Physical Activity & Blood Glucose
SHARE RATE★★★★★ Because diabetes a disorder that affects the way your body processes glucose, when you engage in physical activity you need to be especially aware of changes in blood glucose levels as your body burns extra glucose for energy. This can help you avoid problems like low blood glucose (hypoglycemia). Being aware of changes in blood glucose during physical activity is especially important if you take certain diabetes medications that increase risk for hypoglycemia, including insulin or diabetes medications that cause insulin secretion (called secretagogues), including sulfonylureas (glimepiride) and glinides (repaglinide and nateglinide).1 Should I avoid physical activity if my blood glucose is very high In general, if your blood glucose is very high (250 mg/dL) and you take insulin, you should avoid vigorous physical activity. However, if your blood glucose is mildly elevated and you feel well, you may exercise safely. Remember, make sure to drink water so that you are adequately hydrated before, during, and after any physical activity. Dehydration can affect your blood glucose.2 How should I monitor blood glucose during exercise? Even if you do not use insulin or a diabetes medications called secretagogues that increase secretion of insulin (this includes sulfonylureas [glimepiride] or glinides [repaglinide and nateglinide]) to control your diabetes, you may still want to use a blood glucose monitor to find out how your exercise routine affects your blood glucose level. Physical activities of long duration and low intensity typically cause blood glucose to decrease, but not to a problematic level. Try monitoring before, during, and after training several times so that you understand and anticipate exercise-related changes in blood glucose. Althou Continue reading >>
Exercising Safely With Diabetes
Regular and safe physical activity is especially important for people with diabetes. Blood Sugar and Exercise The most common concern people have about exercise and diabetes is how to keep their blood sugar levels from getting too high or too low. Here are some general guidelines to follow: Exercise at the same time every day, if possible. This will help you find out how exercise affects your blood sugar. Check your blood sugar before exercising. If your blood sugar is less than 100 before you start to exercise, eat a carbohydrate snack. If your blood sugar is 250 or higher, don't start exercising until your blood sugar level is under 250. Exercise with a friend who knows that you have diabetes and knows how to help if your blood sugar gets too low. Make sure you have ID with you that lets people know you have diabetes. If you're sick or have an infection, don't exercise until you're feeling better. Being sick affects your blood sugar. Taking insulin or diabetes pills to lower blood sugar Blood sugar can go too low (hypoglycemia) during exercise if you take too much insulin, the insulin is absorbed too quickly, or the insulin peaks during exercise. It can also happen if you take insulin or pills and don't eat enough carbohydrate. Here are some things you can do: If your blood sugar is less than 100 before you exercise, eat at least 30 grams of carbohydrate before you begin. This will help keep your blood sugar level from dropping too low during exercise. Bring a carbohydrate snack with you whenever you exercise in case your blood sugar level drops too low during or right after you exercise. If your exercise will last for more than an hour, check your blood sugar after each hour of exercise. If your blood sugar is 100 or less, you should eat a carbohydrate snack. Check y Continue reading >>
Diabetes And Exercise: When To Monitor Your Blood Sugar
Exercise is an important part of any diabetes treatment plan. To avoid potential problems, check your blood sugar before, during and after exercise. Diabetes and exercise go hand in hand, at least when it comes to managing your diabetes. Exercise can help you improve your blood sugar control, boost your overall fitness, and reduce your risk of heart disease and stroke. But diabetes and exercise pose unique challenges, too. To exercise safely, it's crucial to track your blood sugar before, during and after physical activity. You'll learn how your body responds to exercise, which can help you prevent potentially dangerous blood sugar fluctuations. Before exercise: Check your blood sugar before your workout Before jumping into a fitness program, get your doctor's OK to exercise — especially if you've been inactive. Talk to your doctor about any activities you're contemplating, the best time to exercise and the potential impact of medications on your blood sugar as you become more active. For the best health benefits, experts recommend at least 150 minutes a week of moderately intense physical activities such as: Fast walking Lap swimming Bicycling If you're taking insulin or medications that can cause low blood sugar (hypoglycemia), test your blood sugar 30 minutes before exercising. Consider these general guidelines relative to your blood sugar level — measured in milligrams per deciliter (mg/dL) or millimoles per liter (mmol/L). Lower than 100 mg/dL (5.6 mmol/L). Your blood sugar may be too low to exercise safely. Eat a small snack containing 15 to 30 grams of carbohydrates, such as fruit juice, fruit, crackers or even glucose tablets before you begin your workout. 100 to 250 mg/dL (5.6 to 13.9 mmol/L). You're good to go. For most people, this is a safe pre-exercise Continue reading >>
Blood Glucose Responses To Type, Intensity, Duration, And Timing Of Exercise
The Big Blue Test (BBT) is an annual initiative by the Diabetes Hands Foundation to raise awareness of the importance of physical activity in managing diabetes. Individuals with diabetes voluntarily exercise and record self-monitored blood glucose levels. During the 2012 BBT, 5,157 diabetic participants (∼90% insulin users) anonymously entered exercise type, intensity, duration, time elapsed since last meal, and blood glucose readings before and after one or more bouts of exercise separately through www.BigBlueTest.org or an iPhone app. Based on a prior BBT (1), exercise choices were walking, running/jogging, cycling, conditioning machines, dancing, and other exercise (nonspecified). Intensity was moderate or vigorous. Duration was ≤10, 11–19, 20–29, or ≥30 min. The timing of exercise after the last meal was 30 min and 1, 2, or ≥3 h ago. Data were reported as mean ± SD. Walking was reported most frequently (48.5%), followed by other exercise (18.7%), running/jogging (11.9%), cycling (8.8%), conditioning machines (6.4%), and dancing (5.7%). Overall, mean blood glucose levels were lower (−31.3 ± 47.1 mg/dL, 16.8%) after exercise, although only 75.8% decreased, 8.8% were unchanged, and 15.4% increased. Walking resulted in the smallest decrease (−25.0 ± 42.4 mg/dL) compared with nonspecified exercise (−33.5 ± 50.0 mg/dL), running/jogging (−40.1 ± 55.1 mg/dL), cycling (−42.4 ± 48.8 mg/dL), conditioning machines (−35.9 ± 48.8 mg/dL), and dancing (−37.4 ± 45.3 mg/dL, P < 0.05). Moderate exercise resulted in a mean decrease of −32.7 ± 44.1 mg/dL, whereas blood glucose only decreased −28.0 ± 53.6 mg/dL after vigorous activity of all durations (P < 0.05). Longer exercise duration generally resulted in increasingly greater decreases in blood Continue reading >>
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Why Is My Blood Glucose Sometimes Low After Physical Activity?
Low blood glucose is defined as a blood glucose level below 70 mg/dl if your meter measures whole blood, or 80 mg/dl or below if it measures plasma glucose (a plasma blood glucose of 90 mg/dl or below with symptoms is also a sign of hypoglycemia). One of the most common causes of low blood glucose is too much physical activity. In fact, moderate to intense exercise may cause your blood glucose to drop for the next 24 hours following exercise. This post-exercise hypoglycemia is often referred to as the "lag effect" of exercise. Basically, when you exercise, the body uses two sources of fuel, sugar and free fatty acids (that is, fat) to generate energy. The sugar comes from the blood, the liver and the muscles. The sugar is stored in the liver and muscle in a form called glycogen. During the first 15 minutes of exercise, most of the sugar for fuel comes from either the blood stream or the muscle glycogen, which is converted back to sugar. After 15 minutes of exercise, however, the fuel starts to come more from the glycogen stored in the liver. After 30 minutes of exercise, the body begins to get more of its energy from the free fatty acids. As a result, exercise can deplete sugar levels and glycogen stores. The body will replace these glycogen stores but this process may take 4 to 6 hours, even 12 to 24 hours with more intense activity. During this rebuilding of glycogen stores, a person with diabetes can be at higher risk for hypoglycemia. Here are tips for safe exercising. Guidelines for preventing exercise related hypoglycemia Check your blood glucose before exercising to make sure your blood glucose is sufficient and/or consume an appropriate snack. Avoid exercise at the peak of your insulin action. Avoid late evening exercise. Exercise should be completed 2 hours bef Continue reading >>
The Ultimate Guide To Biohacking Your Blood Sugar Levels (and Why Sugar Sometimes Isn’t Bad).
If you enjoy the post you’re about to read, you may want to check out the free Diabetes Summit from April 18-25, 2016, in which 30+ experts (including me) share the best tips, strategies and secrets for controlling and reversing blood sugar issues, type 2 diabetes, pre-diabetes and metabolic syndrome… In one of my Quick & Dirty Tips articles last week, I mentioned that one “hack” I use to avoid experiencing big spikes in blood sugar from a big meal is to do some basic strength training with a dumbbell prior to eating that meal, which, as I explain in that article, activates specific sugar transporters responsible for taking up carbohydrate into muscle tissue, rather than partitioning those sugars into storage fat. Since my own personal genetic testing has revealed that I have a higher than normal risk for Type 2 diabetes (there are specific genetic variations associated with diabetes that you can check out here), hacking blood sugar levels to get them lower is a topic near and dear to my heart. This should also be a very important topic for you to educate yourself on, since not only are there are specific genetic variations associated with diabetes that you can check out here), hacking blood sugar levels to get them lower is a topic near and dear to my heart. This should also be a very important topic for you to educate yourself on, since not only are Type 2 diabetes rates rising, both in the United States and globally (even among athletes and so-called “healthy” people), but so are a host of other chronic disease, neural degradation and weight issues directly related to high blood sugar. Characterized by insulin resistance and chronic high blood sugar levels (hyperglycemia), type 2 diabetes can lead to both brain and metabolic dysfunction, and is also a sig Continue reading >>
Blood Sugar Control — During And After Exercise
WRITTEN BY: Christel Oerum Medical disclaimer: No adjustments to care should be done without consulting your medical team. If you are new to exercise, haven’t exercised in a while and/or haven’t seen your medical team in the last 3 months, it is advised to do so before engaging in any kind of physical activities. Exercising with diabetes can be tricky because you never know exactly how your blood sugar will react. However, there are some general rules that apply to all of us and when you know those rules, it becomes easier to recognize patterns, find your personal “formula” for food and insulin, and exercise with fewer blood sugar headaches. In this article, I’ll walk you through three different types of exercise, and what you usually can expect from a blood sugar perspective. I also suggest strategies for managing your blood sugar during and after each type of exercise. Types of exercise Steady-state cardio Interval training Resistance training Blood sugar management during and after steady state cardio The general rule for steady-state cardio (where your heart rate stays moderately elevated for the duration of your workout) is that it will make your blood sugar decrease if you have any insulin on board (IOB). Some people don’t start to see the effect until 20 minutes into a workout, and some will only see the effect during specific types of workouts. What happens during steady-state cardio is that you increase the body’s use of blood glucose. So, if you have high levels of IOB during your cardio session, the muscles will take up more blood glucose and the risk of low blood sugar increases. This risk is not only increased during the cardio session, but also up to 48 hours after you’re done. Strategies for preventing low blood sugar during and after stea Continue reading >>
High Blood Sugar After Exercise?
back to Overview Markus, one of our great German-language authors, wrote about struggling with high blood sugar after exercise. I know it's a common problem, and one I've struggled with personally, so I want to make sure you get to see it, too. From Markus Berndt: It’s one of the first recommendations you get after being diagnosed with diabetes. “Get active, do more exercise, it’s good for you!” And since we’ve been a child we’ve heard that exercise is healthy. If we do it consistently we’re rewarded, literally, with an awesome beach body. Adding exercise into our day is also good for our diabetes. We’re taught that exercise lowers blood sugar, right? But can the opposite also be true? Can you have high blood sugar after exercise? Up close We now know that physical activity usually lowers blood sugar because it reduces how much insulin is needed to move sugar into the cells. While, in the past, most experts advised frequent training intervals at moderate intensity, but recent studies have shown that even short, intense workouts are very effective. For example, a 15-minute intense weight training lowered blood sugar even more than what’s seen in some endurance training. So activity lowers blood sugar – but not always! Personally, I experienced this very early on and was extremely irritated! I just learned that exercise lowers blood sugar, but an intense 45-minute run consistently resulted in higher blood sugars than when I started! What in the world? At first, I was confused and felt like I didn’t understand the world anymore. Then it was more of a “would you look at this?” kind of thing. And finally, I was determined to figure out what was happening. I knew there had to be an explanation. Why does exercise sometimes raise blood sugar? Exercise Continue reading >>
How To Best Manage And Prevent Exercise Low Blood Sugars
If you take insulin or another blood glucose-lowering medication, you are at risk for low blood sugar (usually defined as blood glucose < 65 mg/dl), or hypoglycemia, which can occur during or following physical activity. Low blood sugar can cause trembling, sweating, dizziness, blurred vision, impaired thinking, and even seizures and loss of consciousness. Exercise presents its own special challenges for managing blood sugar. Since any activity increases your body’s use of blood sugar, hypoglycemia can develop more easily. The more you understand about what makes your blood sugars go down (or sometimes up) during exercise, the easier it becomes to control and the more confident you can be about doing activities and staying in control of your diabetes. Much of your blood sugar response has to do with how much insulin is in your bloodstream. If your insulin levels are high during a physical activity, your muscles will take up more blood glucose (since muscle contractions themselves stimulate glucose uptake without insulin) and you’re more likely to end up with low blood sugars. You can even end up with late-onset hypoglycemia, which can occur from right after to up to 48 hours after you exercise. What’s important is to do your best to prevent lows before, during and after exercise by taking the steps listed below. Prevent Lows Before, During and After Exercise Learn how your body responds to exercise by checking your blood sugar levels before, (occasionally) during, and after exercise. If your blood sugar is near or below 70 mg/dl before you exercise, bring it back within normal range before you begin by consuming some carbohydrates. Always be prepared to correct a low by carrying a rapid-acting carbohydrate with you during exercise. Don’t assume you’ll be able Continue reading >>
High Blood Sugar Mystery Post-exercise
I've been eating paleo for about two years (before I knew it had a name!). Recently I started testing blood glucose levels (I'm not diabetic). Fasting levels are generally in the "normal" range (about 85 mg/dL). One hour post-eating, levels are about 100 to 110. I decided to experiment by taking a reading after playing an indoor soccer game. Note that I play goalie, so my activity does not include running. More short bursts of motion. I imagine high cortisol levels (much like a prey item being hunted, which is why I like it, oddly...). Anyway, my level was 167 post-game. Almost diabetic levels! This on a day when I'd been intermittent-fasting (I always fast on game days). I thought the meter might be the suspect (actually Dr. Kurt Harris suggested this, I kind of wondered why there would only be one outlier, in all my tests). So I re-tested after another game. The result? 181 mg/dL! So it appears my liver is dumping large amounts of sugar into my blood, possibly as part of a "fight or flight" norepinephrine or cortisol-mediated response. Is this normal? Continue reading >>
Why Do Blood Glucose Levels Sometimes Go Up After Physical Activity?
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. Here are some tips to safely exercise: Consult your doctor before starting an exercise program. If you are over the age of 35 you may need a stress test. Pick an exercise that you enjoy. Check your blood sugar before and after exercise. Do not exercise if your blood sugar is over 250 mg/dl and you have ketones. If your blood sugar is over 250 but no ketones are present, follow these guidelines: Type 1: If blood sugars are 300 or more, test within 5-10 minutes of begining exercise. If your blood sugar is dropping, you may continue. If it is not dropping, stop exercising. Type 2: Do Not exercise if blood sugars are 400 or more Plan exercise to prevent low blood sugar reactions. Exercise 1 to 1 ½ hours after eating. Always carry a carbohydrate snack (juice, glucose tablets, etc.) with you. Drink plenty of fluids. Wear shoes and equipment that fit well. Find more information about physical activity and diabetes in Staying Healthy with Diabetes – Physical Activity & Fitness available from the Joslin Online Store. Continue reading >>
10 Reasons Why Your Blood Glucose Is Going High During Exercise
High blood sugar is one of the biggest hurdles to improving health, getting in shape and performing well. In this article, I discuss 10 of the biggest reasons why blood glucose levels tend to go high in people living with diabetes during exercise. Please bear in mind that Type 1 and 2 diabetes are different and need to be managed differently. Key factors include; the type of medication, physical activity levels, training volume, muscle mass, other illnesses and susceptibility to life stress. You simply don’t have enough insulin in your bloodstream to facilitate the transport of glucose into target tissues. As a result, your blood glucose levels remain high, increasing the risk of ketoacidosis which exacerbates hyperglycemia. This may be due to missing a dose, eating too many carbs or uncontrolled glucose production from your liver during times of stress. Fix. Administer appropriate amounts of insulin or other diabetic medication specific to your abnormal blood glucose level. Only do this under the close guidance and monitoring of a professional health care team. 2. Prolonged Pump disconnect. Similar to above. Lack of insulin in the blood stream means only one thing for the individual deficient in insulin. High blood glucose. Fix. Ensure you pump is well connected at all time, especially if you’ve spent the day doing manual labor. Be mindful that wearing an exercise belt, for powerlifting and bodybuilding purposes can lead to pump discomfort and disconnect during training, consequently leading to high blood glucose. 3. Malfunctioning needles. If your needle fails to work, you won’t be able to administer insulin accurately, or even at all. Fix. Test needle function by squirting out a few units of insulin. If it’s jammed. Replace it immediately. Always carry spares Continue reading >>
Ketones And Exercise – What You Need To Know
A researcher on diabetes and exercise describes why exercise elevates risk of DKA for people with Type 1 diabetes. In a new set of guidelines for Type 1 diabetes and exercise, I and my fellow researchers warn that people with Type 1 diabetes need to monitor for elevated levels of ketones during exercise. If you have Type 1 and exercise regularly, testing for ketones could save your life. Ketones develop in our bodies when we mobilize fat as fuel. Fat is an important energy source that is used by the body at rest and during exercise. Ketones are a general term in medicine used to describe the three main ketone bodies that the liver produces – acetoacetate, beta-hydroxybutyrate, and acetone. Read “Too Many with Type 1 Don’t Test for Ketones.” sponsor Ketone bodies help fuel the brain and skeletal muscle during times of prolonged fasting or starvation, so in a way ketones are very important for survival. We actually have enough stored fat to generate energy for days, but this can cause a number of metabolic problems, the most important of which is ketoacidosis. In Type 1 diabetes, ketone levels can rise even without starvation, if insulin levels drop too much and levels of other hormones like glucagon and catecholamines rise. This rise in ketone levels in diabetes can cause a life-threatening condition called diabetic ketoacidosis (DKA). Read “How DKA Happens and What to Do About it.” The symptoms of ketoacidosis include: A lack of energy, weakness, and fatigue Nausea and vomiting, stomach pain, decreased appetite Rapid weight loss Decreased perspiration, foul or fruity breath Altered consciousness, mild disorientation or confusion Coma sponsor The reasons for developing high ketone levels in Type 1 diabetes include: Missed insulin injections Failure of insulin Continue reading >>
Why Some Types Of Exercise Can Make Your Blood Sugar Increase
Have you ever wondered why your blood sugar falls during certain types of exercise whilst roaring to sky-high levels during and after other types of exercise? If you’re curious about the scientific explanation of the relationship between exercise and blood sugar, read on. I rarely come across scientific studies that explore how exercise affects blood sugar in people living with Type 1 diabetes, so when I recently got my hands on just such a research paper, I dug in with great interest (they specified Type 1 diabetes, but I would think that the results are applicable to anybody using insulin). Well actually, Google and I dug in. This research paper is heavy reading. You know those scientific papers where you feel like you need an advanced degree (plus a whole lot of Googling) just to understand the introduction? This is one of them. The paper is titled “Effect of intermittent high-intensity compared with continuous moderate exercise on glucose production and utilization in individuals with type 1 diabetes”, and is written by a team of scientists from Australia. It was published in the American Journal of Physiology – Endocrinology and Metabolism in 2007 (not exactly new research, but peer reviewed research nonetheless, which means it’s legit). Anyway, I thought that the subject was relevant and interesting enough to spend the time reading and understanding it. So, since I’ve done the heavy reading, let me share what I’ve learned with you. Exercise and blood sugar impact So why do some types of exercise make our blood sugar drop like crazy while others hardly have any impact? I know from my own experience that I really have to watch my blood sugars if I do steady state cardio, while an interval training session will have little impact or even make my blood s Continue reading >>
Exercise Causes Blood Sugar To Go Down—most Of The Time
You can think of exercise as a great blood-sugar-lowering drug.(HEALTH/ISTOCKPHOTO) Exercise causes blood sugar to go downexcept when it doesn't. In some cases, blood sugar can temporarily increase with exercise. Maddening? Yes. Like so many aspects of type 2 diabetes, your body's response to exercise can be highly individual. The time of day you exercise may affect blood sugar Blake Holden, of Brooklyn, N.Y., finds his blood sugar can vary depending on the time of day he is exercising. "When I exercise in the morning, go for a run, my blood sugar spikes big time. I'm not sure why that happens. But in the evening, it doesn't; it drops." That's why it's crucial to monitor your glucose levels before and after your workout (after getting clearance from your doctor). Ideally, you should check your blood sugar each time you exercise, says Ann Albright, PhD, director of the Division of Diabetes Translation at the Centers for Disease Control and Prevention in Atlanta. But, if that proves to be a huge barrier that keeps you from exercising, then it's probably OK to do it a few times when you first start or restart your exercise routine until you get a feel for how your blood sugar reacts to exercise, Albright says. Consistency is crucial Choose a regular exercise routine and stick to it as often as possible. This can result in consistently lower blood sugar (exercise can cause a drop in blood sugar for up to 12 to 24 hours). "It is really important to have a consistent exercise plan that you can do five days a week," says Virginia Valentine, a certified diabetes educator at the Diabetes Network, Inc., in Albuquerque, N.M. "If a person is a couch potato all week and tries to jump into a significant activity for a few hours on the weekend, it could cause blood glucose that is too Continue reading >>