Blood Sugar Management While Hitting the Pool
Swimming is wonderful exercise and a great way to stay in shape during pregnancy. I've always loved to swim, but never incorporated swimming into my exercise routine until I was several weeks pregnant with Sienna. The first few swim sessions were rough, as I had to master a breathing technique and work on endurance. After that, however, swimming was a pure joy.
This time around, I've enjoyed swimming even more because I was already in good swimming shape before getting pregnant. The biggest change has been the timing of my workouts, since having a toddler at home makes it tough to maintain the afternoon, post-work routine. Instead, three times a week I'm greeted by an alarm at 5:30 a.m. urging me to get up and out the door! Usually I'm in the pool between 6:00 and 6:15 a.m. for my 40-45 minute workout. Although it sounds boring, I like swimming the same routine of strokes and kick-boarding laps each day. I think it helps me not to have to expend too much mental energy deciding which stroke to do on each lap!
Since I've been a morning exerciser ever since Sienna arrived, I've gotten the hang of managing my blood sugars during those tricky dawn phenomenon hours. I expected the pregnancy to change my routine a bit, since my basal insulin needs between 4:30 a.m. and 6:00 a.m. are the highest of the day; but so far, it's been working quite similarly to pre-pregnancy.
I test my blood sugar as soon as I wake up. If I'm in a good range- 80-110 mg/dl, then I probably won't correct. Anything over 110 mg/dl gets a moderate correction bolus. I also have to consider where I am in my infusion site change cycle. If I need to change my site later that day, I will bolus a bit more aggressively as I've noticed the insulin effectiveness isn't great on that last day. If my fasting blood sugar is under 80 mg/dl, then I'll have a glucose tablet or two.
After a short drive to the gym, I'll put my stuff in a locker and disconnect from the pump. If my fasting blood glucose was at all suspicious, I might test again, just to see where I am immediately before starting the workout. One thing I've noticed is the importance of hydration to keeping my blood sugar controlled. I suppose because I'm in the water and not seeing the sweat, I'd never associated swimming with needing to replenish water, the way I do with running or other strenuous exercise. Several weeks ago I started sipping on water throughout my swim and I noticed it helped keep my blood sugar from rising post-workout. Who knew!
Usually I'll shower immediately upon exiting the pool and before testing my blood. Therefore, by the time I test and reconnect to the pump, a good 50-55 minutes have passed. Luckily, my post-workout numbers are usually in the 80-110 mg/dl range. Even with a blood glucose of 80 mg/dl, I give a "correction" bolus equal to about 65% of the basal insulin I missed while disconnected. Often it's .70 or .80 units. For the past couple months, this routine has kept my blood sugar right in the target range an hour later when I'm ready to eat breakfast.
Replacing the missed basal insulin is key and sort of difficult to do the first few times. There's something counter-intuitive about giving a correction bolus when your blood sugar is where you want it to be. But, after awhile it feels normal, especially when experience has demonstrated that you'll be high an hour later if you don't bolus.
It feels good to figure out precisely how to manage my blood sugar during these morning swims, so I can relax, enjoy the benefits of a good workout, and spend some quality bonding time with the baby!