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Reversing diabetese Type 2
xian555 posted:

After about 20 years of treatment of diabetes type 2, 4 weeks ago I discovered circuit training. Since my basal insulin, Lantus, has gone from 42u/day to 18u/day and my bolus insulin, Apidra, gone from 3.6u/gm to 1.6u/gm of carbs.

I am having trouble calculating how much bolus insulin to take after the meal following exercise. It's not clear how much carbs are required for my muscles to recover from the exercise. Given my BMI, exercise type, intensity (calories/hour) and duration, is there a way of calculating how much carbs or calories I need for recovery following the exercise to know how much of the meal needs to be covered with bolus insulin?

Best Regards,

Christian Martel
auriga1 responded:
That is difficult to answer. As far as I know, there is no set formula. Each individual is different in how many carbs they use as fuel. Circuit training will definitely use much more than aerobic exercise alone. Our skeletal muscles use those carbs as fuel. Circuit training stresses those muscles, so those carbs are needed.

I, too, use two insulins. I did use Humalog and Lantus. I switched to Novolin N and Novolin R as a result of loss of health insurance.

I started a part-time job at 15 hours a week. Monday through Friday, I am on my feet three to four hours a day, constantly moving. I am not doing any formal exericse, just moving. Stretching and lifing things and, of course, walking. It was difficult in the beginning because I kept going low due to the constant moving. It did not happen everyday, so I can't figure out what happens when I go low. Did I take an extra step or two or lift something heavier than I normally do that sends me into a downward spiral? My doctor just told me to lower the basal insulin. He also upped the insulin/carb ratio. I used to be at 1 unit of Humalog to every 10 carbs.

I mention the physical activity because it has caused me to lower my dosage of my basal insulin from 40U to 25U. My doctor has me at 1U of fast-acting insulin to every 12 grams of carbs.

You will probably have to experiment somewhat. I have not read up on Apidra, so I do not how long it lasts in the bloodstream and how long it takes to reach its peak.

Do you eat right after exercise? As I said, you will probably have to experiment. Eat and perhaps not take any bolus insulin. Test two hours after your first bite of that meal. If you have not returned to 140 or under, this will give you a good indication how exercise and the food you eat right after "react" together. It is probably best to keep a written record if you decided to experiment.

You may also have to adjust your dosages daily. Keep checking your BS throughout the day if you can. I up my basal insulin by a unit or two if I'm not active on a particular day. If I'm not active, my FBS is higher the next morning.

I completely understand your dilemna. Just remember though that carbs are fuel that are used during your exercise. It is a good question as to how many carbs are needed for "recovery." Each person is so completely different.

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