5 Things I’ve Learned about Exercising with Diabetes

It’s November 26th which means it’s day 26 of the Happy Diabetic Challenge! Today’s prompt is about diabetes and exercise. There’s so much I could say on the subject, so I decided to settle for a bit of a round-up post that explains what I’ve learned about exercising with diabetes over the years…

I exercise on a daily basis.

This statement is not a faux-humble brag, nor is it an exaggeration. Unless I’m sick, I work out in some form or fashion every single day. My workouts will vary in their intensity, but one thing is consistent: My diabetes plays a major role in how long, when, and what type of exercise I choose to do.

Since I grew up playing sports, I’ve had just about my entire lifetime with diabetes to figure out how to make it peacefully coexist – or, at least, merely coexist – with whatever exercise routine I’m completing. As a result, I’ve learned quite a few lessons along the way, and I’ve come to recognize several patterns that my diabetes follows when I exercise:

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My diabetes is practically BFFs with exercise.

1. My diabetes is happiest if I work out first thing in the morning. I never thought I’d be the type of person who works out before eating breakfast, but trial and error has taught me that this is the way to go in order to better manage my blood sugars during a workout. Fasting exercise has worked wonders on my blood sugars: I never have to worry about dealing with an insulin-on-board-inducing low blood sugar, nor do I have to be concerned about what the food I ate prior to my workout will do to my blood sugars while I’m exercising.

2. Different types of exercise affect me (and my blood sugars) in different ways. Many people probably relate to me when I say that weightlifting and high-intensity interval training (HIIT) often yield stable blood sugars during workouts but then trigger the need for more insulin hours later, whereas cardio (such as dancing, running, or circuit training) usually causes sudden drops in blood sugar levels. Of course, it depends on the timing, duration, and intensity of the workout, but it’s interesting to see how different types will require me to react in different ways in terms of my diabetes care.

3. Sometimes I need to suspend my insulin, sometimes I don’t. Again, whether or not I suspend my insulin – or even run a temp basal – depends heavily on when and how I exercise. If I’m doing my morning routine (which happens 75% of the time), then I don’t really do anything with my basal rates: I just keep them running normally. But if I’m taking a midday walk or decide to exercise in the evening, I often have to do something about my basal rate to avoid crashes or spikes. Insulin suspensions or temp basals are wait-and-see situations in those cases.

4. The hardest part about exercise and diabetes is that I can do the exact same routine every day and get different results. If I worked out at precisely the same time, for the same amount of time, and with the same sequence of movements every single day, then…my diabetes wouldn’t give a damn. Every day of life with diabetes is different because of the variables that inevitably cross my path. Things like mood, that time o’ the month, stress, diet, illness, and more can cause major changes in my blood sugar levels. It’s my job to react accordingly to those changes, but that doesn’t mean I always hit the mark on the first try. So with that in mind, it can sometimes be hard to accurately predict how my blood sugar will fare after every single exercise routine. Just thinking about it can be more exhausting than the workout itself.

5. My diabetes is my biggest motivator/fuels my desire to exercise. At the end of the day, I work out because of my diabetes, not because I’m trying to sculpt washboard abs (though I wouldn’t complain if that actually happened). My diabetes loves exercise: It results in an increase in insulin sensitivity and it helps tame my blood sugar levels overall. How could I not be motivated to work out every day with outcomes so tangible?

Yoga with Goats (and T1D)

It seems like a new fitness trend is “going viral” every week: between aerial silks, SoulCycle, and at-home fitness mirrors (in which a real trainer appears in your mirror and you get to watch yourself while they talk you through the workout – whoa FUTURISTIC right?), there is a plethora of ways to get physical that don’t involve standard, boring weights or treadmills.

I recently had the opportunity to try one of the most random, and possibly cutest, fitness craze…goat yoga. Yep. Yoga, but with goats.

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All downward dogs should be called downward goats when doing a goat yoga class.

It’s exactly what it sounds like. You move through a series of yoga poses, but there just happens to be adorable baby goats roaming around the class. They aren’t shy about making their presence known, either. When they aren’t bleating or searching for goat treats under your yoga mat, they’re actually JUMPING ON TOP OF YOU. It doesn’t matter if you’re in a tabletop pose (see my photo, above), downward dog, child’s pose…they’ll find a way to climb on you and turn you into their personal jungle gym.

It was a little disconcerting at first, and it was damn difficult to focus on flowing through yoga poses because you didn’t know if or when a goat would hop on your back or accidentally brush up against you with its horns.

And it was virtually IMPOSSIBLE when my blood sugar went low halfway through the class.

I knew that I was starting to feel off after I completed a short series of bird-dog crunches. I felt oddly exhausted after doing five on each side, so I went to go check my CGM data on my phone when I realized I didn’t have access to any, because I’d just inserted a new sensor that morning and the warm-up period wouldn’t be complete until the end of the goat yoga class.

Great timing on that one, Molly.

I decided to give it a few minutes before I took any corrective measures. So I just sat there, watching people struggle to get bendy with goats running amok. It was really pretty funny, but my sense of humor was shot, thanks to my low blood sugar.

I’m a little embarrassed to admit that the goat factor also prevented me from correcting my low right away, but…well, those things were germy. They’re farm animals, of course they will be messy and smelly. But they were literally peeing and pooping on our yoga mats, and precariously closely to our clothes/bodies. Forget feeling like I needed to sanitize my mat when the class was over – I felt like I needed to power wash MYSELF, at max intensity, just so I could feel totally clean again. So the prospect of checking my blood sugar in the middle of everything seemed absolutely unsanitary and virtually impossible.

But…like, I had to suck it up. After all, I didn’t want to do that thing that goats do, which is faint. Except they do it in a semi-cute way, and because they’re born with a condition that causes muscles to seize up when they’re startled. And there was no way I was about to faint due to a stinkin’ low blood sugar in front of a bunch of strangers and goats.

So I forced myself to navigate to the clean, protected patch of land that my backpack was perched on, dodging poop balls on the way over, and immediately grabbed my hand sanitizer so I could cleanse myself before reaching into my backpack and consuming a small box of yogurt-covered raisins. I still felt gross about it, but I did the right thing and took care of myself.

And I’m happy to report that by the end of the class, my blood sugar was on an upswing and not one goat had peed or pooed directly on me. Sweet success!

 

Hot Yoga: A New Win for my Diabetes

Normally, if you asked me if I would willingly go into a 105 degrees Fahrenheit room for 90 minutes for a workout, I’d say ohh HELL nawwww before you had the chance to finish asking your question.

I’m not someone who has a passion for exercising. I tolerate it. I try to do it daily for two very important reasons: 1) It keeps me in shape and 2) it helps me manage my blood sugars better. Otherwise, there’s very little about exercise that I actually enjoy. I’m not a fan of feeling out-of-breath for long periods of time. I have a love-hate relationship with the post-workout soreness that floods my body after a particularly intense session. And I definitely cannot stand sweating – on just about any given day, I’d rather be freezing cold and wearing layers of clothing than dripping in sweat.

All that said, though, I willingly participated in a fitness class called Bikram yoga…which is also known as hot yoga because you’re in a temperature-controlled room heated exactly to 105 degrees for the duration of the workout. For 90 minutes, you slowly move through 26 poses, and that’s that.

I wasn’t worried about the latter; it was the former that had me sweating (both literally and figuratively). I wondered whether I’d be able to tolerate the heat for a full hour and a half. I also had concerns about my diabetes devices – would I be sweating so much that they would fall off? Would they be able to stay safely in the room with me, or would the heat be too extreme for them? And how would my body and blood sugars respond to the hot yoga, anyways?

I knew the only way to get answers to my questions was to show up for class and find out for myself.

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Me, post-class, dripping in sweat in my car. Next time, I’m bringing a change of clothes.

And that’s exactly what I did. I went to a morning class with my stomach empty and my backpack full of diabetes supplies. My blood sugars tend to respond better to exercise when I don’t have any food in my system or insulin on board, so I made it a point to wait to eat my breakfast after yoga instead of before. But I still wasn’t entirely sure if or how my blood sugar might react to a brand new kind of workout, so I wanted to be armed with several different low snacks. I felt fairly confident about its stability, though, as I headed into the class sitting pretty at 110 mg/dL.

In addition to extra diabetes supplies, I also thought to bring with me some water that I’d filled and frozen the night before the class so I could stay hydrated throughout it with water that was sure to be extra refreshing in the heat.

Even though I had all this stuff with me, I chose to leave most of it in a cubby outside the studio, save for my CGM receiver, a tube of glucose tablets, and my water bottle. I didn’t want to take any chances with my cell phone, PDM, or glucometer and expose them to the heat – I have firsthand experience with an overheated cell phone, and while it does eventually cool back down its own, overheating my devices is not something I’d actively seek to do. I was taking a bit of a risk with the CGM receiver, but since I have the Dexcom app on my cell phone, it’s not like I’d be at a huge disadvantage if something were to happen to my receiver.

So with my gear in hand, I stepped foot into the yoga studio…and immediately started sweating. Yes, that quickly! It was a heavy, stifling, and moist heat – the exact kind that I hate the most. I started to question whether I had the endurance to even sit in this heat for 90 minutes, let alone move seamlessly through yoga poses in it. In the minutes before the class began, I sipped water slowly and told myself that above everything else, I needed to listen to my body throughout the class. I started to feel better as I reassured myself that it would be perfectly acceptable to walk out should I start to feel light-headed, low, queasy, or anything else abnormal.

Fortunately, though, an exit plan wasn’t needed as I made it through the full class! That’s not to say it wasn’t challenging or extremely sweaty – seriously, my body was so covered in sweat that it looked like I’d just come out of a swimming pool – but I proved to myself that I could do it. And the best part was that my blood sugar behaved beautifully: As a reminder, it was 110 mg/dL at 8:30 A.M. Class started at 9 and lasted until 10:30 A.M. I was home by 11 and when I checked my blood sugar there, I was at 118 mg/dL. I couldn’t have asked for better pre-, mid-, and post-workout blood sugar levels.

Was it scary to try this new, moderately intense exercise? Yes. Was I concerned about my diabetes before, during, and after the class? Yes. But was it all worth it? I’d say yes. I overcame my fears and was met by blood sugar success, making hot yoga a diabetes win in my book.

Bike Beyond, the Documentary: An Emotional Cinematic Experience

Last summer, a team of 20 international riders embarked on the journey of a lifetime. They spent 10 weeks cycling from New York City to San Francisco – east coast to west coast. As if this feat weren’t incredible enough, this team was comprised of individuals with type 1 diabetes.

This ride was risky enough, but throw diabetes into the mix, and it seemed impossible. Blood sugars would be a constant concern. Diabetes technology could fail. Careful watch of blood sugars could clash with the focus on cycling. Diabetes burnout could affect the riders physically and mentally.

But – spoiler alert – neither fear nor diabetes would prevent these riders from completing their arduous trip.

When Team Bike Beyond officially started their trek last summer, I remember following along as best as I could through various social media channels. I felt connected to the team: not just because of diabetes, but because I personally befriended a couple of the riders a few years ago at one of the College Diabetes Network’s Annual Student Retreats. I attended as a volunteer, and Jesse and Meagan were there as students. It’s funny how quickly friendships can form over the course of five days, but as anyone who’s gone to one of these retreats can tell you, there’s something about being immersed for a few days with a group of people who just get it. So it’s natural that we bonded over our mutually dysfunctional pancreases.

Anyways, as neat as it was to read those updates from Jesse, Meagan, and the team, there’s no way that words could capture what they were actually experiencing out on the road. I think that’s why watching the documentary was so emotionally captivating to me: Within the first few minutes, tears were rolling down my cheeks as the bikers explained the nervous energy they felt in the days leading up to the ride kickoff. In fact, my facial expressions changed so frequently throughout the film that I’m sure it was comical. One moment I’d be beaming, and in the next my jaw would drop open. I’d laugh when the riders were being goofy together on camera, and marvel with them as they took in stunning scenery across the country.

Overall, the documentary was incredibly well done. Victor Garber’s narration was fantastic – smooth and clear without taking attention away from what was happening onscreen – and the visuals were beautiful. I liked how footage from the riders’ GoPro cameras was incorporated so viewers could get an accurate representation of their perspectives from the bikes. It made me appreciate the physical intensity of the ride that much more, because diabetes aside, cycling such a long distance filled with rocky roads and steep inclines is extremely demanding on the body.

My recommendation? Check out the trailer. I included it above. I guarantee it’ll pique your interest and stir your emotions. You’ll want to watch the full documentary, which you can get here. After watching it, I think you’d agree with me that Team Bike Beyond crushed their goals of raising T1D awareness and eliminating stereotypes by completing this journey.

Three Things I Learned about Myself after Running a 5K

I recently ran in my first-ever 5K race. In the weeks leading up to the race, I experienced a variety of emotions – particularly self-doubt – that made me question whether I could really do it. Would my diabetes cooperate the morning of the race? Should I eat a big breakfast before running, or go into the race fasting? How would I handle correcting a low blood sugar while running? What about a high blood sugar? Was I even competent enough to run?

All of my diabetes anxieties aside, I’ve always hated running. HATED it. I played field hockey every fall when I was in high school, and we were required to run a timed mile before the start of each season. I dreaded this mile because I usually wound up finishing the mile last, or close to last – my asthmatic lungs and negative attitude helped ensure that I would give up running halfway through and resort to walking a sluggish, defeated pace.

So like I explained in a recent blog post, making the decision to go through with this 5K wasn’t easy. But I wanted to take on the challenge and prove something to myself.

AND I DID IT!!! I’m pleased to say that I completed the race on a gorgeously sunny Saturday morning along with hundreds of other runners. I was totally proud of myself for accomplishing this goal, especially since I had less than a month to train for it. Plus, I learned a few things about myself after participating in the race:

  1. I should have more faith in my ability to manage my diabetes. I spent so much time dwelling on the “what ifs” (a bad habit of mine) regarding what my diabetes might do during the race that my stomach was doing somersaults as I approached the start line. But as soon as I turned my music up and started running with everyone else, my doubts vanished. And better yet, I was absolutely fine throughout the race. I didn’t eat anything beforehand and went into it with a blood sugar of 142, and I stayed pretty steady for most of the 3.1 miles (I did start to spike soon after crossing the finish line, but I’m certain that was because of the adrenaline). I simply did what I’d been doing during my past month of training, and my experimentation with fasting vs. non-fasting paid off.
  1. I’m a lot more determined than I realized. I’ll admit that there were a few points throughout the race when I wanted to give up. I was breathing hard and my legs were starting to ache, but not once did I stop running and slow down to a walk. I pushed myself to keep going, even though I didn’t want to, and my determination helped me achieve my personal best running time.
  2. I’m ready to train for future races. This experience awakened something in me that wants more challenges. I’m still not in love with running, but I think I am a fan of trying things out of my comfort zone. I want to continue to get faster and stronger so I can try tougher races and physical tests. It’s almost like it’s an outlet for me to tell my T1D that it can’t stop me – that I’m stronger than it no matter how hard it tries to knock me down.

Training for my First 5K

At the start of the year, I told myself, this is your year. You’re going to be in the best shape of your life and finally run a 5K. I’ve never particularly enjoyed running, which is why the challenge of a 5K was more alluring than a different fitness goal. I felt that doing something I practically dreaded would make accomplishing it that much more gratifying.

But just a few short weeks into 2018, I broke a bone in my arm. I was crushed, because the kinds of physical activity I could do suddenly became severely limited. Instead of taking the injury in stride, I spent a long length of time moping over it. My exercise levels decreased and I stopped caring (for a short while, anyways) about my lean and mean pursuits. All I wanted was to heal, and heal swiftly.

Fortunately, I’ve fully recovered from the fracture, and so have my spirits. A renewed vigor took hold of me in April, and I spent many weekday mornings waking up early to complete a variety of workouts. I started to feel stronger and more confident in my athletic ability. So in the second week of May, just a few days after my 25th birthday, I decided the time was right to register for my first 5K.

And so I did, and I’ve devoted time training for it since then. It’s far from easy, but I must admit that each time I successfully complete a run, the feeling of accomplishment and pride that courses through my body makes it all worth it. It’s doubly wonderfully when I’m able to achieve in-range blood sugars before, during, and after each run.

I don’t have a convoluted strategy for stabilizing my blood sugar while running; rather, it seems to work best for me if I simply complete a fasting workout first thing in the morning. This eliminates a few variables affecting my blood sugar, including carbs consumed during a meal or insulin on board. I’ve found that I don’t even need to run a temporary basal or suspend any insulin – my body seems to do well if I’m running my normal basal rate. But with diabetes being a fickle fiend, I’m always prepared for a potential high or low blood sugar to occur on a run. In other words, portable glucose and my PDM are my constant running companions.

Race day is just a few short weeks away, and I can honestly say that I’m looking forward to it. Sure, I’m a little anxious, but I’m choosing to focus on the fact that I’m finally taking on something that tests me – and my diabetes – in all the right ways. I should be proud of that alone, but I must say, I’ll be over the moon when I get to cross that finish line.

Diabetes Connections: Gym Edition

“Are you a diabetic?” Despite the fact that I was wearing earbuds, I heard the question that was undoubtedly being directed toward me.

I glanced to my right and met the gaze of the teenage girl on the treadmill next to me. I smiled, tugging an earbud out, and said, “Yes, I am. My OmniPod gave it away, didn’t it?”

She nodded eagerly. “I have a Medtronic pump, but I know what an OmniPod looks like. When I saw it, I had to say something to you.”

This marked the beginning of what wound up being a thirty minute interaction with Shae, a high school senior with bucketloads of energy and questions for me about life with diabetes. We specifically chatted about college, and I couldn’t resist telling her all about the College Diabetes Network and what a useful tool it was for me during my three and a half years at UMass. The more we spoke, the more it felt like I was looking at a mirror image of myself from seven years ago. She had just finished taking her AP Psych exam and was relieved it was done. Her senior prom was in a few days, and she described how she’d wear her pump while donning her fancy gown. She was excited about college, but a little nervous about the dreaded “Freshman 15” and whether her diabetes would adjust well to college dining halls.

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It’s so funny to think how something as crappy as diabetes can introduce so many amazing people into your life.

I did my best to answer Shae’s rapid-fire questions frankly but reassuringly. As I told her about how much my CGM helped me in college (especially since I was still on multiple daily injection therapy at that time), she exclaimed that I was inspiring her to want to give her CGM another shot (pun unintended – I love spontaneous diabetes humor).

As we parted ways, we both grinned broadly and wished one another well. This is why moments like this – diabetes in the wild – are so great. Diabetes instantly bonds you to a stranger who you might not otherwise ever interact with, and the beauty in that immediate connection is priceless.