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Tuesday, March 15, 2011

Lows with Lowering Weight

So it's been 2 weeks since my endo suggested that I lose 10 lbs in order to lower the elevated blood pressure I've been having.  And I've stuck to my diet for the most part (usually within 100 calories of my goal) and have kept up a good workout routine including 2 spinning classes a week, jogging 2 miles around my neighborhood, and frequenting my Wii Fit Plus. 

I knew once I started losing weight that my insulin needs would decrease.  This has been evident by the increased number of lows that I've been having.  As far as the scale goes, I've only lost one pound since my appointment, but my body feels like it's more.  But I need to something about these lows because the calories spent correcting them will only hinder my weight loss.  For example, an 8-minute ride on the stationary bike at physical therapy had me at 47 mg/dL?! 

I don't think my basal rate(s) need to be messed with at this time, because my nighttime numbers are spot on if I go to bed in range (80-130 mg/dL).  The majority of my lows seem to occur after working out, which means I'm not disconnecting Arnold soon enough or I'm jacking up my IOB from my meals.  And my insulin:carb ratio seems to have my post-prandials a little lower than I like for them to be.  So I decreased my I:C ratio from 1:12 to 1:15 in hopes of avoiding these lows, and I'll make a point to disconnect Arnold (or at least turn him down) to avoid the post-workout lows. 

But I would love to hear from another type 1 diabetic who has successfully lost weight!  Please, help me figure out how to avoid these lows so I'm not wasting a spinning class on glucose tabs.  And as delicious as it is, I'm getting tired of eating spoonfuls of peanut butter before bed.  Any advice/suggestions would be extremely helpful! 

7 comments:

  1. I've been dealing with the same issues you have. After about 6-8 weeks of increasing exercise and dieting I have only lost a few pounds. But, I have started to see a difference now after changing a few things. I am avoiding lows by exercising right after eating a normal meal (breakfast) and not taking enough insulin to cover the meal so I don't have to mess with basal rates and disconnecting. Also, I did lower my basal rates at the 7-9 hour mark after workout time (I exercise in the morning). Although this took some trial and error. Also, I have been eating more simple, easy to calculate meals with "clean" ingredients, no packaged ingredients and low fats, to avoid the over-calculating and ending up with lows. This has helped me a ton, and I am finally seeing the scale go down! Hang in there you can do it!

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  2. I'm dealing with the same issues and it's a lot of trial and error. Right now I'm experimenting with temp basal rates and my 5:30pm Kettlebell class and it seems that a temp of -50% for 2 hours before and the half hour during class, works pretty well. The other thing coming into play is carb consumption. When I eater fewer carbs in a day, my standard I:C ratio seems to be too much but when I have a higher-carb day, it's fine, so it's a bit of a moving target. Although it sounds like they're awesome right now, keep a close eye on your regular basal rates though, as you lose weight and build muscle, basal needs may decline (mine have gone down 4 units/day) and basal needs are stealthy little buggers. Sounds like you're doing great with your plan!!

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  3. I too have been dealing with these same issues lately. What I have found works best for me is to disconnect my pump entirely when exercising, use my temporary basal rates all the time (before & after exercising) and I admit it took some major trial & error to figure out the timing and decrease amounts. Good luck!

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  4. Hi lady! We've talked about the exercise/weight thing, but I thought I'd share more on here. I lost about 20-25 pounds two years ago while Steven was gone. It took me a loooong time to lose it because of the counter of sugar (tabs) required for lows. I'm not pumping, so sometimes, my lows were unavoidable based on what insulin was still working. I can't offer advice there. But what I can say is this: different exercise does different things to your body. For me, running elevated my numbers (doc thought it was adrenaline). Biking, on the other hand, dropped me fast and without warning. I started having Gatorade on hand instead of water. Still hydrated, but not with a massive amount of calories. Think about that, maybe. Also, I didn't have a cgm, so I'm looking forward to that. The best advice I have is the hardest to hear. Losing weight for a type 1 is not a fast or easy process. It can be done, but it is a sloooow process, so you have to stick with it... which you seem to be doing! Keep up the good work! Also, measure inches! You'll lose those before pounds, plus pounds are gained in muscle mass, too. Seeing the loss in inches will help the morale!

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  5. Lately I've scaled back (when CGM says Low Predicted) to 85% temp basal to avoid lows, due to low-carb eating & gym. Not having the carb reserves, I'm finding I just don't need as much basal as I did when I was eating heavier, starchy foods. Maybe experiment with temp basals at different times of the day, not just during workouts, and see what works. 1-3 hours post-workout is when I tend to drop the fastest, and if I do strength training in the evening I can almost guarantee that I'll wake up low the next morning, since my muscles are rebuilding and depleting my reserves during sleep. I'm down 5 pounds over 2-3 weeks, so something is working...else I have a tapeworm.

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  6. Two big-ole disclaimers up-front: (1) This may not work for you; everyone's diabetes is different; yadda yadda. And (2) I'm not 100% sure that this actually works for me as much as I think it does, although I think that it actually does.

    Here's what I do and what happens when I exercise at a moderate to bad-ass level of effort. I try to have as little bolused insulin on board as possible, since it makes my BG drop like a stone. In the mornings this is easy. In the afternoons, I try to give myself about four hours since I last bolused. After dinner is a nightmare, and I won't give any advice there.

    When I swim in the morning, I don't have to do anything special. And I can either be happy with a 30-40 mg/dL drop for a half-hour or I can have about 15g about 15-20 minutes before I start.

    When I run or bike in the morning or afternoon, I lower my basal to about 60% starting roughly 1-2 hours beforehand. I have a small snack (banana, etc.) ~15 minutes beforehand, and I snack every 45 minutes during (another 20g or so).

    I find, ironically that I need to bolus a small amount right when I'm done -- usually about 0.5 to 1.0u -- to keep from going up because of the adrenaline or extra liver-carb rush or whatnot.

    I did find that I also need to reduce my overnight basal rate a tiny bit on days when I exercise heavily. But I also needed to rework my basal rates in general once I started working out 4+ times per week.

    At some point in the future, an exercise physiologist is probably going to read my comment, shake her head, and mutter some amazement about how I got good results while doing things for the wrong reasons. Oh well. I hope it helps.

    (Oh, and I eventually got rid of 40-ish extra pounds. :^)

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  7. You are doing a great job Holly! I actually really need to start exercising...This is motivating me too! I am scared of lows and I hate eating a bunch of the calories that I work off.

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DISCLAIMER: I am not a doctor, nurse, certified diabetes educator (CDE) or any medical professional of any kind. (But I did stay at a Holiday Inn Express!) Therefore, please do not use any of my postings as medical fact. I am simply a blogger expressing my highs and lows (pun intended) with diabetes. For changes in your medication, exercise regiment, or diet please consult a qualified physician.

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My name is Holly and I live in north Alabama with my hubby, two cats, and a dog.