How exercise increases the effect of insulin and carb usage


So for someone limiting carbs, more muscle mass would affect carb requirements, or could increasing protein do the trick?


I am still stuck on “Type 1” and “not yet taking insulin”.

Is adult onset that much different from pediatric onset?


No, carbs and protein do different things.

The carb requirement really depends on the level you are exercising. You really only need to replace what you are using. More intense and longer workouts means you would need more carbs. More body weight also requires more carbs.

There are percentages that can be used based on what you are doing - trying to gain muscle, lose fat, gain weight, do endurance training, strength training - all kinds of different values depending on what you are doing.

I imagine it is more tricky for someone who is not yet taking insulin. Are you taking it yet? If so, you can take more for whatever you are consuming.

I always adjust my insulin for diabetes, instead of adjusting my diet. My activity decides my diet. Always. Diabetes does not get to decide what I eat.


Just having this debate over in my room. There’s a big variety of labels people received as well as resulting treatments. I was late onset and was diagnosed as having gestational diabetes. My scores were off the charts though… probably because it wasn’t truly gestational. I only did a handful of shots through the remainder of my pregnancy and was successful by not eating much of anything and exercising in spurts throughout the day. However, within about 6 months of my pregnancy, everything changed, and exercise and diet were no longer sufficient. By a year out, my a1c was above a 14 or 15. I always felt that the pregnancy hormones were what pushed everything over. :thinking:


In short, Yes, it can be in some cases. We have a dia friend that was diagnosed with a slow onset form of Type 1, and didn’t take insulin for over 3 years, and now takes a relatively smaller amount than would normally be expected.


Based on what I’ve read the honeymoon period can be longer. But maybe someone else knows better.


Wow. Obviously totally different.

Also different. As I understand coming from the world of Pediatrics, honeymoon has a different meaning. At least for us (Peds) it does not mean “no insulin” (lol) it means erratic. I never understood how the term “honeymoon” really related or made sense.


I still don’t know how it all ties together for someone with low insulin. I know that if I exercise more that I will need more fuel. I was following a few low carbers online who are very active, run marathons etc, so I am trying to figure what they are eating, maybe if they are in ketosis they would just eat lots of fats. I only have 12% body fat. My BMI is in range but on the low side so I need to maintain my weight. I tried eating more oil and fat but I felt sluggish. I am still looking for balance.


I think the low carb might let you extend the no-insulin a bit longer. But if you want to work out frequently and at a high intensity, low carb is not ideal.

Your body can utilize fat for fuel, but not very quickly. Yes, you can find people running marathons on low fat diets, but not in the Olympics. It just depends on what performance level you are trying to reach.

I think it can depend on what is meant by “low carb”. What kind of numbers are you calculating? 50g per day? 100g per day?

It really depends on what you are trying to do with weightlifting and whether you are trying to gain weight (muscle), lose fat, gain strength, compete, etc. So there is no set number, it just depends.

The carb needs for someone who is weightlifting would be less than for someone who is doing endurance training.

Here is a calculator for weightlifters (this is not for runners). Keep in mind, this is not a diabetic link, it is for general purposes only, and you have other factors you are considering.

I can understand you wanting to extend the honeymoon period. But in general, I think the diet becomes easier when you take insulin.

But I would defer that observation to some other adult onset people who can share their experiences with it. I didn’t have a slow onset, I was taking shots right away, so my experience is not helpful in that regard.

@Chris, who are all the members who had a slow adult onset type of diagnosis? I can think of Emily @Pianoplayer7008 right away. And @CarolynA, and @Irish, and @Sam, but I am not sure how slow the ramp up to taking insulin was for them all.

Who else?


Ha, yes, I’ve hadslow onset (still on only bolus, almost 2.5 years post-diagnosis), but I can’t really speak to either exercise or low carb diets extending honeymoon phase, sorry. :blush: I have heard many experiences on other groups of exercise and low carbing being the way to go to manage in the honeymoon phase (to extend it), but my personal theory (and that’s all it is) is that yes, those lifestyle/diet choices extend the honeymoon phase, but for a very specific reason - I have noticed that the more tightly controlled I am (regardless of exercise and diet variations - just talking matching insulin doses to what I need), the easier time I have controlling things, because my pancreas “revives” a bit with the strain on it lessened. When I am mostly flat for days, I will suddenly have a day or two where I don’t even need any exogenous insulin. So my theory is that exercise/low carb diets usually allow for tighter control (whether able to control that tightly in very early stages through exercise/diet alone, or through dosing appropriately once insulin therapy has begun), which in turn relieves the burden on your pancreas, which then in turn extends your honeymoon (and that’s a very simplified explanation - I believe there are even more factors to consider such as when you’re diagnosed, weight/insulin sensitivity or resistance levels, etc, etc). I have zero proof of it, but again, it just makes sense based on what I have experienced and noticed from others with LADA. IF my theory is correct (a big if!), it shouldn’t matter if you exercise and refuel appropriately with whatever amount of carbs as long as you dose insulin accordingly to lessen the demand on your pancreas. Obviously this would be difficult for someone who isn’t yet on insulin who is already seeing higher numbers (I do think exercise/low carb diets alone can be sufficient in the very early stages, but it doesn’t last forever), which is why I believe very strongly in early insulin therapy to help extend the honeymoon phase. As @Chris pointed out, our understanding of LADA is very limited at this point, so it’s realy anyone’s best guess on how to extend the honeymoon period.

All that being said, I’m pretty much going along lately roasting any chance at extending my honeymoon further because I am eating plenty of carbs (~200/day), and have relaxed my BG goal range because life is life right now and I’m just surviving. So you don’t have to listen to me. :laughing:


I wouldn’t really say I was slow onset… it was pretty out of control when it was recognized


This topic is of interest to me too, although I’m pretty “far gone” at this point, so to speak. I was diagnosed just about 8 or 9 months ago and went on basal immediately. My-PCP at the time thought I could get by for quite some time on basal alone, and despite frequent post-meal BGs around 200 still didn’t reccomend bolus insulin. I started bolus after after getting into an endo a couple months later, and it made a world of difference and I totally should have been on it from the get-go.

That being said, a low carb diet and exercise may have almost been enough for me for a while, and probably would have worked for a bit if I’d been diagnosed sooner. Super low carb just is something I’ve not been willing to try up to this point, so I definitely needed the bolus to go along with my medium-carb approach.

I’m intrigued by @Pianoplayer7008 theory though… For me, I notice that a couple days of lower carbs along with consecutive days of exercise is a good “re-set” when things start getting harder to control. I suspect I still have some insulin production (though my endo disagrees), and I don’t know if perhaps the lower strain on my system from a few days of reduced carb load gives it a little spark or what. But when it gets crazy, I take a couple days to eat lower carb things that I know how to bolus for without chaos ensuing, and things seem to get a little more manageable for a while, even after adding a few more carbs back in. I wonder if this occurs for others too??


Have you ever done a c-peptide test?


When diagnosed in February is was 0.8… it says the reference range is 1.1 - 4.4


Any thoughts about testing it again?

I don’t know from personal experience, but it seems like it would be useful for those with the slower adult onset.

@Pianoplayer7008, have you done a c-pep?


Yes, it was 1.6(?) at diagnosis, and last check was in December (so a little over 1.5 yrs post diagnosis), and it was 1.4. Both fasting, range is 1.1-4.4.

I’d love to do a challenge like @Sam did - got BG up (around 200?) and then tested to see what insulin/c peptide levels did. I think that would be a more accurate measure of whether or not your pancreas can still help you out. That being said, I did have a c pep done not fasting (didn’t realize any fasting-needed labs were being done), and at the time, it was 3.4 (BG was 105; A1c 5.6, down from 5.8). That was just a couple months after diagnosis, though, prior to needing insulin (before I got crazy and decided to have a baby, which made everything go nuts).


I’ve wondered about it, but didn’t think knowing would change much of anything, so I’ve never asked him to check it again. Would be fun to see if I’m right or the endo though :slight_smile:


Thank you for all of the replies! I was trying to start insulin but couldn’t figure how to dose it. I am definitely sticking with low carb for now, following Dr. Bernstein diet. I fasted for 24 hours to establish my basal dose but I was in the 70’s at night, but start rising once I get out of bed and usually end up at 100 without eating.

After Lunch and dinner my levels are great, I walk my dogs after dinner, at a brisk pace and there are enough hills that it gets my heart rate up.

I have thought about using basal or bolus soon. I have levemir and apidra. I think the apidra is to fast for my diet but I may be able to take levemir if the dose is right. May start with a half unit timed to peak at noon. Since my BG doesn’t really get too high the only reason would be to give my Pancreas a break. For bolusing while on a low carb diet, maybe i need regular insulin, it’s too bad the only way to do micro doses is with a pump.

Also my levels keep getting better so I am interested in seeing where they end up without insulin. My recent A1C was 5.7, that’s down from 12 on June 19th. My Libre averages are in the 80’s.

I do have some strange symptoms like visual stuff in bright light so I was worried if my brain was getting enough sugar, so that’s another reason to start insulin if there is a chance I’m starving my cells.

I should make a decision soon…haha