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Deliberately raising sugars before exercise

Discussion in 'Fitness, Exercise and Sport' started by TigerBao, Apr 5, 2011.

  1. TigerBao

    TigerBao · Active Member

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    I recently started aikido, and it absolutely annihilates my blood sugars. Short of keeping a tube of dextrose sweets in my gi (training suit) and topping up every 20 30 minutes to keep my sugars going, which I'd rather not do because it's an intense class and I feel it's sabotaging my training to break rhythm, I'm pretty much sending my sugars soaring an hour or so before class. Yesterday I checked my sugars and they were on 17, and injected five units less than I needed to cover my food, and at the end of class my sugars were on 5.6.

    But my concern is, for that time there's lots of excess sugar in my system, which no doubt will cause harm.

    Would it be better to down an energy drink or something closer to when I leave so it will be in my system for less time and I'll start burning sugar more or less straight away? I'm not sure how best to deal with it.
     
  2. cugila

    cugila · Master

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    First of all as a Type 1 you should NOT be exercising when your Bg levels are so high AND you should also be checking for Ketones as high BG and high Ketones is a Medical Emergency......not good !

    Here is a link to a previous thread where this was discussed and what you should do :

    viewtopic.php?f=26&t=18810&start=15#p171454

    Basically you need to test before, during and after the exercise to keep a balance. If your levels are too low to start with then you would need some sort of 'fuel' for the proposed exercise. If too high then some Insulin may need to be injected. If you have the balance right then your levels should not go too high.......if you are high to start with then you need to know and react accordingly.

    The medical advice is that if levels are around 13 mmol/l you should check for Ketones and postpone exercise until such time as the levels have subsided. Exercise can cause levels to rise as well as lower. Complicated isn't it ?? :?
     
  3. noblehead

    noblehead Type 1 · Guru
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    Good advice from Ken (Cugila) and do take note. Here is a site that offers advice to type 1 diabetics who participate in sports:

    http://www.runsweet.com/

    Nigel
     
  4. spideog

    spideog · Well-Known Member

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    How long do your training sessions last for?

    I found when on MDI that I could last about an hour of running if starting with a bg of around 14. I'd then end up with a bg around about 5'ish. Any longer than that though my only option was to take more carbs during the exerscise in order to not hypo, and I'd have to take them every 20 minutes for the duration. I'd not have been in the mood for doing anything if I were as high as the 17's though.

    I'm now on a pump and have not yet got it all figured out with adjusting the levels, but did recently do a half marathon, so a few minutes under 1:30 of intense exersice. I started with a bg of around 11 I think and finished at around 6, but I had only taken the one gel during the race whereas on MDI I would have needed to take about 4 in order to stay upright for that intensity of workout.

    I'm not over enthusiastic about the RunSweet site. It has potential, but I feel it is lacking in any actually usefull information on what people actually have done, what problems they had, how they got round it etc. Just seems to be a bunch of default opinion of what the medical pros think should work. What we really need to know is what real people have done and how they did it. (Sorry for a bit of a rant, but I'm bored of medics sending me towards that site with any exerscise related query) :)
     
  5. TigerBao

    TigerBao · Active Member

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    Well this is.. I can't tell you how frustrating. Aikido is my current passion and it so far has done nothing but lower my sugars dramatically. It seems to me that the only safe option is to go in with reasonable sugars, maybe around the 10 mark, and start downing lucozade sweets every few minutes to avoid a coma :/

    I dunno why exercise would RAISE blood sugars but I've never found that to be the case so far. I did karate until recently which was also quite intense, and that also dropped my sugars like nobody's business.

    The class is an hour and a half but almost constantly involves getting back up from the floor, so it's more of a workout than people might imagine from looking at it. My sugars will probably only last an hour or so if I go in with a good reading.

    I've also only had ketones a few times in my life, and that's when my sugars were in the late 20s and into the 30s. 14 to me is still a worryingly modest reading before I do martial arts, as in karate I would aim to be around 15 and find my sugars around 6 by the end. If my sugars are on 12 at the start I'll need a break somewhere around the three quarters mark to take some glucose. Thankfully the instructor is diabetic so understands this and doesn't chide me for breaking discipline if I just run out of the class to my bag without asking permission to leave first. The aikido class is considerably bigger though and less personal, and I worry that if I have to stop it will disrupt other people's training as well as my own, which makes me feel bad and likely to go back in before I feel up to it so I don't keep them waiting.

    Maybe next lesson I'll keep my sugars reasonable and see how many sweets I have to get through to keep me going :/ I expect it'll take a whole packet if previous sugar readings before and after are anything to go by..

    Will grab myself a drink and peruse the run sweet site, thanks.
     
  6. spideog

    spideog · Well-Known Member

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    I had a 5 mile race on Sunday morning where I started off with everythig approximately the same as other races/ runs so far...but the test I did at the end of the race and the bg's had gone up to the 17's. I think this was down to it being earlier in the day than most other things I've done so far, so depsite me reducing the basals in the same percentage, my basal at that time of day is currently actually set to be lower anyway. Therefore I had even less insulin running around my system so the BG went up instead of down. Never any ketones during all of this and the bg's were back to normal soon enough.

    From my experience I think you'd be pushing it a bit if you tried to last much over an hour without taking anything additional in terms of carbs. Is it possible to keep some tabs closer at hand that you can stuff a couple down your throat in any spare moment without actually needing to leave?

    I'm now having issues on the pump as to how long before exerscise I can eat as the insulin from that bolus still being in my system then seems to cause me issues. But it may be worth experimenting with the last meal before hand as well. How long before, how big a meal, how much do you adjust the bolus by in order to get the bg slightly elevated?
     
  7. cugila

    cugila · Master

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    Not making it up......... :|

    Exercise can and does raise AND lower Bg levels. You might not have experienced it....however, it mainly happens when Bg levels are high (around 13 mmol/l).

    http://medweb.bham.ac.uk/easdec/prevent ... cise.htm#i

    That is the reason why exercise/Insulin/carbs needs to be carefully monitored........
     
  8. TigerBao

    TigerBao · Active Member

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    Wasn't suggesting you were making it up, sorry if I came across like that, and now I think of it I have experienced some times when my sugars were up after doing tai chi and I couldn't place why. I had no idea exercise could do that and it really annoys me that it could lol

    I guess it's decided, then, the only safe option is to carry some lucozade sweets in my gi and partake when I need to. I don't want to do that coz I'm worried about sweat making things messy and unpleasant if it contacts the sweets, but it sounds like the best I can do given the intensity and duration of the class. Will go along Thursday, get my sugars to around 10 or 12 to begin with and carry the pack in my gi and hope it all goes alright. Does this sound reasonable?

    Also, how low is "hypo"? I get hypo symptoms while my sugars are still in the 4s, sometimes in the 5s, but they've been high for a long time and only recently starting to get tighter control, so I figure it's my body not used to them being reasonable. My sugars were on 3.7 and 3.8 this morning and I felt ok after refusing to panic eat like I often do (often causing a yo yo sugars effect) but I don't know how low is dangerous. The lowest I've been in my life was 1.2 and I think I did the right thing to panic slightly then lol but I'm thinking anything above 3.4 or so is ok until it gets to about 8.5?
     
  9. cugila

    cugila · Master

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    A hypo is classed as anything below 4 mmol/l. You should be getting the warning signs before that, such as in the 4-5 mmol/l area. That's good as you don't want to lose your hypo awareness. 4 mmol/l is considered the 'floor.' Stay out of that area. Here is a link to information I posted regarding Hypo's. It should explain things more clearly, if not just ask.

    viewtopic.php?f=20&t=18529#p168549

    As a Type 1 your levels according to the NICE 2011 guidelines are as follows.........
    Fasting (Waking)...........between 4 - 7 mmol/l.
    2 hrs after meals...........no more than 9 mmol/l. Lower is better........
     
  10. TigerBao

    TigerBao · Active Member

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    Fair enough, ta. Just got up and my sugars are on 8.4. Underestimated the sweetness of almonds apparently :$
     
  11. phoenix

    phoenix Type 1 · Expert

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    Google books: Ragnar Hanas hypo. There is an excellent chapter on hypos in his book
    'Type 1 diabetes in children, adolescents, and young adults' , and you can read that chapter online.He states that people feel hypos in the 4-5mmol range as a result of higher average glucose levels and suggests that for a person with type 1 and good control the physical symptoms should occur at between 3.5 and 4mmol.
    Indeed a normal person may not feel the physical symptoms of a hypo until 2.7. In all people diabetic or not EEG changes which detect alterations to the brain as a result of lack of glucose start at about 2.2mmol.
    But it is finely balanced he also states that a person with diabetes and an HbA1c of around 5.2% may consistently not get symptoms until below the level at which the brain is affected.(2.2mmol) This can also occur with swinging levels or very frequently hypos. If you have a hypo one day you are more susceptible to another the next and this can be a downward spiral in your ability to be aware of them.
    That's true from personal experience, with an HbA1c of 4.9% I wasn't sensing hypos until 2 or below, I was perfectly able to function physically but obviously it must have had some impact on my brain function.Now with a slightly higher overall levels I usually 'catch' them at between 3.5 and 3.9mmol and that's according to my doctor and Ragnar Hanas perfectly OK. For me though it was using a pump and the ability to reduce insulin during exercise that made this feasible. Long term insulin by injection just wasn't flexible enough and the only other alternative, as you have found was to raise my pre exercise levels by reducing the bolus with the meal before , or by eating carbs immediately before exercise.
    A book worth getting is Sheri Cohlberg The Diabetic Athletes Handbook, as an exercise physiologist with T1 and is a member of the commitee that drew up the ADA guidelines for exercising (as quoted by Ken) she is worth reading, ... she also makes clear that some athletes don't follow them! 'some diabetic athletes have never experienced ketosis or just never check their urine for ketones because their sugars are never high for that long' (p82) Personally though, I would act on the side of caution, particularly if you have higher average glucose levels.
     
  12. db1

    db1 · Member

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    My personal understanding of blood sugars raising when exercising, is that the brain recognises thats you're doing a task that will require alot of energy, and signals for your liver to dump sugar into your system..

    I find this not to happen all the time, and I believe it very much depends on the time you exercise, some people exercise without it ever happening for them. Its more a of safety feature of the body, albeit not a very precise one at times.

    ... Also regarding low blood sugar awareness... People loose their awareness when they get too many low blood sugars in small timeframe... What happens is that your brain will recognise that it needs more energy, but as your liver has had its glucose storage depleted from the many lows previously, the brain thinks the liver had released the glucose and doesn't signal out any other alarms ie what ever hypo symptoms you'd normaly get (again from my understanding).

    To regain awareness, its recomended that you try not to have any lows for around two weeks or so, untill you liver can build its reserves again...

    I hope this was helpful :wink:
     
  13. day007

    day007 · Member

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    I know it's not what the professionals say to do but the only way I can do excercise is to deliberately raise my blood sugars beforehand. For example the other day I did less insulin with my lunch so it was 14 1hr before excercising, then I had a small bowl of cereal with no insulin so they were probably a bit higher by the time I started. Then I ran for 25 mins and my blood sugar was 3.7 so I had to drink half a bottle of lucozade and then did some cycling whilst drinking the other half and then hypo'd all evening!

    So it may not be best practise to raise your blood sugars but it might be your only option - I mean if my bloods were 6-7 when I started excercising then I'd be hypoing after 5 mins!! I think it's something to do with me getting a very fast heart rate and getting ridiculously hot and red compared to normal people even though I feel completely within my comfort zone.

    Then again, you talk about getting high blood sugars afterwards - I've heard people talk about this but I've only got that twice, all the rest of the time it's lowlowlow after excercise!

    If anyone else does have other suggestions that would be great but I haven't found another way of dealing with excercise.
     
  14. Margi

    Margi · Well-Known Member

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    I've only scanned this thread quickly, so my reply might have been covered earlier, but here's my take on it. Mine is based on years and years of personal experience and five days of DAFNE course during which I learnt more than in the last thirty years, but I still have to adjust even from what that taught me, but it's those experiences that you asked for, so here goes. Please remember though, we are all different, and the super ball has edges on and doesn't always bounce the way you expect.

    Of course, Aikido caught my eye. I did a year of it too: had to stop for many reasons but not because of my diabetes, and I miss it. It was a passion that I'd love to get back to. I also exercise a lot in other ways now, but I spent many years with very little exercise. Right now I have just started two different jobs: one with loads of walking and the other one cleaning. I found, like you, that my BS dropped like a stone when walking. I have always found that. As I was having repeated hypos with reduced short acting insulin, I have dropped my Lantus down. Very slowly, one unit at a time then leave it for a few days before doing it again. I'm getting there gradually and the hypos are getting under control again without too many highs.

    I really wouldn't worry about a BS of 14 before exercise. I know the professionals say it's bad, but they (mostly) are not on the inside trying to juggle the eggs. They don't know how bad it is when said eggs break. You could try eating a few portions of slow release carbs immediately before your aikido class without any insulin. If your base insulin is right, it might be enough to keep the levels fairly steady during class without resorting to glucose. It will take some experimenting to find out how much you need to eat and whether or not to have a tiny bit of insulin with it, but it is something I do when exercising hard and it does work. I don't worry too much about testing unless I feel hypo, or 'off' in other ways, in which case the dreaded spike with exercise has probably happened. It does now and then, as you've discovered, and it sucks royally, but it won't do you any long term damage unless you stay up there a lot of the time. The odd spike is neither here nor there, long term risk wise. My personal theory, and I have not run this by any doctor, so they may say it's wrong, is that often during exercise that is stressful the body kicks adrenalin into the system (someone did say that above without saying 'adrenalin'). With Aikido if, for instance, you have a bad fall and hurt yourself, adrenalin will flood your body and hey presto, your BS goes sky high and doesn't come down. You cannot predict when such a thing might happen: you may have a busy but uneventful day or not.

    When I ride in competition - I do endurance riding (horses) - I always have the will it? won't it? problem. It can depend on how wired my horse is before we start: if he's seriously wound up then I have to admit to worrying a little if the glue on my saddle is going to be strong enough, but sometimes the same can happen and I'm cool about it and so the BS comes down instead of goes up. More often than not when competing my BS tends to go up because Fella can be a bit on the scary side, so I carry my insulin with me as well as loads of juice. I tend not to use the insulin though unless the BS goes over about 17 because until it gets there the chances are it will come down on its own as I go further. With walking the opposite happens because there is no stress, just an hour or two of belting from door to door with catalogues, so the BS comes down. It's an eternal juggling act and the only way to work it out is to fiddle around until you find a system that works for you. And don't worry about starting exercise at 14: if your BS is still coming down then it's not a problem. At 17 you might find it won't budge and then it's a problem. Of course, those figures are the ones that work for me and may be very different for you.

    When you are exercising hard, there is nothing wrong with starting a bit high: far better than dealing with repeated hypos, but don't let it stay high. Heck, I've said that already. Enjoy your Aikido and don't be afraid to talk to your sensei about the diabetes, I'm sure he (she?) won't bite.
     
  15. phoenix

    phoenix Type 1 · Expert

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    Yes, see http://www.runsweet.com/DiabetesAndSport.html
    section 3&4 (cathecholamines = (more or less) adrenaline)
     
  16. Margi

    Margi · Well-Known Member

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    Really useful article. Thanks, I've bookmarked it so I can look it up when I get baffled.
     
  17. LittleGreyCat

    LittleGreyCat Type 2 · Well-Known Member

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    As a T2 this isn't my area of experience.

    However I did read in a cycling magazine a good few years back that they had tested various foods for good slow release of energy during exercise and malt loaf had come out top as a slow release energy source.

    Reasonably scientific testing, as well, with monitoring of exercise levels and blood glucose throughout the trial period.

    HTH

    LGC
     
  18. AlextheScot

    AlextheScot · Newbie

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    I would have to agree with everything Margi said. I have been Type 1 since I was 5 years old (I'm 26) so have had diabetes whilst grwoing up. I used to do ju-jitsu and other sports and know what the thought of a hypo coming on can be like, even if one isn't likely.

    Somehting i have found over the years to be far more important than i should have realised to begin with is eating better through out the day, not just before exercise. I find that i can exercise far longer and with better control if i am taking on carbohydrates in the form of potatoes, rice, pasta etc at least 1 hour before the exercise and with appropriate insulin and then taking soemting more sugary like a banana or mars bar 10 minutes before the exercise. If you only rely on short chain carbohydrate in the form of sugars you will keep burning it up when you exercise. The longer chain carbs give you more consistency i have found.

    With diabetes affecting everyone differently it is difficult to get some rules in balck and white that work for everyone. I'm new to this forum and think that engaging with other diabetics and bouncing ideas off one another seems an excellent way forward to finding a method that works for you.
     
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