Exercise And Blood Glucose Levels
Exercise is good for you. It’s good for the heart, good for losing weight, makes you feel better (really — it releases endorphins that elevate mood), and it’s good for blood glucose — well, sort of. It is good for blood glucose, but it can be tricky at the same time. So today I’m going to talk about how to deal with blood sugar when you’re exercising so that you can minimize the negative effects and enjoy the positive. OK, let’s start with some basics. Aerobic exercise, or cardio, is what we call activity that requires “the pumping of oxygenated blood by the heart,” to be delivered to working muscles. A general rule of thumb is that aerobic exercise is achieved when our heart rate and breathing rate rise in a sustainable way (in order to maintain this pumping of oxygenated blood — the heart rate to circulate the blood, the breathing rate to increase the oxygen intake). Anaerobic exercise occurs when the activity is simply too much for the heart rate and breathing to keep up with, causing you to become out of breath, and it includes activities such as sprinting and weightlifting. Here, we’ll be talking about aerobic activities, such as swimming, running, or dancing. So, what happens with aerobic activity? First, it lowers blood glucose. Why? Because the muscles are working harder and they need energy. The glucose in our blood is energy for our cells. Insulin is the hormone that transfers the glucose from our blood to our cells. So when we Diabetians exercise, we often “go low.” This is because the glucose in our blood is quickly moved into our cells, but the insulin in our blood is still active. Unlike non-Diabetians, the insulin we’ve injected doesn’t go away once the glucose has been moved. It keeps moving glucose out of the blood (and out Continue reading >>
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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 >>
Get In The Zone: My Tips For Avoiding Hypoglycemia During Exercise
Twitter summary: Diagnosing & solving hypoglycemia (lows) & hyperglycemia (highs) during exercise w/ #diabetes. It’s all about personal experimentation. Exercise has been one of four complete gamechangers for managing my type 1 diabetes, but it can frequently be a source of confusion, frustration, exhaustion, and blood sugar unpredictability. I think this is partially why I get so many reader questions on this topic – managing blood sugars during exercise is challenging. Fortunately, it’s not impossible! This article shares what I’ve learned from athletes, healthcare providers, and 14 years of experimenting with blood sugars during exercise. I strongly believe that anyone with diabetes can master exercise, and it all starts with becoming a good driver – maintaining the right speed (100-180 mg/dl) while applying the proper amount of gas and brake (food and insulin) at the right times. The big challenge is that universal driving recommendations aren’t possible, since everyone’s car model (i.e., body), car engine (i.e., diabetes, physiology), and road conditions (type of exercise) are different. The key is not to give up, as it can take a while to climb the learning curve and figure out what works for you. This article offers a toolkit to help you on that path. Part I shares a diagnostic checklist, followed by some potential tactics to avoid lows and highs (Part II). Part III shares what I specifically do, in case it’s useful. I’m a pretty active person (much of my exercise is vigorous) and have figured out what works for me over time, so your adjustments could (and probably will) differ dramatically. You should absolutely talk to your healthcare provider before making any changes to your medications or routine. If you find this article useful, check out Continue reading >>
Why Do I Have Low Blood Sugar After Exercise?
It’s one of the many ironies of insulin-dependent diabetes: Exercise helps manage it by helping our cells become more efficient, but exercise also can cause our blood sugar levels to plunge. What’s with that? To understand this, we must first look at what happens when we make the radical decision to foist ourselves off the couch, violating Newton’s first law of motion, which states that a body at rest will remain at rest. To propel that body into motion takes a tremendous amount of energy, which will first come from stored carbohydrates, and then from our body’s stored fats. If we keep going, as our energy reserves are depleted, our glucose levels diminish as the exercising body dips repeatedly into its energy well. This is true even for people who don’t have diabetes. But for those of us who do, the threat of hypoglycemia (generally defined as blood glucose levels dropping to around 4.0 mmol/L or 80 mg/dL) is something we must take seriously and counter-attack, with vigilant monitoring and planning of pre- and post-exercise snacks. It’s important to note that the effect of exercise on glucose levels depends on what kind of exercise we’re doing. Blood sugar diminishes during moderate-exertion, sustained activities such as running or swimming for an hour or more. Our glucose levels can actually increase during short bursts of strenuous activity, such as weightlifting, tennis, or kickboxing – which is especially problematic for me. The risk of hypoglycemia, however real, is no excuse for any of us to lead a sedentary life. I’m a triathlete who was diagnosed T1 at age 3, and despite the challenges of diabetes, I can out-run, out-cycle and out-swim most people who’ve never had an insulin deficiency in their lives. In fact, having diabetes probably makes Continue reading >>
Low Blood Sugar During Exercise?
Thinkstock Q: I’ve recently started on insulin to help manage my diabetes. Should I be concerned about low blood sugar during exercise? What do you recommend to monitor blood sugar and avoid dips during a workout? A: Managing blood sugar can be very difficult during exercise, especially for someone using medication like insulin to treat diabetes. Exercise naturally lowers blood sugar because sugar behaves as fuel for contracting muscles. Normally, this is a good process and is why exercise may prevent diabetes and obesity. (Diabetes is defined as higher-than-normal sugars in the bloodstream.) However, for people who are taking insulin or oral hypoglycemic medications, exercise can cause too low of blood sugar and lead to symptoms that make exercise very uncomfortable and even dangerous. In fact, the major adverse effect of insulin therapy is hypoglycemia, or low blood sugar. Almost every patient who takes insulin will, indeed, experience hypoglycemia at some point. In my practice, when a patient is started on insulin, he or she is informed of the risk of hypoglycemia and the associated symptoms, which can include nervousness, sweating, shaking, hunger, or even losing consciousness or seizures. The patients are also shown how to prevent and treat hypoglycemia on their own. This may involve eating on schedule, checking blood sugars, or wearing a continuous glucose monitor (CGM). Someone on insulin who is at high risk of hypoglycemia should wear or carry diabetes identification. It’s important to take your medication into account when exercising. During exercise, muscle tissues extract sugar out of the blood and transfer those sugars into muscle cells for use. This sugar-lowering process is a benefit of exercise, and the body has adaptations to prevent sugar levels fro Continue reading >>
Type 1 Diabetes: Avoid Low Blood Sugar During Exercise
People with type 1 diabetes are at greater risk for hypoglycemia, or low blood sugar, when exercising. These tips can help you stay safe. Of course you know exercise is an important part of your type 1 diabetes management plan. And if you’re making an effort to hit the track, the gym or the Zumba floor, kudos are definitely in order! But to get the most carefree enjoyment out of your activity, it’s key to guard against episodes of low blood sugar, also known as hypoglycemia. That’s because during exercise, the body gets energy by drawing blood sugar from the muscles and liver. As blood sugar stores get depleted, potentially dangerous lows can occur. “All human beings need fuel when they exercise,” says Ginger Vieira, a personal trainer and yoga instructor from Burlington, VT, who’s been living with type 1 diabetes since 1999. "But in people with type 1 diabetes, it’s 10 times more complicated because we control the amount of fuel that’s available to our bodies through the insulin we take and the food that we eat." But don’t let that keep you on the couch. Follow these tips for keeping blood sugar on an even keel while you get or stay in shape. Fuel up before a workout. Pick faster-acting carbs like oatmeal, a banana or other fruit, a glass of juice, or sports gels (flavored carbohydrate gels in single-serving packets) for your pre-exercise snack. Stay away from fat-laden treats like ice cream because they take longer to digest. How much should you eat before exercising? "Everyone’s needs are different," says Vieira. She recommends this pre-workout tip: "Eat 10 grams of carbohydrate [the amount in a half-cup of blueberries or five saltine crackers] and don’t take a bolus dose of insulin. See what your blood glucose is halfway through your workout. I Continue reading >>
Low Blood Sugar Symptoms After Exercise
Exercise induced low blood sugar, or hypoglycemia occurs when your body’s blood sugar is used up too quickly. Sugar, or glucose comes from the food that you eat and your body uses it as a source of energy during exercise. When you don’t eat enough food or you participate in vigorous exercise without increasing the amount of food you eat, you can experience the symptoms of hypoglycemia. Severe symptoms can be life-threatening. Video of the Day Your nervous system is extremely sensitive to the effects of low blood sugar. The first neurological effects of hypoglycemia during exercise include confusion, abnormal behavior, fatigue, irritability and trembling, according to Medline Plus. These are signs that your blood sugar is low and that you immediately need to reduce the intensity of your physical activity and eat a food that is high in carbohydrates or drink a sports drink. In addition, you should drink one to two cups of water to make sure you are adequately hydrated. Symptoms of dehydration are commonly confused with the symptoms of hypoglycemia. Continue to monitor these early warning signs and seek medical treatment promptly if they do not improve. More serious neurological symptoms include visual disturbances, seizures, tremor and loss of consciousness. These critical symptoms can be avoided if you take the proper action to increase your blood sugar but they do require immediate medical attention. Low blood sugar after exercise can also have unwanted effects on your gastrointestinal system. Initially you may experience hunger, but as your blood sugar declines you can have nausea, vomiting, malaise and diarrhea. If you begin to experience these symptoms, you should avoid the temptation to “push yourself.” Take the proper precautions to prevent your blood sugar 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 >>
Low Blood Sugar Levels During Exercise: Is Non-diabetic Hypoglycemia Threatening?
Hypoglycemia is the term used for defining low blood sugar levels, and when we’re talking about non-diabetic hypoglycemia, we refer to below normal values of blood sugar that occur in people who aren’t affected by diabetes. The symptoms of hypoglycemia can vary from one person to another, and can be accentuated by certain factors such as the lack of sleep, fasting or dehydration. Triggers of hypoglycemia in non-diabetic people can be very different, but today we’ll only discuss about exercise-induced low blood sugar levels, and we’ll try to understand why this symptom occurs, how threatening it is and how it can be prevented and managed. Exercise can decrease one’s blood sugar levels, but in healthy people the hypoglycemic episode is only temporary. If you constantly experience low blood sugar levels after or during exercise, it may be wise to schedule an appointment with your doctor and get tested for diabetes. Problems with the adrenal and pituitary glands, as well as liver problems, may also trigger hypoglycemic episodes, so it’s important to exclude any potential health issue from the list. Back to exercise-induced hypoglycemia: you probably experienced it several times after strenuous exercise, so the symptoms may sound very familiar. Hypoglycemia manifests through dizziness, headaches, inability to focus, shaking, sweating, blurred vision, irregular heartbeats, and even loss of coordination, anxiety and seizures if you don’t restore the glycogen reservoirs fast after the first symptoms occur. Why do these manifestations appear when exercising? Your body relies on glucose as its main fuel, so this form of sugar is the first one used by the organism for producing energy during exercise. The muscles and brain require glucose to function properly, and gl Continue reading >>
Exercises To Lower Your Blood Sugar
It’s never too late to reap the benefits of exercise, whether you’re 45 or 95. First of all, it simply makes you feel good to move. By becoming more active, you can also lower your blood sugar to keep diabetes under control. “You don’t need to run a marathon to get results,” says Dawn Sherr, RD, of the American Association of Diabetes Educators. “Walking, swimming, and playing with the grandkids are all great ways to get exercise.” Follow these four steps to get started. If you're just starting, ask your doctor which exercise is right for you. Ask if you need to adjust your diabetes medicine before you hit the trail or the pool. Next, think about what you'll enjoy most. You’re more likely to stick with activities you like. Here are a few suggestions: Walk outdoors or indoors on a track or in a mall Take a dance class Bicycle outdoors or ride a stationary bike indoors Swim or try water aerobics Stretch Try yoga or tai chi Play tennis Take aerobics or another fitness class Do housework, yard chores, or gardening Try resistance training with light weights or elastic bands If more than one of these appeals to you, go for them! In fact, combining cardio, like walking or swimming, with stretching or balance moves gives you a better workout. Any way you move will help lower your blood sugar. When you do moderate exercise, like walking, that makes your heart beat a little faster and breathe a little harder. Your muscles use more glucose, the sugar in your blood stream. Over time, this can lower your blood sugar levels. It also makes the insulin in your body work better. You'll get these benefits for hours after your walk or workout. Just remember you don’t have to overdo it. Strenuous exercise can sometimes increase blood sugar temporarily after you stop exerc Continue reading >>
What Is Hypoglycemia?
Hypoglycemia is a dangerous condition in which your blood sugar drops perilously low. Low blood sugar will most often make you feel shaky and weak. In extreme cases, you could lose consciousness and slip into a coma. People develop hypoglycemia for different reasons, but those with diabetes run the greatest risk of developing the condition. Glucose and Hypoglycemia Your body uses glucose as its main fuel source. Glucose is derived from food, and it's delivered to cells through the bloodstream. The body uses different hormones to regulate the amount of glucose in your blood. Glucagon, cortisol, and epinephrine are some hormones that help regulate glucose. Your body uses another hormone called insulin to help your cells absorb glucose and burn it for fuel. If your blood sugar level drops below a certain point, your body can develop various symptoms and sensations. For people with diabetes, this typically happens when blood sugar drops below 70 milligrams per deciliter (mg/dL), although the exact level may vary from person to person. Causes of Hypoglycemia Low blood sugar often happens in people with diabetes who are using insulin or other medicines that increase insulin production or its actions. Too much insulin can make your blood glucose drop too low. Low blood sugar can happen if: Your body's supply of glucose is used up too quickly. Glucose is released into your bloodstream too slowly. There's too much insulin in your bloodstream. Hypoglycemia Symptoms Although no two people will have the exact same symptoms of low blood sugar, there are some common signs to watch out for: Sudden, intense hunger Dizziness or light-headedness Excessive sweating (often sudden and without regard to temperature) Shaking or tremors Sudden feelings of anxiety Irritability, mood swings, and Continue reading >>
How To Treat Exercise-related Hypoglycemia
Did you know, according to diabetes experts, muscles are responsible for about 90 percent of the body’s use of glucose as fuel? Exercise also affects various hormones which have a direct impact on blood sugar levels. It’s not surprising then, that non-diabetic hypoglycemia (or low blood sugar) is common in frequent exercisers and athletes. If you’ve ever worked out on an empty stomach, you’ve probably experienced the dizziness, muscle weakness and exhaustion of a blood-sugar crash. Understanding how your blood-sugar levels are controlled, and what you can do to prevent these crashes, can help you avoid these symptoms. 1. Understand What Hypoglycemia Is And How Blood Sugar Works The sugar called glucose, which is stored in the muscles and liver, is the primary fuel your muscles use during strenuous activities. As part of a careful balancing act, two hormones are released to try to maintain healthy levels of glucose in the blood, where it can be used readily. Insulin is released into the blood by the pancreas when blood sugar levels are too high, where it bonds with specialized receptors on the cells. Insulin stimulates the cells at these receptors and tells them to absorb glucose. Once these cells respond to insulin, blood sugar levels drop. When blood sugar is too low, however, the pancreas releases glucagon instead. This hormone tells the liver to releases some of its stored glucose into the blood so that can be used as fuel. Exercise puts much higher demands on your muscles, forcing them to utilize more fuel — in much the same way as making your car go faster, or pull a heavy load, will increase how much gas it burns. Overtraining can even cause a permanent shift in this balance by increasing insulin sensitivity, which will make it much more difficult for yo Continue reading >>
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 >>
How To Prevent Low Blood Sugar During Cardio Workouts
In my personal experience and in working with many others living with diabetes, prior to activity there may need to be some mental gymnastics to determine the right amount of insulin and carbohydrates necessary to fuel the body but also prevent high or low blood sugars. The questions you need to ask yourself are: Where am I now? Where am I going? When it comes to pre-workout nutrition, you could think of your body as a car. If you are only going to drive around the block, you probably don’t need to fill the gas tank. However, if you were driving out of state, you certainly would need to top off before hitting the road. Planning for the amount of fuel you need is the first step. You will also need to consider the intensity of the activity. You probably know that driving fast burns more fuel. The same is true in the body, diabetic or otherwise. Insulin-dependent diabetics have a more complex system than this. In addition to knowing how much fuel you need, you must also consider the amount of carbohydrates in your body relative to the insulin on board (the insulin remaining in your body since your last bolus including the current basal rate). You must also answer this question: How much carbohydrate do I need to offset the current insulin on board? To answer that question, you will determine five variables: When you had your last bolus How many units it was How many correction units/ boluses were taken The timing of corrections Current basal rate per hour (or total long-acting Lantus or other longer acting insulins). The amount of carbohydrates is the variable a diabetic needs to know in order to perform well. Carbohydrates provide both energy (fuel in the tank) and an offset to insulin on board. Proteins and fats must also be considered, although their contribution to r 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 >>
