Before starting any activity there is the bewilderment of what to eat and do with your insulin to prevent hypoglycemia. Moving from no activity to activity is an important change in your physiology and getting things right at the outset is important for feeling good and maintaining a balanced blood sugar. Once your body is set in motion, physiology takes over and the "rules" to diabetes management start to change. Without being proactive to these nuances, it can leave you higher or lower than you ideally want to be not to mention leave you highly frustrated in the process!
Once you take that first step raising your heart rate, your aerobic energy system kicks in driving a metabolic process that starts to lower your blood glucose levels depending on the amount of insulin you have on board. Assuming that the intensity is fairly modest and not too hard, blood sugar will generally go down in the presence of even a lower amount of insulin on board. How fast blood sugars will track downwards depends wholly on the size of the bolus or basal doses as well as any corrections you have also taken. A bolus three hours ago has minimal impact on starting blood sugars where as one taken only an hour ago, much more so.
The key to getting it right at the start is to take the right amount of food to offset the insulin you have in your body. We have developed the following equations for you to use for sustained activities such as biking or running as well as non-sustained activities such as walking or hiking.
Grams of carbohydrates to consume just prior to a 🏃🏻♂️sustained activity = [composite insulin on board] x [(your IC ratio in grams 'X') x 2)]
*Composite insulin is simply the sum of all current basal and bolus insulin on board.
Grams of carbohydrates to consume just prior to a 🚶🏻♂️non-sustained activity = [composite insulin on board] x [(your IC ratio in grams 'X') x 1)]
This food will be timed as close as possible to the start of your sustained activity and if it is a non sustained activity you may eat some food at the start and the rest during your activity as needed. If your blood sugar is on the lower side you can decide to eat 5-10 minutes prior. If your blood sugar is on the higher side you may want to wait right up to the start of the activity. Your food choices should also vary based on your blood sugar as follows;
🩸< 100mg/dl chose a higher glycemic indexed carbohydrate. An example would be orange juice, candy or other "sweet" carbohydrate that gets rapidly absorbed. (Less sweet options are potatoes, white bread and short-grain rice.)
🩸>100mg/dl and < 150mg/dl chose a moderate glycemic indexed food such as a Powerbar, orange juice, honey, basmati rice and whole wheat bread.
🩸>150mg/dl chose a lower glycemic indexed carbohydrate such as soy products, beans, fruit, milk, whole wheat pasta, grainy bread, brown rice, porridge or lentils.
At this point you may be wondering what happens if my insulin on board is too great? What if I run the starting grams calculation and I cannot eat that much?! There are a few outcomes to this answer and here is how they might play out from least ideal to most ideal.
👎🏻 You cram as much as you can and you may go low within the first thirty minutes of your activity.
👎🏻 You have to wait an extended period of time 30 minutes or more before starting your activity to allow the insulin on board to work its way out.
👍🏻 The better option? In hindsight would have been to take less insulin in the three hour lead up to the activity! Adjusting your food intake and decisions of what to eat and when.
Certainly pre planning and being proactive in this case helps you to prevent low blood sugars while being active but it also helps you to prevent overeating when you don’t want to eat and potentially gain weight.
The Scherb Method ™️
There is an old Chinese proverb that says... "The best time to plant a tree was 20 years ago. The second best time is now."
If you are looking for a better way to manage your diabetes welcome to the approach that will change your type 1 diabetes life and well being forever. The Scherb Method™️ has been distilled from many years of study involving athletic and non athletic people with type 1 diabetes. It has been forged by those who demanded more information and support. Created by the demands of top level type 1 athletes, it has mostly been applied to those who simply want to be proactive in their control. You wonder why are athletes the best proxy for this method if I'm not an elite athlete?! To perform at the top means you have to have diabetes and nutrition mastered before you can even think about going toe to toe with other top level athletes. If you can control for an athletic extreme, it is far easier to apply this when you simply want to move your body and be in control. You have probably thought about or faced the following struggles with your type 1 diabetes management but were unsure how to find the right solution. We created the Scherb Method™️ to solve some of type1 diabetes major management problems.
Solving problems and fears
"We secretly fear that poor control will lead to longer term complications that may limit our life and future"
"We worry we may go low and have a seizure"
"We can't sleep easily at night because we are afraid of low blood sugars and sometimes we remain high as a result."
"We get frustrated when we gain weight even when our blood sugars are in good control."
"We stress about how much insulin to take at our meals and especially after being active."
"We avoid carbohydrates and miss the energy and food enjoyment they can provide."
"We fear our friends, partners, and co-workers may treat us differently because we are not in "control""
"We can't live our full and spontaneous life"
"We don't want to be a burden and at times we shield our condition from others and we are left to cope alone."
"We fear losing opportunities in life, activity, work and more due to our lack of understanding and control."
And maybe you feel like we do about the current state of type 1 diabetes management in the world.
"We wish we didn't have diabetes. We want the cure. ..until then we are willing to try new methods and ideas that will make our lives better. We are unsatisfied with the current standard of care."
"Until there is a cure, we must learn new approaches from others who are having success."
"We struggle with the fact that we must learn our own diabetes management methods on our own, putting our bodies in harms way and at what cost..."
"We know that going to our doctors and telling them what we have been doing the past six months is not advancing our real time diabetes struggles. We feel like we are driving the car from the rearview mirror!"
"One day we will wake up and not have to think about diabetes, until then we know opportunities exist to manage and live better now."
"When we take control, our mental exhaustion and fatigue would ease and that would be a major win."
The Scherb Method ™️ as part of Glucose Advisors University, is a decision support system and methodology designed to help empower Type 1 diabetics to lead a healthy and active lifestyle. This method is taught by Glucose Advisors Cliff Scherb to Type 1 diabetics across the world. It has been designed for those who are looking to take control of their nutrition and dosing regimen in realtime.