Type 1 - Connect

Hi Team,

My main problem with exercise is the crashing low's I can sometimes experience many hours later, even though I think I have adjusted my food and insulin correctly. This really, really puts me off doing exercise, because I don't want to deal with it and it's frightening. Then I beat myself up about not exercising! 

Thank you for the opportunity to ask this question!

Robyn

Hi Robyn,

I can only offer you, Robyn, my experiences when I became a gym member and had very similar experiences with hypos.

Although now 70, I am only coming up to 14 years since I was diagnosed with diabetes.

Within two years, I had neuropathy developing in my feet even, although my 3 monthly HbA1c was always close to 7.

My Endocrinologist diagnosed the neuropathy being caused by the fast rise and fall of BGLs, at that stage.

By changing my diet and exercising, along with a lower average BGL target, I prevented the progression of neuropathy and I still have good feeling in my feet.

For regular exercise, I became a gym member and had the problems with hypos that you have described, Robyn. At that stage, I was very new to Type 1 and was still coming to terms with regulating insulin injections and carbs combined with exercise.

By matching bolus insulin, carbs and when I started exercising, I usually finished an hour session without too many hypos. But there were days, even with testing every 10 minutes and with "hypo fixes", I could not complete an hour period of exercise.

Although I changed to an "am -pm" split basal injection, I did not change the amount of total basal that I was injecting.

My HbA1c dropped to 6.5 then 5.2. This 5.2 result was dismissed by my Endo as most likely to not be correct because of the number of hypos that I had experienced just prior to that blood test.

Looking back now, I think that reading was close to being correct, because I was not using a CGM and I was waking up through the night with a lot of hypos of 2.8 mmol/L.

By reducing the pm basal insulin and matching this injection to the amount of physical activity, I prevented most of the night time hypos.

Even to this day, I still have problems getting bolus and basal injections correct after a period of inactivity then becoming physically active again.

On this first day of activity, I may have to inject more bolus but on the second day, I will have to reduce both bolus and basal injections.

Within the last 3 years, I changed to Ryzodeg (70% basal – 30% bolus) which I now inject only once at night. I still use NovoRapid for bolus corrections. Although I followed the recommendations of not changing my daily amount of Ryzodeg injection, this is why in ended up in hospital with a very stubborn hypo and qualified me for a subsided CGM. It occurred after several days of hard work.

This was a basal induced hypo and no matter what I did or ate, BGLs kept falling. I am now confident with changing my Ryzodeg and matching this injection with physical activity. If I am not sure, I will miss the night injection and inject the Ryzodeg the next morning.     

 My appointment with a Diabetic Educator has been brough forward to next Wednesday so I will back with a CGM, making life much easier.

Paul

Hi Team,

My main problem with exercise is the crashing low's I can sometimes experience many hours later, even though I think I have adjusted my food and insulin correctly. This really, really puts me off doing exercise, because I don't want to deal with it and it's frightening. Then I beat myself up about not exercising! 

Thank you for the opportunity to ask this question!

Robyn

Hi Robyn,

I can only offer you, Robyn, my experiences when I became a gym member and had very similar experiences with hypos.

Although now 70, I am only coming up to 14 years since I was diagnosed with diabetes.

Within two years, I had neuropathy developing in my feet even, although my 3 monthly HbA1c was always close to 7.

My Endocrinologist diagnosed the neuropathy being caused by the fast rise and fall of BGLs, at that stage.

By changing my diet and exercising, along with a lower average BGL target, I prevented the progression of neuropathy and I still have good feeling in my feet.

For regular exercise, I became a gym member and had the problems with hypos that you have described, Robyn. At that stage, I was very new to Type 1 and was still coming to terms with regulating insulin injections and carbs combined with exercise.

By matching bolus insulin, carbs and when I started exercising, I usually finished an hour session without too many hypos. But there were days, even with testing every 10 minutes and with "hypo fixes", I could not complete an hour period of exercise.

Although I changed to an "am -pm" split basal injection, I did not change the amount of total basal that I was injecting.

My HbA1c dropped to 6.5 then 5.2. This 5.2 result was dismissed by my Endo as most likely to not be correct because of the number of hypos that I had experienced just prior to that blood test.

Looking back now, I think that reading was close to being correct, because I was not using a CGM and I was waking up through the night with a lot of hypos of 2.8 mmol/L.

By reducing the pm basal insulin and matching this injection to the amount of physical activity, I prevented most of the night time hypos.

Even to this day, I still have problems getting bolus and basal injections correct after a period of inactivity then becoming physically active again.

On this first day of activity, I may have to inject more bolus but on the second day, I will have to reduce both bolus and basal injections.

Within the last 3 years, I changed to Ryzodeg (70% basal – 30% bolus) which I now inject only once at night. I still use NovoRapid for bolus corrections. Although I followed the recommendations of not changing my daily amount of Ryzodeg injection, this is why in ended up in hospital with a very stubborn hypo and qualified me for a subsided CGM. It occurred after several days of hard work.

This was a basal induced hypo and no matter what I did or ate, BGLs kept falling. I am now confident with changing my Ryzodeg and matching this injection with physical activity. If I am not sure, I will miss the night injection and inject the Ryzodeg the next morning.     

 My appointment with a Diabetic Educator has been brough forward to next Wednesday so I will back with a CGM, making life much easier.

Paul

Hi Team,

My main problem with exercise is the crashing low's I can sometimes experience many hours later, even though I think I have adjusted my food and insulin correctly. This really, really puts me off doing exercise, because I don't want to deal with it and it's frightening. Then I beat myself up about not exercising! 

Thank you for the opportunity to ask this question!

Robyn

Hi Robyn,

I can only offer you, Robyn, my experiences when I became a gym member and had very similar experiences with hypos.

Although now 70, I am only coming up to 14 years since I was diagnosed with diabetes.

Within two years, I had neuropathy developing in my feet even, although my 3 monthly HbA1c was always close to 7.

My Endocrinologist diagnosed the neuropathy being caused by the fast rise and fall of BGLs, at that stage.

By changing my diet and exercising, along with a lower average BGL target, I prevented the progression of neuropathy and I still have good feeling in my feet.

For regular exercise, I became a gym member and had the problems with hypos that you have described, Robyn. At that stage, I was very new to Type 1 and was still coming to terms with regulating insulin injections and carbs combined with exercise.

By matching bolus insulin, carbs and when I started exercising, I usually finished an hour session without too many hypos. But there were days, even with testing every 10 minutes and with "hypo fixes", I could not complete an hour period of exercise.

Although I changed to an "am -pm" split basal injection, I did not change the amount of total basal that I was injecting.

My HbA1c dropped to 6.5 then 5.2. This 5.2 result was dismissed by my Endo as most likely to not be correct because of the number of hypos that I had experienced just prior to that blood test.

Looking back now, I think that reading was close to being correct, because I was not using a CGM and I was waking up through the night with a lot of hypos of 2.8 mmol/L.

By reducing the pm basal insulin and matching this injection to the amount of physical activity, I prevented most of the night time hypos.

Even to this day, I still have problems getting bolus and basal injections correct after a period of inactivity then becoming physically active again.

On this first day of activity, I may have to inject more bolus but on the second day, I will have to reduce both bolus and basal injections.

Within the last 3 years, I changed to Ryzodeg (70% basal – 30% bolus) which I now inject only once at night. I still use NovoRapid for bolus corrections. Although I followed the recommendations of not changing my daily amount of Ryzodeg injection, this is why in ended up in hospital with a very stubborn hypo and qualified me for a subsided CGM. It occurred after several days of hard work.

This was a basal induced hypo and no matter what I did or ate, BGLs kept falling. I am now confident with changing my Ryzodeg and matching this injection with physical activity. If I am not sure, I will miss the night injection and inject the Ryzodeg the next morning.     

 My appointment with a Diabetic Educator has been brough forward to next Wednesday so I will back with a CGM, making life much easier.

Paul

Hi Team,

My main problem with exercise is the crashing low's I can sometimes experience many hours later, even though I think I have adjusted my food and insulin correctly. This really, really puts me off doing exercise, because I don't want to deal with it and it's frightening. Then I beat myself up about not exercising! 

Thank you for the opportunity to ask this question!

Robyn

Hi Robyn,

I can only offer you, Robyn, my experiences when I became a gym member and had very similar experiences with hypos.

Although now 70, I am only coming up to 14 years since I was diagnosed with diabetes.

Within two years, I had neuropathy developing in my feet even, although my 3 monthly HbA1c was always close to 7.

My Endocrinologist diagnosed the neuropathy being caused by the fast rise and fall of BGLs, at that stage.

By changing my diet and exercising, along with a lower average BGL target, I prevented the progression of neuropathy and I still have good feeling in my feet.

For regular exercise, I became a gym member and had the problems with hypos that you have described, Robyn. At that stage, I was very new to Type 1 and was still coming to terms with regulating insulin injections and carbs combined with exercise.

By matching bolus insulin, carbs and when I started exercising, I usually finished an hour session without too many hypos. But there were days, even with testing every 10 minutes and with "hypo fixes", I could not complete an hour period of exercise.

Although I changed to an "am -pm" split basal injection, I did not change the amount of total basal that I was injecting.

My HbA1c dropped to 6.5 then 5.2. This 5.2 result was dismissed by my Endo as most likely to not be correct because of the number of hypos that I had experienced just prior to that blood test.

Looking back now, I think that reading was close to being correct, because I was not using a CGM and I was waking up through the night with a lot of hypos of 2.8 mmol/L.

By reducing the pm basal insulin and matching this injection to the amount of physical activity, I prevented most of the night time hypos.

Even to this day, I still have problems getting bolus and basal injections correct after a period of inactivity then becoming physically active again.

On this first day of activity, I may have to inject more bolus but on the second day, I will have to reduce both bolus and basal injections.

Within the last 3 years, I changed to Ryzodeg (70% basal – 30% bolus) which I now inject only once at night. I still use NovoRapid for bolus corrections. Although I followed the recommendations of not changing my daily amount of Ryzodeg injection, this is why in ended up in hospital with a very stubborn hypo and qualified me for a subsided CGM. It occurred after several days of hard work.

This was a basal induced hypo and no matter what I did or ate, BGLs kept falling. I am now confident with changing my Ryzodeg and matching this injection with physical activity. If I am not sure, I will miss the night injection and inject the Ryzodeg the next morning.     

 My appointment with a Diabetic Educator has been brough forward to next Wednesday so I will back with a CGM, making life much easier.

Paul

Hi Team,

My main problem with exercise is the crashing low's I can sometimes experience many hours later, even though I think I have adjusted my food and insulin correctly. This really, really puts me off doing exercise, because I don't want to deal with it and it's frightening. Then I beat myself up about not exercising! 

Thank you for the opportunity to ask this question!

Robyn

Hi Robyn,

I can only offer you, Robyn, my experiences when I became a gym member and had very similar experiences with hypos.

Although now 70, I am only coming up to 14 years since I was diagnosed with diabetes.

Within two years, I had neuropathy developing in my feet even, although my 3 monthly HbA1c was always close to 7.

My Endocrinologist diagnosed the neuropathy being caused by the fast rise and fall of BGLs, at that stage.

By changing my diet and exercising, along with a lower average BGL target, I prevented the progression of neuropathy and I still have good feeling in my feet.

For regular exercise, I became a gym member and had the problems with hypos that you have described, Robyn. At that stage, I was very new to Type 1 and was still coming to terms with regulating insulin injections and carbs combined with exercise.

By matching bolus insulin, carbs and when I started exercising, I usually finished an hour session without too many hypos. But there were days, even with testing every 10 minutes and with "hypo fixes", I could not complete an hour period of exercise.

Although I changed to an "am -pm" split basal injection, I did not change the amount of total basal that I was injecting.

My HbA1c dropped to 6.5 then 5.2. This 5.2 result was dismissed by my Endo as most likely to not be correct because of the number of hypos that I had experienced just prior to that blood test.

Looking back now, I think that reading was close to being correct, because I was not using a CGM and I was waking up through the night with a lot of hypos of 2.8 mmol/L.

By reducing the pm basal insulin and matching this injection to the amount of physical activity, I prevented most of the night time hypos.

Even to this day, I still have problems getting bolus and basal injections correct after a period of inactivity then becoming physically active again.

On this first day of activity, I may have to inject more bolus but on the second day, I will have to reduce both bolus and basal injections.

Within the last 3 years, I changed to Ryzodeg (70% basal – 30% bolus) which I now inject only once at night. I still use NovoRapid for bolus corrections. Although I followed the recommendations of not changing my daily amount of Ryzodeg injection, this is why in ended up in hospital with a very stubborn hypo and qualified me for a subsided CGM. It occurred after several days of hard work.

This was a basal induced hypo and no matter what I did or ate, BGLs kept falling. I am now confident with changing my Ryzodeg and matching this injection with physical activity. If I am not sure, I will miss the night injection and inject the Ryzodeg the next morning.     

 My appointment with a Diabetic Educator has been brough forward to next Wednesday so I will back with a CGM, making life much easier.

Paul

Hi Team,

My main problem with exercise is the crashing low's I can sometimes experience many hours later, even though I think I have adjusted my food and insulin correctly. This really, really puts me off doing exercise, because I don't want to deal with it and it's frightening. Then I beat myself up about not exercising! 

Thank you for the opportunity to ask this question!

Robyn

Hi Robyn,

I can only offer you, Robyn, my experiences when I became a gym member and had very similar experiences with hypos.

Although now 70, I am only coming up to 14 years since I was diagnosed with diabetes.

Within two years, I had neuropathy developing in my feet even, although my 3 monthly HbA1c was always close to 7.

My Endocrinologist diagnosed the neuropathy being caused by the fast rise and fall of BGLs, at that stage.

By changing my diet and exercising, along with a lower average BGL target, I prevented the progression of neuropathy and I still have good feeling in my feet.

For regular exercise, I became a gym member and had the problems with hypos that you have described, Robyn. At that stage, I was very new to Type 1 and was still coming to terms with regulating insulin injections and carbs combined with exercise.

By matching bolus insulin, carbs and when I started exercising, I usually finished an hour session without too many hypos. But there were days, even with testing every 10 minutes and with "hypo fixes", I could not complete an hour period of exercise.

Although I changed to an "am -pm" split basal injection, I did not change the amount of total basal that I was injecting.

My HbA1c dropped to 6.5 then 5.2. This 5.2 result was dismissed by my Endo as most likely to not be correct because of the number of hypos that I had experienced just prior to that blood test.

Looking back now, I think that reading was close to being correct, because I was not using a CGM and I was waking up through the night with a lot of hypos of 2.8 mmol/L.

By reducing the pm basal insulin and matching this injection to the amount of physical activity, I prevented most of the night time hypos.

Even to this day, I still have problems getting bolus and basal injections correct after a period of inactivity then becoming physically active again.

On this first day of activity, I may have to inject more bolus but on the second day, I will have to reduce both bolus and basal injections.

Within the last 3 years, I changed to Ryzodeg (70% basal – 30% bolus) which I now inject only once at night. I still use NovoRapid for bolus corrections. Although I followed the recommendations of not changing my daily amount of Ryzodeg injection, this is why in ended up in hospital with a very stubborn hypo and qualified me for a subsided CGM. It occurred after several days of hard work.

This was a basal induced hypo and no matter what I did or ate, BGLs kept falling. I am now confident with changing my Ryzodeg and matching this injection with physical activity. If I am not sure, I will miss the night injection and inject the Ryzodeg the next morning.     

 My appointment with a Diabetic Educator has been brough forward to next Wednesday so I will back with a CGM, making life much easier.

Paul

Hi Team,

My main problem with exercise is the crashing low's I can sometimes experience many hours later, even though I think I have adjusted my food and insulin correctly. This really, really puts me off doing exercise, because I don't want to deal with it and it's frightening. Then I beat myself up about not exercising! 

Thank you for the opportunity to ask this question!

Robyn

Hi Paul,

Thank you for the detail of how you try to manage exercise hypo's.  It's reassuring to know that the juggle is real and not just for me! 

I'm going to scale back for a little while to moderate exercise while I sort through the carb and insulin dose maze, and try to get to an equilibrium I am comfortable with. 

Thanks again for the insight!

Robyn

Hi Robyn,

I can only offer you, Robyn, my experiences when I became a gym member and had very similar experiences with hypos.

Although now 70, I am only coming up to 14 years since I was diagnosed with diabetes.

Within two years, I had neuropathy developing in my feet even, although my 3 monthly HbA1c was always close to 7.

My Endocrinologist diagnosed the neuropathy being caused by the fast rise and fall of BGLs, at that stage.

By changing my diet and exercising, along with a lower average BGL target, I prevented the progression of neuropathy and I still have good feeling in my feet.

For regular exercise, I became a gym member and had the problems with hypos that you have described, Robyn. At that stage, I was very new to Type 1 and was still coming to terms with regulating insulin injections and carbs combined with exercise.

By matching bolus insulin, carbs and when I started exercising, I usually finished an hour session without too many hypos. But there were days, even with testing every 10 minutes and with "hypo fixes", I could not complete an hour period of exercise.

Although I changed to an "am -pm" split basal injection, I did not change the amount of total basal that I was injecting.

My HbA1c dropped to 6.5 then 5.2. This 5.2 result was dismissed by my Endo as most likely to not be correct because of the number of hypos that I had experienced just prior to that blood test.

Looking back now, I think that reading was close to being correct, because I was not using a CGM and I was waking up through the night with a lot of hypos of 2.8 mmol/L.

By reducing the pm basal insulin and matching this injection to the amount of physical activity, I prevented most of the night time hypos.

Even to this day, I still have problems getting bolus and basal injections correct after a period of inactivity then becoming physically active again.

On this first day of activity, I may have to inject more bolus but on the second day, I will have to reduce both bolus and basal injections.

Within the last 3 years, I changed to Ryzodeg (70% basal – 30% bolus) which I now inject only once at night. I still use NovoRapid for bolus corrections. Although I followed the recommendations of not changing my daily amount of Ryzodeg injection, this is why in ended up in hospital with a very stubborn hypo and qualified me for a subsided CGM. It occurred after several days of hard work.

This was a basal induced hypo and no matter what I did or ate, BGLs kept falling. I am now confident with changing my Ryzodeg and matching this injection with physical activity. If I am not sure, I will miss the night injection and inject the Ryzodeg the next morning.     

 My appointment with a Diabetic Educator has been brough forward to next Wednesday so I will back with a CGM, making life much easier.

Paul

Hi Team,

My main problem with exercise is the crashing low's I can sometimes experience many hours later, even though I think I have adjusted my food and insulin correctly. This really, really puts me off doing exercise, because I don't want to deal with it and it's frightening. Then I beat myself up about not exercising! 

Thank you for the opportunity to ask this question!

Robyn

Hi Paul,

Thank you for the detail of how you try to manage exercise hypo's.  It's reassuring to know that the juggle is real and not just for me! 

I'm going to scale back for a little while to moderate exercise while I sort through the carb and insulin dose maze, and try to get to an equilibrium I am comfortable with. 

Thanks again for the insight!

Robyn

Hi Robyn,

I can only offer you, Robyn, my experiences when I became a gym member and had very similar experiences with hypos.

Although now 70, I am only coming up to 14 years since I was diagnosed with diabetes.

Within two years, I had neuropathy developing in my feet even, although my 3 monthly HbA1c was always close to 7.

My Endocrinologist diagnosed the neuropathy being caused by the fast rise and fall of BGLs, at that stage.

By changing my diet and exercising, along with a lower average BGL target, I prevented the progression of neuropathy and I still have good feeling in my feet.

For regular exercise, I became a gym member and had the problems with hypos that you have described, Robyn. At that stage, I was very new to Type 1 and was still coming to terms with regulating insulin injections and carbs combined with exercise.

By matching bolus insulin, carbs and when I started exercising, I usually finished an hour session without too many hypos. But there were days, even with testing every 10 minutes and with "hypo fixes", I could not complete an hour period of exercise.

Although I changed to an "am -pm" split basal injection, I did not change the amount of total basal that I was injecting.

My HbA1c dropped to 6.5 then 5.2. This 5.2 result was dismissed by my Endo as most likely to not be correct because of the number of hypos that I had experienced just prior to that blood test.

Looking back now, I think that reading was close to being correct, because I was not using a CGM and I was waking up through the night with a lot of hypos of 2.8 mmol/L.

By reducing the pm basal insulin and matching this injection to the amount of physical activity, I prevented most of the night time hypos.

Even to this day, I still have problems getting bolus and basal injections correct after a period of inactivity then becoming physically active again.

On this first day of activity, I may have to inject more bolus but on the second day, I will have to reduce both bolus and basal injections.

Within the last 3 years, I changed to Ryzodeg (70% basal – 30% bolus) which I now inject only once at night. I still use NovoRapid for bolus corrections. Although I followed the recommendations of not changing my daily amount of Ryzodeg injection, this is why in ended up in hospital with a very stubborn hypo and qualified me for a subsided CGM. It occurred after several days of hard work.

This was a basal induced hypo and no matter what I did or ate, BGLs kept falling. I am now confident with changing my Ryzodeg and matching this injection with physical activity. If I am not sure, I will miss the night injection and inject the Ryzodeg the next morning.     

 My appointment with a Diabetic Educator has been brough forward to next Wednesday so I will back with a CGM, making life much easier.

Paul

Hi Team,

My main problem with exercise is the crashing low's I can sometimes experience many hours later, even though I think I have adjusted my food and insulin correctly. This really, really puts me off doing exercise, because I don't want to deal with it and it's frightening. Then I beat myself up about not exercising! 

Thank you for the opportunity to ask this question!

Robyn

Hi Paul,

Thank you for the detail of how you try to manage exercise hypo's.  It's reassuring to know that the juggle is real and not just for me! 

I'm going to scale back for a little while to moderate exercise while I sort through the carb and insulin dose maze, and try to get to an equilibrium I am comfortable with. 

Thanks again for the insight!

Robyn

Hi Robyn,

I can only offer you, Robyn, my experiences when I became a gym member and had very similar experiences with hypos.

Although now 70, I am only coming up to 14 years since I was diagnosed with diabetes.

Within two years, I had neuropathy developing in my feet even, although my 3 monthly HbA1c was always close to 7.

My Endocrinologist diagnosed the neuropathy being caused by the fast rise and fall of BGLs, at that stage.

By changing my diet and exercising, along with a lower average BGL target, I prevented the progression of neuropathy and I still have good feeling in my feet.

For regular exercise, I became a gym member and had the problems with hypos that you have described, Robyn. At that stage, I was very new to Type 1 and was still coming to terms with regulating insulin injections and carbs combined with exercise.

By matching bolus insulin, carbs and when I started exercising, I usually finished an hour session without too many hypos. But there were days, even with testing every 10 minutes and with "hypo fixes", I could not complete an hour period of exercise.

Although I changed to an "am -pm" split basal injection, I did not change the amount of total basal that I was injecting.

My HbA1c dropped to 6.5 then 5.2. This 5.2 result was dismissed by my Endo as most likely to not be correct because of the number of hypos that I had experienced just prior to that blood test.

Looking back now, I think that reading was close to being correct, because I was not using a CGM and I was waking up through the night with a lot of hypos of 2.8 mmol/L.

By reducing the pm basal insulin and matching this injection to the amount of physical activity, I prevented most of the night time hypos.

Even to this day, I still have problems getting bolus and basal injections correct after a period of inactivity then becoming physically active again.

On this first day of activity, I may have to inject more bolus but on the second day, I will have to reduce both bolus and basal injections.

Within the last 3 years, I changed to Ryzodeg (70% basal – 30% bolus) which I now inject only once at night. I still use NovoRapid for bolus corrections. Although I followed the recommendations of not changing my daily amount of Ryzodeg injection, this is why in ended up in hospital with a very stubborn hypo and qualified me for a subsided CGM. It occurred after several days of hard work.

This was a basal induced hypo and no matter what I did or ate, BGLs kept falling. I am now confident with changing my Ryzodeg and matching this injection with physical activity. If I am not sure, I will miss the night injection and inject the Ryzodeg the next morning.     

 My appointment with a Diabetic Educator has been brough forward to next Wednesday so I will back with a CGM, making life much easier.

Paul

Hi Team,

My main problem with exercise is the crashing low's I can sometimes experience many hours later, even though I think I have adjusted my food and insulin correctly. This really, really puts me off doing exercise, because I don't want to deal with it and it's frightening. Then I beat myself up about not exercising! 

Thank you for the opportunity to ask this question!

Robyn

Hi Paul,

Thank you for the detail of how you try to manage exercise hypo's.  It's reassuring to know that the juggle is real and not just for me! 

I'm going to scale back for a little while to moderate exercise while I sort through the carb and insulin dose maze, and try to get to an equilibrium I am comfortable with. 

Thanks again for the insight!

Robyn

Hi Robyn,

I can only offer you, Robyn, my experiences when I became a gym member and had very similar experiences with hypos.

Although now 70, I am only coming up to 14 years since I was diagnosed with diabetes.

Within two years, I had neuropathy developing in my feet even, although my 3 monthly HbA1c was always close to 7.

My Endocrinologist diagnosed the neuropathy being caused by the fast rise and fall of BGLs, at that stage.

By changing my diet and exercising, along with a lower average BGL target, I prevented the progression of neuropathy and I still have good feeling in my feet.

For regular exercise, I became a gym member and had the problems with hypos that you have described, Robyn. At that stage, I was very new to Type 1 and was still coming to terms with regulating insulin injections and carbs combined with exercise.

By matching bolus insulin, carbs and when I started exercising, I usually finished an hour session without too many hypos. But there were days, even with testing every 10 minutes and with "hypo fixes", I could not complete an hour period of exercise.

Although I changed to an "am -pm" split basal injection, I did not change the amount of total basal that I was injecting.

My HbA1c dropped to 6.5 then 5.2. This 5.2 result was dismissed by my Endo as most likely to not be correct because of the number of hypos that I had experienced just prior to that blood test.

Looking back now, I think that reading was close to being correct, because I was not using a CGM and I was waking up through the night with a lot of hypos of 2.8 mmol/L.

By reducing the pm basal insulin and matching this injection to the amount of physical activity, I prevented most of the night time hypos.

Even to this day, I still have problems getting bolus and basal injections correct after a period of inactivity then becoming physically active again.

On this first day of activity, I may have to inject more bolus but on the second day, I will have to reduce both bolus and basal injections.

Within the last 3 years, I changed to Ryzodeg (70% basal – 30% bolus) which I now inject only once at night. I still use NovoRapid for bolus corrections. Although I followed the recommendations of not changing my daily amount of Ryzodeg injection, this is why in ended up in hospital with a very stubborn hypo and qualified me for a subsided CGM. It occurred after several days of hard work.

This was a basal induced hypo and no matter what I did or ate, BGLs kept falling. I am now confident with changing my Ryzodeg and matching this injection with physical activity. If I am not sure, I will miss the night injection and inject the Ryzodeg the next morning.     

 My appointment with a Diabetic Educator has been brough forward to next Wednesday so I will back with a CGM, making life much easier.

Paul

Hi Team,

My main problem with exercise is the crashing low's I can sometimes experience many hours later, even though I think I have adjusted my food and insulin correctly. This really, really puts me off doing exercise, because I don't want to deal with it and it's frightening. Then I beat myself up about not exercising! 

Thank you for the opportunity to ask this question!

Robyn

Hi Paul,

Thank you for the detail of how you try to manage exercise hypo's.  It's reassuring to know that the juggle is real and not just for me! 

I'm going to scale back for a little while to moderate exercise while I sort through the carb and insulin dose maze, and try to get to an equilibrium I am comfortable with. 

Thanks again for the insight!

Robyn

Hi Robyn,

I can only offer you, Robyn, my experiences when I became a gym member and had very similar experiences with hypos.

Although now 70, I am only coming up to 14 years since I was diagnosed with diabetes.

Within two years, I had neuropathy developing in my feet even, although my 3 monthly HbA1c was always close to 7.

My Endocrinologist diagnosed the neuropathy being caused by the fast rise and fall of BGLs, at that stage.

By changing my diet and exercising, along with a lower average BGL target, I prevented the progression of neuropathy and I still have good feeling in my feet.

For regular exercise, I became a gym member and had the problems with hypos that you have described, Robyn. At that stage, I was very new to Type 1 and was still coming to terms with regulating insulin injections and carbs combined with exercise.

By matching bolus insulin, carbs and when I started exercising, I usually finished an hour session without too many hypos. But there were days, even with testing every 10 minutes and with "hypo fixes", I could not complete an hour period of exercise.

Although I changed to an "am -pm" split basal injection, I did not change the amount of total basal that I was injecting.

My HbA1c dropped to 6.5 then 5.2. This 5.2 result was dismissed by my Endo as most likely to not be correct because of the number of hypos that I had experienced just prior to that blood test.

Looking back now, I think that reading was close to being correct, because I was not using a CGM and I was waking up through the night with a lot of hypos of 2.8 mmol/L.

By reducing the pm basal insulin and matching this injection to the amount of physical activity, I prevented most of the night time hypos.

Even to this day, I still have problems getting bolus and basal injections correct after a period of inactivity then becoming physically active again.

On this first day of activity, I may have to inject more bolus but on the second day, I will have to reduce both bolus and basal injections.

Within the last 3 years, I changed to Ryzodeg (70% basal – 30% bolus) which I now inject only once at night. I still use NovoRapid for bolus corrections. Although I followed the recommendations of not changing my daily amount of Ryzodeg injection, this is why in ended up in hospital with a very stubborn hypo and qualified me for a subsided CGM. It occurred after several days of hard work.

This was a basal induced hypo and no matter what I did or ate, BGLs kept falling. I am now confident with changing my Ryzodeg and matching this injection with physical activity. If I am not sure, I will miss the night injection and inject the Ryzodeg the next morning.     

 My appointment with a Diabetic Educator has been brough forward to next Wednesday so I will back with a CGM, making life much easier.

Paul

Hi Team,

My main problem with exercise is the crashing low's I can sometimes experience many hours later, even though I think I have adjusted my food and insulin correctly. This really, really puts me off doing exercise, because I don't want to deal with it and it's frightening. Then I beat myself up about not exercising! 

Thank you for the opportunity to ask this question!

Robyn

I was hoping there would be a post regarding the definition of stupidity but Type 1 Diabetes does not fit into this box.

You can inject the same amount of insulin, eat exactly  the same and amount of food and have the same amount of physical activity for the week and have very different BGL outcomes for each day.

Diabetes is a very complex chronic disease and when my son was diagnosed back in 1996, we were told, hopefully there would be a cure within 5 years.

Well, that 5 years' may be getting closer, because Type 1 diabetics may not have lost all their beta cells, and with recent new scientific advances showing that cells can be regenerated and grown and along with anti-body suppressant drugs, there may be a cure on the horizon.

I know that I am very lucky that I still have hypo awareness, although it is at a very low BGL, I can operate a cane harvester, drive in a straight line when cultivating cane and have never cut myself when filleting fish at this low level and this level has not changed since I was first diagnosed with Type 1. All these activities require high levels of concentration and may be, this is part of the reason, why I still have hypo symptoms.

I may have a chemistry background, but I still find it very hard keeping BGLs under control and there are limitations with the number of tests, different degrees of physical activities and change of diet not to mention the stress of everyday life, that add to the degree of difficulties that is required to manage Type 1 diabetes.

Paul

I was hoping there would be a post regarding the definition of stupidity but Type 1 Diabetes does not fit into this box.

You can inject the same amount of insulin, eat exactly  the same and amount of food and have the same amount of physical activity for the week and have very different BGL outcomes for each day.

Diabetes is a very complex chronic disease and when my son was diagnosed back in 1996, we were told, hopefully there would be a cure within 5 years.

Well, that 5 years' may be getting closer, because Type 1 diabetics may not have lost all their beta cells, and with recent new scientific advances showing that cells can be regenerated and grown and along with anti-body suppressant drugs, there may be a cure on the horizon.

I know that I am very lucky that I still have hypo awareness, although it is at a very low BGL, I can operate a cane harvester, drive in a straight line when cultivating cane and have never cut myself when filleting fish at this low level and this level has not changed since I was first diagnosed with Type 1. All these activities require high levels of concentration and may be, this is part of the reason, why I still have hypo symptoms.

I may have a chemistry background, but I still find it very hard keeping BGLs under control and there are limitations with the number of tests, different degrees of physical activities and change of diet not to mention the stress of everyday life, that add to the degree of difficulties that is required to manage Type 1 diabetes.

Paul