Today, Christel Oerum of the DiabetesStrong team is taking over SixUntilMe to share how she and exercise have become good friends, offering some insight on how she managed to stay toned and keep her blood sugars from crapping out. Thanks for inspiring me to get off my ass today, Christel. 🙂
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My story and experience
I’ve been living with type 1 diabetes for 20 years and been exercising on-and-off for most of my adult life. But I really got into fitness in 2012, and quickly started to notice that my blood sugars weren’t always cooperating.
Sometimes a workout would send my sugars plummeting and sometimes they would skyrocket. I was really puzzled and annoyed, so I went online to do some research and basically came up empty-handed.
I found a few (hard to read) scientific papers, some too-generic information (like “measure your blood sugar before exercising”), and a few good posts on endurance sports (which I don’t do). Nothing about just going to the gym and lifting weights for an hour.
Luckily, I’m a problem-solver at heart, and since there was no useful information to be found, I was just going to have to do the heavy lifting (pun intended) on my own and come up with answers.
I started very simply, taking notes with a pen and paper. I took notes about everything; what I ate (not just the carbs), when I ate, amount of insulin, IOB during workouts, workout type, time of day, etc. Anything I thought might be useful, I wrote down.
Somewhat to my surprise, I started to see clear patterns already after a few days. Those patterns turned out to be applicable (see this Lancet January 2017 for more information) for most people living with insulin dependent diabetes, so I decided to share my experience and guidelines on my website Diabetes Strong.
And just as there are tricks to ease into exercising, there are also tricks and knowledge available to help manage your diabetes during (and after) exercise.
Top 3 tips to exercising safely and effectively with diabetes
Understand the basics of exercise
The key thing to understand about exercise is that there are two main types of exercise and they will (in general) affect blood sugars in two different ways.
Aerobic exercise, like jogging, biking, walking or swimming, is characterized by a relatively stable elevated heart rate. This type of exercise will generally make blood sugars go down (potentially dramatically) during exercise and might flatline afterwards.
Anaerobic exercise, like resistance training, interval training, and some team sports, is characterized by intense bouts of activity with periods of rest or lower-intensity movements in between. Anaerobic exercise often make blood sugars rise during exercise, but can have a significant lowering impact on blood sugars after exercise.
Given these differences, you probably already have figured out that you need different diabetes management strategies depending on the type of exercise you’re doing.
You also need to be aware that the effect of exercise on your insulin sensitivity can last up to 48 hours after you’re done, so you might need to make adjustments to your diabetes management long after you finish exercising.
Spend the time learning your formula
We’re all different, and we react differently to exercise. That’s why we need to know the guidelines described above, but also just how exercise will impact our individual blood sugars. This comes down to what I call “finding your personal formula for food and insulin around exercise.”
I have developed a method for doing this based on exactly the same principles I used to find my own formula back in 2012.
The method is all about trial and error. Write down everything you do, look for patterns, and make small, incremental changes. After a while, you will start to get a good idea about how different types of exercise (and food) effect your blood sugar.
When you start tracking your data, remember the three golden rules:
- Reduce the number of variables – do the same exercise routine the first week or so. If you can also keep your active insulin on board when exercising the same, even better, but it’s not a requirement
- Test, test, test – as a minimum, you will have to test your blood sugar before your workout, right after, and 60-90 min after
- Accept missteps – it’s most likely that you won’t get it right every time, and that’s OK. Keep glucose tabs around and learn from your mistakes
I have created a tracking sheet you can use to collect the data. You can download it and see my step-by-step guide in my post “How to Find Your Formula for Insulin and Food Around Workouts” on DiabetesStrong.
Eat to fuel your workouts not your insulin
Exercise and nutrition go hand-in-hand, whether you live with diabetes or not. It’s absolutely essential that you eat according to your health and fitness goals.
Whether it’s strength goals, weight management goals, running distance goals, or general health goals, you need to eat right in order to achieve them. Just hitting the gym, the trails, or putting on an exercise video isn’t enough.
I believe in two basic principles when it comes to exercise, nutrition, and diabetes management.
One is that you shouldn’t need to “carb up” to do a 30-min cardio exercise routine. It’s my belief that you (in collaboration with your medical team, if needed) should be able to manipulate your insulin dosage to allow for shorter cardio sessions without going low. It helps a lot with weight management if you can do cardio without having to eat as many calories as you burn to control your blood sugar.
Of course, longer cardio sessions and endurance sports are a different case and may require a pre-workout meal.
Second is that you can benefit from eating before an anaerobic exercise session, simply because it can improve performance and support blood sugar management. You’ll need insulin on board to prevent blood sugars from spiking during an anaerobic session and a good pre- and/or post workout meal can help you achieve that.
I suggest including some carbs and protein in your pre-workout meal, which could be in the form of a shake, some of my cottage cheese pancakes (one of my favorite recipes), or something else you enjoy. My rule of thumb is minimum 20 grams of protein and 10-20 grams of carbs for a workout meal. But of course, that will also depend on your goals and what type of nutrition regimen you follow.
So, track to find your formula, eat up, have fun, and enjoy your workout!
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