The Type 1 Diabetes Self-Care Manual by Jamie Wood

Author:Jamie Wood
Language: eng
Format: epub
Tags: ebook
Publisher: American Diabetes Association
Published: 2018-03-18T04:00:00+00:00

Hyperglycemia

People are often surprised when they start exercising and find that their blood glucose levels rise instead of fall. This happens when the body perceives exercise as an added stress, so adrenaline and other hormones come out to raise blood glucose levels. If you are just starting an exercise program and you join a spin class, at first your body struggles to keep up. Your blood glucose levels may rise. But over time your body gets fitter and the exercise is less stressful, so the stress hormones don’t come out and blood glucose levels may fall with the same exercise. Intensity makes a difference: walking on flat ground for 60 min almost always lowers blood glucose levels, but hiking up a mountain for an hour may lower OR raise blood glucose levels. Your level of fitness can change over time. If you get sick or travel and stop exercising for a while, you may be a bit out of shape and find differences in how you respond to exercise.

Expect the unexpected, and be prepared. During competition, Olympian Gary Hall, Jr., would see his blood glucose rise because of the stress of the race from 150 to 350—in just 21 sec! That happened every time, except when it didn’t, and very rarely his blood glucose level would be 35 at the end of a race. So the answer is to be ready with rapid-acting carbohydrates even if you think your glucose will always be high after a certain exercise.

The biggest mistake people tend to make is to over-treat the high blood glucose after exercise. After a workout, the body needs to restore glucose into muscle (the muscle stores glucose as glycogen), and it is like a sponge sucking up water, whether the blood glucose level is high, low, or normal. This is a time when you need to give your body fuel (carbohydrates) and perhaps insulin, but use less insulin than usual (maybe half a dose, but discuss with your health-care team) to avoid immediate post-exercise rebound lows. But regardless of whether your blood glucose level is high after exercise, you are still at risk of lows 12–24 h later (often at night), so watch for this and adjust your overnight insulin dose as needed.

Certain types of high-intensity exercise, such as sprinting and powerlifting, can increase blood glucose levels in the short term. The body responds to anaerobic exercise by pumping up levels of stress hormones, which, among other functions, trigger the liver to pump out extra glucose to keep the muscles from becoming depleted. If you’re in a competition, like a race, that stress can also trigger hyperglycemia. Trying too hard to prevent hypoglycemia—by over-consuming carbohydrates or withholding too much insulin—can also lead to a high. Illness and a blocked insulin pump may also be behind a seemingly exercise-related high. Going into exercise a little bit high is fine—exercise will likely take care of the situation.

Strategies such as doing a cooldown of light walking or cycling for 15–20 min after strenuous exercise can help lower blood glucose levels more gradually.

Download

Copyright Disclaimer:
This site does not store any files on its server. We only index and link to content provided by other sites. Please contact the content providers to delete copyright contents if any and email us, we'll remove relevant links or contents immediately.