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How much does fear of hypoglycemia affect how much you exercise?
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After 56 yrs being T1D since a young child, I don’t worry about lows, I just instinctively take carbs along with me no matter where I go (and especially when exercising).
Same for me.. after 70 years since age 20… I use exercise as my BOLUS !!
I said “other” because it IS a concern that I have to manage, and it imposes a restriction on me. E.g., at lunch time I have to adjust my bolus for whatever carbs I’m having to account for whether or not I’m going for an afternoon bike ride, and that more or less commits me to whatever I decided. If I have to cancel due to rain or some other exigency, I may be struggling with a high all afternoon. Or if I bolused the full amount thinking I wasn’t going to get in a ride, maybe because of weather, but then the weather clears, I’ve got too much IOB and have to work around that. I try never to miss exercising because of these concerns, but they are a constricting factor.
Exactly. This is similar to my experience, where I can manage it ok most days, but impromptu changes in exercise plans are tough. I cannot bike with IOB.
Most exercise does not worry me but at the gym I like to walk on a treadmill, and that causes my glucose to drop rather quickly. So I try to make sure my glucose is high before starting on the treadmill. I then monitor my CGM during the 60 minutes or so I’m on the treadmill and stop if my glucose gets too low.
‘Worry’ may be an overstatement. Being aware and carrying carbs to avoid the lows is they way I deal with it.
I answered some. For me it is always social gatherings that cause fear of going low. People mean well, and I do my best to plan ahead for myself, but the fear from delays in eating and so forth set my hair on fire.
Learning how to exercise with T1D and prevent highs and lows is definitely a big learning process! I’m actually publishing a book on this early next year! 😀
I would like to read this! I have struggled almost my entire life with T1 (53 years) and have never managed to figure out how to exercise without the seesawing of sudden drops and over-treatment of the ensuing highs.
Mojosie! Keep an eye out for on Amazon (and maybe even here on T1D Exchange) around Feb/March of 2023. Here’s an article I wrote that might also help you in the meantime: https://beyondtype1.org/avoid-exercise-low-blood-sugars/
Other. I exercise daily and still worry about lows. The Tandem Control IQ makes it more difficult, ironically. I’m managing it most days and lows don’t keep me from getting on my bike, but it is still a concern.
I echo the comments about awareness and precautions. When I do intense interval training I supplement water by mixing in 15 carbs of juice and if low, reduce my nasal to 60%. When walking more than a few miles, I bring a snack or glucose tablets.
Why? I have had situations where sugar dropped fast during workouts, never unconscious but close a few times. Like everything T1D, it’s a learning curve and careless to not expect some bumps in the road but exercise is a very good way to prevent damage from lack of control, so these proactive precautions are worth the annoyance.
Being ready to handle a low is something that I need to do regardless of my activity. As for not exercising? Any excuse will do for me. 🙂
For many years, I exercised hard, 5 to 7 days per week. Back then, I carried bottles of grape juice with me, and was able to keep going by drinking juice. By the way, I was/am a distance runner. At some point, in the late 1990’s gastroparesis kicked in. I could no longer get my blood glucose to rise while I was running/exercising. Then, I adopted an approach of getting my blood glucose above 200’s before I worked out. But, my blood sugars dropped like a rock while I was running, and I often struggled with low BG’s, and had to shorten my runs.
Over the past year, I discovered that taking high proteins before I run allowed my to run much farther before my blood glucose’s went low. So that’s my routine now, I drink a protein drink about an hour or more before I go out running (or biking), wait for my BG to rise, and I’m good to go.
But to answer the question, “Not at all – I worry about lows, but my worries do not deter me from exercising.” There are occasions when I miss a workout because of hypoglycemia, but I usually get my workouts in.
Oh, I forgot to mention that I disconnect my Tandem pump, with Control IQ, before I run. I reconnect my pump after my run. Otherwise, the Control IQ tries to get my blood sugar down, which I don’t want.
I prefer a low over a high anytime of the day. Admittedly this whole outlook was brought on by the assistance of CGM and basal IQ which has now been augmented by Control IQ.
After living this gig as a diabetic for almost 70 years, I became very blasé about lows, and always seemed to get away with it. Recently I’ve been experiencing anxiety, and find that I’m much more apt to make sure there’s candy in a pocket. If I get half way up the hill and realize there’s no candy available, I turn around and head home. I really don’t like it when the disease takes the upper hand, and try to avoid confrontations with its bossy side!
It isn’t the lows that limit my exercise. It’s my severe hypoglycemia unawareness that is the culprit.
I don’t exercise much at all.
My t:slim x2 and Dexcom CGM manage my blood glucose when playing pickleball three times weekly. I do keep a careful eye on my CGM and snack as necessary. Fear of hypoglycemia does NOT limit my exercise!
I discovered that any exercise affects my numbers and I find it difficult to anticipate the effect. I use my CGM with the low alarm set at 100 and pay close attention to how I feel. The drops can be subtle or wild and crazy. I try to never be far from a supply of apple juice.
As a fitness instructor, I teach 6 strength training classes every week. I make sure I start class with a higher blood sugar because it can drop 50-60 points. I wear a Dexcom and keep a bottle of 15 grams of glucose close by, on those rare occasions where I go low
Other. My “exercise” is limited to everyday life activities, grocery shopping, up and down two flights of stairs doing my laundry. I’m never far from glucose tabs or apple cider if at home. I no longer have any sense of hypo or hyperglycemia so the CGM is my guide. Earlier in my life hypoglycemia ended my opportunity to participate in the only sport I enjoyed, golf.
At 83, I don’t do aerobic exercise anymore. But, just the activities of daily living lower my BG’s significally and I have to be vigilant always.
My favorite exercise is body boarding in the ocean (with no pump or back up glucose). After one bad experience, fear of lows kept me out of the water for years. The example of an avid diabetic surfer gave me the courage to try again. After carefully studying the effects on my BGs and learning what starting level would be safe for an hour, I can now body board with confidence. Part of my strategy is to turn Control IQ off so I don’t get stealth boluses when I’m deliberately trying for a high starting BG.
DexCom G6 greatly relieves concerns about hypoglycemia, but discomfort from bone cancer restricts how much I exercise.
With My tandem G6 w/ cgm and glucose tablets help me feel safe.
I have to plan for exercise; I can’t jump on a bike and go. Exercise mode doesn’t stop me from going low.
I didn’t see my answer. I don’t exercise much, and I do think about hypos before exercise, but I don’t let that deter me from exercising when I can.
I like this community. It’s nice to see I am not the only one. I do worry about going low. I hate that in order to exercise I have to eat carbs first. I quite often grab a banana, but I wish I could be normal, without concern of carrying sugar.
CGM helps. Check before, turn down pump, check during, check after, resume normal insulin
I no longer worry about low blood sugars since I’ve started on the Tandem pump with Dexcom CGM. It really keeps me in check….most of the time.
Unwanted lows while exercising makes me feel disgusted: for not getting math right and for the interruption that takes time to raise bgs. A big low might bring fear at the time if so confused I couldn’t pause insulin and treat with glucose tabs! But fear does not deter me exercising.
It used to cause fear, but I plan ahead and often have someone along. I’m not a robot so hypoglycemia will happen. Disgusting and sometimes embarrassing.
If I’m a bit lower than usual before exercise I make sure to have a protein carb snack as my dietician recommended yet I seem to be managing well and if anything I tend to bring my glucose readings down after working out yet rarely dangerously low!
Fear isn’t a factor for me. It’s more common sense and doing the math. My Tandem x2 which adjusts basals and gives bolus corrections when needed (Control IQ), Dexcom and meter are all invaluable tools.
If the risks are too great, I won’t work out until it’s safer.
I don’t like how there responses are structured. It matters enormously what the situation/environment/time since last shot/food/other exercise. Response is wholly dependent on actual circumstances at the time of exercise
My glucose levels fall a lot with exercise.
I make sure that my glucose level is at least 150 before exercising and eat something. I then suspend insulin delivery from the pump for the duration of the exercise and check every 20 minutes to see if I am going low. I often have to take some glucose tablets during exercise and wait for the glucose to go up.
I can’t say the fear of going low prevents me from exercising, but starting the exercise is many times delayed because my sugar is below 100 when it is time for me to exercise. Consequently, I eat carbs, depending on the circumstance I also eat protein to bring my sugar up, and wait till my sugar is rising before starting the exercise. This is frustrating as I sometimes exercise with a friend at a certain time in the evening and I hate telling her I need to start our walk a little bit later to compensate for my low blood sugar. She totally understands as she was a nurse, but I hate disrupting our start time. Exercise is the hardest thing to account for in managing my diabetes, and since I exercise 99.9% of most days of the year, managing sugar levels during exercise is my most frustrating part of being diabetic.
Of course I have to remember to activate my exercise profile and activity setting about an hour before exercising and stopping it about 30 minutes before the end of the exercise. Starting it is usually remembered but stopping the settings is frequently forgotten till much later.
I have juice with me when I exercise. Do not need it all the time but I am ready in case I do go low.
I chose “Other” because I don’t really “worry” about lows. Low blood sugars have been a part of my life for over 50 years, so when they happen I simply treat them. This is true no matter if I am at work or exercising or food shopping, etc. They can happen at any time, so why worry? Just take care of it when it does!
Diabetes doesn’t stop me from exercising, but laziness and Netflix sure do.