Ask The Expert
Monitoring

Congratulations on your efforts to reduce your weight. You are definitely starting out on the right track by reducing the amount you eat and becoming more physically active.

The dilemma you face when you take insulin is that your body doesn’t automatically compensate for the change in activity and food intake by adjusting your blood glucose levels as it does in people who don’t have diabetes. Although your body requires less insulin when you become more physically active, the insulin you have taken is still working to lower your blood glucose. Therefore, you have to make the adjustments in your insulin based on what you intend to eat and how much you plan to exercise. Then, you’ll need to make additional adjustments as you evaluate how your blood glucose responds to your new eating and exercise plan.

Here are some suggestions to help you:

• Reduce your insulin. You will need less insulin because you’re eating less and because your body becomes more sensitive to insulin when you are more active. You’ll need to consider the insulin that is effective while you’re exercising and the insulin that is effective after you exercise. The glucose-lowering effect of exercise can last from 12-24 hours after you’ve finished exercise, based on how long and how intensely you exercise.
  • Talk to your diabetes healthcare team about how much to reduce your basal or long-acting insulin.
  • Base your meal-time insulin (bolus) on how much you plan to eat at the meal and reduce the meal-time insulin that is active during and following exercise by up to 50%.1 For example, if you exercise in the late afternoon, you may need to reduce your pre-supper insulin by up to 50%. Again, first check with your healthcare team.
• Work with a dietitian to help you develop a meal plan that is moderately reduced in calories and that provides snacks to accommodate your routine and help prevent low blood glucose. Don’t try to drastically reduce your food intake to lose weight quickly.
• Monitor your blood glucose frequently – at least before and after meals and before and after exercise and keep a record. This will help you evaluate how your body responds to your meal plan and exercise program, helping to prevent low blood glucose and allowing you to make adjustments in your insulin as needed.
• Consider planning to exercise after you eat or before breakfast to avoid times when your insulin levels are at their peak (most effective) or when you are more prone to hypoglycemia such as before meals.

Be sure to enlist help from your diabetes healthcare team to assist you in your efforts at losing weight and becoming more fit. Any lifestyle changes can affect your insulin needs, but more frequent glucose monitoring can help you see how your body responds and help you identify how best to adjust your insulin.

Best wishes for success in your weight loss, healthy eating, and exercise program.

Source:

• Klingensmith GJ. Intensive Diabetes Management. 3rd ed. Alexandria, VA: American Diabetes Association; 2003:108.