do you even carb

klorophile  asked:

If you're still open to questions about diabetes: is it "safe" to practice sports with Type 1 Diabetes? How do you know how to adjust everything if you're having a more demanding day than usual?

I’m definitely still open to questions. :)

Exercise is definitely tricky for diabetics, but it is also vitally important. Just getting a minimum of 30 minutes of exercise a day can help prevent two thirds of potential complications. There are three main reasons for this. 1. Exercise has numerous health benefits period, and diabetics really do need to be as healthy as possible. 2. It makes your body more sensitive to insulin so you can avoid highs. 3. If you gain muscles mass, you will burn more carbs even if you are doing nothing. In short, exercise is important.

However where it gets tricky is point two. If you give yourself insulin before exercise, and your body becomes more insulin sensitive as a result, you can drop low. As a result, diabetics must account for the exercise they are planning at the prior meal times. If it’s less than 30 minutes at a time of mild exercise, say walking to the grocery store, usually no adjustment is needed. However, if you will be exercising moderately or very vigorously for longer than that, you will have to decrease any insulin taken within two hours before you begin your exercise by anything between 10-50% depending entirely upon the duration and difficulty of what you are doing. This can also vary from individual to individual, and some experimentation is required. 

If the length of exercise is long-term, such as a day-long camping trip with a lot of hiking, then you will need to decrease your long-lasting insulin, and adjust your insulin carefully at meal and snack times. Additionally, what is called “ex-carbs” will likely be necessary. Ex-carbs are extra carbohydrates that you will take without insulin and is proportionate to your weight and/or the exercise difficulty. This way, as you burn sugar, you are slowly gaining it back without going high or low. Slow sugar release snacks are, unsurprisingly, the best for this. Bananas and granola bars are quite popular. Ex-carbs are also useful for spontaneous and unanticipated exercise wherein you have not been able to adjust your insulin at the prior meal.

Another pressing concern for vigorous exercise is adrenaline. If you’re in a high-stakes basketball game for instance, your body may release adrenaline. This is the hormone associated with the fight-or-flight response. Hence, it tells the body to convert fat stores to sugar to act as fuel in anticipation of, and in response to harsh exercise. Thus, exercise can raise blood sugar if it is intense. Therefore, it is not wise to participate in heavy exercise unless your blood sugar is 5.? or 6.?. In other words, anything between 5.0-7.0. (Incidentally, if your blood sugar is high, it is wise not to do anything more than mild exercise, as you could get DKA from the combo of high blood sugar and tough exercise.) After your blood sugar rises, provided it does rise, then when you’re done exercising, it will suddenly plummet. Hence, if you have not reduced your insulin within two hours before your exercise began, it may be necessary to reduce at your next meal in anticipation of this phenomenon. (This post-exercise plummet is also why for long-term exercise you would decrease your long-lasting insulin as the drop in blood sugar can happen hours afterward in such a scenario and it is wise to avoid nocturnal lows where possible.)

Finally, it is important to realise that exercise isn’t merely playing sports or going to the gym. It is also gardening, scrubbing the oven, working an eight-hour shift, or pacing your room. As a result, most T1Ds are obliged to plan out their days, or at least what they’re going to be doing with the next few hours, quite meticulously. They also need to be quite aware of what they’re doing. It took me awhile to get used to monitoring how much I pace when I have my music on for example. That way they know how much less insulin they need to inject. This is also why they frequently carry snacks: In case there’s a sudden change of plan and they need ex-carbs. It is always better to plan your exercise carefully, than have a lot of lows, as treating many lows is not only dangerous, but can cause you to gain weight. Obviously, that would be counter-productive. 

So, what do we do if we’re having a demanding day? We plan, plan, plan, calculate, calculate, calculate, and do the best we can. We check our blood sugar as needed, and treat highs or lows if they come. The above sounds difficult, and it is, (I struggled with it a lot when I was newly diagnosed), but once you’ve been T1D for a while, it’ll start to become second nature. Moreover, most people have routines, so eventually you’ll get an idea of how to compensate for all of the exercise in your life.