Help how to loose weight

I have had diabetes since I was nine, I am now 33, I am happy with my general control up until now. I have completed a Dafne course, which has helped me achieve a HPA1C of 7.1%, which I am very happy with.

The problem is I have become a keen mountain biker, and have been regular riding for about 8 mouths and have covered 2000+ miles. But I am yet to lose any weight. I am 5’8” and weigh 92kg which is too heavy… On a normal Sunday and Wednesday night ride I would cover approximately 30miles and burn 3500 calories each ride.

Because I have not got the results I am after, I have stepped up my training to, going out around three times a week doing approximately 30 miles on each ride, as well as three times a week I cycle on an exercise bike for an hour at 60% heart rate (fat burning zone).

When I first started riding I was having to eat a lot the following day to stop myself from becoming low, but now I have reduced my insulin ratio from 1.5:1 to 1:1 which has stopped me from having to eat. But if I miss any training I have to return to my normal ratio the following day otherwise I will go high.

Last night I went out for a 28 mile ride, I had a 3cp for dinner (new boiled potatoes 200g at 6pm) with a blood sugar level of 5.6. When I arrived home my blood sugar level was 11.6 @ 10pm. I did not eat or drink any carbohydrate. I then checked my sugar level at 11.30 before bed which was 5.8, I was keen to see if my background was correct, so I didn’t eat anything. This morning I was woken by the paramedic after recovering me from a hypo.

Does this mean I have to have two different background amounts and two different ratios for when I am exercising and when I am not…. I am trying very hard to get this under control but I don’t know the best way to work out all the variables….

I am assuming my metabolic rate speeds up when I am exercising, and my body needs less insulin to control my blood sugar level. So, do I need to do the same level of exercise all the time so my metabolic rate stays the same, giving me time to get my background and ratio right?
It does annoy me when I am having to take on loads of calories just to stop me for being low.
Any ideas on what I should do would be great.

Cheers Chris

I'm not sure what else to suggest considering it says in the DAFNE handbook that if you want to aim to lose weight, aim to reduce your insulin. Considering my DAFNE nurse told my group that insulin is a growth hormone, I am not surprised by this being in the book.

When you do exercise, your body uses the insulin a lot more effectively resulting in you needing less of it to prevent a hypo. However, sometimes it's just as effective to eat more CPs before the exercise, but with the weigh loss plan, I would assume that this would not be as effective as simply reducing your insulin by the recommended amount in your DAFNE book for the exercise you take.

I am not sure how well it works if you don't take any insulin for a small meal before exercise... but you'd think that the BI would be enough for that...

If you have any doubt about your ratios or background, I would concentrate on that first because exercise can confuse things - but if you're finding that your results are good most of the time, especially considering you have a exercise heavy regime, I then think you're doing a marvelous job.

I do a lot of exercise most days of the week from just walking to work and doing my job generally. I've found that despite getting my blood sugar levels right most of the time to cater for this exercise, my weight hasn't shifted much... it hovers up and down half a stone... but I am at a weight that I'm happy with so I don't worry about it too much.
With this, I do wonder if you just need to give it a bit more time - or perhaps on a more positive thought, perhaps most of your weight is muscle?

Hope I've been of some help... best wishes!

bad news Chris, the answer I believe is yes. You do need different BI and ratio on days you exercise and days you don't. As JWo points out your fitness levels effect your insulin requirements as the fitter you are the better your body uses insulin to assist the conversion of sugar to energy. You also need to understand that when you exercise it causes your muscles to increase their energy requirements for much longer than the exercise actually lasts. It can cause your BG to be lower for upto 24 hours. I used to have this problem on the mornings following a gym visit. I am not suprised that you hypo-ed in the night after your 28 mile ride. Your 'high' reading at 10pm was most likely due to all the sugar pumping around your body to feed your muscles during the exercise. As I said because the requirement lasts 'after' the exercise , your
BI probably assisted your body in keeping the flow of BG out of your blood into your muscles while you slept hence the hypo.
It is a tricky balance and there have been a number of posts on these forums about exercise and BG's. I don't think there is an easy answer unfortunately, although there should be a number of people that can help with advice.
The problems you have with weight could be due to the fact that exercise helps to convert 'fat' to muscle and of course muscle has weight so the net result may not be weightloss. Again I don't think there is an easy answer to this, I personally wish there was but thats life I guess.

Hi,
Most of my hypos occurred during the evening after a physical day at work (not during the extra activity when I sometimes took extra CP's, but 6-8 hours later). I experimented with a 25% reduction in my QA for my dinner and a 40% reduction in my BI at bedtime. This gives me a fairly flat blood glucose over night and is more likely to keep me within target at bedtime. When I don't work that hard physically I leave the ratios and the background alone. Before DAFNE I used to hypo a lot during the evening and as a result I ate lots of sugary snacks. Since I've reduced the frequency of the hypos I've lost about 5Kg, which is quite a lot because I was only 65Kg to begin with. As we all know, ratios and background are an individual thing and what works for one person may be entirely different for someone else. I think it's in the DAFNE handbook about reducing QA and BI following prolonged exercise.

Hi,
I have also been having the same problem with hypo's in the night due to hard training night before, at the min i am training for a fight in muay thai boxing and have to loose weight and i find by splitting my Bi and also lowering it half at night and half in the morning and this is Glarjene, i'm talking about, having some carbs after training but not giving any QA for this, test again before bed because dont forget your liver wants it's glucose back from what it lent you for your exercise i normally go bed around 12 - 13 mmols then wake up around 7-8 mmols have break fast but half the QA and test again at snack time it's working for me at the moment but every ones different. hey but that diabete's for ya trial and error.

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