exercise increasing blood glucose?

[academicdiabetic]

Hi All,

Does anyone else have issues with exercise increasing blood glucose levels? I understand the theory that the liver will convert fat to blood glucose, but I am not sure how on earth one 'controls' for this.

By way of example, today my blood glucose started on about 16... (high but not unusual unfortunately), I ate one 'total' yoghurt (6.8g carbs) and took morning dose of levemir (7 units - I split the 24 hour total dose of 14 units into two)... then all hell kicked off at work and I had to dash around doing a lot of physical stuff, thus exercising a lot and not having anything else to eat for about another 5 hours... at which point my blood glucose was at 24.6...

I find that sometimes exercise and lack of food takes my blood glucose down quite sharply, but on other seemingly identical occasions it takes it up just as sharply.

Does anyone else have this issue and, if so, do you have an explanation and a way of avoiding the situation?

Thanks very much for any input

 

[luceeloo]

I have the same problem and have found that my blood sugar always rises during and after exercise. The more intense the exercise, the more it rises.
With me, it does drop lower about an hour after I've finished the exercise. But, as yet, I haven't discovered a way to stop it from rising in the first place.

 

[Sid Bonkers]

Does anyone else have issues with exercise increasing blood glucose levels? I understand the theory that the liver will convert fat to blood glucose, but I am not sure how on earth one 'controls' for this.

By way of example, today my blood glucose started on about 16...

Hi academicdiabetic, firstly you need to be very careful exercising when your bg levels are over 14 mmol/L this is the danger zone for exercise and you really should never exercise when your levels are this high.


Slow exercise like walking will generally reduce bg levels but any strenuous exercise will have the opposite effect as glucose will be released by the body to fuel the exertion. Glucose is stored in our muscles and liver and is released either when bg levels fall low or when our bodies require a boost ie when exercising.

One way to stop a rise in bg levels is to eat some carbs prior to exercise and then these will be used to fuel your exercise, but again I stress no one should exercise when the bg levels are over 14 mmol/L as it can be very dangerous

Some useful web sites

http://www.diabetes.co.uk/diabetes-spor ... sugar.html

http://www.mayoclinic.com/health/diabet ... se/DA00105

http://diabetes.webmd.com/guide/exercise-guidelines

 

[academicdiabetic]

Thanks for both responses.

Sid - that's interesting, but why is exercising with BG over 14 dangerous? (In what way?) I have probably been exercising with BGs over that amount for at least 6 years (hats off to my guardian angel!). Until I started taking insulin, my blood glucose consistently went down with exercise, it is now that I am taking insulin (when in theory energy requirements should be 'sorted') that I find this problem. Confusing!

Thanks again.

 

[Riesenburg]

Hi academic,

I have just posted a rather lengthy answer to just that question on the type 1 forums. Yes Sid is correct it can be rather dangerous to exercise with a 14. Have a look at: http://www.diabetes.co.uk/diabetes-forum/viewtopic.php?f=19&t=46346 it's an interesting discuss going on there.

If you need more pointers let me know always happy to share what I know
Frankie

 

[phoenix]

Bluntly, at a level of 14 you have plenty of glucose in your bloodstream for exercise but your insulin level may be not enough to
a) utilise that glucose
b) prevent the release of more glucose from the liver in an attempt to provide energy needs
c) to prevent the subsequent rapid breakdown of fats and production of ketones

at that level you need to test for ketones and then if no ketones are present, exercise very cautiously and test frequently. In the scenario you were describing it seems that you may have released a lot of stress hormones such as cortisol. These would trigger a release of glucose from your glycogen stores in muscle and from the liver sending your levels higher.
This can also happen with anaerobic exercise. Aerobic is more likely to decrease levels.

http://runsweet.com/DiabetesAndSport.html

What worries me is that you seem to be starting from such a high level, you mention 16mmol/l as being not unusual. This to me suggests that your basal insulin is not high enough.

 

[academicdiabetic]

Hi Frankie and Phoenix, thanks for your responses.

Sid and Phoenix, thank you for the interesting websites

Luceeloo - did any of these comments ring any bells/help you also? What do your BG levels usually run at?

Frankie, the thread you pointed me to was fascinating. I used to be extremely fit and am desperate to get back to regular resistence weight training, so this is all really helpful, very complicated to balance, however!

Phoenix and Frankie, re high blood glucose and ketoacidosis: I'm on insulin because I keeled over and went into intensive care, for what turned about to be a pretty serious DKA. Since being on insulin I have had no ketones identifiable at all with urine sticks (so, doing its job that way), but I am guessing my pancreas still goes through bouts of producing insulin (although no-one in the NHS seems in the least bit interested in establishing whether this is the case or not, which I find odd, since surely that is an important bit of information for most patients?), since once I started on the recommended doses of insulin (standard basal, and bolus with carb counting) I found myself in hospital again on a number of occasions due to sudden serious hypos. On the basis of pure experience, the only workable balance is keeping my BGs running 'too high' in order to avoid the inevitable hypos (hypos being more seriously damaging than hypers, a point few people seem to flag). Despite these high levels, I have found no indication of ketones, whether on high intensity exercise or otherwise.

I will see whether high intensity muscle-tone vs slow aerobic exercise makes any difference.

Thanks again for all your help, its great!

:thumbup:

 

[Culsie07]

Hi Acedemicdiabetic,

Your high BGs suggest that you don't have enough insulin in your bloodstream to allow the glucose to pass through the cell walls into the muscles. Some of the sites suggested above give some very good advice on exercising with diabetes. I particularly like the Runsweet site.

I'm T2 and when I exercise (jogging) my BGs are usually about 3 to 5 points higher after my exercise. However, a few hours later, and for the rest of the evening my blood glucose level stays a few points lower.

It was explained to me once that as we exercise we use up the glucose stores within our muscles making them want more glucose to replace what's been used, and to do this they release a hormone (glucagon) to stimulate the liver to make more blood glucose - this part seems to work fine in us T2s. The higher blood glucose should then stimulate the pancreas to make more insulin.
However, T2s either don't produce enough insulin, or our muscle cells have a degree of insulin resistance, either way the increased levels of blood glucose are unable to pass through to the muscle cells, which if we're still exercising get even more depleted of glucose, and release more of the hormone to stimulate the production of even more blood glucose, etc etc

The harder we exercise the quicker we use up the glucose in our muscles increasing this effect, and vice versa. Part of the 'balancing act' is finding out what levels of exercise, and for how long, we can tolerate the particular exercise without sending our blood glucose through the roof.
This will be different from person to person as we all have different abilities to produce insulin, or have different levels of insulin resistance. As a T1 you will be able adjust your insulin dose to compensate, taking care not to inject too much increasing the risk of hypos

Culsie

 

[Chris3578]

Hi all, I'm a newbie here and I was reading this post and couldn't help having some input on it. I was in the same situation with regards to keeping my blood sugars higher when beginning exercise (football training or games) due to not wanting to have a hypo during it. As it was my full time job I was deliberately running my bg levels in double figures daily, a lot of the time higher than the proposed cut off of 13 mmol!! I would then be further frustrated with the reads of my levels once I'd finish no matter how hard or long I'd worked for. It was the suggested by my doctor that maybe the stores of glucose in my liver were being pumped the my blood stream by the adrenalin of doing exercise and to combat this, taking an injection before training and before and at half time of games. As you could imagine I though he was mad but I plucked up the courage to try and test it and found that not only was I more stable bg wise, I was performing at a much better level. Even before games where I check my bg levels and see it is around the 8mmol mark, I still take 4 units of novo rapid before warm up, check again 10 mins before kick off and it's sitting at 7mmols then have 3/4units again, check at half time and its still within the 6-8mmol range and have another 3/4 units and check at full time. Baring in mind that throughout this process I take a sports drink out to the pitch with me or have some access to QA sugars whether it would be on the bench or in the goal. And also at full time, be aware of a quick drop in bg levels as I've found that this is the time to have maybe 2 QA CPs and 2 slow acting cho also. Although everybody is different, this works for me, I was apprehensive at the start but I now wish I'd have done this my whole career!!

 

[phoenix]

There's a professional rugby player who writes of using a similar technique for matches, though a different one for training.

In the early stages I would go into matches having done everything the same as a training day. I would go into a game with my blood glucose level between 6-8mmol/L and sip glucose drinks during stoppages. It took me a good few games before I realised why my blood glucose readings were very high both at half time and full time. I stopped drinking the sports drinks and stuck to water. This had very little effect. I then took the leap and injected 1 unit 5 minutes before kick-off and 1 again at half time. Because of my sensitivity to insulin I was worried that I would simply induce hypoglycemia, however, this had the desired result and I would finish games between 6-9mmol/L. My body’s response to playing in big matches in front of big crowds of course made my glucose levels shoot up. I will constantly be on guard, as I become more of a seasoned campaigner, for any changes in my nerves!

Chris Pannell (Worcester Warriors)
http://runsweet.com/Rugby.html

 

[donnellysdogs]

I do physical gardening.. Today gor 5 hours forking out stinging nettles and weeds along a river bank.

I have 2 choices when I do this solid type of work.. Reduce basal to run at 60% 1hr before starting work or... Have one yum yum when I start snd another one 2 hours into work. Guess which option I take-lol!! However this stenuos work is only 1 day each week, so I count it as my treat day!!

I have had an odd day now and again where set failure has put me at 17 before this treat day. I just correct giving myself 60% of the correction bolus if I get this happen and work as normal...

However...... getting to the point now... If you are remaining at higher levels more regularly, you should not exercise.

Tbh, if I was getting extremes of highs and lows I would be testing and keeping a really detailed log book of records of food, exercise doses etc and seeing my dsn or gp... There is no way that I would accept that my life is going to be full of either lows or highs because of help, knowledge or confidence...

I say gp, as I have had a superb, excellent one years aho that would allow me to email him every two weeks with my records and he would email me back... It depends as a type 2 how many blood strips and who you have the best relationship with...

Its not just official 'exercising' that is dangerous with highs, just any physical exertion at home, work or socially is to be counted as exercise...i count my job as my job, but it is huge exercise.....but not to me on a normal living basis.

You should not have to be in a position where you have to accept this as your present or future.

Huge amounts of good advice in other posts here.....

 

[donnellysdogs]

By the way... Exercising (work) if above 12... I will only hive myself 60% of my correction dose...
However, if I was above 12 sat at home watching TV i would give myself 160%.

Anwhere with levels between 8 and 12 I would give myself my normal correction dosage....

If my levels ever go above 12 I do not take a normal correction dose.

It worries me that original OP is intentionally running high due to hypo fear... This is not a sustainable way of life and is not recommended....

 

[C burns]

Hi,
My bs hav bn significantly high (16-hi) for the past year due to other illnesses. Over the past few months I started running approx 4/5 k every 2nd day. My consultant thought this was a gd idea to build my muscles and lower bs. Was this bad advice? I dnt want to kp up running if its pointless as its very time consuming when I work full time, go 2 Uni in the evenings and hav 2 young children.

 

[Des22]

Hi. I have had diabetes for 20 years now. I have had a HbA1c between 6 and 8 all that time. However this year it has been quite difficult to manage my blood sugars because I have been training for and competing in triathlons at a local level. I have found that when racing I will take my normal carbohydrate intake but reduce the insulin by either half or a third depending on the distances. I will take the insulin and food an hour before the race and then an extra 30g of carbohydrate
Before racing and approx anther 30g during the event wen I get out of the open water. This formula works for me.