The IOB Predicament... What do you do with a climbing blood sugar prior to starting exercise?

I call it “The Force”.
:yoda: image
Ask @daisymae. She is now a believer!

But what do you mean now? Are you asking about what you should do after you run, as far as carbs are concerned and so forth?

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I’m doing this in pieces… but here’s my line. And what a fine one it is. I left the house just after 1, and that correction was when I got back…

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Can you provide these stats for me?

  • Length of run (in minutes)
  • Exercise intensity
  • Starting BG?
  • Any BG tests in the middle?
  • Finishing BG?
  • Basal adjustments - how much, when, and how long?
  • Any carbs before starting? (beside coffee, which I assume was unsweetened?)
  • Any carbs needed during the run?
  • Carbs needed after?

I know that some of these have been mentioned, but It’s easier for me to see it all in one place.

EDIT:
Seeing BG numbers are more valuable to me than CGM. Especially given how little confidence I have in the Medtronic CGM. And even my CGM when running is pointless. I often don’t even take it with me.

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Pointless to me, too… or at least until it’s too late. But it will show the trend anyway. And, yes, I’ll get you all of my info in a minute. It was great, and things have been a little rocky but still quite good since. I’ll be back…

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  1. 10 min walk then 30 minute run, followed by 20 minutes of alternating running and walking (more run than walk), followed by 20 minutes of walking
  2. High intensity
  3. Starting BG: 126
  4. No tests in the middle
  5. Finishing BG: 69
  6. Basal adjustments: I followed your recommendations and started a 0 basal 30 minutes before starting and didn’t turn it off until returning home… and something is wrong with my math because i was suspended a total of 2 hrs and 15 min. All I can think of is that it took me a little longer than I though getting out the door, I walked longer than I thought at the end of the workout, and I didn’t end the suspend right away (maybe 5 minutes late)
  7. No carbs before except one cup of coffee which of COURSE was sweetened with a little sugar free creamer (I count a cup as 8 g of carbs)
  8. I had one glucose tablet when I was about 15 minutes away from home.
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This looks promising. You did not end in the ditch. Finishing at 69 is decent.

That drop of about 50 points is what we want to improve.

Given that you needed a gtab toward the end, and had a 50 point drop, how about next time doing the exact same thing but doing a suspend of zero basal 60 minutes before, instead of 30 minutes.

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I’ll do that. I was actually thrilled with today… I’m usually WWL (walking while low) by the end, but today I had a bit of a swagger. :smiley:

In case I haven’t said thank you enough, thank you. :slight_smile:

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You are welcome. Let’s get some more trials in to see if it fits together.

Was the hard part significant? Pulse rate close to 85-95% of max? Enough to raise your BG?

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That’s kind of a hard question… I’ve never thought of my BG as rising during a workout unless I’ve started too high OR have done something to really make my BG rise… so I wouldn’t know. I used to wear a heart rate monitor with every workout. My heart rate was around a 190-210 with a good workout. I don’t wear a monitor anymore, but I know that when I’m working, I’m working hard…

Not much of an answer. Could’ve just said I don’t know…

There is a certain intensity where your body will release stress hormones which cause your liver to convert glycogen (stored carbs) to glucose. The process is called glycogenolysis.

It is helpful to know what heart rate and duration will cause that to happen.

Sometimes I might start a workout with a BG near 70, and if it is one that is of high intensity, I will take insulin right when I start. Even though my BG is not high. Just because I know a spike will happen.

I have no idea where it is for you. That comes with testing and paying attention to BG and heart rate over and over.

But for example, it might happen if you hit 190 for 20 minutes, or maybe 210 for only 10 minutes. It is a combination of intensity and duration. Just a certain point where your body says, “Nicky you need some help. Here is some fuel”.

Just a useful thing to know.

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:woman_facepalming:

I’m starting to get the feeling it’s not so much that you’re using “the force” as it is you know every single number associated with every single bodily function and every possible interaction and …

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I got that way from paying attention to it.

Why did my BG spike after this workout?

…days pass…

Well, what do you know, it happened again…

Lemme see…speed? duration? intensity? heart rate?

Your lactate threshold heart rate is usually the area where you spike.

If you run as fast as you can hold a constant pace for 30 minutes, that’s generally your lactate threshold pace. It is where lactate in your blood starts to accumulate at a faster rate than it can be removed.

So the heart rate you have at that pace is the general area of a BG spike caused just by exercise.

EDIT:
Really none of this is very important right not. Just be aware that a significantly high intensity workout can cause a spike. And it can be a massive spike too.

When it happens to me, mine are generally 80-100 points from just the workout, no food involved. And it can be extremely fast, like popping up 100 points in 10 minutes.

Then I’m very safe because this would not ever happen. If I ran as fast as I could, I’d be done in 30 seconds… 35 on a good day. So I’m not going to worry about lactation…

:smiley:

I suppose it wouldn’t hurt to brush off the old heart rate monitor today. I’ve enjoyed not paying attention for a long time, but it would be interesting to see. And I will say my BG has gone every which direction during workouts, but I’ve always assumed it was a carb intake issue. It ALSO explains, now that I think about it, an episode I never did figure out… I was leading a Zumba class, and my heart rate was very high for most of the class. It peaked at a 224, which was the highest it’s ever been. I was very sick, and my head was really bad. When I finished, I sat down, throbbing headache and nauseous, and tested. I was above a 600. I knew it all had to go together somehow, but I didn’t know how. But maybe?

Okay. Good information. Oh, i meant to ask. I don’t need to do the 4 hours again that I did yesterday, right? I just want there to be no IOB and want to hit 0 basal 60 minutes prior to starting??

It is not as fast as you can run, and running for 30 minutes.

It’s the fastest pace you can hold for 30 minutes!!
(is it a 10 minute mile? a 15 minute mile? a 6 minute mile? whatever it is that you can hold for 30 minutes)

You can run whenever you want. But the important thing is to see the BG trend before you run.

And I just want BG numbers from your Contour, your insulin doses and basal adjustments, and your carbs.

Just carbs, insulin numbers, and BG numbers

So glad you clarified… this was definitely more likely to have a ditch ending.

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Just saw you repeated that… was that a dig? Like i was maybe going to provide something more than that?

No. It was much too subtle to be a dig. If you hang around here long enough, you’ll see my digs are obvious. :stuck_out_tongue_winking_eye:

You can provide whatever you like. But I will only look at the things I mentioned.
Plus run intensity and duration. I’d like that too.

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Okay… I’m not sure what happened, but today everything hit the floor… my BGs, my calibration factors, my behind. I decided to skip the coffee ALL DAY and just let nature motivate me. So I never got up. :slight_smile:

Tomorrow, I’m hitting the pot hard. And starting off with a run. So then my plan is… to get up, start a 0 basal… and? how do I handle my first cup of coffee if I’d like to have two before I head out??

Well that is the problem. Your pot habit…

How much does coffee spike you? Give me a carb equivalent, as in, how much you normally bolus for it.

Whatever insulin you take away from your zero bolus of one hour, take that away from your coffee bolus.

Example: If a zero bolus removes 0.50 units for the one hour before your run, remove that from your coffee bolus.

The problem is that if you drink coffee long enough before your run, anything you do for it will start to affect you long before you start.

Like this - “I am going to run in an hour. But I will do stuff that tinkers with my BG for the 1 hour before I start…”

It’s kind of like when I say, 0 IOB when you run. I want nothing that interferes with you.

And coffee…it interferes…

Does all of that make sense?

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