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!

 

Starting Off on the Wrong Foot

“How are you today, ma’am?” The man behind the Dunkin’ Donuts counter smiled and looked at me expectantly, as I started back at him blankly.

I wasn’t sure how to answer. My mental state wasn’t great, that was for sure. I’d just come from a visit to a walk-in clinic, where I’d had X-rays of my foot taken to see whether or not it was fractured.

The previous 24 hours had been a bit of a whirlwind. I’d worked and gone to my first-ever kickboxing class, which was an awesome experience. I’d had dinner with my partner and started playing video games soon after as a way to unwind after the long day. That’s when pain in my foot flared up, suddenly and significantly.

Could I have injured it in the kickboxing class, without even knowing it? Was I overdoing it on exercising, in general? How and why did the pain just start up like that? Almost immediately, I plopped myself down onto the couch with an ice pack and extra cushions, hoping that I could stop the pain as quickly as it started.

No such luck. I went to bed early that night, but the pain was so severe that sleep was virtually impossible. I tossed and turned for hours, wondering what the hell was going on and coming up with a plan to get it checked out A.S.A.P.

That’s how I found myself at a walk-in clinic, a little over 12 hours after I first felt the pain. I was evaluated by a nurse practitioner who told me that “the likelihood of a fracture was low” (thank goodness) and that it was “probably tendinitis.” I was given instructions to rest, ice, and elevate my foot for the weekend, and take non-steroidal anti-inflammatory drugs (otherwise known as NSAIDs, like Ibuprofen or Aspirin) as needed.

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I’m trying to put my best foot forward as I deal with this injury.

That meant hours and hours of being sedentary.

That meant no exercise of any kind – I even had to keep walking at a minimum.

That meant my spirits were crushed.

I was glad that it wasn’t worse, and proud of myself for not waiting to seek medical treatment. But that didn’t mean I was thrilled with the outcome. Basically, I had to take the wait-and-see approach. Time will tell how long the pain lasts, and I can’t stand not knowing. I also can’t stand not being able to be active. Daily exercise is a key element to maintaining good blood sugars. Sitting around idle doesn’t do my diabetes any favors, but it’s not like I had any other choice.

I left the clinic, trying to process this information. This certainly wasn’t the way I wanted to kick off the long Memorial Day weekend. It definitely could have gotten off on a better foot. (Okay, okay, I’ll stop with the puns.) I found myself at a nearby Dunkin’ Donuts minutes later. I hobbled in, hoping that an iced coffee might lift my spirits somewhat.

I blinked, bringing myself back into the moment, and smiled wryly at the Dunkin’ cashier. “I’m okay,” I said to him. It wasn’t just a response to his question, it was also a reassurance to myself. I’m okay and I will be okay. I won’t let this get me down.

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.

The Possible Pod Failure, or “Do You Hear What I Hear?”

Judging by the title of this blog post, you might assume that I’m rewriting yet another Christmas song to make it about diabetes. Well, I’m here to tell you that is false – no more Christmas carol transformations for me! (At least, not until Christmas 2019.)

Rather, this post is all about an odd, kind of silly thing that happened to my mother and I when we were out on a walk with Clarence, my parents’ dog.

We both heard a high-pitched beeping coming from…somewhere.

We exchanged glances and my mom asked me if I heard that sound. I nodded, and we both sighed as we fished through our pockets for our PDMs. That’s because we both just knew that one of us was experiencing a pod failure, and that the pressing of a couple buttons would reveal who was about to become extremely annoyed.

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My walking buddies, moments after the false alarm.

But both of our PDMs indicated that our pods were working just fine. Bemused, she told me that sometimes her PDM won’t recognize the pod failure right away, and it will be the pod itself that emits the beep-of-dread. So I started lifting up layers of my heavy winter clothing to see if my pod was making the sound, while she briefly stopped walking to listen closer to her pod.

After our careful scrutiny, we determined that…

…the beeping sound was actually someone using a weed whacker or some other piece of lawn-care equipment in the distance. Oops.

We continued our walk, chuckling a bit about it while Clarence pranced along in between us. It was a relief to know that we wouldn’t have to scramble home so one of us could take out insulin and a fresh pod to apply as soon as possible.

What’s the point of sharing this little vignette? To show that diabetes is such a significant part of our lives, always one of our first thoughts, even in the most mundane cases. It also illustrates how volatile diabetes can be – just like that, a random beep can change the course of the day and determine your next series of actions.

Just some food for thought, all triggered by a (literally) false alarm.

 

Favorite Things Friday: My SPIBelt

One Friday per month, I’ll write about my favorite things that make life with diabetes a little easier for me.

For most people with diabetes, there’s no such thing as traveling light.

It doesn’t matter if we’re packing for a vacation or taking a brisk afternoon stroll – we’ve got to have a certain amount of supplies on hand in order to be prepared for any number of scenarios that could occur while we’re “away”.

As you can imagine, this can be pretty annoying, especially when it comes to simple matters like leaving the house for 20-30 minutes. It’s not like we can go out empty-handed. We need to stash our purses/backpacks/bags with the appropriate diabetes supplies, and it can get pretty bulky. I used to find it especially cumbersome if I was just trying to go for a walk in the neighborhood and had no choice but to carry a purse with me the entire way, which slowed me down and frustrated me.

Then I got my SPIBelt.

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My Dexcom SPIBelt

This miniature fanny pack changed everything for me! It looks small, but stretches to hold all of my essentials for when I head out on runs or longer walks. I can fit my cell phone, glucose tablets, and OmniPod PDM in the tiny pouch. There’s even enough room leftover for my dog’s treats and poo bags, leaving my arms and hands free to hold his leash when we go on walks together.

Other features of my SPIBelt include a slit in the pouch for earbuds, a secure clip in the back, and adjustable waistband so it can fit snug to the body, no matter how many layers of clothing I’m wearing. And unlike other armbands, pouches, and drawstring bags I’ve used in the past, my SPIBelt is actually comfortable. It stays in one place, so I’m not distracted by constant movement around my waist. I was definitely impressed by it the first time I took it on a run and didn’t have to keep on adjusting it as I moved. It’s much more discreet and doesn’t look quite as “old-school” as fanny packs or other similar bags.

This particular SPIBelt was given to me by Dexcom as a thank you for participating in their G6 ad campaign, but as I’ve come to find out, SPIBelts are widely available online and in stores.

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.