Thursday, June 29, 2006

Soccer and pumping - additional conclusions

Since starting the experiment on pumping I have had some issues when playing soccer (BG's that piss me off, and Soccer and pumping). My nurse has been convinced that the high BG's that I see after a game, where I have been disconnected for 1-2.5 hours, were mainly due to release of "fight"-hormone (adrenaline) during the game, and not the period of time being disconnected. I was not too sure about that conclusion, though I certainly agree that the adrenaline probably does take part in the high-party. I have found that adding Lantus and Actrapid to my insulin regimen on game days have almost eliminated the problem, which makes me even more convinced that the post-game hyperglycemia issues that I have been experiencing running solely on NovoRapid from my pump and being disconnected 2-3 times longer than recommended in the manual, are not a mere result of excessive adrenaline release. Today at work we had "Activity Day" in our department. This arrangement was arranged by the department's social committee with the purpose of making all the staff and students get together and enjoy a summer afternoon with games and chatting around the barbeque. Thus, we only had to work until noon, and then we all meet outside on the grass for dart, croquet, petanque, vikingespil, soccer, volleyball and foot-tennis. Of course I was up for a soccer game together with quite a few other people from my group. We set up a field on the rough (this part of the lawn is seemingly not mowed as often as those parts were fields were set up for vikingespil, petanque, croquet and dart!) and played two halfs - we needed a break and a drink (the department hosted the barbeque along with plenty of beer and some soft drinks to enjoy before, during and afterwards) :-) I guess that we played something like 30 and 45 minutes, but I really don't know because I didn't check the clock while playing, so it may actually have been longer than that. As always, when playing soccer, I disconnect. I reconnected during our break though. During the second game I didn't feel that fit, suspecting a hypo comming along, so, because I hate stopping in the middle of something, I just consumed half a packet of glucose tabs not leaving the game. When we stopped, I tested just before the barbeque was ready: 3.8 (68). Well, the hypo during the game seemed to be true and I was still on the low side, so I ate some raisins while waiting for the sausages and bread on the two grills to be eatable. About 14.30 PM food was ready. I was not really that hungry as I had an early lunch before the beginning of the activities, but I wouldn't miss the sausages. I only had one though, along with one bread, and figured that a bolus of 1 unit should cover that. A couple of hours later, when getting ready to go home, I tested 9.0 (162). Why??? I didn't really give more thought to it, I was a bit hungry so I bolused 2.3 units (wizard's recommendation) for a bun, ate it and hit the road on my bike. The 2.3 units for the bun is usually more than enough to cover it, especially when going on a 9 km bike ride afterwards, but when I tested before dinner 1.5 h later I was 216!!! By this time I realized that maybe, because I didn't take any Lantus in the morning to cover the periods of time being disconnected during the games, I was probably experiencing the post-game hyperglycemia effect that I have become familiar with since starting the pump. As far as I can tell, I didn't go as high as I have sometimes been following games, which may give adrenaline the honor of throwing the readings through the roof after all, because as the intensity of the games today was not as high as in our games of the tournament, the adrenaline release was probably lighter. Still, I dare to say that this also proves that adrenaline is not the only culprit in this post-game hyperglycemia game, it just does take part.

For the record, by 19.30 PM I was back in range at 4.5 (81) again, so eventhough it required a larger bolus for my dinner this post-game hyperglycemia attack was not as stubborn as previously seen :-)
Now it is time for the final reading before going to bed, I hope this one is just as good as the previous one!

1 comment:

Chrissie in Belgium said...

Hi Heidi,
All the litterature one reads about talks of hypos after exercise. But, as you,I most often have hypers after exercise. We know each exercise type affects our body differently. Is it aerobic, anaerobic, stressful etc. Most litterature says that with stressful activities adrenalin will cause the bg to rise, but even then hypos may occur many hours later. I consistently had INCREASING bg values after a fast 3-4 hour walk. I do not disconnect. Instead I eat my normal lunch, but take only 60%. Usually I take 3U immediately and 2U spread out over 2 hours. I just skip the "extended 2units". Usually I do not begin the walk until about an hour after lunch - well that is what I aim for. Given that insulin functions with a delay, I reasoned it was the extended part of the mealbolus that should be removed because that is when I would be walking. I also decrease my basal just a teeny bit. I take very small amounts of insulin so it is irrelevant to go into details. I have experimented and found that the slower I walk, the more my bg will decrease during the 12 following hours. The faster I walk, I guess you would call this stress, the more my bg increases during the following 12 hours. I usually do NOT have hypos after a fast, long walk. Of course there are exceptions! Last weekend the ozone levels were very high and although I didn't walk very fast my bg values increased. Maybe my body was more stressed by the ozone? I analyze things to pieces! Exercise is really hard with diabetes. I do not think you should ever disconnect. You must always have some insulin. YOU achieve this through taking insulin by syringe. What a balance act we have here with a million unknown variables.... Will Cross needed more insulin than he expected for his most difficult part of the climb of Mt Everest. He expected to have to decrease insulin levels! It is nice to know I am not alone with increasing bg values after exercise.