exercise instead of insulin??

Hi

I always cut back on insulin if I know i'm going to be gardening/excersising. If its unplanned excersise then I just eat extra carbs and always carry dextrose or something extra to eat as well just incase. Excerise makes diabetics much more sensitive to insulin.

Avi

Hi Ron, welcome to the forum, be careful not to confuse the mode of action of your basal(long acting) v rapid (quick acting) insulin!

If you change your daily routine significantly you first need to look at adjusting your basal insulin e.g. more exercise reduce you basal insulin. (basal insulin adjustment may take two to three days before you see the result, do not adjust by more than 1unit at a time)

As you surmise, if you eat without taking your quick acting insulin, your food which is converted into glucose will not be converted into energy for your muscles, but stay in your blood causing your bs levels to rise. Also what you are seeing at present is that by exercising your body is becoming more sensitive to the insulin you are taking.

Hi
A good book that explains a lot of this is Think Like a Pancreas by Gary Scheiner, I bought my copy from Amazon.
Avi

RonG said:

The thing that I don't understand is that surely it can't *just* be that if your blood sugar is between 4 and 6 then that's ok ........

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Yes, that is exactly it! If your blood sugar is between 4 and 6 then your body has been able to handle the rise in blood sugar from your meal. It will do this using insulin though. It can't do it without any insulin at all.
The thing is that it's often pretty difficult to do it only with exercise (or alcohol!), even with basal insulin sloshing around. Your blood sugar shoots up after a meal and without any short-acting, it's tough to get it down by exercise alone. If you are managing to do so, though, that's great. Just keep an eye on your blood sugar to make sure it isn't creeping up.

Interestingly I read something somewhere (if anyone else knows of it would be v. interested to read it again) where some diabetics in Jersey managed to keep alive during the German occupation by using exercise. Insulin was in very short supply and they reduced to minimum levels and just worked their socks off. Of course in those days they didn't have home blood meters so who knows how low they managed to keep their levels - but I think they kept healthy enough that there was no sugar in their urine.

Here is one link about it.

http://www.bbc.co.uk/ww2peopleswar/stor ... 8110.shtml

wow. Thank you sue - I hadn't realised he was the only one to survive. It must have been his story I read about, although in the one I read, he said he had made the decision to exercise a lot as well. How terrifying, to have no insulin at all.

Glucose is moved into cells via glucose transporters. GLUT4 is the transporter which moves glucose into skeletal muscle cells. It is stimulated by insulin but also by muscle contraction It has two types of receptors and (it's thought) that there are sufficient that can be stimulated by muscle contraction to allow insulin into a cell for energy, some say this is true at all times, but certainly there are enough to get glucose into the cells during aerobic exercise. (competitive exercise and anaerobic exercise can be a bit different as they bring things like adrenaline into play)
Insulin also acts to stop the liver releasing glucose.Quite frequently during exercise this is a problem with injected insulin, you need the extra fuel but a relatively high insulin level prevents the liver from releasing it. (hence hypo)

I use hardly any insulin whilst exercising, nor for some hours afterwards. I have a pump and set it to 0.1units an hour for running.Today in fact I ran half of a 7 mile run without the pump attatched (for some reason it became really uncomfortable and itchy and I ended up taking the cannula out) . I can't say there was no insulin as there was probably some that hadn't yet been absorbed but there was very little, at the end of the run glucose level was 4.6mmol (and I had had some dextrose at the 2 mile point)
When I run long runs (12 miles upwards) I eat carbs before and drink them during, all with no bolus insulin and very little basal.