Why is this "type" of exercise making me insulin resistant?

[Brendon.Dean]

https://imgur.com/a/mL26J1Z

In the past hockey would raise my glucose to around 12 mmol/L. Now even with taking insulin to try and cover the exercise, not only does it not work, I can spike to 14-18 mmol/L AND remain insulin resistant throughout the night with high glucose, and the next day. I'm NEED to get to the bottom of this, Weight training has a similar effect by during weight training my heart rate usually maxes at 150-160 tops. I'm extremely conditioned and have moderate strength.

Why when this form of exercise should actually cause significantly less insulin use afterward and insulin sensitivity.. am I experiencing the total opposite? I am so frustrated. I'm not lazy, I educate myself and apply all the things we should be doing as a T1 and my health has gotten worse.

 

[Deleted Account]

There are times when diabetes seems to be there to annoy and frustrate us.
I am not sure I will ever know everything that diabetes does to my body (and we are all different) but, based on my experience, these are my thoughts.

There are a few things that happen when we exercise
- our liver releases extra glucose to give us energy
- our body becomes more efficient at using insulin

The first will cause our BG to rise and the second will cause our BG to fall.
If we do exercise which is stop - start which usually happens during a team sport (such as hockey) and when we do resistance training (such as weight training), the first of these two things tends to happen but we do not keep going long enough for the second to happen. As a result our BG rises.
My stop - start and resistance training is climbing and I always saw my BG rise high until I changed to an insulin pump.

The only way I managed my BG during climbing on injections was to take "too much fast acting insulin". Instead of targeting a BG of 5.5, I would target a BG of 3.0. This was scary because I know it is in the hypo range but the effect of climbing raising my BG would mean I would no hypo and the extra insulin would mean my BG was not quite in double figures.
I tend to climb for about 2.5 hours with a 30 minute break after 1.5 hours. During this break, I would test and give myself another correction dose but not as aggressive as the first - targeting 4.5mmol/l.

Your prolonged insulin resistance is a little more confusing and not something I experience.
The only thing I can think of is that when our BG gets high (for me this is over 14mmol/l) our bodies become insulin resistant and we need more insulin to bring our BG down. For me, the upper part of the range you mention is high enough for me to need twice my usual correction dose.
Then there is the problem that, when we see our BG rising, we may get stressed about it ... and stress raises our BG further.

Have you had a look at www.runsweet.com?
This is a site dedicated to people with type 1 doing all sorts of exercise (from archery to ultra marathons and most sports in between) with some useful hints and tips.

 

[Brendon.Dean]

The first will cause our BG to rise and the second will cause our BG to fall.
If we do exercise which is stop - start which usually happens during a team sport (such as hockey) and when we do resistance training (such as weight training), the first of these two things tends to happen but we do not keep going long enough for the second to happen. As a result our BG rises.
My stop - start and resistance training is climbing and I always saw my BG rise high until I changed to an insulin pump.

This makes sense and made me realize a pattern. When I have a game (1 hour stop start like you said) I go super high. When I play pickup hockey where the shifts can be 5-10 minutes and then some rest for a total duration of 2 hours, my blood sugars tend to fall in range to slightly high 10-12 mmol/L.



Have you had a look at www.runsweet.com?
This is a site dedicated to people with type 1 doing all sorts of exercise (from archery to ultra marathons and most sports in between) with some useful hints and tips.

I actually had not heard of it, so thank you for sharing this! I did check out the hockey section which isn't ice hockey, but hey maybe I can figure this out for myself and be the person to write the blog for that section!

 

[Mbaker]

In your shoes I would try to contact a specialist in diabetes and sport. Maybe Volec and Phinney. There are many elite Type 1 athletes such as Henry Slade who have to do resistance training. I really hope you can progress this. @johnpol might be able to offer some advice and or @therower.

 

[evilclive]

Your prolonged insulin resistance is a little more confusing and not something I experience.
The only thing I can think of is that when our BG gets high (for me this is over 14mmol/l) our bodies become insulin resistant and we need more insulin to bring our BG down. For me, the upper part of the range you mention is high enough for me to need twice my usual correction dose.

I think that might be relevant. I find highs can sometimes take what feels like ridiculous amounts of insulin to correct - it's surprising.

 

[CliveT1]

Check out Henry Slade (England Rugby) blogs/articles...

Adrenalin playing competitive sport has a different effect (I guess due to cortisol, liver dump etc), when compared to a moderate workout in the gym, he has issues with highs when he play.

 

[johnpol]

I have trained all my adult life with weights and on my experience your liver is releasing a lot of glucose to cover the energy expenditure from the muscles during what ever sport you are doing, the body will utilise its stores of glucose from the muscle really quickly, this will cause the huge spikes in your sugars during and post exercise and in some way cause a resistance to any extra insulin that you put in. I go hypo through the night after exercise upto 7hrs after, everybody is different and so is our reactions to very strenuous sport coupled with the stress and adrenalin dump you get from competitive sports the reaction is more exaggerated than "normal" sports. I used to have to take extra injections after finishing my sessions to cover the liver dump but then be prepared for the hypo hours later, as I am on a pump now it gets less frequent. Test your sugars and see the pattern emerging and then see what effects that a short game does compared to a long duration game does, once this pattern has emerged devise a plan to combat it, ie insulin after a long game as opposed to no insulin after a short game, it may be that the effects of the liver dump last longer in you than in others.

sorry I can't be of much help my background is in strength training and I'm massively resistant to insulin and have to do things a bit differently

 

[ert]

I'm watching this thread with great interest. To compete again, I'd have to inject insulin, as I don't have enough and any hard exercise spikes my sugar for days.

I'm always reading articles on blood sugar management for athletes. Have a look at:
Intense Exercise Has Unique Effects on Both Insulin Release and Its Roles in Glucoregulation
Implications for Diabetes (type 1)
http://diabetes.diabetesjournals.org/content/51/suppl_1/S271
Figure 1 looks like what's happening to you, the effect of intense exercise and recovery on blood glucose, rather than just insulin resistance.
In terms of managing this sugar spike, I'm in awe of everyone who has posted advice above.

 

[bulkbiker]

https://imgur.com/a/mL26J1Z

In the past hockey would raise my glucose to around 12 mmol/L. Now even with taking insulin to try and cover the exercise, not only does it not work, I can spike to 14-18 mmol/L AND remain insulin resistant throughout the night with high glucose, and the next day. I'm NEED to get to the bottom of this, Weight training has a similar effect by during weight training my heart rate usually maxes at 150-160 tops. I'm extremely conditioned and have moderate strength.

Why when this form of exercise should actually cause significantly less insulin use afterward and insulin sensitivity.. am I experiencing the total opposite? I am so frustrated. I'm not lazy, I educate myself and apply all the things we should be doing as a T1 and my health has gotten worse.

Just a thought... but are you carbing up before taking part in your sports? I'm guessing that the combo of carbs and high intensity exercise could maybe contribute?

Post edited by moderator.

 

[Freema]

https://imgur.com/a/mL26J1Z

In the past hockey would raise my glucose to around 12 mmol/L. Now even with taking insulin to try and cover the exercise, not only does it not work, I can spike to 14-18 mmol/L AND remain insulin resistant throughout the night with high glucose, and the next day. I'm NEED to get to the bottom of this, Weight training has a similar effect by during weight training my heart rate usually maxes at 150-160 tops. I'm extremely conditioned and have moderate strength.

Why when this form of exercise should actually cause significantly less insulin use afterward and insulin sensitivity.. am I experiencing the total opposite? I am so frustrated. I'm not lazy, I educate myself and apply all the things we should be doing as a T1 and my health has gotten worse.

Maybe your body raises adrenaline very much in sports like hockey ; it is after all a fight-game and with very High raised adrenaline ones liver spits out much more of glucose reserves and maybe also transformes more proteins into blood glucose... the body does this to make sure one has enough energy to survive fights

 

[Diakat]

Can we all remember that the Forum rules state we should respect dietary choices - be that low carb, moderate carb, or indeed no carb, or high carb. Please also recognise that the OP is type 1 so may have more flexibility in dietary options.

 

[Member496333]

Just a thought... but are you carbing up before taking part in your sports? I'm guessing that the combo of carbs and high intensity exercise could maybe contribute?

Post edited by moderator.

I was thinking the same thing.

 

[Brendon.Dean]

So I took all advice into consideration. I finished eating my meal about 3 hours before this weeks game and started the game at 5.6 (didn’t bolus anything) and ended at 8.1 and 40 minutes later was at 7.9. I think the timing is going to be huge but I need to try this a bunch more times to see if I didn’t just get lucky.