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15 Responses

  1. Carol
    Carol August 28, 2008 at 7:19 am | | Reply

    AMEN!!!! I love to exercise because of the way it makes me feel, both mentally and physically. But I often think that my diabetes management would be better without it. I tried to get my endoc to help me with my BG issues surrounding my morning runs. He handed me an old style log sheet with only before and after meal BG readings, carbs and insulin doses. No room for anything else. I never faxed it to him.

  2. Alex
    Alex August 28, 2008 at 7:36 am | | Reply

    I agree, but is there a good system out there for measuring activity? For carbs I can look at food labels and write down a number and for blood glucose levels I’ve also got a number. For exercise I can give you an amount of time, but I’m not sure that I know how much difference there is between an hour of gardening, an hour of golf, and a half hour jog. I’m pretty sure there is one, but I don’t know how to quantify it.

  3. Scott K. Johnson
    Scott K. Johnson August 28, 2008 at 9:04 am | | Reply

    Great post Gary! You already know I’m a big fan of you and your books (Think Like a Pancreas is one of my favorites).

    Very cool to see you doing a guest post here!

  4. CB
    CB August 28, 2008 at 9:04 am | | Reply

    Gary’s right on the mark with his remarks. A reference I’ve used that provides useful information about the relationship between exercise and BG level is Sheri Colberg’s book, “The Diabetic Athlete”, which I believe has a new edition out now. She has lots of info about all kinds of exercises – from ice hockey and cycling to kickboxing.

  5. tmana
    tmana August 28, 2008 at 9:34 am | | Reply

    I’ve been playing around with a number of monitors recently. The One Touch Ultra2 and One Touch Ultra Smart both have the ability to record “mild” or “strenuous” exercise… but not what type of exercise, calories burned, etc. My Polar Heart Rate monitor estimates calories burned based on my weight, heart rate, relative perceived exertion, and duration of activity… but I find the higher-calorie-burning activities (aka, cardiovascular exercise) is relatively neutral on my blood glucose levels while weight training can cause them to plummet.

    All of which begs the question, does anyone have a gym facility where PWD can exercise and track blood glucose along with heart rate, exercise type, and perceived exhaustion to get a more “scientific” idea of how exercise affects our diabetes (both individually and collectively, intra- and inter-type)? Or is this something that will require the next generation of CGM before we can get any usable numbers?

  6. Bernard Farrell
    Bernard Farrell August 28, 2008 at 12:40 pm | | Reply

    Great post Gary.

    Unfortunately most device makers don’t really respond all that well to customer’s suggestions and requests. It amazes me that they don’t all take the time to get review panels around device prototypes…how hard that would be.

    But pressuring them by requesting these features is certainly I way to start. I’ll be sending e-mails to Cozmo and Dexcom over the weekend.

  7. Kevin McMahon
    Kevin McMahon August 28, 2008 at 2:31 pm | | Reply

    How many people on pumps have ever used the temp basal feature? I suspect the answer is that a very small percentage and then consider that pumpers represent a small percent of insulin dependent persons w D.

    What if we got more people to use the tools that already exist? Would we would be closer to understanding the next round of advanced tools?

    The manufacturers went to a lot of trouble to build the temp basal feature into their pumps yet at the end of the day it takes the person who operates the tool to get the most out of it. While there are rules of thumb for activity related temp basal adjustment, there is no substitute for individual experimentation with adjusting basal insulin in advance of planned activity or inactivity. I guess this is where patients linking up with experts like Gary comes into play and that’s not something you can easily manufacture.

  8. Carol
    Carol August 28, 2008 at 3:48 pm | | Reply

    Kevin, I agree with you that gizmo’s won’t fix the problem if we don’t do the work to fully utilize those gizmos. But some of us DO use the tools at hand, and would welcome new guns in our arsenal. I personally use different temp basals depending on type of exercise I’m planning to do. One of my fav pump features is being able to program different basal patterns so I can try to get prepped for a morning run while I sleep. What I’d really like is a tool that would help me to assess the effectiveness of what I’m doing so I could have a more rational appoach to making adjustments to those rates. Granted that would be a complex tool…or maybe I need to sign up with Gary to get some help :) Logging (more specifically NOT logging) and analyzing my own data is my weakest link.

  9. Kristin
    Kristin August 28, 2008 at 11:37 pm | | Reply

    Temporary basal rates are WONDERFUL!! They are the MAIN reason that I stay on the pump!!! Being able to exercise without needing to eat extra snacks or dealing with lows makes for a happy, healthy diabetic!!

    I can’t say that I really log my activity level often, but Log for Life does have an option for that available now. You can sign up for the Beta version of this site at http://www.logforlife.com

  10. Hans
    Hans August 28, 2008 at 11:38 pm | | Reply

    [quote]Since its inception, the American Diabetes Association has proclaimed Insulin/Medication, Food/Carbs, Exercise/Physical Activity and Blood Glucose Monitoring to be the cornerstones of diabetes management. Plenty of attention is given to adjusting insulin based on carb intake and blood glucose levels, so where’s the beef when it comes to adjustment for physical activity?[/quote]

    The official beef is in sports carbs. Don’t modify medication, that’s doctor’s only! Add carbs when you exercise! That’s the official view here in Germany, and I cannot imagine it being any different on your side of the pond. – It is quite effective in keeping type2s from loosing weight :-(

    Adding carbs can only be part of the game for people with a really high physical profile on a regular to daily basis. But none of the few I know of in that group and whom a random blood exam any time of the day would hardly ever show as diabetic would be able to explain any injection in terms of insulin to carbs to activity ratio that could be programmed into a pump. It’s like swimming, is the explanation that seems to come closest.

    The learner can do everything right – do all the figuring out and weighing and reducing and adding for exercise etc. – and drown. And then after doing it again for days and weeks and even months on end and without any measurable alteration in what he does the same water sort of starts supporting him and he can swim. And from then on it seems like he can do whatever he wants and keep his head above the water line – or his bg within his healthy narrow limits :-)

  11. Dennis
    Dennis August 30, 2008 at 2:50 pm | | Reply

    Sound nice Gary, but My bet is? Prices will go way up and cost even more (too much) for most of us poor people to afford it..( And a seperate Meter now just for Those takin Insulin? great! that ought to cost Double the other one’s and the Test Strips as well )

    Repetiton Gets the job done.. Just keep records of before and After and after a few times, you have a good idea of what to do..

    As for Carbs vs Insulin? I don’t eat anything I don’t know the Tot. Carbs.. I’m not one fo those that has to eat all kinds of different things all the time.. and our Disease Dictates this kind of eating..

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