[Andreas Gregoriou]

Hello everyone. I have just signed in to this forum. I'll give small introduction of myself and my history and then I hope you can help me out with a problem I have.
I haver had diabetes for the last 20 years (since I was 4 years old). In the past I didn't pay as much attention to my health (having usually high sugar levels and eating various kinds of food). The main problem I had was my morning reading were alaways high (250's-300's).
Last year I visited a doctor and we managed to balance out my health. I now have a diet I follow, using less insulin (form 98 daily went down to 50), lost weight and feeling much better in general. This diet though uses some food supplement pills (don't know how important this is. I stopped this diet for a period of time and started again a couple of months ago. I lost around 6kg so far and I decided to join a gym.
Now the problem starts here!
Ever since I joined the gym, i check my self more frequently than before in order to avoid any mishaps in the gym. The problem is that before the gym my sugar levels are within the appropriate range but when I leave the gym my sugar level rise! Some numbers are 98 before gym, 270 after. 110 before, 311 after. 82 before, 282 after.So now you can see that the rise is quite high.
I spoke with the trainers there and they have no idea how to tackle this. The doctor has no idea how or why this is happening. If I use more insulin during lunch then it's too much to balance out with the food I eat. I don't eat or drink anything but water before during and after gym and I don't even push myself so hard during the gym.
I have run out of ideas on how to tackle the matter. Everything was great before gym (average of 120-150 daily sugar levels) and after I started excercising the exact opposite happens of what SHOULD happen.
Has anybody had any similar experiences? Heard anything like this before? Know any ways to stop this? I keep surprising my doctor all the time but this was a big hit for him and for me.

Thank you

 

[diabetes86]

How hard do you exercise at the gym?

Hard exercise does make BG go up. Your liver dumps sugar so you can get away from the tiger chasing you (fight or flight)

Less strenuous exercise may help.

 

[Adjitater]

your liver will only dump glucose if you don't have enough on board. Take a sportd drink with you and take small sips of it as you exercise it will keep you more stable. worked for me when I was on MDI

 

[Andreas Gregoriou]

Hello guys. I excercise to about a 70% of my abilities. (still new at that). I'll give both oppinions a try and let you know

 

[scneilson]

I am type 2, 62 years and walk about 3 miles a day or 2 on a treadmill at highest elevation. If I am under 100 BS when I start, I eat half a banana an hour before exercise to avoid liver dumps. I consider under 70 a low BS.

 

[Dr. Steve]

Hello everyone. I have just signed in to this forum. I'll give small introduction of myself and my history and then I hope you can help me out with a problem I have.
I haver had diabetes for the last 20 years (since I was 4 years old). In the past I didn't pay as much attention to my health (having usually high sugar levels and eating various kinds of food). The main problem I had was my morning reading were alaways high (250's-300's).
Last year I visited a doctor and we managed to balance out my health. I now have a diet I follow, using less insulin (form 98 daily went down to 50), lost weight and feeling much better in general. This diet though uses some food supplement pills (don't know how important this is. I stopped this diet for a period of time and started again a couple of months ago. I lost around 6kg so far and I decided to join a gym.
Now the problem starts here!
Ever since I joined the gym, i check my self more frequently than before in order to avoid any mishaps in the gym. The problem is that before the gym my sugar levels are within the appropriate range but when I leave the gym my sugar level rise! Some numbers are 98 before gym, 270 after. 110 before, 311 after. 82 before, 282 after.So now you can see that the rise is quite high.
I spoke with the trainers there and they have no idea how to tackle this. The doctor has no idea how or why this is happening. If I use more insulin during lunch then it's too much to balance out with the food I eat. I don't eat or drink anything but water before during and after gym and I don't even push myself so hard during the gym.
I have run out of ideas on how to tackle the matter. Everything was great before gym (average of 120-150 daily sugar levels) and after I started excercising the exact opposite happens of what SHOULD happen.
Has anybody had any similar experiences? Heard anything like this before? Know any ways to stop this? I keep surprising my doctor all the time but this was a big hit for him and for me.

Thank you

This raises thread raises an important (and what seems like a surprisingly common) phenomenon. The replies have already been great in shedding light on the subject. I’ll try to give a short explanation explaining likely underlying mechanisms.

The islets of the pancreas have Alpha cells that produce Glucagon, and Beta cells that produce Insulin (... as well as other cell types that aren’t central to this explanation (Delta and F cells.))

Ideally when blood glucose levels are high Insulin (as you would know) should be released to tell certain types of cells around your body to uptake glucose out of the blood stream (glucose then converted and stored in muscles and liver as glycogen).

When blood glucose levels are low, Glucagon is released to tell your body to convert the glycogen back to glucose and release it back into the blood stream (thus increasing your blood glucose levels).

In an individual without diabetes these two processes work in a balancing act to keep blood glucose within optimal ranges. It sounds like you have been diagnosed with Type 1 diabetes for some time. Your beta cells are likely to have been destroyed (due to your immune system or other factors) but the same may not be true for you alpha cells. Hence if your blood glucose becomes low (as you exercise, particularly if you’re working hard) your body may be releasing a bucket load of Glucagon causing an increase in your blood glucose levels to those high levels you observed.

Some types of exercise can also stimulate the release of human growth hormone (GH). GH can also result in more conversion of glycogen in the liver to glucose. GH can also lead to increased break down of stored fats into fatty acids in the blood which are in turn used as an alternate source of fuel to glucose by some tissue (so more glucose in blood going into the blood, but less being burned up by some tissues that are using fatty acids instead). GH also plays a number of other roles as I’m sure you are aware.

I know this whole process can sound complicated and a little confusing. But there are some great suggestions around for how to keep the glucose high enough that it doesn’t trigger a ‘dumping of glucose’ as many rightly describe it... without elevating your glucose to inappropriate levels. It’s great that you are keen to exercise while making sure your glucose levels are appropriate. With a bit of practice and monitoring I’m sure you’ll find a routine that suits your body!

If in doubt an exercise physiologist specialising in diabetes may be able to help you with specific advice.

 

[Dr. Steve]

Sorry that last post was seriously lacking gramma... I shouldn't post long replies without reading them a second time! Feel free to PM me if anyone wants clarification.

 

[goo_stewart]

Dr Steve, that is a great explanation of what occurs, but I have some more questions about diabetes and exercise. Firstly, is it a good idea to carb load, let's say an hour before exercise so the meter reading is 180 BG? I only ask because some folks say that I shouldn't be spiking that much, so is the carb loading a good idea? I exercise a reasonable amount (run 5km, cycle and sometimes, if the whim takes me, even go on the rowing machine) and am just about to come off my meds. So, the big question is, should I be carb loading (as I have been doing since I was diagnosed with type 2 6 months ago), or should I just act like I did before I was diagnosed with diabetes?

My second question is about exercise and diabetes in general. Why does exercise help me - I am not overweight, I am reasonably fit and always have been. I can understand the process of exercise being helpful to anyone who may be overweight, but why me? I know it is just a generally good thing to exercise, but is there any specific 'goodness' with exercise and regulation of BG levels? I am a bit ignorant of the biology here, so apologies.

Anyway, thanks for your previous explanation, much appreciated. I also can't read your wordpress link here as it is blocked at work.

 

[Dr. Steve]

Thanks for your reply and questions goo_stewart. Sorry for the delay. I’ve been swamped at work

Although it would be inappropriate to give you prescriptive advice in a forum such as this (for a number of reasons), here are some of my general thoughts on these issues which I hope are helpful to you and others.

First, in regard to ‘carb loading’ in the sense that you described it, many people doing moderate-high intensity exercise for an extended period (20-30mins + ) do consume extra carbs before exercising. Depending on the person and various factors at play this may help stabilise BG levels during and after exercise. I think one of the important lessons to remember is the importance of monitoring often (before, during and after), particularly until you get used to the way your body responds to your preparation and the exercise you undertake. This is particularly important when there are changes in your exercise program or your meds are changing (or stopping).

You could try a few different things (or a combination of things) and see which best suits your body (few sips sports drink during exercise, eating a few extra carbs, consume a small carb/protein mix etc.). You are probably also already aware that not all carbs are equal in terms of their immediate effect on you BG levels (fast acting versus slow acting).

Your second question is another good one. I know we (as a society) often think that exercise is primarily to lose / maintain weight. While exercise can contribute to this end, there are significant other health benefits from exercise for everyone, especially for people with diabetes.

In no particular order (from the top of my head) exercise can: reduce insulin resistance, improve circulation, decrease hypertension (high blood pressure), decrease bad cholesterol and increase good cholesterol, reduce the risk of diabetes related complications, increase muscle mass (which aside from making you stronger will also increase the amount of glucose you burn at rest), reduce depression, increase quality of life / well being and strengthen your heart. I’m sure there are probably other benefits that have slipped my mind, but you get the idea. People with diabetes have a considerably higher risk of various other conditions (like heart disease etc.). Exercise can help minimise the chance of suffering one of these other potentially life threatening and debilitating conditions such as a heart attack, stroke or leg amputation. When you are otherwise pretty fit and well these terrible conditions aren’t usually on your mind, but the patterns you establish today will affect the results you experience tomorrow!

It doesn’t matter how many people I see with a limb amputation, blindness or other preventable complication from diabetes, it still gets to me every time. From my experience these are usually good, honest, decent, likeable people with families who care for them deeply. This motivates me to try and help motivate others to get active and take responsibility their own health choices. It is always encouraging to get involved in forums like this and see everyone learn, support and encourage one another, overcome obstacles and figure out ways to better manage their diabetes.
Keep up the good work everyone!

 

[BadThad]

In no particular order (from the top of my head) exercise can: reduce insulin resistance

I can't say for sure, but for some reason the past couple of weeks I'm needing less insulin. There's been several days where my BG was below 150 all day long and I didn't require insulin except for the automatic, nightly Lantis. For some reason (I'll discuss with my doctor next week) I still have not been told if I'm T1 or T2. This odd drop off of insulin need is making me think I'm T2....but I'm not doctor. LOL

I was told that I an "honeymooning" and that sometimes insulin acts to "kick start" the pancreas. Since I'm new to diabetes, this term was also new to me. I thought it was because I starting working out harder the past couple of weeks....perhaps I'm seeing this reduction in insulin resistance? How long does it take for this effect to start? Note that I was only diagnosed a month ago.

Thanks

 

[Dr. Steve]

Hi BadThad, sorry for the delay. I haven't had a chance to get online. I think I can recall a study that indicated exercise can increase insulin sensitivity for up to 16 hours following exercise. Over time regular exercise can lead to multiple physiological changes in the way glucose is transported and metabolised for longer lasting reduction in insulin resistance. Hence, I believe regular exercise in the long termwill give the best results for reducing insulin resistance (benefit from both immediate and adaptive changes). Sounds like you are doing well though at this stage, keep up the good work! Hope you can find out from your doctor whether you are Type 1 or 2. Good luck with it!

 

[BadThad]

Hi BadThad, sorry for the delay. I haven't had a chance to get online. I think I can recall a study that indicated exercise can increase insulin sensitivity for up to 16 hours following exercise. Over time regular exercise can lead to multiple physiological changes in the way glucose is transported and metabolised for longer lasting reduction in insulin resistance. Hence, I believe regular exercise in the long termwill give the best results for reducing insulin resistance (benefit from both immediate and adaptive changes). Sounds like you are doing well though at this stage, keep up the good work! Hope you can find out from your doctor whether you are Type 1 or 2. Good luck with it!

Thanks for your time Doc!

Great info from that study. I think I'll excercise every 16 hours. LOL Just saw my physician a few minutes ago, I am doing great. The only thing I knew she was going to do is up my Lantus to 12u at night (from 11) because my fasting BG has been about 130-149. I told her as soon as she walked in what I knew she was going to do. My BP was 122/84 and I feel great for a 47 year old man.

They took more blood today to do the C-peptide test for T1/T2. I still can't believe the hospital missed the test when I was in there. Afterall, that's why my doctor sent me....I'm completely healthy other than diabetes.