Diabetic starting running

dwyershane

Hi All

Not sure if this is in the right section, feel free to move.

Basically I am starting running after many years of being a couch potato!

Just looking for any hints or anything to look out for from diabetics on here regarding pre/post exercise foods maybe and anything else ye may think relevant

thanks

C-Shore

Hello,

I have diabetes so hopefully I can help you.

I actually started writing a long response, which I have stopped (but will add later) because I never asked you a relatively important question that I need to ask before giving any insight - are you type 1 or type 2?

robinph

Here's a link to a thread of mine from way back in the day when I was starting out:

http://www.boards.ie/vbulletin/showthread.php?p=56523308

As C-Shore said, are you T1 or T2 and are you on any medication that would lower blood glucose?

dwyershane

how could I forget to mention that, apologies I'm type 1 on novarapid 4 times a day and lantus once a day.

robinph that's a great link thanks a million, I'm not looking to run an marathons (yet!) but just to get fit and out of the house.

how does it affects your blood sugar levels? any tips on not passing out half way through

robinph

I used to be on 3 Humalog and 2 Lantus shots a day until I got the pump. You will have to take it careful and test, test and test some more to learn how different activities effect you.

How is your sensitivity to Hypo's? It can be much harder to spot them whilst running as the symptoms can be much the same as the feeling of being knackered from going running for me.

Test before a run, run but take some form of quick acting sugar with you such as gels/ dextrose tabs/ sugary drink, test when you get back from the run, then test again an hour or so later.
After a while you'll learn what levels work for you in terms of what pre-run BG level is safe for you to start running at. You will probably find that your insulin requirements will reduce and may need to alter dosages for different shots after a while of increasing your level of activity.

Do you alter your dosages and do you do any carb-counting?

dwyershane

I would be fairly sensitive to Hypo's alright, I would usually sense aroung 4.0.

I usually alter dosage with my evening meal depending on levels throughout the day or whats im planning on eating - dont do carb-count, Im on a list for the berger course, not likely to be called anytime soon!

I guess the only way to know is to test for the first regulary for the first few runs. I know with soccer last summer, my levels tended to rise instead of go down so might be the same for running.

Lets see how good this c25k app is ha

n-dawg

Not a diabetic myself but a good friend was diagnosed as type 2 a few years ago. He writes a little blog about his running. I guess there are some little nuggets of advice there that may help you. For him he finds running is excellent for controlling his blood sugar levels.

http://tentsmuir.wordpress.com/2012/06/10/running-with-asthma-diabetes/

robinph

Levels going up rather than the expected down is confusing alright, but I've had that happen to me when starting training again after a break of being lazy for a few weeks usually. You may find that effect will change after you have been getting a few more runs in and your body gets more used to what you are doing to it. It also tends to happen to me after races where the level goes up rather than down despite everything else seeming to be the same as any other run, the added adrenalin having an effect as well.

Definitely do not go out for a run with your level at 4. I would tend to aim to have my level a bit raised above the target range before running, and from trial and error have learnt what works for me. Don't want to throw any numbers at you though as it's something you really need to discover yourself IMHO, so I think your best of learning your own numbers rather than basing anything off what I do.

I do now know what BG number I should be at in order to cover X miles in X minutes of intensity and get back with my BG in range. There are of course any number of other things that can cause things to go a bit wrong depending on when you last ate/ bolused and what it was you ate, how stressful the day was, what time of day you are running.

I don't take my blood tester with me usually, unless it's a very long run I'm doing, but in learning what is going on as you run it wouldn't do any harm to stop and test part way round a run and see which way the levels are going. Do not leave the house without some sugar on you though, and preferably some form of ID as well.

These other "healthy" people on here have it easy not having to worry about blood levels every minute of the day.

C-Shore

Thanks for clarifying that.
As I said earlier, I had started writing a response and that's below, but as robinph said, it's all about testing.
Test your blood sugars often and test different methods to see what effect they have.
Here is what I had written earlier and most of it still stands:

I'm not actually a big user of this forum but your thread popped up and caught my eye, because I am a 24 year old Type 1 diabetic since 13 so I feel I can give you some insight.

A bit of a background on me - I have cycled since the age of about 11 and while I stopped cycling from 13-15 while I adjusted, I have been running, cycling, swimming and weight lifting since 15 to this day with about a year off from all cardio exercise when I had to move away for a year.

If I could recommend a book to you it would be Living Life with Diabetes by John Keeler who does a lot of exercise and he addresses almost every issue I ever came across. So it’s quite reassuring.

To give you a short answer of my experience, it's completely trial and error and I still make mistakes.

It's hard to give you exact advice because the training I do probably differs to what you want to do but to give you brief tips on how I do things.
Essentially, I would put it in a nutshell like this:

• Check your blood glucose levels before you start, and frequently after you finish
• Don't take extra carbohydrates until you are running much longer distances, just eat as normal
• Adjust your insulin down slightly when you train, but never cut out food or insulin before you train
• Always have glucose or maltodextrin with you when you train
• Practice, test and re-test different methods until you find a method that works for you. Unfortunately, that's the way it has been for me and many other people I talk to

If it helps, I’ll break it down below as to what my training days are like so that you have something to work off, it might not be any use to you.
Of course I’m not a doctor, but I’ll outline my experiences and try to put them into your circumstances. Don’t take any of them literally, and adapt to suit yourself.
I’ll split it into two areas I suppose, “Considerations I take when training with Diabetes” and “What I have to do with my food because of Diabetes” and they are as follows:

Considerations to take when training with Diabetes

• If your last injection of short acting was over two hours ago and you want to go training, check your blood sugars and if they are above 6.5, consider taking 1-2 units of Insulin because as I’m sure you’re aware, carbohydrates don’t work without insulin. So you need to take in Insulin to metabolise the carbohydrates either from your food, or what your body pulls from glycogen stores in your liver.
• If your blood sugars are less than 6.5, you still need insulin, but taking any Insulin at that level will push you close to hypo, so maybe take about 15g of carbohydrates with 1-2 units so that you have enough energy for your run.
• Bring your phone with you when you go out training, the best preparations often end up with you sitting on the side of the road having eaten everything you have.
• Tell someone your route, you’d be surprised how easily you get caught off guard and the phone I recommended bringing with you in the last point has no battery because you forgot to charge it.
• Bring glucose/maltodextrin with you everywhere, I personally bring PowerBar Energize Shots. Have them when you train and when you go out after, afterwards is where you usually get a low.
• Test your sugars before going out and every half hour for 4 hours after you finish, this will help you understand what effect the exercise has on you. Like I said, it’s really trial and error with controlled testing. After a while you won’t need to test as often afterwards.
• Don’t be surprised if your glucose levels are high after training. It seems backwards, but it happens. It’s either an adrenalin issue, or your body dumping from your glycogen liver stores, in reaction to strenuous exercise that you’re not used to. It doesn’t happen to me as much now, but when I was younger and started exercising again after getting diabetes it was the most frustrating thing ever. Don’t worry about it though, and don’t react with a large dose of Novarapid. Just keep monitoring it and if it isn’t going back down after 40 minutes, I would possibly take intermittent dosages of about 1-2 units every forty minutes.

What I have to do with my food because of Diabetes

This is what my daily setup is like, it may be different for you but hopefully this gives you some insight into what works for me and may give you some guidance.

• I eat a mid-size meal with 60% complex carbohydrate and 30% protein about an hour before training and take about 50%-70% of the typical insulin dosage for the weight of carbohydrates you usually take.
• You don’t need to “stock up” on carbohydrates before training, try to eat as normal, if not a little less than usual so you don’t get sick while trying to metabolise your food as you run. If you frontload your carbs, you’ll find yourself feeling sick, end up taking too much insulin to try to bring it down and as your body adjusts after training, your glucose levels will possibly come down very quick and end up hypo.
• Make as many of your meal carbohydrates complex carbohydrates (long acting carbohydrates), so whole grains are what you’re looking for here.
• It won’t be the same for you, but in my case I take about 50g of Porridge, and with milk and a little sugar I take in almost 50g carbohydrates for breakfast with about 6-8 units of Humalog depending on my reading from that morning. Then I’ll do 1 hour of weight lifting.
• For lunch I eat about 50g carbohydrate and 30g protein with about 8 units of Humalog.
• In the evening I try to take in the same for dinner, about 50g carbohydrates and 30g protein, with another 6 units of Humalog, then I wait about 30 minutes, test my blood sugar and if it’s ok I do either 1 hour of cycling, 45 minutes of running or 30 minutes of swimming. In terms of energy expenditure, each one equates to about 500 calories of energy which is the equivalent to 125g of carbohydrates. So I have taken 50g carbohydrates to fuel the exercise, and I have a glycogen and fat stores that I try to use for the remaining energy.
• I take a mix of whey, casein and soy protein after weight training in the morning for muscle repair, which is about 1g of carbohydrates, and the same again at mid-afternoon. For recovery after cardio training then I try to eat a further 50g of carbohydrates, usually more porridge about 9pm. I do this in the evening to replace glycogen stores and prevent a hypo overnight. I find this late snack is essential because if I don’t take it, then I get a low during the night. I take about 4 or 5 units of Humalog with this
• Then I go to bed and take about 22 units of Lantus, which starts me off the next day anywhere between 5 and 10 mmol. I honestly don’t know why this varies so much, there’s probably so many variables that input into this, particularly around recovery times and how long it’s been since I last trained.

So that’s what I do on training days, the only thing I do differently on my rest days, is that I don’t always take the porridge late at night. Plus, as you know, the 4 injections is far more flexible so it depends on what time I eat my dinner.
I eat much the same in terms of the amount of carbohydrates on non-training days, I just increase my insulin by about 10%-20%, which isn’t a lot and that may be due to the carbohydrates required for recovery.

Sorry it’s quite long, but I hope it helps.

robinph

Me just being able to hit the thanks button once for that post isn't enough. Wish you'd been around with a post like that years ago C-Shore, awesome information there.

C-Shore

Yeah I just feel that I should try to provide the help that I would have liked when I got diabetes.

As I'm sure you know yourself, it is a trial and error process but there were so many questions that I just didn't have anyone to answer when it came to sport but like you, we seem to have mastered it as much as it can be mastered.

It's crazy the way you react differently on different days with all the variables that you outlined in your last post, which was really good.

The hardest part of finding the right information is that T2 filters into most of the information and confuses everything.

Trial and error in a controlled manner is the best way to get into it though dwyershane and I'd be happy to answer any questions you have along the way because it would be great to see you take it up.

dwyershane

C shore thanks a million for the above some really good pointers I will be taking on board. I dont have the carbs v insulin v exercise as fine tuned as you - its very impressive. I only moved over to novarapid in the last year so thats still new to me.

@robinph These other "healthy" people on here have it easy not having to worry about blood levels every minute of the day

This is so true - I guess they dont realise how lucky they are, unfortunately this is the card dealt to us in life

Hopefully with a bit of work and watching, this 5 KM should be a piece of cake :P parden the pun

I def think testing will be the key - before, after and an hour after finishing for the first few weeks.

Did a run this evening and no ambulance needed so thats a good start!

CramCycle

There is a workshop on in Tallaght general hospital entitled Excercise and Diabetes on the 3rd of April. Might be worth a look, if anyone is interested in going drop me a PM and I'll forward you on the organisers details.

Not affiliated with them, the Dietician told me about it when I arrived at my appointment yesterday in lycra.

niamhsligo

Anyone have any advice on what to do on race days? Find sugars go up? due to adrenaline.. Have been reluctant to take insulin as afraid of lows during race but find it much harder to run if sugars high. Last 2 races 17 starting out. Doing a try a tri in a few weeks-pool swim- but this means pump will be off for 10-15 mins of swim.Should I just leave basal rates as normal, check after swim and adjust for cycle(10k) and run(4k)? Should I increase basal if high or small bolus? Hope to do sprinttri in June in sea so would be a bit more worried about hypos then!