Challenges with managing exercise
Managing exercise provides one of the most complex challenges for diabetics. For example, aerobic exercise such as running may seem like a simple activity. However, a 30-minute run vs a 45-minute run may require entirely different pre-run dosage adjustments, varied carbohydrate intake while running and changes to recovery schedules and management of background insulin in the evening. Anaerobic exercise, such as lifting weights at the gym, is also fraught with complexity. Anaerobic exercise is technically supposed to raise blood glucose in the short term, however many diabetics who attend the gym regularly will tell you that it isn’t this simple. Depending on the length of workout and types of exercise, you may be performing a mix of aerobic and anaerobic exercise. How should you adjust your dosage routine before, during and after?
There are also challenges with using insulin pumps when cycling, long distance running or other activities which may last for a number of hours. Even with preparation ahead of time and setting higher serum glucose targets on my pump, I will regularly find that hypoglycaemia is fast approaching when exercising for more than an hour, even when taking in carbs. The pump will also shut down its intelligent insulin delivery system if insulin delivery has not been required for a few hours. This can be massively frustrating when trying to recover after a long ride and having no automatic insulin adjustment for up to five hours.
Ideally, my system would give me the ability to input an exercise type, expected duration and possibly intensity (although that can be a little subjective). This ideal system would automatically calculate and make adjustments to insulin delivery before, during and after exercise, as well as suggesting when to take in carbohydrate to maintain energy and avoid hypoglycaemia.