We’re featuring excerpts from Ginger Vieira’s new book, Dealing with Diabetes Burnout. In this final edited excerpt from the book, the longtime life coach and diabetes advocate shares the lessons she’s learned from years of exercise with Type 1 diabetes.
There is no doubt that exercising with diabetes is about one million times more challenging than exercising without diabetes, particularly if you take insulin. Low blood sugars and high blood sugars are major party-poopers in the middle of a walk, yoga, spinning class, tai chi, or strength-training. I’m here to tell you that it can be done and you can enjoy exercise, but it takes a little work, a little more effort, and a bunch of self-study.
When I personally started to become really active and committed to exercising regularly, I was working really hard to balance my blood sugar during things like Ashtanga yoga, strength-training, and various forms of cardio like power-walking and the stairmaster. And it wasn’t easy, but at the very same time I was learning with the help of my trainer, Andrew, about what was literally going on in my body during different types of exercise. Learning about this basic science, taking a deep breath, and viewing my body as a science experiment is the only reason I am able to exercise happily and confidently today.
Here are five lessons I’ve learned on balancing blood sugars during exercise:
1. Understand What Type of Exercise You’re Doing
Jogging and strength-training will both have very different impacts on your blood sugar, even though your heart rate may rise during both.
Cardiovascular or aerobic exercise uses glucose primarily for fuel. This means that jogging, running, the elliptical, power-walking, cycling, power yoga, and even gardening—anything that raises your heart rate for an extended period of time—will lower your blood sugar.
Anaerobic activity, like strength-training, sprinting, interval, or circuit training—during which your heart rate goes up, then down, up, then down, and muscle is being broken down—is going to burn more fat for fuel during the activity, but may increase your sensitivity to insulin later in the day while it works to repair and build those muscles. It’s also very common to see your blood sugar rise during this type of exercise; it’s totally normal and actually promotes strength-gains. More mellow forms of exercise, like casual walking or gentle yoga, aren’t likely to raise your heart rate high enough to actually burn glucose, but that depends on the individual.
2. Control as Many Variables as Possible
When you’re starting a new form of exercise and want to know how that workout is going to impact your body on a regular day with a “regular” blood sugar, be sure to eat a meal of which you already know the carbohydrate count, and don’t start your workout with an out-of-range blood sugar (over 180/under 80).
For example, when I switched from powerlifting in the afternoons to doing bodyweight-only plyometric training first thing in the morning, I set up every workout in the beginning to be as similar as possible. I did this so I didn’t have variables like food or high blood sugars, which can require different correction doses before exercise, compared to a non-exercising part of the day. I also performed my workout at the same time of day.
From this, I quickly learned that when I wake up first thing in the morning, with an in-range blood sugar, I can perform my bodyweight workout on an empty stomach and I need one unit of insulin to actually keep my blood sugar from rising. For me, this is the ideal time for exercising because my energy is at its highest and I like to get my workout taken care of before I get started with the rest of my day.
3. Treat Your Low Blood Sugars with Only a Few Types of Foods
The food you choose to treat your low blood sugars with does make a difference, not only in the amount of calories you’re consuming but also in how quickly your blood sugar will rise. Using a glass of milk or a peanut butter sandwich to treat a low before exercising is going to give you a lot more calories than you really need and the fat and protein will slow down the
digestion, prolonging when your blood sugar will be safe for exercise again. If you’re worried about going low again, use fat and protein after treating with a fast-acting carbohydrate to help sustain your blood sugar. (In many cases, though, this really isn’t necessary. Low blood sugars just require more patience than we’d like to give them!)
4. Take Really Great Notes!
Pick one form of exercise. Write down the time of day, your pre-exercise blood sugar, anything you just ate, and any insulin you just took. Then write down exactly what kind of exercise you’re doing and for how long you’re doing it. Check your blood sugar half-way through your exercise, and again at the end of your workout. If your blood sugar is high, then you know you either didn’t need to cut back on your insulin dose for the food you ate, or
you didn’t need the extra boost of glucose you purposefully consumed for your workout, or you actually need a little bit of insulin in your body during exercise. If you’re low, then you know you can either cut back on your insulin dosing next time (through basal or bolus insulin) or you can consume more carbohydrates uncovered by insulin.
Aim to perform the exact same experiment again, adjusted based on the information you gained from your first experiment, and keep repeating until you find the right balance!
5. Try Exercising First Thing in the Morning, on an Empty Stomach
This is a secret trick from the bodybuilding world. Bodybuilders are constantly trying to burn as much body fat as possible without burning up muscle. Thanks to being surrounded by bodybuilders when I first became serious about exercise, I learned based on normal human physiology that exercising first thing in the morning, on an empty stomach, with an in-range
blood sugar, is the easiest time of day to keep your blood sugar from dropping because your body is primed to burn fat for fuel instead of glucose. This is because you have been fasting all night long, and your body’s backup stores of glucose have been used for energy while you were sleeping, and so your body uses fat for fuel instead.
It’s just science. That’s all. Take the time to learn and experiment, remembering that an unexpected high or low can simply mean there’s something about exercise and the human body that you haven’t learned quite yet!