What I do

All very good Megaman and hope this good progress continues!

Nigel

I've done quite a bit of running over the last few years, although never quite enough for what I should be doing. In my training for a couple of marathons last year I found that I could usually just about do a hours running before I'd get a hypo, if I was running any further than that then I'd have to take an energy gel every 20 minutes from the start of the run to be able to keep going. That starts to get quite sickly though after three hours of taking gels and having to carry them round with you.

Okay Megaman, so you let your sugars run high before you begin exercise.

But is the body not supposed to release sugars when the need be (increased muscular activity)? And if the sugars are not sufficient by themselves, does it not then switch to using stored fat?

Apparently, since you let your sugars run high before exercise, your body does not have to release any more during exercise? And your body won't reach the stage of having to use up fat anyway which comes after the release-of-sugars stage. Which means you are not burning any fat off as you exercise.

I am saying all this because I think I am suffering from poor blood-glucose management during my exercise and want to understand the concepts better.

In any case - whether you stack up on sugars before exercising or your body releases them into the bloodstream in response to triggers received from muscular activity - the muscles won't be able to use that sugar significantly due to diabetes, would they (that's the case for Type-2 diabetes, don't know about your type of diabetes though)? - so what's the point in stacking up on sugars before starting exercise?

My blood sugars are higher immediately after exercise than they are before it and I am trying to figure out what to do and why. Are my blood sugar levels high because the muscles could not make use of sugar released by body in response to increased muscular activity or are they as a rebound due to low blood sugar sometime during exercise? If former, no point in stacking up on sugars just before exercise (muscles won't be able to make use of it), if latter, why do the sugar levels in diabetics drop so suddenly so drastically while exercising when they won't in a normal person (presumably)?

In any case - whether you stack up on sugars before exercising or your body releases them into the bloodstream in response to triggers received from muscular activity - the muscles won't be able to use that sugar significantly due to diabetes, would they (that's the case for Type-2 diabetes, don't know about your type of diabetes though)? - so what's the point in stacking up on sugars before starting exercise?

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I run and have for a long time tried to avoid starting with higher levels, drip feeding with glucose. I'm beginning to realise that I actually run better when I start with higher levels. However most 'experts' give a level of 7-12mmol as a good starting point for people who use insulin, rather than the 18mmol used by Megaman. (Indeed they would tell you to check for ketones at that level). It may be different for Megaman as he has cystic fibrosis which adds additional things to think about.

In the case of people who don't take insulin exercise (especially aerobic exercise) induces a fall in insulin levels which promotes a release of glucose from the liver.
When people use injected insulin this fall can't happen, indeed the action of exercise can make insulin more potent. When glucose levels fall ,just as in a normal person, there is still an excess of insulin in the blood. This excess of insuli will block the release of glucose from the liver . The result is a hypo.
People who inject insulin may need to reduce their insulin with the meal before exercise ... this will result in higher levels at the start or eat some lower GI carbs just before starting and/or take frequent small amouts of rapid glucose during exercise.

The muscles do not actually need insulin to access glucose during exercise; there are other glucose transport systems.

The type of exercise does make a difference in what happens to glucose levels. Aerobic exercise is more likely to lower them, anaerobic to make them rise afterwards.... although they may fall a little later in the day. This heart rate chart shows what normally happens with different types of exercise..
http://www.runsweet.com/HeartRate.html

There maybe some articles that will help you here
http://www.shericolberg.com/articles-resources.asp
The author is an expert on diabetes and exercise, she is T1 herself but much of her work has been with people with T2.

I am indeed receiving some good guidance in this forum, my thanks for all the replies!

anaerobic to make them rise afterwards.... although they may fall a little later in the day

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It looks like, then, that I am doing a mix of anaerobic and aerobic - my sugar rises after exercise, but falls overnight (I exercise in the evening) to reach 3.5 (+/- .3 or so) some 6.5 hours after I fall asleep.

From the link to the graph (glycemic response graph at the bottom at http://www.runsweet.com/HeartRate.html), it becomes clear to me that it is normal even in healthy people for blood glucose to register at higher levels after such exercise (so it is anaerobic exercise which is the cause, and not being diabetic (i.e., body unable to control high blood sugar level effectively)).

The next question then becomes, is it okay to continue with anaerobic-aerobic exercises and experience higher blood sugar level after exercise (reaches to 10-12 mmol/l)? Thus, no need to control it by taking in extra sugar before/during exercise (since it would occur in normal people as well and falls during the following hours anyway)?

I will meet my GP in a few days to discuss what to do about low blood sugar 6.5 hours after I fall sleep on the day I exercise. Will post results here.

Oh yes, and my thanks for the link to numerous articles on diabetes - will take some time to digest all that info at http://www.shericolberg.com/articles-resources.asp

Isn't 18 a bit high? Sure its for avoiding a hypo but wouldn't taking a bit of glucose throughout the exercise be a better plan? Fighting the hypo with glucose in stead of fighting the hyper with exercise...

I would be similar to Megaman in intentionally getting the sugars a bit high before exercise. Although if it was as much as 18 I'd probably just not be in the mood for the exercise. I would happily go out for an hour plus running starting with a level of 13 and a bit, anything much below 7and I'd have to take gels first to be safe if I was going to be doing much more than 30minutes or 4 or 5 miles.

Okay, went to my GP and the GP told me the fact that sugars are high after exercise is nothing to be alarmed about in my case - it happens due to anaerobic exercise and since the blood sugars fall within the normal range a couple of hours after finishing exercise, that's fine. No need for me to stack up on sugars before starting exercise - anaerobic exercise leads to temporary rise in blood sugar anyway even in normal people. I was told this is not rebound after a hypo and that I 'will' recognize a hypo because of the trembling/sweating (I personally am not too sure about recognizing a hypo)

Regarding my blood-sugar falling to about 3.5 about 6.5 hours after I fall asleep, my medication has been reduced and the effects are being monitored. Have another appointment in a few days and will provide the feedback then.

One thing worth mentioning is that the GP told the Hb1AC should be between 6.5 and 7.5 %- it is not the same thing as blood sugar (whose normal range is between 3-6 or 4-7 mmol/l, depending upon who you ask). I was told my Hb1AC is 6.7 and is excellent, had it been below 6, that would have caused concern to my GP (in GP's own words).