Hyperglycemia: When Your Blood Glucose Level Goes Too High
Hyperglycemia means high (hyper) glucose (gly) in the blood (emia). Your body needs glucose to properly function. Your cells rely on glucose for energy. Hyperglycemia is a defining characteristic of diabetes—when the blood glucose level is too high because the body isn't properly using or doesn't make the hormone insulin. You get glucose from the foods you eat. Carbohydrates, such as fruit, milk, potatoes, bread, and rice, are the biggest source of glucose in a typical diet. Your body breaks down carbohydrates into glucose, and then transports the glucose to the cells via the bloodstream. Body Needs Insulin However, in order to use the glucose, your body needs insulin. This is a hormone produced by the pancreas. Insulin helps transport glucose into the cells, particularly the muscle cells. People with type 1 diabetes no longer make insulin to help their bodies use glucose, so they have to take insulin, which is injected under the skin. People with type 2 diabetes may have enough insulin, but their body doesn't use it well; they're insulin resistant. Some people with type 2 diabetes may not produce enough insulin. People with diabetes may become hyperglycemic if they don't keep their blood glucose level under control (by using insulin, medications, and appropriate meal planning). For example, if someone with type 1 diabetes doesn't take enough insulin before eating, the glucose their body makes from that food can build up in their blood and lead to hyperglycemia. Your endocrinologist will tell you what your target blood glucose levels are. Your levels may be different from what is usually considered as normal because of age, pregnancy, and/or other factors. Fasting hyperglycemia is defined as when you don't eat for at least eight hours. Recommended range without diabet Continue reading >>
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The Influence Of Hyperglycemia On The Therapeutic Effect Of Exercise On Glycemic Control In Patients With Type 2 Diabetes Mellitus
Randomized clinical trials show that aerobic exercise training improves glycemic control in patients with type 2 diabetes mellitus (T2DM).1 However, interindividual variability is large.2 This may be explained by genetic variability,3 but ambient hyperglycemia4 and pancreatic β-cell function5 may also contribute. We examined whether changes in glycemic control following a 12- to 16-week aerobic exercise training intervention were influenced by the pretraining glycemic state in 105 individuals with impaired glucose tolerance or T2DM. This study was approved by our institutional review board, and subjects provided informed consent. Before and following a 12- to 16-week period of aerobic exercise training, body composition, aerobic fitness (maximal oxygen uptake [V̇o2max]), and glycemic control (hemoglobin A1c [HbA1c], fasting glucose, and oral glucose tolerance test [OGTT] levels) were determined in a total of 105 older (mean [SEM] age, 61 [1] years), overweight or obese (mean [SEM] body mass index, 33 [1] [calculated as weight in kilograms divided by height in meters squared]) individuals with impaired glucose tolerance (n = 56) or T2DM (n = 49; diagnosed a mean [SEM] 4.8 [0.9] years prior and not insulin treated). Relationships between preintervention variables and intervention-induced changes in variables were assessed by linear and nonlinear regression. See eMethods in the Supplement for full details of the study design. Mean (SEM) change in body weight (−4.6 [0.5] kg), whole-body adiposity (−1.9% [0.3%]), V̇o2max (+0.23 [0.03] L/min), fasting plasma glucose (−0.35 [0.08] mmol/L), and 2-hour OGTT (−0.8 [0.2] mmol/L) (to convert glucose to milligrams per deciliter, divide by 0.0555) were significantly improved following exercise training (full data are given Continue reading >>
Exploring The Variability In Acute Glycemic Responses To Exercise In Type 2 Diabetes
Journal of Diabetes Research Volume 2013 (2013), Article ID 591574, 6 pages 1Faculty of Physical Education & Recreation, University of AB, 1-059 Li Ka Shing Center, Edmonton, AB, Canada T6G 2H9 2Department of Agricultural, Food and Nutritional Science, University of AB, 2-012D Li Ka Shing Center, Health Research Innovation, Edmonton, AB, Canada T6G 2H9 Academic Editor: Francesco Chiarelli Copyright © 2013 Tasuku Terada et al. This is an open access article distributed under the Creative Commons Attribution License, which permits unrestricted use, distribution, and reproduction in any medium, provided the original work is properly cited. Abstract Aim. To explore the factors associated with exercise-induced acute capillary glucose (CapBG) changes in individuals with type 2 diabetes (T2D). Methods. Fifteen individuals with T2D were randomly assigned to energy-matched high intensity interval exercise (HI-IE) and moderate intensity continuous exercise (MI-CE) interventions and performed a designated exercise protocol 5 days per week for 12 weeks. The duration of exercise progressed from 30 to 60 minutes. CapBG was measured immediately before and after each exercise session. Timing of food and antihyperglycemic medication intake prior to exercise was recorded. Results. Overall, the mean CapBG was lowered by 1.9 mmol/L () with the change ranging from −8.9 to +2.7 mmol/L. Preexercise CapBG (44%; ), medication (5%; ), food intake (4%; ), exercise duration (5%; ), and exercise intensity (1%; ) were all associated with CapBG changes, explaining 59% of the variability. Conclusion. The greater reduction in CapBG seen in individuals with higher preexercise CapBG may suggest the importance of exercise in the population with elevated glycemia. Lower blood glucose can be achieved Continue reading >>
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Exercise-induced Non-diabetic Hypoglycemia
If you experience headaches or dizziness when exercising, you may be experiencing hypoglycemia, or low blood sugar levels. Your body converts food into glucose, a type of sugar, and uses it for immediate energy needs or stores it in your muscle and liver cells as glycogen to use between meals or during exercise. Exercise, especially strenuous exercise, can deplete glycogen stores and cause you to experience symptoms of hypoglycemia. Video of the Day When you begin your workout, your body takes glucose in your bloodstream or glycogen in your liver and uses it to propel your muscles. After 15 minutes, you rely on liver glycogen stores. When those are depleted, you turn to fat as an energy source. An unfit person consuming 45 percent of her calories from carbohydrates, stores 100 grams of glycogen in her liver. At a moderate exercise pace, you burn 1 gram of glucose per minute and would theoretically completely diminish your glycogen stores after 1 hour and 45 minutes of exercise. Hypoglycemia's Effect When glycogen stores are depleted, you also experience hypoglycemia. According to the University of Maryland Medical Center, your brain relies on glucose for fuel, so without sufficient amounts, you can experience dizziness, sweating, blurred vision, headache, loss of coordination, anxiety, irritability and heart palpitations. If you don’t get more sugar into your system, it can lead to seizures, coma, permanent brain damage and even death. Eat complex carbohydrates before working out if you are prone to symptoms of low blood sugar. Complex carbohydrates include whole-grain breads, cereals and pastas and vegetables. While exercising for long periods, eat or drink simple carbohydrates, such as sports drinks and pretzels. The University of Maryland Medical Center states that Continue reading >>
Exercise And Blood Sugar Management In Type 2 Diabetes
Staff Member with the Division of Endocrinology University of British Columbia, Vancouver, B.C. This is the second in a two article series on Diabetes and Exercise. This article will discuss type 2 diabetes and how to manage blood sugars during and after exercise. A number of key ideas regarding the fundamentals of fuel metabolism in conjunction with exercise were discussed in the first article in the last issue (Fall Equinox, Vol. 4, No.2 ) and I recommend you review that information since it is relevant to this article. Type 2 diabetes is typically the result of the following breakdowns in glucose regulation : increased insulin resistance in the body tissues decreased insulin output by the pancreas excessive glucose output by the liver. Typically these breakdowns occur gradually over the course of years. It is worth noting that this is different from type 1 diabetes where the primary problem is the almost complete absence of insulin production by the pancreas with the breakdown being immediately apparent as symptoms can be life threatening. The treatment for type 1 diabetes is relatively simple and the choices few; insulin. In some way some type of insulin will be delivered into the body as treatment. It may be a pen, a syringe, a pump or eventually inhaled but the same principal applies; the provision of insulin that the body's pancreas no longer makes. With type 2 diabetes the options are varied and will likely change over time as the disease progresses. Insulin resistance, insulin production and excessive liver glucose production will all change over time and require adjustments in therapy. I emphasize this point since, as you will read later, the nature of the diabetes therapy will determine the degree of risk of low blood sugars and the necessary precautions to t Continue reading >>
Type 1 Diabetes: Exercise Often Raises Blood Glucose In Type 1 Diabetes
Regular physical activity and exercise are recommended for the general population for overall improved health. However, exercise of moderate intensity increases the risk of hypoglycemia during and following exertion in those with type 1 diabetes mellitus (T1DM). Accordingly, exercise guidelines for T1DM focus on prevention of exercise-induced hypoglycemia. The risk of hypoglycemia may discourage some with T1DM from exercising. Children and youth may be embarrassed by the temporary reduction in coordination and physical performance associated with hypoglycemia and by the fear of letting teammates down while playing. Some parents may discourage their children from normal participation in physical activity and from playing competitive sports because of concern about severe hypoglycemia. However, this fear may reduce a child’s physical activity, which may lead to reduced overall health, reduced enjoyment from exercise, and restricted confidence in meeting the demands imposed by living with a chronic health condition like diabetes. As a result, long-term exercise habits as well as personal growth and psycho-social development may be blunted. Concern with hypoglycemia from exercise is probably even more heightened in those with hypoglycemia unawareness, or the absence of symptoms during hypoglycemia. However, some of these concerns might be allayed by the realization that vigorous exercise tends to raise blood sugars rather than lower it. The fact that vigorous exercise tends to raise blood sugar appears to be relatively unknown to many with T1DM. However, the effect has been confirmed in a number of studies. These studies have identified an exercise threshold that elicits this response. The threshold exercise intensity occurs at or above 80% of a person’s maximum exercis Continue reading >>
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Exercise Induced Hyperglycemia: Symptoms & Treatment
In this lesson exercise-induced hyperglycemia will be discussed. The lesson will go over what exercise-induced hyperglycemia is, what symptoms may be present, and how it is diagnosed. Treatment options will also be discussed. What is Exercise-Induced Hyperglycemia? You go out for a run and halfway through you start to feel lightheaded, have blurred vision, and trouble concentrating. There are multiple things that could be wrong, but one likely cause is exercise-induced hyperglycemia. Hyperglycemia is the medical term for high blood sugar. Usually symptoms are not present until the blood sugar reaches over 200mg/dl. A normal blood sugar is usually between 70-99mg/dl. Exercise-induced hyperglycemia is not very common. In fact, it is more common for people to suffer from exercise-induced hypoglycemia (or low blood sugar), since people who participate in long or strenuous exercises can break down too much glycogen, which can cause low blood sugar. On the other hand, exercise-induced hyperglycemia is common in those who have diabetes. If your body does not produce insulin correctly, this can cause glucose to rise, which causes hyperglycemia. Symptoms There are many different symptoms associated with hyperglycemia. For exercise-induced hyperglycemia, it is important to note that these symptoms will take place either during a strenuous workout or directly after finishing a workout or exercise. Any of the symptoms that are present during hyperglycemia can happen for exercise-induced hyperglycemia. Some of the main symptoms that may be felt are: Trouble concentrating Blurred vision Headache Feeling lightheaded Increased thirst If the hyperglycemia is severe, it can lead to coma and even death. Getting a diagnosis If you believe that you are experiencing symptoms of exercise-indu Continue reading >>
Influence Of Exercise Induced Hyperlactatemia On Retinal Blood Flow During Normo- And Hyperglycemia
Purpose. Short term hyperglycemia has previously been shown to induce a blood flow increase in the retina. The mechanism behind this effect is poorly understood. We set out to investigate whether exercise-induced hyperlactatemia may alter the response of retinal blood flow to hyperglycemia. Methods. We performed a randomized, controlled two-way cross over study comprising 12 healthy subjects, performed a 6-minutes period of dynamic exercise during an euglcaemic or hyperglycaemic insulin clamp. Retinal blood flow was assessed by combined vessel size measurement with the Zeiss retinal vessel analyzer and measurement of red blood cell velocities using bi-directional laser Doppler velocimetry. Retinal and systemic hemodynamic parameters were measured before, immediately after and 10 and 20 minutes after isometric exercise. Results. On the euglycemic study day retinal blood flow increased after dynamic exercise. The maximum increase in retinal blood flow was observed 10 minutes after the end of exercise when lactate plasma concentration peaked. Hyperglycemia increased retinal blood flow under basal conditions, but had no incremental effect during exercise induced hyperlactatemia. Conclusions. Our results indicate that both lactate and glucose induce an increase in retinal blood flow in healthy humans. This may indicate a common pathway between glucose and lactate induced blood flow changes in the human retina. Continue reading >>
The Exercise-induced Improvement In Hyperglycemia Is Mediated By Dht Produced In The Skeletal Muscle Of Zucker Diabetic Fatty Rats
1Ritsumeikan University, Kusatsu, Shiga, Japan 2The Jikei University School of Medicine, Tokyo, Japan 3Department of Life Science, Wayo Women’s University, Japan Citation: Sato K, Fujita S, Yamauchi H, Shiroya Y, Kitamura H, et al. (2013) The Exercise-Induced Improvement in Hyperglycemia is Mediated by DHT Produced in the Skeletal Muscle of Zucker Diabetic Fatty Rats. J Diabetes Metab 4:239. doi:10.4172/2155-6156.1000239 Copyright: © 2013 Sato K, et al. This is an open-access article distributed under the terms of the Creative Commons Attribution License, which permits unrestricted use, distribution, and reproduction in any medium, provided the original author and source are credited. Visit for more related articles at Journal of Diabetes & Metabolism Abstract The ability of exercise to improve hyperglycemia by enhancing glucose metabolism in the skeletal muscle of type 2 diabetic patients is well established. We reported sex steroid hormones can be locally synthesized in skeletal muscle and decrease fasting blood glucose levels in obese rats. Here, we determined whether exercise-induced production of sex steroid hormones in skeletal muscle could directly reverse hyperglycemia in the Zucker diabetic fatty rat model using osmotic mini pump. Thirty Zucker diabetic fatty rats were randomly assigned to the following groups: control, exercise, or exercise with continuous infusion of 5α-reductase inhibitor. The results indicated 6 weeks of exercise significantly reduced serum insulin and fasting glucose levels compared to control group. Dehydroepiandrosterone, 5α-dehydrotestosterone, and 5α-reductase levels were all significantly higher in skeletal muscle of the exercise group. Moreover, exercise increased glucose transporter-4 translocation with a concomitant upregulat Continue reading >>
Physical Exercise In Type 1 Diabetes: Recommendations And Care
The management of type 1 diabetes mellitus (T1DM) is based on three pillars: insulin therapy, nutrition, and regular practice of physical activity. Physical exercises are associated with metabolic demands that depend on the individual's energy stores and level of physical conditioning, and vary according to environmental conditions and intensity, duration, and type of exercise. All these factors, added to eventual distress with competitions, exert influence on glucose metabolism. The athletic career of diabetic individuals is often hindered by a risk of hypoglycemia during and after the exercise, frequent hyperglycemia before, during, and after certain physical activities, occurrence of ketoacidosis, and presence of chronic microvascular and macrovascular complications. Aerobic exercises reduce the levels of blood glucose while anaerobic exercise may promote transient hyperglycemia. Although diabetic individuals may achieve excellence in sport, their physical performance should be maximized by strict blood glucose control, adequate modifications in insulin dose on the day of the exercise, and appropriate nutritional intake. This review discusses the impact of physical exercise on glucose metabolism, as well as nutritional considerations and strategies appropriate to the practice of physical exercises by patients with T1DM. Keywords diabetes mellitus, type 1; exercise; physical activity; blood glucose; nutrition therapy Continue reading >>
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Hyperglycemia And Exercise. (glucotoxex)
This study will determine whether exposure to short-term high blood glucose levels impairs exercise-induced adaptations in glucose tolerance, and whether the pattern of high blood glucose levels plays a role. Healthy male volunteers will undergo a screening visit and three experimental trials. Screening Visit: Having read the participant info sheet, a study investigator will discuss the project with the potential participant who will have the chance to ask any questions. Informed consent will be sought and a General Health Questionnaire will be completed. Body weight, height, and skinfold measurements will be taken. Participants will also complete an exercise test to measure V̇O2max test along with heart rate and blood pressure measurements. Individuals eligible for inclusion in the study will then return to the lab for 3 experimental trials, each separated by ~1 week. Trials will be completed using a randomised, counter-balanced, cross-over design. Between experimental trials participants will be instructed to maintain their normal diet and activity habits. During the 48 hours prior to each experimental trial participants will be instructed to refrain from vigorous exercise and alcohol. For 3 days prior to each experimental trial participants will record their dietary intake, and wear an accelerometer and continuous glucose monitoring devices to measure physical activity levels and glucose control. Experimental Trials: Participants will come to the lab between 7 and 9 am following an overnight fast since 10 pm the previous night. Resting heart rate, blood pressure, blood flow, and flow-mediated dilation will be measured and antecubital intravenous lines will be placed. Baseline blood samples will be collected. At T=0, 6, 7, and 9 hours, intravenous glucose tolerance t Continue reading >>
Intense Exercise Has Unique Effects On Both Insulin Release And Its Roles In Glucoregulation
Implications for Diabetes In intense exercise (>80% Vo2max), unlike at lesser intensities, glucose is the exclusive muscle fuel. It must be mobilized from muscle and liver glycogen in both the fed and fasted states. Therefore, regulation of glucose production (GP) and glucose utilization (GU) have to be different from exercise at <60% Vo2max, in which it is established that the portal glucagon-to-insulin ratio causes the less than or equal to twofold increase in GP. GU is subject to complex regulation by insulin, plasma glucose, alternate substrates, other humoral factors, and muscle factors. At lower intensities, plasma glucose is constant during postabsorptive exercise and declines during postprandial exercise (and often in persons with diabetes). During such exercise, insulin secretion is inhibited by β-cell α-adrenergic receptor activation. In contrast, in intense exercise, GP rises seven- to eightfold and GU rises three- to fourfold; therefore, glycemia increases and plasma insulin decreases minimally, if at all. Indeed, even an increase in insulin during α-blockade or during a pancreatic clamp does not prevent this response, nor does pre-exercise hyperinsulinemia due to a prior meal or glucose infusion. At exhaustion, GU initially decreases more than GP, which leads to greater hyperglycemia, requiring a substantial rise in insulin for 40–60 min to restore pre-exercise levels. Absence of this response in type 1 diabetes leads to sustained hyperglycemia, and mimicking it by intravenous infusion restores the normal response. Compelling evidence supports the conclusion that the marked catecholamine responses to intense exercise are responsible for both the GP increment (that occurs even during glucose infusion and postprandially) and the restrained increase of GU Continue reading >>
K417 Diabetes And Exercise Part 1
Types of Diabetes 1) Type 1 diabetes (T1DM) ~no insulin production 2) Type 2 diabetes (T2DM) ~insulin resistance 3) Gestational diabetes (GDM) ~insulin resistance due to pregnancy 4) Pre- Diabetes diabetes and pregnancy: gestational diabetes When you are pregnant, too much glucose is not good for your baby. -Out of every 100 pregnant women in the United States, between three and eight get gestational diabetes. -Gestational diabetes is diabetes that happens for the first time when a woman is pregnant. -Gestational diabetes goes away when you have your baby, but it does increase your risk for having diabetes later. -If you have already have diabetes before you get pregnant, you need to monitor and control your blood sugar levels. -Either type of diabetes during pregnancy raises the risk of problems for the baby and the mother. -To help reduce these risks, you should follow your meal plan, exercise, test your blood sugar and take your medicine. 9 common signs and symptoms -Excessive thirst (polydipsia) -Urinating often (polyuria) -Feeling very hungry (ployphagia) -Fatigue -Losing weight without trying -Sores that heal slowly -Dry, itchy skin -Losing the feeling in your feet or having tingling in your feet -Blurry eyesight neuropathy 60-70% of patients (numbness in limbs) -HR response -Mask ischemic symptoms -Numbness -Orthostatic hypotension -If neuropathy is present, avoid high impact activities -Difficult going from laying/sitting to standing - Orthostatic hypotension -Difficulty gripping weights, equipment -Impaired HR and BP response initial questions for a diabetic 1) How long have you suffered from diabetes? 2) What medications are you taking? -Information about how, what pattern, they take their medicine. -How long have they been taking their current diabetes medica Continue reading >>
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Mechanism Of Exercise-induced Hypoglycemia In Depancreatized Dogs Maintained On Long-acting Insulin.
Human diabetics on intermediate and long-acting insulin occasionaly become hypoglycemic during exercise. We have shown previously that during exercise, hypoglycemia did not occur in depancreatized insulin-infused dogs because the increments in glucose production and utilization were proportional and of the same magnitude as in normal dogs. Therefore, to elucidate the mechanism of the glucose-lowering effect of strenuous exercise, we measured glucose production and utilization, metabolic clearance of glucose, and serum immunoreactive insulin in postabsorptive depancreatized dogs 8 h after a subcutaneous injection of protamine zinc and crystalline insulin. During rest, plasma glucose was stable, but ranged between hypoglycemia and hyperglycemia. Hyperglycemia was associated with overproduction of glucose, indicating insulin deficiency despite normal or elevated serum immunoreactive insulin. Glucose clearance, as in normal dogs, increased threefold but glucose production increased only marginally (50%) and, consequently, glucose decreased in plasma. The decrease of plasma glucose was directly proportional to the preexercise concentration and production of glucose. The magnitude of inhibition glucose production was not correlated with the serum immunoreactive insulin indicating either that some released insluin was not active or that a moderate immunoreactive insulin increment induced a near-maximal inhibition. It is concluded that in depancreatized dogs injected with protamine zinc insulin, exercise accelerates mobilization of insulin from its injection site presumably because of increased blood and lymph flow. Glucose utilization did not exceed that in normal dogs, but hepatic glucose production failed to increase sufficiently to meet the needs of muscle in exercise. Clic Continue reading >>
Exercise In People With Type 1 Diabetes
Exercise is recommended for everyone with diabetes. In people with type 1 diabetes exercise provides many benefits—improved cardiovascular health, a psychological lift, stronger bones, stronger muscles and more restful sleep. It evens aids in weight loss and improved insulin sensitivity. In fact, there have been studies that demonstrate that people with type 1 who exercise have lower mortality rates. But one thing it hasn’t been proven to do is decrease A1C levels. When people with type 2 diabetes engaged in regular exercise, their A1C levels drop. The research looking at exercise benefits in terms of glucose control for people with type 1 isn’t as sanguine. The reason there isn’t always a positive impact on A1C has to do with the ever present risk of hypoglycemia and hyperglycemia whenever a person with type 1 diabetes exercises. Both exercise-related hypo- and hyperglycemia occur in people with type 1 diabetes because the physiology of exercise works a bit differently. When we exercise we need more glucose to fuel our muscles. So in people without diabetes, glucagon is activated and causes the liver and muscles to breakdown glycogen in a process called glycogenolysis . At the same time, the liver starts to replenish its glucose stores from amino acid backbones through gluconeogenesis, so it can have backup glucose for extended periods of activity. Concurrently the level of insulin declines, weighing the hormonal milieu away from energy storage to energy generation. In people with type 1 diabetes, insulin levels, injected exogenously, don’t decline. This blunts glucogenolysis and continues to enhance glucose uptake by the muscles. While the muscles need glucose, too-rapid consumption depletes the glucose in the blood stream. If production of glucose by the li Continue reading >>
