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13 Responses

  1. Marianne
    Marianne November 19, 2011 at 6:07 am | | Reply

    What are you brave, brave boys thinking? Go for the goo – rip those hairs out with the best wax you can find. There’s a lot less rash, itch and nastiness – and the sites stays clear of hair for a lot longer than it does with shaving – as smooth as the proverbial baby’s backside so to speak.

  2. Sysy
    Sysy November 19, 2011 at 6:57 am | | Reply

    Thanks for answering my question, Wil! I have stuck with that recommendation over the years but lately have noticed that a lot of type 1 kids exercise over 250 and so I started wondering if I just had outdated information. Thanks for your response, I think it’s a crucial thing to clear up. Oh and thanks for the beer! :)

  3. Vicki
    Vicki November 19, 2011 at 7:08 am | | Reply

    Thanks Will for clearing things up for us old timers and bringing it home in a new way!

  4. Steve
    Steve November 19, 2011 at 7:49 am | | Reply

    It’s not only chicks who dig guys with body hair. Just saying’…

  5. Mary Fairweather Dexter
    Mary Fairweather Dexter November 19, 2011 at 10:37 am | | Reply

    Between my scoliosis, my post-pregnancy stretchmarks, and being relatively small, I also have challenges finding suitable places to insert the infusion set and the sensor.

    Took the quiz: vampire.

    1. Natalie
      Natalie November 20, 2011 at 6:29 pm | | Reply

      Mary, I found out from a Medtronic representative that it’s OK to use the part of your belly where you have pregnancy stretchmarks. She said they aren’t really scars, just stretched out skin, and that the cannula goes below them into normal subcutaneous tissue. I did try that, and it worked OK for me. If you decide to try it, though, maybe better to be cautious and check BG often for the first few hours. Good luck! :-)

  6. Carol
    Carol November 19, 2011 at 1:01 pm | | Reply

    I understand the 250 rule, and generally follow it. But I have violated it on several occasions. I work out a lot, participate in triathlons and running races, etc. Race days are a significant challenge, and my blood sugar does not always “play nice” like it usually does in training due to nerves. So when I see a high # pre-race, or post swim (if the wait is long and I’ve been disconnected longer than planned) I usually bolus and soldier on. Not ideal in terms of performance or anything else, but so far I have survived without pulling out of a race. Also, if I know that a high is a timing issue — ie. run got delayed longer than planned after I reduced a breakfast bolus — I will usually head out and BG will drop quickly. All that to say I think the rule is good, but if we’re testing (and/or CGMing), and in touch with how our bodies respond, may not be hard and fast in all circumstances.

  7. Scott
    Scott November 19, 2011 at 9:43 pm | | Reply

    Someone else sent me the “don’t exercise if you’re over 250″ info about two weeks ago. Here’s the problem – I exercise fairly hard (burn about 500 calories in about 30 minutes) on the eliptical machine – and I can EASILY drop 200 points during that time. So I generally break out the apple cider and licorice, wait until my sugar is sailing past 200, and then start exercising.

    Not sure why I drop so quickly, makes me feel sometimes like I’m defeating the purpose when I have to stuff sugar into myself prior to exxercising.

    1. Mary Fairweather Dexter
      Mary Fairweather Dexter November 20, 2011 at 8:21 am | | Reply

      Do you pump? Have you tried a very low temp basal?

  8. Hannah B
    Hannah B November 20, 2011 at 8:24 am | | Reply

    In the 25 years I’ve had T1, I’ve generally used exercise to bring down a high (anything from 180 to 400, and usually in combination with a correction bolus). I find that I feel better and better as the exercise session progresses, and that I’m back in range much sooner than I would be by just waiting around for insulin alone to do the trick. I’ve never had DKA or felt worse afterward.

    Anyway, I’m confused, because the ketone explanation makes sense in theory. If you’re not yet producing ketones when you start exercising (despite being high), does that change the guideline? (I’ll confess I never bother checking for ketones. I just hydrate and, if possible, exercise.)

  9. Sysy
    Sysy November 20, 2011 at 9:23 am | | Reply

    @Hannah B, I’m not sure but since exercising while so high can encourage ketones to form, it seems a bit risky. I mean I understand why sometimes someone would exercise with a high but in order to lower chances of ketones being formed, the rule is no exercise over 250. (At least, that’s what I gather)

    @Scott, I’d soooo recommend you Ginger Vieira’s book “Your Diabetes Science Experiment” because it goes into tons of helpful exercise, insulin, and diabetes info. I use shots and take my Lantus from 20 units to 16 or 15 on days I exercise a lot and honestly, it covers me through exercise and I avoid all lows. Even better, a temporary low basal rate on a pump helps, too, as someone mentioned. It’s just not the best workout when we do it while high.

  10. Karmel
    Karmel November 20, 2011 at 9:24 am | | Reply

    I am not a doctor of any kind, but my understanding, as Will briefly implies, is that the issue is not hyperglycemia but rather hypoinsulinemia– that is, problems occur when you exercise without sufficient insulin in your body, regardless of your blood glucose levels. The warning about exercising while high seems to come from the fact that if your blood glucose is really high, chances are you don’t have enough insulin in your system. In other words, not exercising when hyperglycemic gives you a wide safety margin from inducing ketoacidosis by exercising without enough insulin. So, in theory, if I know my body and I know that though I am high, I don’t have ketones, I’ve administered insulin, and I should be heading down soon enough, I can and will exercise to speed the descent. It’s a bit of a risk, but not much if I am sure I have insulin that will take effect shortly. From “Exercise and the Management of Type 1 Diabetes” (Steppel and Horton, 2003, http://www.springerlink.com/content/mpk18mj60x481073/):

    “In a setting where insulin levels are very low or absent (i.e. a diabetic patient in poor metabolic control), any level of exercise can induce formation of ketones and hyperglycemia. As exercise begins, peripheral glucose uptake is impaired by lack of insulin, hepatic glucose production is stimulated and lipolysis is increased. This combination of responses causes the already elevated blood glucose to continue to rise. Clearance of ketones is thought to be defective and contributes to the rapid rise in serum ketones [32]. Because of this phenomenon, it is generally recommended that patients check their blood glucose levels prior to exercise. If the glucose level is greater than 250 mg/dl, they should then check either urine or serum ketones. If ketones are present, they should delay onset of exercise until they have taken supplemental insulin. They can then take part in exercise once ketones have disappeared and glucose levels have fallen.” (p. 358)

    In any case, though, drinking a beer when high is probably not the wisest idea… Maybe get Sysy a glass of water instead?

    1. Hannah B
      Hannah B November 20, 2011 at 9:40 am | | Reply

      Thanks, Karmel! That info’s very interesting and makes sense. I guess that by the time I’m actually out the door to exercise, my correction bolus has already kicked in and/or I have enough insulin on board to prevent ketones. Like Carol, above, I work out a lot and would be really bummed, after all the prep for a particular workout/event, to have to bail!

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