Today's topic for Diabetes Blog Week:

Let's get moving.

"Exercise . . . love it or hate it? Do you have a regular exercise routine? Or do you have trouble finding your exercise motivation? How do you manage your insulin and food to avoid bottoming out during your workout?"

I'm extremely fortunate, in that I love to work out. I love the way it feels to strain my muscles, get my heart-rate pounding, break a sweat, and then bask in the endorphins afterward. I've always worked out, even before the 'betes. So keeping up a regular exercise schedule was no big change for me. But I can imagine how tough it must be to get started if exercise is never something you've enjoyed...

For my part, I feel blessed every time I take one of my gym classes — aerobics or spin cycle or "body conditioning." How lucky am I to still be able to do all this after diagnosis with a chronic illness?  When I start getting grumpy about all the time it demands, I remind myself that some people spend those hours in a clinic undergoing dialysis or some other unpleasant treatment. If my "treatment" is enjoying myself jumping around to loud music, or peddling blissfully along the nature trail near our home, then I am one lucky sick puppy indeed!

Did I mention that we belong to TWO gyms? OK, I know that sounds hardcore, but we've been members forever at one of them and don't want to give up our "legacy" pricing. That's also the one with a great outdoor pool, and also a sports day-camp that really make our kids' summer. The other one is 24/hr Fitness. Pretty basic. Good spin classes. Either way, I have lots of choices, so I can never use the excuse that "there's nothing good at the gym today."

Recent record-keeping has shown me that I work out about 6-7 hours a week. Not bad for a busy mom-lady, I think. And how did I learn to manage my insulin needs around all this exercise? With a lot of trial and error, I tell you.

I just kept playing with temp basal programs on my pump until I got it down to a few fundamental programs: -50% for two hours for an aerobics class (also works for running), and -80% for spin/cycling. If I'm low at the start, I usually eat a handful of raisins or half an energy bar.  Or sometimes if I've dosed too soon before the start of a workout, I just suspend insulin delivery for up to an hour.

This is what seems to work for me: your mileage will most certainly vary.

Lucky for me, my new expert CDE Gary Scheiner (whom I just can't seem to stop mentioning of late) is also an expert on tweaking doses for exercise.  One of his helpful little tables:

However, his suggestion that I stop using temp basals and simply eat 20-30 grams of carb prior to a workout didn't pan out so well for me — my results were much more irregular than when I relied on my temp basals. Also, I didn't want extra food intake when I'm not even hungry. As far as that goes, we agreed: "if it ain't broke, don't fix it."

Naturally, my fancy temp basals don't always do the trick, but on the whole, I'm pretty proud of myself for 1) continuing to exercise regularly, even when I'm at my busiest, and 2) not letting the diabetes ruin it for me.


Editor's Note: Please see also, selected posts on exercise and diabetes —

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