#511 Diabetes Variables: Exercise

July 21, 2021Scott Benner

Diabetes Variables: Exercise

Scott and Jenny Smith, CDE share insights on type 1 diabetes care

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DISCLAIMER: This text is the output of AI based transcribing from an audio recording. Although the transcription is largely accurate, in some cases it is incomplete or inaccurate due to inaudible passages or transcription errors and should not be treated as an authoritative record. Nothing that you read here constitutes advice medical or otherwise. Always consult with a healthcare professional before making changes to a healthcare plan.

Scott Benner 0:00
Hello friends, and welcome to Episode 511 of the Juicebox Podcast.

Back again with another diabetes variables episode means Jenny's here, and today we're going to talk about exercise. That is a variable. You know, I asked the Facebook community Juicebox Podcast type one diabetes, for a list of things that impacted their blood sugar, they came up with over 150 of them. I don't get to exercise because I'm sitting here making this podcast but I hear from a lot of you that you do the running about Nah, I also hear kids play sports, etc, etc. Anyway, exercise is very important as we know. So let's talk about it. Please remember while you're listening that nothing you hear on the Juicebox Podcast should be considered advice, medical, or otherwise, always consult a physician before making any changes to your healthcare plan, or becoming bold with insulin. If you love Jenny and want to check out what she's doing in her professional life, she works at integrated diabetes comm or check her out.

This episode of The Juicebox Podcast is brought to you by the Dexcom g six continuous glucose monitor. You can learn more about Dexcom and get started with the G six today@dexcom.com Ford slash juice box. The episode is also sponsored by touched by type one end. And there's another one I know the Contour Next One blood glucose meter. Find out more at Contour Next one.com forward slash juicebox and touched by type one is it touched by type one.org. And they're on Facebook and Instagram. Do please check them out. So the variable of exercise will now bring out that I can't remember the difference between two words because they sound similar. I can kind of remember but

Jennifer Smith, CDE 2:25
arrow aerobic versus anaerobic

Scott Benner 2:27
aerobic versus anaerobic I always pause my I always go aerobic versus anaerobic. Here's how I do it. This is gonna I'm so embarrassed. I start thinking about Jane Fonda in her 40s and a leotard and I think that's aerobics that's moving quickly. And that's the thing that brings your blood sugar down. I can't believe that's how I make the connection in my head.

Jennifer Smith, CDE 2:51
That's funny. Is that the let's get physical? Is that the Joe that would be

Scott Benner 2:55
that would be the girlfriend grease. Oh my god. Oh yeah. My wife's favorite movie is Greece. And now I feel really stupid for not being able to think of she's Australian. Now. I'm gonna know everything about her but her name. Hold on a second. I'm Slavia Newton. JOHN, is that Yeah, Olivia. JOHN would be let's get physical. The thing I think of is, like I said that that leotard from which by the way, is doing the Jane Fonda Workout. And she comes out and she goes, that thing kicks my ass. She's like, I and she's like, how is she doing? It covered head to toe in that like bed stretching. I was like, I don't know, harden. I was like, that was a really long time ago. I'm like, you know, that woman's a famous actress and she's like she is it just became like Internet popular. You know what I mean? Anyway, so So there's two different kinds of exercise. Yeah, something that's aerobics or would playing soccer be aerobic. Yes. basketball. Yes. Okay. Hockey. Yes. Running, obviously, exercise. But now if I lift weights, no.

Jennifer Smith, CDE 4:09
If you're doing lifting in and of itself. I'm not like circuit training or while circuit training could be circuit of weights to some circuit training is cardio and lifting or cardio and resistance kind of combined. But in general, aerobic means that you are breathing in oxygen kind of at that higher rate, you're increasing your heart rate. That's aerobic exercise. Yes. I mean, you could be taking a dance class or doing a Jane Fonda Workout that is all aerobic. Yes, anaerobic is typically like lifting or resistance training. Some yoga can be an interesting combination of both. If you're doing something like a vinyasa flow where you actually have the resistance of your own body weight, but you're flowing through the moves enough to actually get a cardio increase.

Scott Benner 5:04
I feel like you're showing off a little bit by saying that. I've never heard those words together before. I was like, really? Like Jenny's flexing. She knows something that I don't know. But I know you're not doing that. I know you don't have that thought in your body. Everyone know? What, what about yard work? What about yard work where I'm lifting things, but I'm hustling around at the same time. That's both do they cancel each other out?

Jennifer Smith, CDE 5:25
Kind of Bolus? No, I Well, perhaps for some people. But for the majority of people that I work with who do a lot of yard work, myself included at certain times of the year. It tends to be because of the lifting component and the consistent low level movement. I mean, you're not like running between shovelfuls of like mulch or extra dirt for your garden. But you are moving and you're moving enough that the low level aerobic nature tends to create enough sensitivity to insulin to drop your insulin needs.

Scott Benner 6:05
The robot can will went out most likely. Yes. I guess unless you're literally stopping in between bolts to do dumbbell presses or something. Right. Right. Okay. Yes. Excellent. So, if I'm going to do something a robotic, I mean, what I tell Arden is to set a Temp Basal, like an hour before she does it. That's usually what we try. She's not excellent at doing that. She She likes to just test the limits of her algorithm. She's like, it'll catch it. I'm like, it's not magic. You know that thing. And so if she doesn't set one, she will reach that like that 60 range. But you also have to be able to remember that Arden's using an algorithm. So it's taking her basil away, just taking it away too late. It's enough time to stop around 60. But had she done it a little sooner? I think she she's in the 80s no problem,

Jennifer Smith, CDE 7:00
right.

Scott Benner 7:02
But if you're working out on purpose, we're heading out the yard to work. Tell me if I'm wrong, I would avoid active insulin that wasn't countered with carbs. So I wouldn't mind her going out in the yard to work if she had a meal that I knew was really well Bolus, you know, great, Pre-Bolus great carb ratio, then I would think it was okay. I don't mind the food and the insulin fighting while she's outside. But if I were to miss on that Bolus, or if I made too big of a Bolus, active insulin while you're exercising is almost a certainty for dropping, right?

Jennifer Smith, CDE 7:41
Yes, is cardio exercise specifically or the aerobic exercise? Yes. I even have a lot of people who definitely find that that yard work or whatever the aerobic kind of thing is, that like peak in action of that Bolus is typically going to have it sort of height of action during the exercise time. So oftentimes have you can't adjust Basal ahead of time, or there's really not enough time of activity that it's purposeful to adjust the basil for, then adjusting the Bolus down and allowing the food to work to cover what you're doing. aerobics Lee with less insulin in the picture to cover the food, lower insulin with activity paired together, they tend to balance that food out,

Scott Benner 8:38
okay. All right, so But now, if you're going to go do serious lifting, those people have to Bolus before they do that, right.

Jennifer Smith, CDE 8:47
Some do. Some there are multiple ways that people go about anaerobic true anaerobic like lifting sessions or resistance sessions. Some of the lifters that I've worked with have to Bolus after doing some experimentation for seeing how much of a rise they're getting. And when the rise is actually happening. They may Bolus as soon as they start their session, they might do a temporary Basal increase that started about 30 minutes before their session starts so that they're ramped up enough that the rise doesn't get going once they start their lifting. And some find that they actually need to Bolus more in the middle or by the end, because they find the rise in blood sugar is more in the aftermath of the lifting session.

Scott Benner 9:36
Is there something physiologic physiologically that you're aware of that makes that happen? Like is it like, Is it the lifting version of like a fat rise? Like do you mean like, Is there something that actually happens inside of the body that you know of, or just you just know this as a role that the lifting does? I think Jenny's googling she has a very or she's on her notes or something

Jennifer Smith, CDE 9:56
I know I was thinking because some is Some is a adrenaline, obviously. And it depends on what type of I mean, if you're really working with like your power lifters, you've got a huge amount of like adrenaline that kind of gets driven out in order to do these lifts. And usually, if you're like, a strong power lifter with lots of weight, you're not doing loads of reps, you're tending to lift, heavy kind of, to exhaustion of heavy amounts, and then you kind of move on. So, you know, there, that's a component is adrenalin, obviously, it's glycogen also kind of gets released, it's a stored, it's stored in your muscles, it's stored in your liver. So that release of glycogen releases the stored glucose into your muscles to kind of get moving. And that can also cause a spike during sometimes, like I said, some lifters find that it happens after the lifting session. And if it does, again, it's the timing of when to take extra insulin and also how much because despite it causing a rise now and maybe directly after, because of what you've done to your muscles, lifting weights, it essentially tears the muscle fibers apart, right? That's why you lift more and you do more, right, you know, and you give breaks between because those muscle fibers repair themselves in between lifting sessions. And that metabolically increases your body's use of food. Right. So you can end up hours after lifting sessions actually needing that Temp Basal decrease now, or needing to Bolus less, because your body is more sensitized to insulin now, even though it wasn't later,

Scott Benner 11:53
almost like shivering to keep yourself warm, your body's doing something to and it's using up energy to do that. Right. I I'm gonna ask you one last question on this one. Yeah. And you might not have any experience with it. But some people use, you know, steroids to build themselves up, does that change in that and they use them? In part because it shortens the need for recovery time? I wonder if that. I know, that's a weird thing to bring up. But like, I wonder if that impacts that I guess we'd have to find somebody using illegal steroids and has type one diabetes to ask. But I just anyway, I guess there's no,

Jennifer Smith, CDE 12:32
no, it's well, it's it's a question. I mean, in terms of discussing like exercise and potential for blood sugar shifts, because you're using steroids. I mean, steroids in and of themselves, cause a rise in blood sugar. So along with the lifting, which could be causing the rise in blood sugar, you may need to counter kind of both for that. That's interesting. for that.

Scott Benner 12:56
I just yeah, I'll tell you from the after dark episodes, what I've learned is, everybody has needs and they're not always the ones we talked about. So I just wanted to bring it up for a second. All right, yeah. Thank you very much. Yeah, absolutely. Hey, if you're looking for an absolutely rock solid, dependable, accurate, easy to carry, easy to use, easy to see at night, blood glucose meter, look no farther than the Contour. Next One blood glucose meter. Find out more at Contour Next one.com. forward slash juice box. This thing is terrific. The test strips have second chance testing. So if you get some blood but not enough, you can go back get more without making a mess of your accuracy or ruining the strip. How nice is that? Right? It's got a super bright light for nighttime viewing the screens incredibly easy to look at and to read. And the thing is designed in a way that it's just super simple to hold and to use. It's a well thought out. But simple design. Contour Next One comm forward slash juice box. And lastly, the Dexcom g six continuous glucose monitor, see the rate and number of your blood sugar in real time on your iPhone or Android or on your Dexcom receiver dexcom.com forward slash juicebox being able to see your blood sugars in real time is a game changer. It will allow you to make changes to insulin changes the carbs that are meaningful and not just guesses you'll actually be able to see where things impact your blood sugars or your loved ones blood sugars. And the share and follow features allow up to 10 followers. So your child could be followed by you, your spouse and eight other people. Or if you're an adult, and you're looking for some friends or some family members to have your back. You can do that as well. dexcom.com Ford slash juicebox. Thank you so much for listening to this episode of the Juicebox Podcast. Let me just thank Jenny and we'll get out of here. Jenny Smith is a CD. She's a type one for over 33 years. And she's just an amazing font of knowledge about diabetes and using insulin, and she works at integrated diabetes. You can find out about hiring Jenny at integrated diabetes that calm thank you so much to the sponsors to you guys. I hope you're enjoying the variable series. And I Oh, and let me say this real quick, touched by type one, find them on Facebook, Instagram, and it touched by type one.org quick episode today but I'll be back tomorrow with another