I have been following the "Diet Revolution" since July 1st and can say now I hit a 50 lb. loss as of this morning. I still have a way to go but it now seems manageable...thank you Dr. Atkins!!

While I have walked a mile a day throughout, I live in an area where it can get pretty cold, so have chosen to go to the gym and use a variety of machines as well as stationary bike etc.

On 20 grams a day of carbohydrate and insulin injections (NPH and LISPRO) I have made time to go to the gym 2 hours after I eat. (7:00 p.m.) I have chosen the one time to make insulin management easier.

I walked into the gym two days in a row in Canadian Measurements at 7.7 and 7.8 which is normal blood sugar. After 30 minutes my blood sugar is over 10 and that is with nothing but water intake.

I am assuming that my liver is doing its own version of "morning phenomina" and creating its own sugar, due to the low carb diet.

If that is the case, how do I stick to the low carb plan and also do the excercise I want to do.

If this should be in the excercise forum, just tell me.

Pauline

Hi North!

From what I understand, your liver and muscles are doing a glycogen dump in response to the stress hormones released during exercise which is causing your blood sugar to rise. How long do your blood sugars stay elevated after you exercise or do they go hypo a while after you finish? A good book to get to explain how this works and why would be Dr. Bernstein's Diabetes Solution. There's a very good chapter in there on exercising for diabetics, both insulin dependent and non-insulin dependent.

Hi! I let the sugar 'live' for four hours then gave insulin and was fine in the morning. Which is better for the low carber...to increase the carbs before the excercise, or treat with insulin afterwards? P

With dinner and Lispro at 5:00 and workout at 7:00, you may be experiencing a glycogen dump in an environment that has little to no insulin available to manage the dump. Your morning dose of NPH is probably mostly gone by dinnertime.

Based on the assumption that the scenario above is operating, one thing you might try, which is what we do with our son and his baseball habit, is to decrease your Lispro dose at dinner and do your workout one half to one hour after dinner. Also, if you are injecting Lispro into the arm or leg and want to exercise with the Lispro dose still available, you will have to change your injection site to the stomach or fatty part of the upper hip. Under the skin of the arm or leg, the Lispro can be absorbed too quickly (for tight control) into the blood stream during exercise. Of course, now your problem will be hypoglycemia rather than hyperglycemia. There exists a combination of Lispro, Food, and Exercise that will carry you through the exercise nicely, avoiding a low by proper balance and not getting a high due to lack of circulating insulin.

Also based on the assumption, have you thought about switching from NPH to Lantus? Lantus lasts for approximately 24 hours (one injection daily) and has no peak. It is absorbed steadily through the day from the injection site and thus is similar to natural insulin response in non-diabetics (as opposed to NPH which rises, peaks, and falls over several hours that vary from day to day and from person to person). There have been some recommendations that people wanting to go on the pump so that they can avoid the peak problems with NPH first try using Lantus. The bad news about Lantus: Some people feel a burn at the injection site as the pH of Lantus is less than 5. Another maybe bad news: My son's endocrinologist won't try him on Lantus because it hasn't been in use long enough to really know much about it.

Isn't the Balancing Game Fun (NOT!).