Over the past month and a half a smaller percentage of my workouts have been cut short by exercise induced lows than the percentage of workouts cut short in my previous 10 months of training. In addition to using PBN'sIronman Cocktail and EFS I've experimented with my basal rates. This experimentation has led to much more stable blood sugars during exercise.
Under the advice of my previous endocrinologist I was reducing my basal rate to 5% or 10% of the hourly delivery 90 to 120 minutes prior to exercise. This effectively reduced the novolog in my body to zero, meaning I was exercising with no insulin in my system. After reading a few articles on sports medicine and nutrition it occurred to me that insulin was necessary to help move carbohydrates from your stomach and blood stream to your muscles. Without insulin the carbs I was ingesting sat in my digestive track and were not transferred to the body parts that required energy. I think this is why when I'd return my pump to normal settings after an exercise low my blood sugar would sky rocket.
After 6 weeks of experimentation I have settled on turning my pump down to 30% of an hour's full basal rate and maintain that delivery rate of insulin for the duration of exercise (except swimming when my pump is detached). This change has allowed me to maintain a blood sugar of 150 to 190 during exercise while more importantly transferring energy to my muscles. Granted my fitness improves weekly but over the past 6 weeks I have not had the fatigue, cramping or bonking issues I ran into over the winter. From both a diabetic and nutritional standpoint I'm in a much better place now.
All this experimentation does not solve the most annoying issue about insulin pump therapy however. Why doesn't the pump allow us to set an advanced rate reduction?!? If I plan on working out in the morning I need to change my basal rate pattern from pattern A to pattern B. Pattern B is a carbon copy of Pattern A except I manually calculate 30% of whatever basal rate I would have an hour before exercise (or in this case before I wake up). I'm constantly changing Pattern B's time intervals or basal rate. This extra step probably takes more calculation than any other I've had to make as a diabetic. It would be alot easier to program my pump in advance 5am rather than having to calculate the correct basal rate and time interval.