Sunday 21 August 2011

A good hard knitting session

As a type 1 diabetic there are many things that frustrate me about the condition; kinked cannulas, ignorant comments, doctors surgery staff (who seem to get paid to raise by blood pressure), people who assume I got it because I was fat (nope, I just love pies) and when my pump has been warning for hours that I'm about to run out of insulin, yet i somehow still forget it and end up going high, to name a few. But perhaps the most frustrating situation for me as a diabetic, is exercise.

There is no exercise which is bad for you and the truth is everybody out there, diabetic or not, should be exercising. Our ancestors didn't get us here by watching 'Come Dine with Me or 'CSI: Miami'. Instead they exercised. A lot. We are taught that any exercise is better than none and we are constantly bombarded in the media by images of morbidly obese people who we are told didn't make the effort to do enough exercise.

But for me exercise has such dramatic effects on my sugars that it is the last great paradox when it comes to my diabetes self-management. This is because when I do gentle exercise, my sugars go down. But with strenuous exercise, they go up. They go up a lot. The technical reason for this is that when you exercise gently, your body uses up the glucose in your body as fuel. However, when you increase the intensity, you put your body into 'fight or flight' mode. The stress of that exercise tells your body (as our Come Dine with Me watching ancestors knew) that you either need to wrestle that mammoth to the ground, or run the hell away from it! What happens, is your body releases adrenaline and cortisol in order to provide you with an extra boost of energy. Unfortunately these two hormones also blunt the body's response to insulin. In a nutshell, it means that when I do something as intense as body combat (a new love of mine and the most intense workout I have ever done) a few hours after the workout, my blood sugars go through the roof, thanks to the tiger-tackling adrenaline my body released earlier, which subdued my insulin response.

The frustration is that even though the exercise benefits me so greatly by increasing my heart rate, strengthening my heart, lungs and muscles and providing that all important circulation boost, the blood sugars of 15mmol (270 mg/dl) when the normal range is 4-7mmol means that all my other body parts such as nerve endings, kidneys and eyes are now being damaged by the excess sugar in my blood stream. Added to this, if I now correct that high blood sugar, that sugar which is in excess to what my body needs, will be stored as fat. Slightly frustrating considering I just hurled myself around a room for an hour for the purpose of improving my health and losing weight.

You could argue that I should just always go for a walk or gentle jog. But for me, when I exercise I like to really feel like I've exercised. A gentle stroll feels about as challenging to me as a good hard knitting session or a really vigorous deep breath! I like to come out shaking, a little light-headed, covered in sweat and itching to come back tomorrow.

Well after several weeks of Sunday morning body combat followed by horrendously high sugars, for the first time today after 4 weeks of trying, I actually got somewhere. Through a process of experimentation, over the last month I have amended just one thing each time to see what might help. I won't go through each week because I've already rambled on enough, but I thought you may find it useful to know that I started this morning off at 8mmol (a little high for me) and am now stable at 7.5mmol (a first after combat). The key for me was:

  • Eat some protein 1-2 hours before I go. I choose and omelette with turkey ham and cheese
  • Take the pump off as late as possible before starting the exercise.
  • Test Blood Glucose (BGs) regularly throughout
  • Put the pump back on asap after the class (previous weeks I left if at home. This time I took it with me)
  • Bolus 2.5 units on finishing (please note this figure is ABSOLUTELY INDIVIDUAL to me! I know this because it is the ratio I need to bring me down from 15 which is where I have been in the past after the class - please do not copy this without knowing your own correction ratio).
So far since the class I have not moved from 7 which as far as I am concerned is a huge 'win'. Next week will be the big test because if I know my diabetes, I will have a job keeping everything the same from week to week. But it is a start. And a good one at that.

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