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Exercise and weight loss with an insulin pump

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Does anyone have information on managing blood sugars when trying to exercise and lose weight. I struggle with having to "feed" the lows that are a result of exercise.  Is there a chart or graph or formula for adjusting insulin with a pump to manage exercise?  I'm looking for some reliable resources. Thank you!
posted Apr 5 in Conversation by Tanya (520 points)
retagged Jun 30 by KarenG

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I've found the book Your Diabetes Science Experiment by Ginger Vieira very helpful in figuring out exercise.  Here is an Amazon link: https://www.amazon.com/Your-Diabetes-Science-Experiment-Instead-ebook/dp/B007NME2S4/ref=la_B008ZPEGQ6_1_3?s=books&ie=UTF8&qid=1491420017&sr=1-3  It has a lot of great advice on many topics, including exercise.  There are also worksheets to help you figure stuff out.  I actually made several photocopies of the exercise worksheet and used it to log each workout and it really helped me figure out how best to exercise without going low.  (Not all the time, mind you, I haven't found anything foolproof.  Sigh)

Does anyone else have a some advice that has helped?

answered Apr 5 by KarenG (16,340 points)
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As for everything with diabetes, it varies for everyone. From the book "Diabetic Athlete's Handbook" by Sheri Colberg the amount to reduce your basal rate depends on duration of the exercise and intensity of the exercise. For example if you exercise for 30 minutes at a moderate rate, she suggests a 10-20% reduction rate. For 60 minutes of moderate activity, she suggests 20-40% reduction.

For me, if my blood sugar is at my goal (120 or less), I decrease my basal during exercise by 20%. If I'm high starting out, I will not decrease my basal at all. It also depends on the weather. If it's hot out and I run outside, I may actually increase my basal or give myself a small bolus before I run (my blood sugar tends to go up when it's hot outside...don't ask me why). Honestly, having a CGM is incredibly helpful because you watch the trend and adjust accordingly.

To start, maybe try decreasing your basal by 10-20% for the amount of time you exercise. Also, check out the book that I mentioned above and "Think like a pancreas" by Gary Scheiner. Both are good resources for exercising, though Scheiner's book is more than just exercise.

I hope that helps!
answered Apr 6 by Asgundlach (740 points)
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Thank you! I have added the books to my wish list on Amazon.
answered Apr 6 by Tanya (520 points)
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Because of all the variables such as how much insulin is on board, the time it takes for your insulin to absorb, what your blood sugar is when you start, the status of your infusion site, how recently you have eaten, how much you ate, how strenuous the exercise, the length of time you exercise, whether it's that time of the month, and about a million other things, it is difficult to to have an exact formula for how to adjust your pump. When I go out for exercise I predict the best I can how to adjust my basal and whether I need to eat something before I start. It's trial and error. I've gotten better at predicting what I need and avoiding lows during exercise. But I still take a meter and glucose tabs with me or have them both nearby.
answered Apr 12 by janmosso (1,460 points)
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Reducing your basal rate right before exercise doesn't help.  I try and turn it down 30% about 45 minutes before I run. I also eat a snack with protein before I go.  Those lows during exercise can be nasty. Watching the arrows on the CGM are very helpful to me.

Since I typically exercise late afternoon, overnight can be tricky for me too. I sometimes reduce my overnight basal if I ran that afternoon.
answered Apr 12 by T Crebbin (1,000 points)
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Normally I walked after my supper meal. I will dose for my meal, set a Temp Basal Rate of 80% for 2 hours, walk my 40 minutes, check my Bg and most of the time it works great, my main goal is to not eat any more after my supper meal. This has helped me avoid lows.  I would say that this works probably about 85% of the time. My Endo told me to do this because he knows how much I enjoy walking.
answered Apr 13 by pecan pie (1,060 points)
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Does your pump have a temporary basal setting?  If so, I was told by my CDE that I should drop it by 25% 30 min before exercising and for 1 1/2 hours after.  Then make sure I track bg results at both times AND any normal times during that 2 hour span.  Some people have to drop it more and some less.  Some need longer time before and after and others are good with a shorter time span.  I, too, would love a resource; but I also expect to have to always make adjustments to what the tables and graphs tell me because MY body may not treat insulin or insulin needs the same way as yours.  Good luck!
answered Apr 19 by bndtnana (460 points)
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I so relate to this! It's so frustrating!

I found a lot of help from a book called the Diabetic Athletes Handbook.

It has really good starting point info on how to decrease basal and bolus at certain percentages based on exercise type. It's a good place to start. Then you'll likely just have to dial it in for your own individual response as you notice patterns. I always wrote down exactly what worked so I could continue to replicate it.

Also I like this website that is about exercising with insulin:

https://thefitblog.com/

Let us know how it goes!

answered May 2 by jschliebner (470 points)
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I bookmarked the fitblog and found it on Facebook too. Thank you!
answered May 2 by Tanya (520 points)
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