Rising blood sugars whilst exercising

Amrit1712 said:

Hi all,

Christmaa holidays so I've got a bit of time on my hands. I've started doing circuits in the morning once I get up but my levels have been rising. Today I got up and my level was 8.0 then I had a omelette with Turkey in it etc... No carbs. After doing a circuit for about 30 mins, I waited another half an hour and checked my level 10.4. I don't understand why it's risen? Because its the morning and I haven't taken insulin? Also happened the other morning and when I went cycling after waking up, my level shot to 19 halfway through the ride

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There are quite a lot of things that could be going on here.

1. Dawn Phenomenon - happens as your body prepares to get going in the morning. Doesn't always happen at dawn...
2. Cooked eggs are notoriously bad for requiring compensating insulin. There are a couple of topics on this on the forum. (e.g. http://www.diabetes.co.uk/forum/posts/1009400/)
3. Cycling tends to be an anaerobic exercise, which causes the liver to dump glucose as the muscles need it for energy - I see bg rises with cycling too.
4. I don't know when you take basal, but for some people it can be running out in the morning and as a result can cause bloods to rise.

Best thing to do is take them one by one and try and identify what is happening.

Hi I find circuits will raise my sugars. We had a different bloke doing it this morning and my usual bolus didn't cover it. I went from 5.1 to 10 by the end of the session. It normally hits high 7s. So rage bolusing afterwards.
I don't eat before a morning session as I have Dawn Phenomenon going on.
Have you tried a bolus before hand? Obviously with testing yo make sure you stay safe?

I went out for a 3 mile walk BG was 6.7 only had a glass of water beforehand, when I tested again an hour and a half later after my walk BG was 8.2

I had a 3 egg, cheese and mushroom omelette, then went walking again, just over 3 miles, 2hrs after my 2nd walk BG was 8.0, it's frustrating, but it's an identifiable pattern, I can at least refer to when I have my review in about weeks with my DN.

I'm type 2 currently I've been on no meds for the past 2 months against my GPs wishes, they prescribe 3 different medications for my diabetes.

Amrit1712 said:

Yes so annoying! Would be so much easier if we knew how exactly different things effect out bg control but unfortunately it just doesn't seem to make sense half the time

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The last couple of days, I've made sure I've had breakfast before I go on my hour plus walks, that seems to have worked, morning BG 5.7 before breakfast, 3 hours post breakfast and walk BG 6.7 I can only hope, as you say half the time it doesn't make much sense what we do.

Ok no early workout as I had an 8am GP appointment, I skipped breakfast too.
BG last night was 7.7 when I went to bed, when I got back from GP I did my BG 9.7
I guess I really need to work on not skipping breakfast, even when I'm not doing exercise.

Plus note past two weeks averages have been 6.4 and 7.2.

Hi,

I'm am new to the pump and really struggling with my running now.

Diabetic over 35 years type 1 since a kid.

I have been doing a stupid amount of testing (hourly), even during my runs (only 7 miles max now, but have run 3 marathons the past 4 years, not on the pump and not as testing aware).

My sugars tend to dip slightly with an hours spin session (hard), but this is even with 90% less insulin for an hour before the spin, and I remove the pump while spinning, advice was this is ok for sports under an hour.

When ever I run my sugars can rise from 4 after the run like this evening an hour later 19 !!! I kept my pump on and ran a trickle of insulin tying to compensate a little for the impending high.

I dosed for tea and a yoghurt, but had a shower before having yoghurt and sugars so hi I won't be eating it and had more corrections dose insulin.

Usually my sugars go up to about 15, so although the I am resisting the temptation to give a dose of insulin immediately when I get in from my run, I have weeks of run stats now that reflect the high .......

It's all down to the liver kicking out sugar for over an hour worth of hard intensity exercise, the insulin and carbs in you cannot cope. Basically too if I give more insulin whilst running I will hypo, it's only when I stop does the problem start :-/

I'd love to hear from other pump users eh have managed this.

Spinning good all sorted l....

Running not sorted

Thanks in anticipation

Misty X

@MISTY10 could you super bolus? It's when you give your basal for the hourish as a bolus, then reduce the basal for that hour?

I did an insanity class last night with a 1 unit bolus, an increased basal still got a spike. Did the spin class after to ride it off but still 8s and 9s. Turned out it was my f@@@ing cannular site. So of course I rage bolused with my pen.
Waiting for my transmitter to turn up for my cgm so had to set the alarm through the night for testing and found I was in the 3s all night. That was after reducing by basal a for the night.
Exercise is good for you even though I look like a bag of boiled .........

@MISTY10 Are you sprint training to see an increase like that? The only time I see a hard uplift in my glucose with exercise is when I do proper anaerobic workouts (last night rather caught me out as I had a big weight training session and jumped 4mmol/l even with a pre-bolus of rapid acting to try and head it off).

As you say yourself:

MISTY10 said:

Usually my sugars go up to about 15, so although the I am resisting the temptation to give a dose of insulin immediately when I get in from my run, I have weeks of run stats now that reflect the high .......

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I don't understand why you haven't been giving yourself that bolus shot when you finish your run - you've got the data and can see the pattern, so it would make sense to take appropriate steps to manage it, which this seems to be. Many of us take boluses (myself and @Mrs Vimes especially) at specific times in relation to exercise in order to head off liver dump related rises, all managed through observing our blood glucose levels and working out the pattern.

Alternatively, you could try setting an increased TBR around 20 mins before you finish your run? This shouldn't be getting fully into your system until substantially after your run has finished and in theory at least, would affect the rise you're seeing post run, rather than the run itself?

Def not sprint training at 9-10 min miling!!

I have spinning this evening and club run tomorrow for 1.5 hours. I will have to try and faff about with my pump whilst running as I approach the club house I think !! My levels always jump from 5 to 15 for a run, I'm new to the pump so wAnted the stats to give the same results do I can formulate a plan.

Thank you !!

MISTY10 said:

Hi,

I'm am new to the pump and really struggling with my running now.

Diabetic over 35 years type 1 since a kid.

I have been doing a stupid amount of testing (hourly), even during my runs (only 7 miles max now, but have run 3 marathons the past 4 years, not on the pump and not as testing aware).

My sugars tend to dip slightly with an hours spin session (hard), but this is even with 90% less insulin for an hour before the spin, and I remove the pump while spinning, advice was this is ok for sports under an hour.

When ever I run my sugars can rise from 4 after the run like this evening an hour later 19 !!! I kept my pump on and ran a trickle of insulin tying to compensate a little for the impending high.

I dosed for tea and a yoghurt, but had a shower before having yoghurt and sugars so hi I won't be eating it and had more corrections dose insulin.

Usually my sugars go up to about 15, so although the I am resisting the temptation to give a dose of insulin immediately when I get in from my run, I have weeks of run stats now that reflect the high .......

It's all down to the liver kicking out sugar for over an hour worth of hard intensity exercise, the insulin and carbs in you cannot cope. Basically too if I give more insulin whilst running I will hypo, it's only when I stop does the problem start :-/

I'd love to hear from other pump users eh have managed this.

Spinning good all sorted l....

Running not sorted

Thanks in anticipation

Misty X

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Hi @MISTY10
I know some people cope with post exercise liver glucose release (gluconeogenesis) by upping their insulin after they finish.

Another way you can curb the rise is to do a more drawn out cool-down after a run. The heart rate needs to be lowered enough for the body to stop the cortisol induced stress response. With a lower heart rate (but still exercising), your muscles will be re-stocking with glycogen as fast as they can - drawing out glucose directly from the bloodstream. They don't actually need insulin for this.
A cool down should help curb post-exercise high.

Have you considered asking for advice in the Team Blood Glucose Sporty Type 1's Facebook group? It might be worth joining if you want more detailed advice about insulin adjustments.
www.teambloodglucose.com

I didn't know about the cool down theory, how long a cool down would I need after 1.5 hour run do you suggest.
This will be a bit tedious after a half marathon race but an increased basal may have to be the way to go there once I get my fitness back and the miles up.
I'll look up the group you suggest.
Many thanks !!

Bebo321 said:

Hi @MISTY10
I know some people cope with post exercise liver glucose release (gluconeogenesis) by upping their insulin after they finish.

Another way you can curb the rise is to do a more drawn out cool-down after a run. The heart rate needs to be lowered enough for the body to stop the cortisol induced stress response. With a lower heart rate (but still exercising), your muscles will be re-stocking with glycogen as fast as they can - drawing out glucose directly from the bloodstream. They don't actually need insulin for this.
A cool down should help curb post-exercise high.

Have you considered asking for advice in the Team Blood Glucose Sporty Type 1's Facebook group? It might be worth joining if you want more detailed advice about insulin adjustments.
www.teambloodglucose.com

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Your thoughts are bit different from what I normally hear. Hopefully, you can elaborate a bit more to help some of us understand.

You mentioned gluconeogenesis which I understand to be the process of converting energy other than carbs (usually excess protein) into glucose. However, can you touch on how that affects post-exercise "liver dumps?"

It's my understanding that our bodies can only hold about 2000 calories worth of glycogen. That's split up into 500 which is stored in our liver and 1500 spread out through our skeletal muscle. It's my understanding that our livers can decide when to release that 500 (unfortunately, not always when we want it to). However, the 1500 calories in our skeletal muscle cannot be transferred throughout our body. Basically, glycogen in your thighs can't ("Can't" edited after I spotted the typo) replenish lost glycogen in your arms.

It's also my understanding that the 500 calories of glycogen stored in your liver are what cause your blood sugar to spike abnormally. However, those 500 calories can only last so long and probably won't last longer than 1-2 hrs.

Long story short, I think I understand why we have blood sugar spikes within the first hour of exercise, but after a certain point we've depleted our liver glycogen stores which means it couldn't spike our blood sugar until its replenished again.

You're much more qualified to discuss this than I am and I'm hoping you can point out what I'm missing in the equation.

Taken from:

http://www.diabetesselfmanagement.com/nutrition-exercise/exercise/exercising-with-an-insulin-pump/


The type of exercise you do can also cause blood glucose level to rise (albeit temporarily). A short period of intense exercise, such as heavy weight lifting or sprinting, especially when done before breakfast, can cause your blood glucose level to rise during the activity and stay elevated for two or more hours afterward. High blood glucose after intense activity is found both in people who have diabetes and in those who don’t; it is attributed to an exaggerated hormonal response to intense activities. For such activities, pump users may need to elevate basal insulin rates during and for a period after the exercise, or give an additional small bolus of insulin.

Taken from diabetes uk

How does the sport affect your sugar levels?

Different sports can affect different people in different ways and in some cases the effects can vary from one session to another. Some sports can raise blood glucose levels whereas other sports may lower sugar levels.

Read more detail about the effect of different sports on blood glucose levels.
Blood glucose testing before, after and, where possible, during sport can help you to spot trends in how your own sugar levels are affected by a particular sport or exercise.

If you are taking part in a sport that lowers blood glucose levels but doesn’t last more than an hour, it may be beneficial to disconnect your pump for that sport. Some people may decide to give a small bolus shortly before disconnecting their pump. It is recommended to discuss whether this would be appropriate with your doctor.

If, however, the sport tends to raise your blood glucose levels, you may need to stay connected to your pump to prevent your blood glucose levels going too high.

Your diabetes health team should be able to help you with making insulin dosing decisions and whether or not to disconnect your pump.

Taken from:

http://www.joslin.org/info/why_do_blood_glucose_levels_sometimes_go_up_after_physical_activity.html

Why do blood glucose levels go up ?

When you exercise your muscles need more glucose to supply energy. In response, your liver increases the amount of glucose it releases into your bloodstream. Remember, however, that the glucose needs insulin in order to be used by your muscles. So if you do not have enough insulin available, your blood glucose levels can actually increase right after exercise. Basically, stimulated by the demand from your exercising muscles, your body is pouring glucose into your bloodstream. If you do not have enough insulin available to "unlock the door" to your muscles, the glucose cannot get into your muscles to provide needed energy. The end result is that glucose backs-up in your bloodstream, causing higher blood glucose readings.

Misty x

That's more in line with the information I've come to understand.

However, it is a bit contradictory to what Bebo321 mentioned (especially the last paragraph about the need for insulin).

TorqPenderloin said:

That's more in line with the information I've come to understand.

However, it is a bit contradictory to what Bebo321 mentioned (especially the last paragraph about the need for insulin).

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Hi Torq, what I've done sometimes is tagged cardio on the end if the weights haven't raised sugars too high or done a spin class. If the rise is too high then I do take insulin. I think that's what Bebo is getting at ish?

Off on a run in an hour gonna try reducing basal for an hour then returning basal to normal then finishing run then raising the basal for two hours ..., I'll keep you posted :-/

Misty x