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The ABCs of insulin and fitness

BY TAMI SCHOEPFLIN, RD CDE

Using an insulin pump and want to exercise? Balancing exercise, insulin and blood sugar can be as simple as A-B-C.

A is for Activity

Sometimes, people with diabetes are surprised to find out how well exercise can help control blood sugar levels.1 If you aren't exercising now and want to begin, you should discuss your plans with your doctor or healthcare professional.

You don't need any special equipment, nor do you need to join a gym to exercise. Walking can be a wonderful way to get active—or try anything that gets you moving. Just be sure you have good support for your feet.

If you use an insulin pump or continuous glucose monitor, keep in mind that when you're active—especially in warmer weather—you're likely to sweat, which can cause your adhesive to come loose. Be sure to check that everything is still attached after you exercise. You can spray antiperspirant on your skin before inserting a new infusion set to help the tape stay put.

B is for Blood Sugar Checks

You can see the effects of exercise on your blood sugar by checking your sugar levels before and after you exercise. In addition to helping you see the impact of exercise, testing after activity can alert you to low blood sugar, because hypoglycemia can occur during exercise.2

If you're using an insulin pump, try either reducing your meal time bolus insulin if exercising within 90 minutes of a meal. Or consider using your insulin pump's temporary basal rate feature to prevent hypoglycemia. Programming a temporary basal rate of 50% for the duration of your activity will give your body half of the usual basal rate while you exercise. Ask a member of your healthcare team to help you determine what percentage of your basal rate to use. Some pumpers need to start their temporary basal rate an hour before activity. Others may need to continue their temporary basal rate for several hours after they're done exercising. Keep a chart of your blood sugar readings to see how it's working for you. Pay close attention to your blood sugar for at least 24 hours after exercise. If you experience repeated hypoglycemia or hyperglycemia challenges, you may want to contact your healthcare team for assistance in fine-tuning the duration of your temporary basal rate.2

C is for Carbohydrates

In addition to using the temporary basal rate, you may also want to eat a snack before you exercise. How many carbs you'll need depends on how intensely and for how long you plan to exercise. For example, if you think you'll be walking for 30 to 60 minutes, you might need 15 or 30 grams of carbohydrates before you go.2

Work with a healthcare professional to figure out how many carbs to consume, what percentage to reduce your basal rate and how long to program a temporary basal rate. It may take a few sessions to figure out what works best for you.

Oh, and along with all these exercise tips, don't forget a high-energy playlist.

Tami Schoepflin is a registered dietitian and Certified Diabetes Educator®.

1dLife. Exercise for diabetes control. Available at http://dlife.com/exercise-diabetes-control/. Accessed February 16, 2018.
2Scheiner G. Exercise and pump therapy. In: Bolderman K, Argento N, Scheiner G, Barlow S, eds. Putting Your Patients on the Pump. 2nd ed. Alexandria, Virginia: American Diabetes Association; 2013. Available at: http://integrateddiabetes.com/Articles/hcare/exercise%20&%20pump%20thera.... Accessed February 16, 2018.

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