Exercise

A Crazy Idea

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It was freezing inside the house on Saturday morning. But the weather looked so nice outside.

Like, too good not to go outside.

Considering how hard it’s been to get out in-between uni work, birthday celebrations and darker evenings of late, I just knew that I had to take advantage of the sunshine. Not to mention my doc’s lingering reminder of a low Vitamin D level from my last blood test.

And, it’s kind of stimulating to venture out during the day when the sky and the sunlight are different to the early mornings and late afternoons that I’m used to. Like, brighter. Fresher. The surrounds are more peaceful and quiet.

Knowing that I’d be in desperate need of a break from exam revision this weekend, I had a really crazy idea. I pulled out my running shoes, shorts, Rockadex pump belt and topped it off an old t-shirt. I also decided that I’d best put on my medical alert bracelet and shove my iPhone in my pump belt, just in case…

I thought that by 11ish most of my breakfast insulin would have worn off and I’d get the best of that midday light. I really just swagged the temp basal rate, doubling the 30% reduction I use for moderate activity at work and hoping for the best.

It’s been years since I last ran. I remember how terrible it made me feel because I don’t exercise and I’m terribly unfit and I push myself far more than what’s reasonable for someone whose internal dictionary cannot comprehend the word exercise.

I did a quick jog down the road, detouring through suburbia and ending at my favourite spot surrounded by boardwalks and green grass and lakeside houses with balconies that I could only dream of being able to afford. And occasional swans.

As I propelled myself forward, hearing my feet hit the ground and my breathing grow heavier, I realised one thing. I wasn’t thinking about uni and exams and what I’ll have for lunch this week or the appointments on my ‘to do’ list and all of my other worries of the world.

My mindset had returned to the present.

That run didn’t feel so bad after all.

Not What I Planned For…

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16:22 I arrive home. Blood sugar is 4.6 with a downward arrow and around 1 unit of insulin on board. Little guy has not yet been for a walk today.

16:33 I prepare a milky coffee and grab one of the Walkers Shortbread Festive Shapes from the cupboard. 15 grams of carbs. Enough to course correct the hypo, with a little extra glucose for the quick walk I’m planning.

16:54 Almost ready to walk and my Libre is still reading 3.4 and steady. A finger prick reads 4.3. I figure I’ll need a little more glucose for my walk, but I really don’t feel like glucose tabs today. I open the cupboard, delighted to find a packet of pretzels there. I measure out 15 grams of pretzels and chew them down.

17:01 I have the little guy’s attention before I’ve even grabbed his lead from it’s little drawer. Just before I’m about to head out the door, the phone rings. I pick it up, and decide on a quick detour to the train station to collect my sister from work since I’m heading out anyway.

17:06 Today’s walk will probably be lighter than usual, given that I have the little guy in tow who’s still recovering from surgery a few weeks ago. I bolus for half of the pretzels I ate as I’m sitting in the car driving towards the train station, figuring I’ve overestimated my glucose needs.

17:15 My sister asks if the little guy has been for a walk today as we’re heading back from the station, and I explain that I was planning on doing so prior to this detour. She then says that she is going for a walk with a friend, and offers to take him with her.

17.19 Back home. Blood sugar is 5.3 and trending upwards. Too polite to explain how much of this afternoon’s groundwork hinged on me taking the little guy for a walk, I convince myself I have other things to do and bolus for all of the insulin I missed. And then some.

Exercise with diabetes is so damn hard.

How to Get Active Without Entering a Gym

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I don’t do running. I don’t do workouts. I do, however, believe that physical activity should not be confined to these two things alone.

“Over the years, I haven’t had the best relationship with exercise.

I’ve tried to get into a routine of jogging, but usually expect too much of myself and feel poorly afterwards. I’ve previously used casual gym passes, but ultimately they are costly and aren’t geared to someone who might go once or twice a week. During my school years I was never really taught how to play sports, and usually tried to stay as far away from the ball as possible!

It has only been in more recent years that I’ve embraced other forms of exercise beyond the conventional gym or running. There are so many activities that qualify as exercise, making it possible to burn calories while doing something that you actually enjoy!”

You can read more in this week’s column for Diabetes Daily here. 

Review: Fit With Diabetes e-Book by Christel Oerum

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As much as I like to proclaim that I don’t exercise, the reality is simply not true. While I might not partake in dedicated workouts or fitness regimes, there is plenty of physical activity in my day. My job keeps me on my feet all day, and I do enjoy getting outdoors and going for walks through my neighbourhood in the afternoons. Not to mention all of the incidental exercise involved with tasks like housework!

As with every other aspect of my life, my diabetes needs due consideration when I’m active as well.

I’m a big fan of reading offerings that give me practical information I can take away and apply to my own diabetes management at home. It’s one of the reasons why I’m such a big fan of Christel Oerum, a longtime T1D and co-founder of the website Diabetes Strong (diabetesstrong.com). Christel created her website after struggling to find information about exercise and nutrition with diabetes. 

Christel has recently launched an e-book, Fit With Diabetes, and kindly sent me a copy which I had the pleasure of reviewing.

The book kicks off with a chapter on goal setting and finding your motivation, which will likely resonate with most readers. Who doesn’t have something at the back of their mind that they’re aspiring towards? Even if your direct goal isn’t fitness related, I’m willing to bet you would find something in this book that will help you reach that goal. Improved blood sugar levels, better nutrition and healthier lifestyle comes to mind.

I was nodding my head as I read through the chapter on Cardio, the main form of physical activity that I tend to make adjustments for. Given that getting up and going to work every day involves cardio, I’ve had no choice but to endure months and months of practice, patience and frustration to finally reach a place where I can work, eat and navigate my blood sugar levels without so much bumpiness.

Most cardio workouts increase insulin sensitivity during and after a workout, causing blood glucose levels to drop. The book provides practical suggestions for reducing basal rates and insulin doses for meals in advance of a workout, right through to avoiding lows in the hours afterward. Christel’s lived experience really shines through as she provides plenty of real life examples for undertaking cardio with both an insulin pump and Multiple Daily Injections.

Have you ever noticed your blood sugar levels starting to rise after exercise is over? One of the lightbulb moments that I had while reading this chapter was that a reduced pre-workout insulin bolus might need a follow up if food is still digesting once the workout is over. Ding!

The book moves into resistance training, and admittedly this chapter didn’t speak to me so much as I haven’t stepped inside a gym in years! Christel talks through navigating blood sugars during these higher intensity workouts, which can cause blood glucose levels to rise.

This chapter is definitely written in the spirit of motivating the reader to get into the gym and move past any personal reservations or fears. There are several pages of sample resistance workouts and illustrations in the book, with exercises that will suit both the gym go-er and someone with basic equipment at home.

For me, however, the most valuable part of this book was the chapter on nutrition. I say this because the nutrition advice in this book makes the most sense, but in my opinion isn’t reaching enough people with diabetes. I’ll have more to share on this soon…

Christel talks through calculating your daily kilojoule (or energy) needs in order to fuel your body and match the energy you expend each day. It was refreshing to hear her recommending carbohydrates rather than avoiding them altogether. Based on her own experience, she recommends a diet of 30% carbohydrate, 40% protein and 30% fat, however of course you could adjust these percentages to suit your own preferences. 

Another handy tool that Christel suggests to help track your nutrition is the smartphone app, My Fitness Pal. I’ve been using it myself since reading this book and it is amazing.

There are also chapters on meal planning and recipes, losing weight with diabetes and further advice to support a healthy lifestyle.

The Fit With Diabetes e-book very much runs in similar veins as Gary Scheiner’s Think Like a Pancreas. It wasn’t screaming at me to change everything about myself, nor was it holding back on providing practical suggestions because ‘everyone is different.’ The book is simply there to help you get more out of physical activity while managing diabetes.

Even if you’re not a fitness nut like me, I am very confident that you will find something to take away from this book. You can purchase your copy of the eBook here, and you can also follow Christel at diabetesstrong.com.

Disclosure: Christel sent me a copy of the Fit With Diabetes e-book. There was no expectation that I would write about or promote the book, and all opinions expressed here are my own!

Outside the Bubble.

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“Diabetes! Diabetes! This way!”

The lady behind the counter was shouting and gesturing wildly as I entered the rec centre for an evening on exercise and nutrition put together by my fellow Young Adult Diabetes Committee members.

The YADC came to life a year ago and has since grown into a vibrant community of young adults living with diabetes, who are predominantly type 1s. As I found myself explaining to someone in attendance that night, this group really came about to fulfil a need that was currently missing in the Perth community.

As I took a seat and the evening’s proceedings kicked off, I found myself mentally nodding as I heard concepts being explained by our guest speakers that I was all too familiar with.

I looked around the room, glancing at some of the other people with diabetes and their loved ones in attendance. I observed many of them listening attentively, taking in all of the information they were hearing or jotting it down in note form. My own two parents were sitting behind me, and I wondered how easy this information was for them to take in.

They know the concepts behind managing type 1 diabetes quite well. At home, I find myself talking a lot about some of the exciting developments I read about in the DOC, my advocacy activities and diabetes related travel.

However, I’ve always been very independent in the physical management of my condition. I don’t bother them with all the nitty gritty stuff, like trying to figure out the best time to bolus for a high fat high protein pub dinner when my blood sugar is x mmol.

The evening broke off into group sessions, where I found myself chatting with some of my fellow type 1s in the room. It was nice (but also saddening) to hear other experiences in public hospital diabetes care that mirrored mine, while there were also some inquisitive questions asked of the pumpers and CGM users.

I departed this event with a far greater insight from all of the different perspectives I had heard and observed in the room during the course of the evening, and all of the different motivations for attending.

During our committtee meetings, good ideas simply seem to pop among this very bright group of YADC members. I spend my spare time trawling social media, squealing with excitement over the latest device or venting my frustration over the latest coverage of diabetes in the media. I get to catch up with people in the industry and other diabetes bloggers when I’ve received opportunities to travel, who are people just like me.

This event, however, had finally brought me outside of the diabetes bubble that I so often find myself sitting in. I just need to figure out how I can spend some more time here.