Sunday, February 17, 2013

The Grey Area of Diabetes Prior to Exercise

Diabetes is full of these choices. Constant choices. How much insulin, how many carbs, etc. I like to think of it as driving a stick-shift, after awhile it just happens. However, one of the choices I've yet to figure out is the grey area prior to a workout.

The grey area is the time period between a regular meal and a preworkout snack. I use the rapid acting insulin, Humalog. There are a few of them, which may or may not be different from one another depending on who you ask (Humalog, Novalog, Apidra). Rapid acting is the insulin a person uses in an insulin pump or taken as an injection for a meal/correction. 

Rapid acting takes about 15 minutes to start working, peaks at about 90 minutes and is out of your system in 3 hours (or 4, again depending on who you ask).

Here's the problem. 

Preworkout food can be eaten and an injection given if I'm about to start a workout. A full meal can be eaten if I'm over two hours from a workout. But what happens if a workout is 90 minutes away? Or 60 minutes away? I'm in the grey area. Decision time. Do I have a full meal? Do I give a full injection? 

A full injection might peak at the start of the workout sending me into a low spiral downward. Not giving the full amount might send me off to a workout with a high blood sugar. Decisions. 

Really, there are only two times when this is a problem for me. One, during a workout after work. I just opt to not eat after lunch when I know I'm going to workout after work. The second is on the weekends, typically when I wake up 60-120 minutes before a long group ride. Do I eat breakfast? Do I wait to have something small before the ride? 

It's a rough decision. I want a large meal before a long ride but for me I just can't give a full injection during the grey area and not be sent low during the ride. The best decision for myself is to wait, not eat breakfast and have something before the ride. 

The reason I'm even bringing this up? Yesterday before my group ride I opted to eat breakfast with a small injection, not the full amount for the food I consumed. Waiting for the group to leave at the meet up spot ninety minutes later my blood sugar was through the roof. I gave myself a correction and then stressed the next 90 minutes about going low. I ended the ride with perfect blood sugars but the stress of a low wasn't worth it. 

Until insulin is even better, timing is everything. I even write this blog to remind myself of that. Yesterday was an odd choice for me, maybe I needed the reminder. Next time the food/injection can wait until right before the ride. I'll stay out of the grey area.

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