Linking Diabetics Coast 2 Coast
Chat with Gary Scheiner, CDE
*** (08:57):Welcome to Exercise and Diabetes Chat with Gary Scheiner , Gary Scheiner !
Gary Scheiner says to (08:57):
Good evening!
karend1 says to (08:58):
Hi Mr. Scheiner
Gary Scheiner says to (08:58):
Call me Gary.
karend1 says to (08:58):
Hi Mr. Gary
karend1 says to (08:58):
j/k
karend1 says to (08:58):
hi henry
Gary Scheiner says to (08:58):
You're funny. They hold telethons to cure people like you.
karend1 says to (08:58):
what happened to evita ;)
landileigh says (08:58):
hey Gary!
karend1 says to (08:59):
I will behave
landileigh says (08:59):
how have you been? It's been awhile since our last chat!
landileigh says (08:59):
karen... you don't have to, Gary won't!
Gary Scheiner says to (08:59):
Just kidding. I'm trying to focus here... Phillies, Sixers and Flyers are all on at the same time here.
landileigh says (08:59):
JAIMIE!!!
Henry says to (08:59):
Hi Karend, it was me.... I just changed my name to my Id to my real name so people don't het confused...
Jon says to (08:59):
Hi Gary! Welcome back!
Jaimieh says to (08:59):
Hi all
karend1 says to (09:00):
j/k again henry/evita, no one is getting my humor tonight :)
karend1 says to (09:00):
hi jaimie
Gary Scheiner says to (09:00):
So who's pretending to moderate this thing tonight?
Jon says to (09:01):
Landileigh and I will try to keep things under control
Jon says to (09:01):
and Gina should be here shortly
landileigh says (09:01):
LOL, i think that would be me and Jon until Gina gets here
Ellen1816 says to (09:01):
I think Gary should moderate and be the guest :-)
Gary Scheiner says to (09:02):
Phillies are yet to score a run this year, and the Flyers are getting shut out. Sixers are losing to the lowly Bobcats. I should really give up on sports.
Jon says to (09:02):
Shall we begin? Welcome to chat with Gary Scheiner!
landileigh says (09:02):
jamie you twit! you tweet and and tweet!
Gary Scheiner says to (09:02):
Thank you Ellen! Your check is in the mail.
landileigh says (09:02):
YAY! gina is here!
Henry says to (09:03):
Hi Gina
gina says to (09:03):
hi everyone
Ellen1816 says to (09:03):
Yes Karen
Jaimieh says to (09:03):
Hi Gina
gina says to (09:03):
Hi Henry
gina says to (09:03):
jamie
gina says to (09:03):
everyone!
coachtheresa says to (09:03):
Hi all
Ellen1816 says to (09:03):
Hi Gina
gina says to (09:04):
hey cyber momma
landileigh says (09:04):
actually here to hear what Gary has to say
sdivone says to (09:05):
hi :)
gina says to (09:05):
Hey Gary are you ready? or should we wait a few minutes?
Gary Scheiner says to (09:05):
I'm here... might as well rock & roll.
Ellen1816 says to (09:06):
Is rock and roll exercise?(lol)
landileigh says (09:06):
Gary, I have been working on a program with PWD called Biggest Loser 'D' Style, mainly a program for support. But I myself have had trouble losing weight. Keeping up carbs to manage insulin, and losing weight are so difficult!
gina says to (09:06):
Gary how about you give people a little background on yourself and what you do
gina says to (09:07):
and then we can have everyone start with the questions!
landileigh says (09:07):
I'm currently 238 lbs, with S4 CKD. what can i do exercise wise?
Gary Scheiner says to (09:07):
If you take insulin, you'll only be able to lose weight if you find a way to cut back on the doses.
Jon says to (09:07):
so less carbs then?
landileigh says (09:07):
gary answer after your intro please
AllisonBlass says to (09:08):
Hello everyone! Good to see everyone again!
gina says to (09:08):
Hey Allison.
coachtheresa says to (09:08):
Never thought eating took so much thought until I became a didbetic!
Gary Scheiner says to (09:08):
Well... I'm a certified diabetes educator and type-1 diabetic for 25 years. I run a practice near Philadelphia specializing in intensive therapy; work with people via phone & internet a great deal.
Jon says to (09:09):
you really helped my son a lot by convincing his doctor to put him on a pump!
gina says to (09:09):
Garys website is www.integrateddiabetes.com if you all want to check it out
Gary Scheiner says to (09:09):
I'm also an exercise physiologist and serve as one of the directors of the Diabetes Exercise & Sports Association.
coachtheresa says to (09:09):
Very fustrating. Everything I like has carbs.
gina says to (09:09):
Me too lol
Gary Scheiner says to (09:09):
Hi Allison! How's stuff at JDRF?
gina says to (09:10):
Ok everyone if Gary is ready ask your questions but please give him time to answer
Scott.K.Johnson says to (09:10):
Hi!
coachtheresa says to (09:10):
I have managed to get off my pills with diet & some exercise.
AllisonBlass says to (09:10):
Things are good, though I don't work at JDRF! I work for a PR agency.
Gary Scheiner says to (09:11):
There is more than one way to pare back the insulin doses. Reducing stress levels helps. Getting more physical activity. Cutting portions back and eliminating snacks.
gina says to (09:11):
Snacks is my problem
gina says to (09:11):
especially at night
Scott.K.Johnson says to (09:11):
I'm a huge fan of Gary's, just wanted to hang out for a bit and observe. Hi Jaimie.
Gary Scheiner says to (09:11):
Glad to hear it Jon! Hope he's doing well.
landileigh says (09:11):
What can I as someone who is insulin dependent and with S4 CKD do for exercise? i'm soooooooo tired all the time
Gary Scheiner says to (09:11):
Scott! The guy that got my comuter working! How's it going?
sdivone says to (09:12):
what is S4 CKD if you don't mind me asking??
coachtheresa says to (09:12):
Me too!
Gary Scheiner says to (09:12):
Make that comPuter.
Scott.K.Johnson says to (09:12):
Doing alright Gary! Thanks!
landileigh says (09:12):
Stage 4 Chronic Kidney Disease
Gary Scheiner says to (09:12):
S4 CKD? Please spell it out.
sdivone says to (09:12):
ok ... thanks!
Denise1103 says to (09:13):
Hi Gary, I'm Denise from Australia
landileigh says (09:13):
I currently have a GFR (Glomular Filtration Rate) of 25
coachtheresa says to (09:13):
What is that GFR
landileigh says (09:13):
Glomular Filtration Rate
Jon says to (09:13):
does that have something to do with kidneys?
landileigh says (09:13):
it is a calculation of your creatinine levels
landileigh says (09:14):
that your kidneys produce
Gary Scheiner says to (09:14):
There's not much you can't do with kidney disease. Just need to stay hydrated and minimize the "impact" so that you don't build up a lot of wastes from muscle breakdown. You really should work with an exercise specialist to design a program for you.
coachtheresa says to (09:14):
oh thanks
gina says to (09:14):
Gary, I go to the gym about 4 times or more per week
Jaimieh says to (09:14):
have you tried just a walking program landileigh
gina says to (09:14):
have a lot of problems with lows as well as high
sdivone says to (09:15):
me too gina
Gary Scheiner says to (09:15):
If you have difficulty with evening hunger (or between-meal hunger), consider asking your doctor about starting you on symlin or byetta. Theyr'e great for keeping appetite down between meals.
gina says to (09:15):
especially the next morning after
gina says to (09:15):
i asked my doc about symlin he said i dont need it
Jaimieh says to (09:16):
can you tell us anything about leptin levels Gary in regards to higher blood sugar readings....cravings and weight loss
coachtheresa says to (09:16):
My problem is in the morning. I go to bed @ 107 and in the am my BS id 126? Any ideas?
ms says to (09:16):
Gary, have you found that the side effects outweight the benefits? What percentage of ppl. do you feel have used it successfully?
Gary Scheiner says to (09:17):
Highs from exercise are usually due to adrenaline production. That comes from high-intensity or competive types of activities. Sometimes people need extra insulin prior to some exercises.
AllisonBlass says to (09:17):
@coachteresa: that sounds pretty normal - small fluctuations are normal, aren't they, Gary?
gina says to (09:18):
i wish my flucuations were that small
gina says to (09:18):
107-127
sdivone says to (09:18):
oh boy me too!!!!
gina says to (09:18):
mine is more like 90 and then 308
AllisonBlass says to (09:18):
yeah, me too sometimes
Gary Scheiner says to (09:18):
Leptin is a hormone secreted by fat cells, mainly during the night. It helps to suppress appetite. Not much we can do about that. But cardiovascular exercise seems to cause similar effects.
coachtheresa says to (09:18):
I was between 87 and 99 for a long time now I can not get below 100
gina says to (09:18):
theresea are you type 1 or 2?
coachtheresa says to (09:19):
Type 2
gina says to (09:19):
ah
gina says to (09:19):
Gary, do you have any suggestions on what to do before during and after exercise for us? to keep our numbers steady?
gina says to (09:19):
I am on a pump i dont know about anyone else
toronto says to (09:20):
I am finding it easier to exercise now that I am on levemir and no longer on lantus. Is there a reason why this would be so?
gina says to (09:20):
you cant scroll up?
sdivone says to (09:20):
gina, do you do temp basals or suspend at all?
bjphilly says to (09:20):
me too gina
Richard157 says to (09:20):
Gary, we have a mutual friend named Kathy. We are helping her with her Omnipod.
Heather says to (09:20):
gary I have a question if you are trying to lose weight what is the best way because I always spike when I excerise or just walk
Denise1103 says to (09:20):
I am on a pump too and find less fluctuations with exercise. If doing intense cardio I drink small amoutns of sports drink which seems to stop the big high a few hours after I finish
Jaimieh says to (09:22):
I have to say I'm having better results on levemir vs lantus as well, water weight gone
AllisonBlass says to (09:22):
That way you can scroll up and the chat won't bring you to the bottom when there is a new comment.
Gary Scheiner says to (09:22):
If you're trying to lose weight, It helps to exercise AFTER eating if you take insulin. That way, you can reduce your meal boluses instead of having to snack.
toronto says to (09:22):
water weight gone here too - and I don't crash after only 1 glass of wine anymroe :)
Heather says to (09:23):
thanks
Whirly Girl says to (09:23):
Gary - what are your thoughts on interval training - alternating between easy and hard cardio - in regards to weight loss?
gina says to (09:23):
the chat is going too fast
Denise1103 says to (09:23):
Gary - do you think it is necessary to reduce your basal insulin for pump users when doing exercise less than 1 hour?
Karend1 says to (09:24):
when I lower my basal for exercise I go high later and I still can go
low during exercise even after lowering my basal
Seewraj says to (09:25):
Gary, can a person have both Type I & II Diabetes?
Gary Scheiner says to (09:25):
Excellent point, Whirly Girl. Interval training has been shown to raise metabolism nicely, which helps with long-term weight control. It seems to work better than standard workouts for weight loss.
Richard157 says to (09:26):
Type 1 with insulin resistance, yes. That's ME.
Richard157 says to (09:27):
Double diabetes.
gina says to (09:28):
Whrily girl: Gary - what are your thoughts on interval training - alternating between easy and hard cardio - in regards to weight loss?
Whirly Girl says to (09:28):
Gary already answered - thanks!
gina says to (09:28):
I wanted to ask Gary which exercise is better overall - strict cardio like spin or more of a total body fitness like an exercise class? from sivone
Sue6423 says to (09:29):
Will exercise decrease insulin resistance ?
Gary Scheiner says to (09:29):
Denise - basal adjustments can be very helpful for long-term activities, and they need to be started an hour or two before the activity begins to have much effect. Disconnecting or lowring basal during a short workout has little benefit.
Seewraj says to (09:29):
Gary, does the type of exercise differ for Type I & Type II Diabetes?
Gary Scheiner says to (09:30):
Seewraj - definitely. Most commonly, a person with type-1 diabetes can become insulin resistant due to weight gain, long-term steroid use, and/or genetics.
gina says to (09:30):
henry asks: Is there any reaso why excersice could lead to weight gain? I've noticed that if I don't excersice my weight keeps stable, but If I start to go to the gym frequently I always gain about 5 pounds
Seewraj says to (09:31):
thanks Gary
Gary Scheiner says to (09:31):
Sue, just about every form of exercise helps muscles to make better use of insulin and reduces overall insulin resistance.
Seewraj says to (09:31):
I'm Type II diabetic
Seewraj says to (09:31):
i am only doing fast walking one hour at least 5 days weekly
allysmomma says to (09:32):
my 14 yo daughter is type 1
Seewraj says to (09:32):
n staying away from medication
Seewraj says to (09:33):
in the beginning, i was taking glucophage 1g three times a day
Gary Scheiner says to (09:35):
There really is no "type 1 exercise" or "type 2 exercise", Seewraj. Whatever is safe, enjoyable and effective will work.
gina says to (09:36):
henry asks: Is there any reason why exercise could lead to weight gain? I've noticed that if I don't exercise my weight keeps stable, but If I start to go to the gym frequently I always gain about 5 pound
Richard157 says to (09:37):
increased muscle
Richard157 says to (09:37):
causes weight gain
Gary Scheiner says to (09:38):
KarenD1 - sorry I missed your question earlier. If you're going low during the workout, you need some more carbs before or during the exercise, And if you're rising afterwards, you need to bolus some insulin right after
the workout.
andy1463 says to (09:38):
I've definitely lost a few inches on my waist but stayed the same weight with exercise
Sue6423 says to (09:39):
can exercise cause hypoglycemia 8 hours later??
andy1463 says to (09:39):
Sue, I've done a few endurance events that gave lows for 3 days afterwards. It's certainly possible
Gary Scheiner says to (09:40):
If anyone would like to contact me directly regarding 1-on-1 assistance with their diabetes management or exercise program, please send me an e-mail after tonight's program: gary@integrateddiabetes.com
gina says to (09:41):
is your training covered by insurance
gina says to (09:41):
not training i mean 1 on 1
Gary Scheiner says to (09:41):
Great question, Sue. Lows can occur many hours after a workout. We call this "delayed onset hypoglycemia". It usually follows exhaustive exercise. If it becomes a pattern, insulin & snack adjustments can be used as a preventive measure.
gina says to (09:42):
Gary to go with that do you suggest having a snack before working out?
gina says to (09:42):
and what kind of snack
Gary Scheiner says to (09:44):
You can use temp basal reductions (if using a pump), reductions in long-acting insulin, or low-glycemic-index snacks as a way to prevent delayed onset hypoglycemia.
Sue6423 says to (09:44):
Does lactic acid have anything to do with "dealyed onset hypoglycemia" ?
Jaimieh says to (09:46):
you can help clear lactic acid buildup after vigorous workout by drink tbsp of udo's oil
Gary Scheiner says to (09:47):
Not really, Sue. But if you're building up a lot of lactic acid, it's a sign of anaerobic energy burning/high intensity, so delayed drops are possible.
courtney says to (09:48):
Gary, I thought anaerobic exercise would actually raise your blood sugar
sdivone says to (09:49):
Gary, what would you consider a short workout?
Gary Scheiner says to (09:50):
BTW, the Diabetes Exercise & Sports Assoc. (DESA) will be having a big national conference in Boston this June. Joslin is heavily involved. These conferences are tons of fun & great learning/networking opportunities. www.diabetes-exercise.com for info.
Gary Scheiner says to (09:51):
An aerobic exercise like weight lifting or sprints usually raise BG while you do them, but lead to increased insulin senstivity and drops in BG hours later.
gina says to (09:52):
Gary, what kind of diet do you suggest while you are into an exercise routine? how many carbs per meal you think?
Gary Scheiner says to (09:53):
Short workouts depend on the issue. For using temp basal rates, I'd consider anything less than 90 minutes to be short. For aerobic vs. anaerobic, 20 minutes is often considered a cutoff.
k2 says to (09:53):
Gary what are your thoughts on water aerobics & swimming for aerobic activities & how can I prep for those activities if I use a pump?
jmerwin says to (09:54):
I'm familiar with BG raising due to weight lifting and other exercises that require large muscle groups working. But why would a 2-3 mile run lower BG one day, and a few days later the same workout raises BG?
sdivone says to (09:54):
thanks!
Gary Scheiner says to (09:54):
Any other last-minute questions?
andy1463 says to (09:54):
Gary, do you have any tips for all day exercise? About twice a month I ride my bike about 120 miles in a day, consuming mostly fruits and fats and managing lows (and near-lows) with small amounts of juice.
Whirly Girl says to (09:55):
Gary - do you have any books/resources that you recommend to diabetics regarding exercise?
courtney says to (09:55):
Gary, what do you suggest for endurance runs/bike rides when it comes to blood sugar management and proper refueling
Richard157 says to (09:55):
Gary, do you know any people who have been diabetic for 60 or more years without complications?
Gary Scheiner says to (09:56):
Water exercise is tremendous for both aerobic and strength conditioning. Water activities often drop BG more than land activities due to the 360-degree resistance, so large reductions in insulin (or lots of extra carbs) are
often needed.
Jon says to (09:57):
Only 5 minutes left and we have a few questions left in the que, so we are going to have to ask you to save any other questions for next time, or email them to Gary directly
Whirly Girl says to (09:57):
Gary - do you have any books/resources that you recommend to diabetics regarding exercise?
k2 says to (09:57):
Thanks Gar - (it's kelly kunik) have been doing lots of water aerobics as of late!
Gary Scheiner says to (09:58):
Sheri Colber's book, The Diabetic Athlete, is a tremendous source of information and inspiration.
courtney says to (09:58):
Gary, what do you suggest for endurance runs/bike rides when it comes to blood sugar management and proper refueling
Gary Scheiner says to (09:58):
Hey Kel! Glad to hear you're staying active!
Richard157 says to (09:59):
Gary, do you know any people who have been diabetic for 60 or more years without complications?
k2 says to (09:59):
I trying to!
k2 says to (09:59):
Have lost 12 lbs
Gary Scheiner says to (09:59):
Courtney - we need a lot of time to discuss a situation like endurance events. It takes a careful balance of basal insulin and extra carbs throughout. I'm a big fan of using continuous monitors to fine-tune & manage the
whole process.
gina says to (10:00):
Its 10pm.
k2 says to (10:00):
Thanks Gary!
k2 says to (10:00):
Thanks Gina
Jon says to (10:00):
karend1 asks: I would love to exercise right after a meal, but not sure how much
to decrease bolus, how do you calculate this?
gina says to (10:00):
Unless Gary wants to stay a little longer
gina says to (10:00):
thats all t he time we have right now
Gary Scheiner says to (10:01):
Richard - In fact, I do. A 68-year diabetic woman. Research is showing that there is a genetic sequence that protects some people against microvascular and neural complications.
sdivone says to (10:01):
thank you gary and gina (})
gina says to (10:01):
no problem
gina says to (10:01):
Gary if you want to put up your information again
gina says to (10:01):
in case someone wants to hire you
gina says to (10:02):
1-to-1
Gary Scheiner says to (10:02):
Karend1 - it is based on the type/duration of the activity and your prior experiences. Contact me if you would like to figure it all out.
Jon says to (10:02):
Thanks a lot for chatting with us tonight Gary!
bjphilly says to (10:02):
see you next tues. in chat gary
Jon says to (10:02):
Thanks everybody for being here!
Whirly Girl says to (10:02):
Thanks!
gina says to (10:02):
we will have a chat transcript up tomorrow of this chat
Jaimieh says to (10:02):
Thanks Gary, Gina & Jon
gina says to (10:03):
No problem Jaime!
sdivone says to (10:03):
will the transcript be emailed??
Gary Scheiner says to (10:03):
You're welcome, everyone. Take good care of yourselves!
Jon says to (10:03):
We will have a transcript up on the Diabetes Talkfest past chat transcripts page tomorrow
k2 says to (10:03):
Thtank U ALL!
gina says to (10:03):
You will be able to get it off the diabetestalkfest.ning.com homepage
Richard157 says to (10:03):
Thanks to all of you for this chat. Good night Gary!
AllisonBlass says to (10:03):
Night everyone
sdivone says to (10:03):
great, thanks gina
gina says to (10:03):
:)
gina says to (10:03):
Thanks Gary
Jon says to (10:05):
It is now open chat, have a good night everybody
Henry says to (10:05):
Thanks everyone... that was a great chat....
gina says to (10:05):
the Chatroom will be open for another hour
gina says to (10:05):
Thanks for coming Henry
karend1 says to (10:06):
bye guys
gina says to (10:06):
bye karen
Henry says to (10:06):
I'm glad you made it at this time so we could attend from the other side of the world..... Cheers
gina says to (10:06):
:)
*** (10:07):Gary Scheiner quit the room!
Gary Scheiner says to (08:57):
Good evening!
karend1 says to (08:58):
Hi Mr. Scheiner
Gary Scheiner says to (08:58):
Call me Gary.
karend1 says to (08:58):
Hi Mr. Gary
karend1 says to (08:58):
j/k
karend1 says to (08:58):
hi henry
Gary Scheiner says to (08:58):
You're funny. They hold telethons to cure people like you.
karend1 says to (08:58):
what happened to evita ;)
landileigh says (08:58):
hey Gary!
karend1 says to (08:59):
I will behave
landileigh says (08:59):
how have you been? It's been awhile since our last chat!
landileigh says (08:59):
karen... you don't have to, Gary won't!
Gary Scheiner says to (08:59):
Just kidding. I'm trying to focus here... Phillies, Sixers and Flyers are all on at the same time here.
landileigh says (08:59):
JAIMIE!!!
Henry says to (08:59):
Hi Karend, it was me.... I just changed my name to my Id to my real name so people don't het confused...
Jon says to (08:59):
Hi Gary! Welcome back!
Jaimieh says to (08:59):
Hi all
karend1 says to (09:00):
j/k again henry/evita, no one is getting my humor tonight :)
karend1 says to (09:00):
hi jaimie
Gary Scheiner says to (09:00):
So who's pretending to moderate this thing tonight?
Jon says to (09:01):
Landileigh and I will try to keep things under control
Jon says to (09:01):
and Gina should be here shortly
landileigh says (09:01):
LOL, i think that would be me and Jon until Gina gets here
Ellen1816 says to (09:01):
I think Gary should moderate and be the guest :-)
Gary Scheiner says to (09:02):
Phillies are yet to score a run this year, and the Flyers are getting shut out. Sixers are losing to the lowly Bobcats. I should really give up on sports.
Jon says to (09:02):
Shall we begin? Welcome to chat with Gary Scheiner!
landileigh says (09:02):
jamie you twit! you tweet and and tweet!
Gary Scheiner says to (09:02):
Thank you Ellen! Your check is in the mail.
landileigh says (09:02):
YAY! gina is here!
Henry says to (09:03):
Hi Gina
gina says to (09:03):
hi everyone
Ellen1816 says to (09:03):
Yes Karen
Jaimieh says to (09:03):
Hi Gina
gina says to (09:03):
Hi Henry
gina says to (09:03):
jamie
gina says to (09:03):
everyone!
coachtheresa says to (09:03):
Hi all
Ellen1816 says to (09:03):
Hi Gina
gina says to (09:04):
hey cyber momma
landileigh says (09:04):
actually here to hear what Gary has to say
sdivone says to (09:05):
hi :)
gina says to (09:05):
Hey Gary are you ready? or should we wait a few minutes?
Gary Scheiner says to (09:05):
I'm here... might as well rock & roll.
Ellen1816 says to (09:06):
Is rock and roll exercise?(lol)
landileigh says (09:06):
Gary, I have been working on a program with PWD called Biggest Loser 'D' Style, mainly a program for support. But I myself have had trouble losing weight. Keeping up carbs to manage insulin, and losing weight are so difficult!
gina says to (09:06):
Gary how about you give people a little background on yourself and what you do
gina says to (09:07):
and then we can have everyone start with the questions!
landileigh says (09:07):
I'm currently 238 lbs, with S4 CKD. what can i do exercise wise?
Gary Scheiner says to (09:07):
If you take insulin, you'll only be able to lose weight if you find a way to cut back on the doses.
Jon says to (09:07):
so less carbs then?
landileigh says (09:07):
gary answer after your intro please
AllisonBlass says to (09:08):
Hello everyone! Good to see everyone again!
gina says to (09:08):
Hey Allison.
coachtheresa says to (09:08):
Never thought eating took so much thought until I became a didbetic!
Gary Scheiner says to (09:08):
Well... I'm a certified diabetes educator and type-1 diabetic for 25 years. I run a practice near Philadelphia specializing in intensive therapy; work with people via phone & internet a great deal.
Jon says to (09:09):
you really helped my son a lot by convincing his doctor to put him on a pump!
gina says to (09:09):
Garys website is www.integrateddiabetes.com if you all want to check it out
Gary Scheiner says to (09:09):
I'm also an exercise physiologist and serve as one of the directors of the Diabetes Exercise & Sports Association.
coachtheresa says to (09:09):
Very fustrating. Everything I like has carbs.
gina says to (09:09):
Me too lol
Gary Scheiner says to (09:09):
Hi Allison! How's stuff at JDRF?
gina says to (09:10):
Ok everyone if Gary is ready ask your questions but please give him time to answer
Scott.K.Johnson says to (09:10):
Hi!
coachtheresa says to (09:10):
I have managed to get off my pills with diet & some exercise.
AllisonBlass says to (09:10):
Things are good, though I don't work at JDRF! I work for a PR agency.
Gary Scheiner says to (09:11):
There is more than one way to pare back the insulin doses. Reducing stress levels helps. Getting more physical activity. Cutting portions back and eliminating snacks.
gina says to (09:11):
Snacks is my problem
gina says to (09:11):
especially at night
Scott.K.Johnson says to (09:11):
I'm a huge fan of Gary's, just wanted to hang out for a bit and observe. Hi Jaimie.
Gary Scheiner says to (09:11):
Glad to hear it Jon! Hope he's doing well.
landileigh says (09:11):
What can I as someone who is insulin dependent and with S4 CKD do for exercise? i'm soooooooo tired all the time
Gary Scheiner says to (09:11):
Scott! The guy that got my comuter working! How's it going?
sdivone says to (09:12):
what is S4 CKD if you don't mind me asking??
coachtheresa says to (09:12):
Me too!
Gary Scheiner says to (09:12):
Make that comPuter.
Scott.K.Johnson says to (09:12):
Doing alright Gary! Thanks!
landileigh says (09:12):
Stage 4 Chronic Kidney Disease
Gary Scheiner says to (09:12):
S4 CKD? Please spell it out.
sdivone says to (09:12):
ok ... thanks!
Denise1103 says to (09:13):
Hi Gary, I'm Denise from Australia
landileigh says (09:13):
I currently have a GFR (Glomular Filtration Rate) of 25
coachtheresa says to (09:13):
What is that GFR
landileigh says (09:13):
Glomular Filtration Rate
Jon says to (09:13):
does that have something to do with kidneys?
landileigh says (09:13):
it is a calculation of your creatinine levels
landileigh says (09:14):
that your kidneys produce
Gary Scheiner says to (09:14):
There's not much you can't do with kidney disease. Just need to stay hydrated and minimize the "impact" so that you don't build up a lot of wastes from muscle breakdown. You really should work with an exercise specialist to design a program for you.
coachtheresa says to (09:14):
oh thanks
gina says to (09:14):
Gary, I go to the gym about 4 times or more per week
Jaimieh says to (09:14):
have you tried just a walking program landileigh
gina says to (09:14):
have a lot of problems with lows as well as high
sdivone says to (09:15):
me too gina
Gary Scheiner says to (09:15):
If you have difficulty with evening hunger (or between-meal hunger), consider asking your doctor about starting you on symlin or byetta. Theyr'e great for keeping appetite down between meals.
gina says to (09:15):
especially the next morning after
gina says to (09:15):
i asked my doc about symlin he said i dont need it
Jaimieh says to (09:16):
can you tell us anything about leptin levels Gary in regards to higher blood sugar readings....cravings and weight loss
coachtheresa says to (09:16):
My problem is in the morning. I go to bed @ 107 and in the am my BS id 126? Any ideas?
ms says to (09:16):
Gary, have you found that the side effects outweight the benefits? What percentage of ppl. do you feel have used it successfully?
Gary Scheiner says to (09:17):
Highs from exercise are usually due to adrenaline production. That comes from high-intensity or competive types of activities. Sometimes people need extra insulin prior to some exercises.
AllisonBlass says to (09:17):
@coachteresa: that sounds pretty normal - small fluctuations are normal, aren't they, Gary?
gina says to (09:18):
i wish my flucuations were that small
gina says to (09:18):
107-127
sdivone says to (09:18):
oh boy me too!!!!
gina says to (09:18):
mine is more like 90 and then 308
AllisonBlass says to (09:18):
yeah, me too sometimes
Gary Scheiner says to (09:18):
Leptin is a hormone secreted by fat cells, mainly during the night. It helps to suppress appetite. Not much we can do about that. But cardiovascular exercise seems to cause similar effects.
coachtheresa says to (09:18):
I was between 87 and 99 for a long time now I can not get below 100
gina says to (09:18):
theresea are you type 1 or 2?
coachtheresa says to (09:19):
Type 2
gina says to (09:19):
ah
gina says to (09:19):
Gary, do you have any suggestions on what to do before during and after exercise for us? to keep our numbers steady?
gina says to (09:19):
I am on a pump i dont know about anyone else
toronto says to (09:20):
I am finding it easier to exercise now that I am on levemir and no longer on lantus. Is there a reason why this would be so?
gina says to (09:20):
you cant scroll up?
sdivone says to (09:20):
gina, do you do temp basals or suspend at all?
bjphilly says to (09:20):
me too gina
Richard157 says to (09:20):
Gary, we have a mutual friend named Kathy. We are helping her with her Omnipod.
Heather says to (09:20):
gary I have a question if you are trying to lose weight what is the best way because I always spike when I excerise or just walk
Denise1103 says to (09:20):
I am on a pump too and find less fluctuations with exercise. If doing intense cardio I drink small amoutns of sports drink which seems to stop the big high a few hours after I finish
Jaimieh says to (09:22):
I have to say I'm having better results on levemir vs lantus as well, water weight gone
AllisonBlass says to (09:22):
That way you can scroll up and the chat won't bring you to the bottom when there is a new comment.
Gary Scheiner says to (09:22):
If you're trying to lose weight, It helps to exercise AFTER eating if you take insulin. That way, you can reduce your meal boluses instead of having to snack.
toronto says to (09:22):
water weight gone here too - and I don't crash after only 1 glass of wine anymroe :)
Heather says to (09:23):
thanks
Whirly Girl says to (09:23):
Gary - what are your thoughts on interval training - alternating between easy and hard cardio - in regards to weight loss?
gina says to (09:23):
the chat is going too fast
Denise1103 says to (09:23):
Gary - do you think it is necessary to reduce your basal insulin for pump users when doing exercise less than 1 hour?
Karend1 says to (09:24):
when I lower my basal for exercise I go high later and I still can go
low during exercise even after lowering my basal
Seewraj says to (09:25):
Gary, can a person have both Type I & II Diabetes?
Gary Scheiner says to (09:25):
Excellent point, Whirly Girl. Interval training has been shown to raise metabolism nicely, which helps with long-term weight control. It seems to work better than standard workouts for weight loss.
Richard157 says to (09:26):
Type 1 with insulin resistance, yes. That's ME.
Richard157 says to (09:27):
Double diabetes.
gina says to (09:28):
Whrily girl: Gary - what are your thoughts on interval training - alternating between easy and hard cardio - in regards to weight loss?
Whirly Girl says to (09:28):
Gary already answered - thanks!
gina says to (09:28):
I wanted to ask Gary which exercise is better overall - strict cardio like spin or more of a total body fitness like an exercise class? from sivone
Sue6423 says to (09:29):
Will exercise decrease insulin resistance ?
Gary Scheiner says to (09:29):
Denise - basal adjustments can be very helpful for long-term activities, and they need to be started an hour or two before the activity begins to have much effect. Disconnecting or lowring basal during a short workout has little benefit.
Seewraj says to (09:29):
Gary, does the type of exercise differ for Type I & Type II Diabetes?
Gary Scheiner says to (09:30):
Seewraj - definitely. Most commonly, a person with type-1 diabetes can become insulin resistant due to weight gain, long-term steroid use, and/or genetics.
gina says to (09:30):
henry asks: Is there any reaso why excersice could lead to weight gain? I've noticed that if I don't excersice my weight keeps stable, but If I start to go to the gym frequently I always gain about 5 pounds
Seewraj says to (09:31):
thanks Gary
Gary Scheiner says to (09:31):
Sue, just about every form of exercise helps muscles to make better use of insulin and reduces overall insulin resistance.
Seewraj says to (09:31):
I'm Type II diabetic
Seewraj says to (09:31):
i am only doing fast walking one hour at least 5 days weekly
allysmomma says to (09:32):
my 14 yo daughter is type 1
Seewraj says to (09:32):
n staying away from medication
Seewraj says to (09:33):
in the beginning, i was taking glucophage 1g three times a day
Gary Scheiner says to (09:35):
There really is no "type 1 exercise" or "type 2 exercise", Seewraj. Whatever is safe, enjoyable and effective will work.
gina says to (09:36):
henry asks: Is there any reason why exercise could lead to weight gain? I've noticed that if I don't exercise my weight keeps stable, but If I start to go to the gym frequently I always gain about 5 pound
Richard157 says to (09:37):
increased muscle
Richard157 says to (09:37):
causes weight gain
Gary Scheiner says to (09:38):
KarenD1 - sorry I missed your question earlier. If you're going low during the workout, you need some more carbs before or during the exercise, And if you're rising afterwards, you need to bolus some insulin right after
the workout.
andy1463 says to (09:38):
I've definitely lost a few inches on my waist but stayed the same weight with exercise
Sue6423 says to (09:39):
can exercise cause hypoglycemia 8 hours later??
andy1463 says to (09:39):
Sue, I've done a few endurance events that gave lows for 3 days afterwards. It's certainly possible
Gary Scheiner says to (09:40):
If anyone would like to contact me directly regarding 1-on-1 assistance with their diabetes management or exercise program, please send me an e-mail after tonight's program: gary@integrateddiabetes.com
gina says to (09:41):
is your training covered by insurance
gina says to (09:41):
not training i mean 1 on 1
Gary Scheiner says to (09:41):
Great question, Sue. Lows can occur many hours after a workout. We call this "delayed onset hypoglycemia". It usually follows exhaustive exercise. If it becomes a pattern, insulin & snack adjustments can be used as a preventive measure.
gina says to (09:42):
Gary to go with that do you suggest having a snack before working out?
gina says to (09:42):
and what kind of snack
Gary Scheiner says to (09:44):
You can use temp basal reductions (if using a pump), reductions in long-acting insulin, or low-glycemic-index snacks as a way to prevent delayed onset hypoglycemia.
Sue6423 says to (09:44):
Does lactic acid have anything to do with "dealyed onset hypoglycemia" ?
Jaimieh says to (09:46):
you can help clear lactic acid buildup after vigorous workout by drink tbsp of udo's oil
Gary Scheiner says to (09:47):
Not really, Sue. But if you're building up a lot of lactic acid, it's a sign of anaerobic energy burning/high intensity, so delayed drops are possible.
courtney says to (09:48):
Gary, I thought anaerobic exercise would actually raise your blood sugar
sdivone says to (09:49):
Gary, what would you consider a short workout?
Gary Scheiner says to (09:50):
BTW, the Diabetes Exercise & Sports Assoc. (DESA) will be having a big national conference in Boston this June. Joslin is heavily involved. These conferences are tons of fun & great learning/networking opportunities. www.diabetes-exercise.com for info.
Gary Scheiner says to (09:51):
An aerobic exercise like weight lifting or sprints usually raise BG while you do them, but lead to increased insulin senstivity and drops in BG hours later.
gina says to (09:52):
Gary, what kind of diet do you suggest while you are into an exercise routine? how many carbs per meal you think?
Gary Scheiner says to (09:53):
Short workouts depend on the issue. For using temp basal rates, I'd consider anything less than 90 minutes to be short. For aerobic vs. anaerobic, 20 minutes is often considered a cutoff.
k2 says to (09:53):
Gary what are your thoughts on water aerobics & swimming for aerobic activities & how can I prep for those activities if I use a pump?
jmerwin says to (09:54):
I'm familiar with BG raising due to weight lifting and other exercises that require large muscle groups working. But why would a 2-3 mile run lower BG one day, and a few days later the same workout raises BG?
sdivone says to (09:54):
thanks!
Gary Scheiner says to (09:54):
Any other last-minute questions?
andy1463 says to (09:54):
Gary, do you have any tips for all day exercise? About twice a month I ride my bike about 120 miles in a day, consuming mostly fruits and fats and managing lows (and near-lows) with small amounts of juice.
Whirly Girl says to (09:55):
Gary - do you have any books/resources that you recommend to diabetics regarding exercise?
courtney says to (09:55):
Gary, what do you suggest for endurance runs/bike rides when it comes to blood sugar management and proper refueling
Richard157 says to (09:55):
Gary, do you know any people who have been diabetic for 60 or more years without complications?
Gary Scheiner says to (09:56):
Water exercise is tremendous for both aerobic and strength conditioning. Water activities often drop BG more than land activities due to the 360-degree resistance, so large reductions in insulin (or lots of extra carbs) are
often needed.
Jon says to (09:57):
Only 5 minutes left and we have a few questions left in the que, so we are going to have to ask you to save any other questions for next time, or email them to Gary directly
Whirly Girl says to (09:57):
Gary - do you have any books/resources that you recommend to diabetics regarding exercise?
k2 says to (09:57):
Thanks Gar - (it's kelly kunik) have been doing lots of water aerobics as of late!
Gary Scheiner says to (09:58):
Sheri Colber's book, The Diabetic Athlete, is a tremendous source of information and inspiration.
courtney says to (09:58):
Gary, what do you suggest for endurance runs/bike rides when it comes to blood sugar management and proper refueling
Gary Scheiner says to (09:58):
Hey Kel! Glad to hear you're staying active!
Richard157 says to (09:59):
Gary, do you know any people who have been diabetic for 60 or more years without complications?
k2 says to (09:59):
I trying to!
k2 says to (09:59):
Have lost 12 lbs
Gary Scheiner says to (09:59):
Courtney - we need a lot of time to discuss a situation like endurance events. It takes a careful balance of basal insulin and extra carbs throughout. I'm a big fan of using continuous monitors to fine-tune & manage the
whole process.
gina says to (10:00):
Its 10pm.
k2 says to (10:00):
Thanks Gary!
k2 says to (10:00):
Thanks Gina
Jon says to (10:00):
karend1 asks: I would love to exercise right after a meal, but not sure how much
to decrease bolus, how do you calculate this?
gina says to (10:00):
Unless Gary wants to stay a little longer
gina says to (10:00):
thats all t he time we have right now
Gary Scheiner says to (10:01):
Richard - In fact, I do. A 68-year diabetic woman. Research is showing that there is a genetic sequence that protects some people against microvascular and neural complications.
sdivone says to (10:01):
thank you gary and gina (})
gina says to (10:01):
no problem
gina says to (10:01):
Gary if you want to put up your information again
gina says to (10:01):
in case someone wants to hire you
gina says to (10:02):
1-to-1
Gary Scheiner says to (10:02):
Karend1 - it is based on the type/duration of the activity and your prior experiences. Contact me if you would like to figure it all out.
Jon says to (10:02):
Thanks a lot for chatting with us tonight Gary!
bjphilly says to (10:02):
see you next tues. in chat gary
Jon says to (10:02):
Thanks everybody for being here!
Whirly Girl says to (10:02):
Thanks!
gina says to (10:02):
we will have a chat transcript up tomorrow of this chat
Jaimieh says to (10:02):
Thanks Gary, Gina & Jon
gina says to (10:03):
No problem Jaime!
sdivone says to (10:03):
will the transcript be emailed??
Gary Scheiner says to (10:03):
You're welcome, everyone. Take good care of yourselves!
Jon says to (10:03):
We will have a transcript up on the Diabetes Talkfest past chat transcripts page tomorrow
k2 says to (10:03):
Thtank U ALL!
gina says to (10:03):
You will be able to get it off the diabetestalkfest.ning.com homepage
Richard157 says to (10:03):
Thanks to all of you for this chat. Good night Gary!
AllisonBlass says to (10:03):
Night everyone
sdivone says to (10:03):
great, thanks gina
gina says to (10:03):
:)
gina says to (10:03):
Thanks Gary
Jon says to (10:05):
It is now open chat, have a good night everybody
Henry says to (10:05):
Thanks everyone... that was a great chat....
gina says to (10:05):
the Chatroom will be open for another hour
gina says to (10:05):
Thanks for coming Henry
karend1 says to (10:06):
bye guys
gina says to (10:06):
bye karen
Henry says to (10:06):
I'm glad you made it at this time so we could attend from the other side of the world..... Cheers
gina says to (10:06):
:)
*** (10:07):Gary Scheiner quit the room!
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