#dsma The Most Difficult Thing About Managing Diabetes and Exercise

“This post is my March entry in the DSMA Blog Carnival.  If you’d like to participate too, you can get all of the information at http://diabetessocmed.com/2011/march-dsma-blog-carnival“

Hm, the most difficult thing about managing diabetes and exercise...

Well, for me, I think it's the fact that there are so many variables to consider.

• Activity level- mild, moderate, or heavy activity
• How much said exercise typically drops his blood sugars
• How much of a temp basal should I put him on?
• Should I give him a snack before exercise, of so, how many carbs and should I include protein?
• Spontaneous exercise?
• and the list goes on...

Let's talk first about the "Spontaneous exercise" since I'm sure that term might be misunderstood by some.

Spontaneous factor:

The spontaneous factor, is very difficult for me. You see, Lenny is 5 years old, and well, we all know how spontaneous a 5 year old can be! One minute they wanna sit on the couch and watch Spongebob Squarepants, and the next minute they wanna go jump on the trampoline, then the next minute, they just want to take a brief stroll around the neighborhood to say HI to the neighboring kids!

The fact that their energy level, and activity level changes from minute to minute, hour to hour, can be difficult to manage the blood sugars. Excessive exercies (remember that trampoline!) can cause Lenny to crash, and crash hard, if  not well prepared for.

Activity level- mild, moderate, or heavy:

This makes me remember one day last spring. Lenny wanted to go play outside since it was a beautiful day, so of course, I let him. Honestly, he really wasnt that active while outside. In fact, most of the time he was out there, he was playing with sidewalk chalk or (willingly) sweeping the sidewalk. He had just had his afternoon snack right before going outside, which included a cheese stick for the protein (because protein often times helps prevent him from crashing after playing outside) and some sort of carbohydrate (I dont recall what it was exactly).

The simple activity of playing with sidewalk chalk (sit down activity, mind you) and raking leaves caused him to go from a beautiful blood sugar reading, to a severe hypo reading within an hour and a  half time. Raking leaves and playing with sidewalk chalk is one of those type of activities I would have considered to be a low activity level type of exercise. Appearently, I was mistaken that day.

Should I put him on a temp basal? If so, how much?

This one makes me think about gym class and recess at school. Now, I am not able to be in the school for gym class and recess, and I do not always know what the activity is for that particular day, therefore, it can be hard to judge how much of a temp basal to put him on. Currently, we have him being put on a -50% temp basal (getting about half the basal he normally would) to account for activity he receives between gym class and recess being back to back after lunch. While, this does seem to help his sugar pull through better by afternoon snack time (right after recess), it does not, however, help his dinnertime number remain in good standings. Oddly enough, his blood sugar levels seem to drop low 3-4 hours after exercise lately. Regardless of dropping his basal by half the original amount and giving him a snack after exercise. We are still tweeking and trying different things to see what can be done with this.

Should I give him a snack before exercise?:

This one kind of goes hand in hand with both the spontaneous exercise and the temp basal comments above. Giving a 5 year old a snack before he has a  high activity moment can be kind of difficult... especially if you are not really expecting him to go from watching TV to bouncing off the walls at a speed of 0-60 in 1.5 seconds! LOL! It is also not always able to be planned to give that snack before gym class/recess, atleast not in our case due to the fact that he has just finished his lunch an hour before gym class starts. However, thanks to the wonderful DOC, they have given me some great advice on other tactics to try and see if they work!