Most athletes have a set of rituals before training or racing. It could be preparation of a heart rate monitor, tighten shoe laces for the right tension, or pumping your favorite PSI into bike tires. The diabetic athlete (DA), has another subset of things to consider prior to any exercise related directly to diabetes.
Insulin on Board (IOB) – how much insulin is currently active in your system and how much longer will it be there for (an amount of time that can vary person to person and can change due to absorption/sensitivity)
Carbs on Board – did you eat something an hour ago? two hours ago? It’s probably still doing something to your body — and you likely have some IOB if you have Carbs on Board.
Expected duration/exertion of exercise – is this a walk around the park, a 5k, 50 Mile bike ride? The longer you go and the harder you work, the more change you may want to consider prior to exercise (adding food, removing insulin). This will affect your temp basals and any pre-exercise bolus.
Expected nutrition during exercise - fairly self-explanatory, but with one complexity — how much insulin will you give yourself as you eat during exercise. Finding out how much your insulin sensitivity changes will enable this type of adjustment.
Current and trending BG – starting at 150 trending down and starting at 150 and trending up will produce drastically different BGs during and after exercise. Figuring out which way you are trending — look at IOB, Carbs on Board and BG readings from 1hr, 30min and just prior to exercise to find out some directionality (unless you are a CGM user) and you have that data.
The options to make changes are always the same: add insulin, remove insulin, add carbs.
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