Trying to eliminate running BG LOWs and post run BG HIGHs

Sports & Exercise
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No, I don’t bring test strips or lancet with me, but I did have my Omnipod pump. Testing would be better I know, but I have a hard time getting blood from my fingers when it’s cold :frowning:

Even if I “timely” reduce my basal? I thought by reducing the basal that I wouldn’t need to eat. Today, wasn’t timely I guess, but in the past this method worked very well. I don’t really like eating while running :frowning: I don’t generally carry water in the winter months because it is too cold to carry, but I had thought about adding something like lemon to the water just to get that extra sugar intake in small amounts w/out having to eat. Does that seem like a solution?

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There are two separate things here. One is diabetes. For that, you just do whatever works. If you can cut basal insulin and manage that way without carbs, it’s fine.

The other is the running part. For that, giving your body carbs is the best thing from a perspective of fueling the exercise.

So when I said you should have carbs, it wasn’t for the diabetes, it was for the running part. :smiley:

There is a level of exercise where you can use all fat metabolism. And then as you speed up, you are increasingly using more carb metabolism (muscle glycogen, and glucose in your blood and what you have recently eaten).

Anyway, I was just referring to you as a runner, not as a diabetic runner. And I think that is the best way to go. That is always my goal, every run.

This is a very simple explanation.
how-does-my-body-fuel-exercise

And this one is a bit more complex:
RER-how-exhaled-air-tells-us-our-fuel-source

Anyway, I am not trying to talk you out of something that works for you as far as BG management. I am just talking about the ideal way to fuel your run as a non-diabetic. As you increase your intensity, you increase the carb requirements. That’s when you really want to start taking in carbs as a part of the run.

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I’ve read this:

I’ve tried to apply it to my running but I think I probably don’t get enough carbs for my long runs. I’m a slow runner in general but I feel pretty exhausted after my runs for the most part. Course it does depend on my BGs to some extent. I don’t know what that says!!

Yes, I agree, best to treat the body as a runner, not a diabetic runner! I think that is what I do or try to do but then end up having too many lows!:frowning:

Well, at least the fruit gummies worked today. Let’s see how tomorrow goes! :slight_smile:

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Okay, see, @Eric? This is why I wanted to do a couple of runs where I show my dexcom numbers alongside my meter numbers. Today I jotted down a couple. I’ll put them in my write up just so @trying can see what they look like. Obviously hers won’t do the same mine do, but maybe it’ll give her an idea??

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@Nickyghaleb are your meter BGs out of sync, too, with the cgm? In my case, I don’t think it is just due to the cgm delay. I think the cgm is just off since I don’t feel those lows. Of course, sometimes it is accurate and I really do have lots!! :frowning:

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I’m not sure I’d say they’re out of sync necessarily. However, a lag is only one part of the problem. My Dexcom, which was also true for the Libre, often overshoots on a climb. I know that’s not what you’re describing at all, but I’m just trying to demonstrate another pattern. The lag, obviously, results in a less extreme sensor value than my actual BG, but the overshooting does the opposite and appears to be a more extreme value than my BG.

I just can’t much rely on a CGM during exercise. That’s the conclusion I’ve come to. I understand it is really meant for trend, and that’s fine during other times of the day, but because I can get a little BG bounce going on during exercise, those numbers just can be too deceiving. I become afraid I’m still crashing when, in fact, I’ve already turned. Or I think I’m good when I’m headed down fast. For all of these reasons, and thanks to Eric’s encouragement (and gadgets!), I’m testing all throughout the run. I’ve stopped looking at my Dexcom or responding to any alerts at all because I’m always a few steps ahead of it. If it’s letting me know I’m headed down, I’ve already spotted it and taken action. I, personally, just can’t stay on top of it with the CGM because I’m basing my decisions on flawed numbers.

This isn’t a pitch for going CGMless during your run. I was just trying to confirm that there’s lots my CGM is showing during my runs that just isn’t reliable. Which, I guess, might make this a pitch for doing a Fingerstick or two while you’re out.

Today my dexcom took note of my climbing BG as I got on the treadmill. I was starting at a BG of 134, Dex 123 (or so). My Dexcom over the next 10-15 minutes showed a steady climb up to a 179 with arrow up. My actual BG at that time was a 124. Next value was a 179 while my actual BG had dropped already to an 89. I’m not mad at my Dexcom, but I’m learning that I stand a better chance when using meter readings.

I had one other thought…

Oh! About not feeling your lows. This also might not pertain, but today I dropped to a 50 during my run, and I was wobbly as all get out. I was spacewalking, uncoordinated, and just feeling like I needed to be done. I felt that 50 way more than the 40-something I had in the middle of my run last week. Even as I got back to ~60, I was just wrecked. Last week I think I ran 6 or 7 miles in the 55-65 range. I’m not sure, but I think when I drop fast at all during the run, I feel the low more than when I coast low. Today was a low 50. The other day was a fine 50. Today I had insulin on board, and the other day I didn’t.

And it could all not apply to you in the least. These are just the things on my mind these days. :smiley:

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@Nickyghaleb Thanks for your experience on cgms. I really appreciate your observations and you describe it so well! This is what I see, too. It is almost like only the trend is useful, not the actual number. And even the trend can be deceiving with the lag!

Wow, your reaction yesterday to your mild low in the 50s must have been scary. I guess even the meter may have been off, especially as you had IOB. Your BG must have been lower than 50s, or in the process of going lower. That’s when you know you’d better eat something!

I will try bringing the test strips and lancet with me today :slight_smile:

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And I’ll try keeping an eye on my CGM to see how they line up… and then pretend like I’m doing it to help someone else. :grin:

Have a wonderful day and a wonderful run!

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So today’s run was pretty good. I reduced my basal a bit longer before my run, 40 minutes instead of 30 minutes pre-run. Same ratio, 0.1U/hr. I also ate 10g carb (1/2 sm banana) pre-run as I was in the low 60s. At run-start, right away my BG peaked at 119 (cgm) then started to go down. So I had two separate food intakes of 4g each (2 Kirkland fruit gummies) and that seemed to work.

I did do a fingertest during the run, about an hour in, and surprisingly, it was nearly the same as the cgm! 78 vs 75. The meter test is the red square on the xDrip+ graph below, between the two, 4g treatments. At run-end, BG 75 (cgm) vs BG 101 (meter) and I bolused 1.3U immediately for the Boost shake which I drank 20 minutes later.

So all in all it worked out pretty well. BUT I had a couple lows since the run though :frowning: I did a temp basal at 50% of basal for a couple of hours. Still only BG 68 now.

xDrip+ graph:

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Screen Shot 2019-03-01 at 5.26.45 PM.png756×568 81.7 KB

And the numbers…

  • 40 mins pre run-start: 9:37, BG 71 (cgm), Temp Basal reduced by 80% for 2.5 HRs: 0.5U/hr down to 0.1U/hr
  • Eat: 10:00, BG 62 (cgm), eat 1/2 sm banana 10g carb
  • Run-start: 10:17, BG 79 (cgm), IOB 0U
  • Eat: 11:22, BG 78 (cgm), BG 73 (meter) eat 2 fruit gummies 4g carb
  • Eat: 11:40, BG 61 (cgm), eat 2 fruit gummies 4g carb
  • Run-end: 12:40, BG 75 (cgm), BG 101 (meter), Bolus 1.3U immediately upon end
  • Run-end: Resume normal Basal (0.5U/hr)
  • Post-run: 13:00, BG 93 (cgm), drink 1 Boost Chocolate Shake 16g carb
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I have noticed that whenever I have a reduced basal before a run, any carbs before the run will do a lot more. I always try to be conservative with carbs before a run when I have any reduced basal. Or I take the carbs right when I start. If I take carbs on a reduced basal 15 minutes before starting, I often see a spike.

Great numbers today!

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Ah, that explains the immediate climb then once I started running. I did eat the banana about 10 minutes before I actually started. Worked out okay, but the bg climb sort of startled me! :slight_smile:

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It can work out fine if you do carbs before, but I just like to be very conservative with carbs on a reduced basal. If I take carbs right at the start, it times pretty well in terms of being available when my body is calling for it.

Once you get past that first few miles, you can stabilize and be pretty solid. It takes a few miles at steady-state pace for all the energy systems to become activated.

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I hope you understood my last post with all of those typos! I fixed them.

I will try a small amount of carbs today at the run start. Short run today, on a snow covered bike parh, not my usual trails :frowning:

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Yesterday, I only ran a short bit on a paved bike path, less than 2 miles, but due to the snow storm I quit early. I did do about an hour of snow shoveling though!! That certainly brought down my BGs!

Today I returned to trail running, hoping the snow wouldn’t be too deep. I prepared with crampons and gaiters though. The temp was so warm though snow had already started to melt, making a mess of the trails, a combination of mud, ice and snow! So I again ended cutting it short due to the uneven terrain as my ankle is still weak :frowning: I did my usual prep, reducing my basal down to 0.1U/hr or 20% of my normal basal. I also ate 4g (fruit gummies) carb right at start since my BG was on the low side, 78 (cgm).
This brought my BG up but I still ended my run low, at BG 49. I think this low was really more to due with the terrain being so difficult to maneuver. I should have taken more carbs during the run.

So all in all it worked out pretty well despite cutting the run short. BGs have been unusually stable post-run, too. I’m not sure what to attribute that to! Instead of a Boost drink post run, I ate mixed nuts and cheese :slight_smile:

Tidepool graph:

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Screen Shot 2019-03-03 at 5.18.06 PM.png1390×1044 62 KB

And the numbers…

  • Pre-run: 11:25, BG 96 (cgm), Temp Basal reduced by 80%: 0.5U/hr down to 0.1U/hr
  • Run-start: 12:00, BG 78 (cgm), IOB 0U, eat 2 fruit gummies 4g carb
  • Run-end: 13:40, BG 48 (cgm), BG 49 (meter), Bolus 1U immediately upon end
  • Run-end: Resume normal Basal (0.5U/hr)
  • Post-run: 14:10, BG 61 (cgm), eat mixed nuts and cheese @16g carb
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Are you doing rehab for it? Are you familiar with using rice? It’s a great strengthening technique.

It’s kind of like this video, but you would get a large enough container that allows you to rotate your foot and ankle completely, in all directions. Up and down, circles, side to side, back and forth.

Have your foot completely covered and move it in as many directions as you can. This provides much better resistance than a simple elastic band, which only resists in a single direction.

Just make sure you have a large enough container. Instead of a bucket, use a plastic bin.

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No, no rehab per se, but I do soak it every evening in Epsom salt and use an icy hot patch afterwards! I’ve also been doing ankle lifts to try to strengthen both ankles. I stand on the edge of a stair with just my toes with a 15 pound weight in one hand, then raise myself with my toes (like on tippy toes), and lower myself below the step edge (about 45 degrees), repeatedly for about a minute. Then I switch hands for the weight and repeat. I do 3 sets of these. I think it helps.

Wow, no, I’ve never heard of rice therapy!! I’ll have to go out and buy some rice!! This sounds like a great idea. I imagine this provides a more complete ankle workaround compared to the resistant bands. Thanks!

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Exactly!

Also running in soft sand can be a good strengthening exercise. Or walking on the outsides of your feet for a minute or so, then walking on the insides, then walking on your toes, then heels.

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Running on sand will have to wait for a few months til we warm up! :slight_smile: I’ll try the walking technique. Thank you!!

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Make sure your ankles are strong enough to do that. It’s good exercise but can be surprisingly tough if you are still recovering.

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I’m able to run, I just can’t maneuver uneven terrain very well. So, I think the walking exercise you mentioned would be really good for that, but done very carefully! :slight_smile:

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