Diabetes/Excercise/Blood Sugar

[mrburden]

Hi,
After being diabetic for well over 30 years I thought I knew at least the basics of how it all works (or doesn't work) but here's something I've just found out about.
I always thought that, as a diabetic, excercise would lower your blood sugar. But it seems that's not always the case...
I have had a few experiences where I have done a blood test before cycling and the result was about 10 - 12ish. I then cycle a few miles into town then, about 30mins later cycle home again (about 5 miles total @ about 15 mph). Once home my bs level has risen to above 20!!
My specialist told me that I am running out of insulin. This in turn means that the glucose, needed for energy by the muscles, cannot be absorbed from the blood stream into the muscles. The liver still releases glucose into the blood stream because you are doing the excercise but without the insulin, it remains there, giving the high bs reading.
Therefore the advice seems to be that if you have a high bs (11-17) excercise with caution and if it's above 14 with keytones present do not excercise.
I got hold of a copy of "Diabetes & Sport" issued by Gwent Healthcare NHS Trust which goes into this subject very well and has some interesting tips.

 

[ebony321]

Hi,

I also assumed this was the case until i went on the DAFNE course and was educated properly regarding exercise.

''Therefore the advice seems to be that if you have a high bs (11-17) excercise with caution and if it's above 14 with keytones present do not excercise.''

that statement was also made very clear in the course so i agree with that 100%

seems nothing is straight foward

 

[phoenix]

Exercise high blood glucose and insufficient insulin are a dangerous mixture. I found this out when I was diagnosed. I went for a mountain bike ride on a relatively remote trail and developed what I thought were breathing difficulties. This was caused by DKA. I'm very lucky that I was with my OH who got me back to civilisation and a doctor.

This paper explains type 1 exercise and blood sugar in quite a lot of detail but what is really useful is the checklist (table 2) on how to take part in exercise safely.
http://www.diabetes.ca/files/riddell--final.pdf

 

[humph]

When you exercise your muscles don't use glucose from the blood stream initially, they use their glucagon reserves. If the exercise is intense the liver will dump more glucose into the blood, the muscles will the attempt to use blood glucose and once exercise is complete, it will replenish its stores of glucagon by converting glucose.

I have seen the same results from exercise, sometimes much lower readings and sometimes very high, this must be down to the liver dumping to much glucose into the system in response to exercise.

 

[copepod]

www.runsweet.com is also good for online advice for all levels of sports / physical activity, not just elite athletes.

 

[Type2Spouse]

Does this just apply to Type 1? How do you know if ketones are present?

My husband has just been diagnosed with T2 (he is on 1000mg of Metphormin daily) and we are about to commence an exercise regime (just brisk walking initially).

His BS levels have not yet exceeded 8.9 (2 hrs after eating), but we have only been checking BSL for one week so far and are still in the "trial and error" phase of diet management.

I am doing as much research as I can, and came across this discussion, hence, my questions above.

 

[copepod]

Runsweet is aimed at type 1s, but could be some use for type 2s on insulin; not much use for type 2s on diet & exercise with/out medication - in fact, there's a gap of information for that group.

 

[phoenix]

Does this just apply to Type 1? How do you know if ketones are present?

My husband has just been diagnosed with T2 (he is on 1000mg of Metphormin daily) and we are about to commence an exercise regime (just brisk walking initially).

His BS levels have not yet exceeded 8.9 (2 hrs after eating), but we have only been checking BSL for one week so far and are still in the "trial and error" phase of diet management.

I am doing as much research as I can, and came across this discussion, hence, my questions above.

If your husbands levels approach the higher levels I would think that you should discuss things with your doc, hopefully they won't.
I did look up the answer to your question and this is what the American Diabetes Asscociation say:

Previous ADA exercise position statements suggested that physical activity be avoided if fasting glucose levels are >13.9 mmol/l (>250 mg/dl) and ketosis is present and that it be performed with caution if glucose levels are >16.7 mmol/l (300 mg/dl), even if no ketosis is present (55). We agree that vigorous activity should probably be avoided in the presence of ketosis. However, the recommendation to avoid physical activity if plasma glucose is >300 mg/dl, even in the absence of ketosis, is probably more cautious than necessary for a person with type 2 diabetes, especially in a postprandial state. In the absence of very severe insulin deficiency, light- or moderate-intensity exercise would tend to decrease plasma glucose. Therefore, provided the patient feels well, the patient is adequately hydrated, and urine and/or blood ketones are negative, it is not necessary to postpone exercise based solely on hyperglycemia

http://care.diabetesjournals.org/content/29/6/1433.full
This is a full but academic report on Exercise and Type 2.

Brisk walking, increasing either or distance and speed is a sensible way to introduce exercise, in fact if you can find nice places to walk it shouldn't seem like exercise in the sense of 'medicine', just an enjoyable activity.
One thing I found when looking up the answer to your question was a study which suggests that the best time for people with type 2 to walk (for glucose control) is after meals.(actually this seems like 'common sense' ! If your timetable allows, it might be worth seeing if this is a good time for his walks .
http://www.defeatdiabetes.org/news/view.asp?catid=&subcatid=&id=56335

 

[Type2Spouse]

Phoenix,

Thank you for your comprehensive and helpful post

 

[Type2Spouse]

Great news! The treadmill was delivered today. Hubby checked BS 2 hours after lunch - 7.1. He then went onto the treadmill for 10 mins (it was as much as he could take first time) walking at 6kph and took sugars again - 6. What a result!!!!

 

[Cowboyjim]

Fascinating subject. I have nearly always exercised on a cross-trainer for a mile or so within an hour of a meal. Sometimes I go for a walk. I do not measure my BG every time but the times I have it has been less.
One is tempted to do self-experiments but this is all getting rather retentive over and above the usual roster of self testing your way through the food cupboard. I have gone on about this in other threads.
So for now I will continue to do the two-belt and braces thing - diet, pills and exercise. Mind you I warn you that this will likely cause you to shed those pounds... I could do with adding some. 8)

 

[phoenix]

Great news! The treadmill was delivered today. Hubby checked BS 2 hours after lunch - 7.1. He then went onto the treadmill for 10 mins (it was as much as he could take first time) walking at 6kph and took sugars again - 6. What a result!!!!

Glad it worked so well, if 6kph is a bit fast, why not lower it a bit? As he gets fitter he can speed up.
One tip as he gets used to it is to vary the speed, inclination quite frequently otherwise the treadmill can get very boring.

So for now I will continue to do the two-belt and braces thing - diet, pills and exercise. . 8)

Now why do you think that theres a huge picture of three legged stool on the door of the diabetic education room at my hospital ? :wink:

 

[Type2Spouse]

Yeah, well he found 6kph a bit strenuous, hence only being able to do 9/10 minutes. The biggest challenge is getting him to read the manual.

Baby steps...we're on the right track...I think!

Once again, thank you Phoenix for being right on the button!

 

[mrburden]

Does this just apply to Type 1? How do you know if ketones are present?
quote]

Hi,
Ketones are substances that are made when the body breaks down fat for energy. Normally, your body gets the energy it needs from carbohydrate in your diet. But stored fat is broken down and ketones are made if your diet does not contain enough carbohydrate to supply the body with glucose for energy or if your body cannot use blood sugar properly.
Generally a good sign that keytones are present in the body is the smell of "acid drops" or pears on the breath. Some newer blood test monitors have the ability to test for keytones as well as BS levels but in the past urine test sticks gave combined keytone/sugar results.

 

[lionheart]

I worked out with a personal trainer today and he's trying to get up to speed on training T2's (as am i, being newly diagnosed). He tested my BS midway through the session and it was 8.9. Does that sound like it's OK? I didn't test before the session or after as i can't afford test strips at the moment.