Diabetes Self-Management Blog

For me, one of the few things related to my diabetes that induces stress yet also is something so very necessary for me is exercise. I love going to the gym, to a spinning class, or even (yes) a cardio workout class (which is often 20 women, a gung ho aerobics instructor, and me).

The classes are great because they are an hour of intense exercise and push me more than if I were to try and get that level of workout in on my own. I feel wonderful after a hard workout. The exhaustion reminds me of running cross-country or of cycling competitively in college.

Yet preparing to go to the gym, as well as the few hours I’m there and then the hours following an intense workout, often causes me great anxiety. I know, I know: Hundreds if not thousands of professional athletes out there with diabetes handle it just fine. And, also, there are thousands of people with diabetes who exercise at levels way beyond what I do at the gym three or four times a week.

But that’s them. It doesn’t necessarily lessen my fear of hypoglycemia.

Maybe I just don’t know enough about living with Type 1 yet. You have to remember that I’ve yet to, um, celebrate(?) my one-year diagnose-iversary. I tell myself that, in time, I’ll figure out better ways to handle it. I keep thinking there’s a way to do something prior to working out that would help keep my blood glucose levels elevated (around 150 mg/dl), but not too high. Eat more? Remove my insulin pump sooner?

See, I’ve fallen into an exercise routine that’s far from ideal, yet it is working. I’ll disconnect my insulin pump about an hour before I go to spinning class (I’m taking these classes in the evenings now, instead of the mornings). It will have been several hours since lunch, up to five hours, so on the way to the gym I’ll drink a bottle of Gatorade or eat a PowerBar. I’ll warm up for about 20 minutes on the bike and try to ensure that my blood glucose is above 150 mg/dl before kicking up the intensity.

I may be able to make a change for the better—but the unknown, what might happen if I screwed up, and the consequences of hypoglycemia keep me keeping on with my own status quo. But with a blood glucose level too high, there’s a risk of hyperglycemia. And then there’s worry because I’m still not sure when I’ll hit my second low (it’s not as pronounced when I exercise at night as it is when I exercise in the morning).

But I’m handling it. And I know experience will help, as will talking to other people with diabetes who exercise often. Sometimes I feel as if it might be a good thing to hit that low threshold, to see how far I can go. Although I know (I know) it’s never smart to flirt with hypoglycemia. Yet there’s a part of me that wants to know just how far is too far.

But I’d never intentionally push it to hypoglycemic levels. And so I’ll have to continue to wonder if, when I check my blood glucose 40 minutes into a 60-minute class and it’s at 110 mg/dl, it means I’m heading down into a low if I keep up the intensity. I’ll have to estimate how much Gatorade or other carbohydrate drink to take in. When I check my blood glucose level and it’s around 80 mg/dl (toward the end of a workout) does that mean I should stop exercising? Or, can I just ease off a bit, load up on some carbs, and continue on?

Will there ever be a point at which I’ll be able to exercise and not think about my diabetes?

Probably not.

I’ll confess that before writing this week’s entry, I didn’t go to any of the forums or do Web searches about this issue. Yeah, I’ve read about it before. I know there are many places to go for advice on how better to ensure that I have adequate carbs on board for high-endurance activity. But this is me being lazy, passive-aggressive toward diabetes. It’s easy to stick with what works. I know I’ll figure it out eventually. Heck, I may even get some comments on this post that clue me in.

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