Wednesday, February 20, 2013

Extreme Exercising

I posted the other day about what it feels like to be 400, but left out one detail:  

Most doctors and the ADA don't recommend exercising if your blood sugar "ins't in range."  From the Mayo Clinic:


Consider these general guidelines relative to your blood sugar level — measured in milligrams per deciliter (mg/dL) or millimoles per liter (mmol/L).
  • Lower than 100 mg/dL (5.6 mmol/L). Your blood sugar may be too low to exercise safely. Eat a small carbohydrate-containing snack, such as fruit or crackers, before you begin your workout.
  • 100 to 250 mg/dL (5.6 to 13.9 mmol/L). You're good to go. For most people, this is a safe pre-exercise blood sugar range.
  • 250 mg/dL (13.9 mmol/L) or higher. This is a caution zone. Before exercising, test your urine for ketones — substances made when your body breaks down fat for energy. Excess ketones indicate that your body doesn't have enough insulin to control your blood sugar. If you exercise when you have a high level of ketones, you risk ketoacidosis — a serious complication of diabetes that needs immediate treatment. Instead, wait to exercise until your test kit indicates a low level of ketones in your urine.
  • 300 mg/dL (16.7 mmol/L) or higher. Your blood sugar may be too high to exercise safely, putting you at risk of ketoacidosis. Postpone your workout until your blood sugar drops to a safe pre-exercise range.

Exercise is a big part of my life, just like diabetes.  If I followed these rules diligently, I would probably only work out 50% of the time.  And if you personally know me, I'm fairly stubborn when it comes to my workout routine.  I'll do what I want to do, whether diabetes is playing fair or not.

If I'm less than 70, I'll eat 10-15 carbs and go exercise.

If I'm less than 100, it depends.  If I have insulin on board, then I'll eat 15 carbs.  If I don't I most likely won't do anything and o exercise.  

If I'm 100 - 150, I don't do anything and go exercise.

If I'm 150-200, I take a small bolus if I don't have any active insulin.  This would be between 0.1 and 0.5 units and go exercise.

If I am 200 - 250, I take 1/4 of the correct bolus and go exercise.

If I am 250 - 300, I take 3/4 of the correction bolus and go exercise.

If I am above 300, I take 100% of the correction bolus and go exercise and check my blood sugar 30-45 minutes later.

Even with the above guidelines that I have adapted over time I still have issues.  For example, when I do speed work or track workouts I tend to go high.  If I do long, slow runs I tend to go low, especially if it it cold outside.  With that being said, I carry some type of carbohydrate with me (mostly GU) 99% of the time when I run.  If my guidelines fail me, I can rely on my GU to get me through the run outside.  If I am at the gym, I simply go to the locker room and check my blood sugar and will just eat something right there.  

What I do and what you do may be completely different things, which makes diabetes such an individual disease.    

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