe 70-80% of normal and then might reduce my basal 60-90 min before exercise.

    The most helpful thing I did when I first started doing triathlon was to keep detailed logs of everything I ate, my insulin, basal rates, exercise types/intensity. I just wrote it all down. Then I generated a number of scenarios that I could refer to, adjusting as necessary. Also from this I calculated a ballpark carb ratio that I use during cycling, which is naturally much different than my regular one.

    Keep at it! If you continue to exercise regularly enough, finding things you enjoy, you will never want to give it up.

  10. January 16, 2010 5:04 PM

    Your site is very easy to use and has been very helpful in the way other people are dealing with diabetes. My mother has type 2 diabetes and I am always looking for new information to make her life easier. Keep up the easy to read blogs and your personal thoughts on diabetes they are great.

    • January 16, 2010 6:33 PM

      Why thank you. It’s so nice to hear that kind of feedback!

  11. Kelsey permalink
    January 17, 2010 10:24 AM

    Yes, this is a typical post-workout pattern for me too. I also take the skipped insulin immediately after the workout. It’s not uncommon for me to bolus a full unit with my blood sugar at 90 mg/dl because I know that high will start creeping up on me. Since I’m usually disconnecting for a shower too, I add a little extra insulin for the basal I’ll miss then. It works really well. Good luck!!

  12. January 17, 2010 10:24 AM

    couple of points I wanted to add.
    1. Is weight loss one of your goals for doing this?
    because the obvious thing in weight loss is not fitness but rather diet. i.e. calories going in vis calories going out. I am on a 1500 a day diet and while weight loss was not the main goal for diabetes management solutions project, I have still managed to drop 9 pounds in 3 weeks.
    2. What do you do in your workout routine?
    I am on a 7 day workout week(I know you are up to 4 so congrats keep that going)
    I do cardio all 7 days and add strength training on alternating days, you might consider adding strength training to your workout if you are not already.
    building muscles help fuel burn efficiently and you do loose the extra fat you don’t need.
    All in all I know it is slow coming but just remember that you are doing the right thing, and the fruits of your labor will be coming along soon. Small changes at a time and celebrate those milestones.
    Ronald Gregory

    • January 17, 2010 3:42 PM

      I do some strength training in all my workouts. I definitely know that the weight will come off in due course. I have made small changes to my diet but at this point I am comfortable with what I am eating and don’t feel I could do much less. I am trying to eat out less often though, and also have my meals planned, which are big faults of mine. I am trying to focus not just on what I eat, but *how* I eat which I think will help. Weigh loss is a goal, but it’s a part of the overall package of being healthier so I know it will come in due course. I am trying not to focus too much on it, though, because I tend to get very discourage and want to give up!

  13. January 17, 2010 5:00 PM

    Most of us are just lazy…that’s why we don’t go to the gym. But you’ve actually got a valid excuse.

    Glad you’re not letting that stop you.🙂

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