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Permalink Reply by Jacky on January 4, 2011 at 11:38am

My daughter does. We've learned to do a 1/4 correction after excercise, but it still doesn't stop a low about 2 hours post acrtivity, but not every time. We've been told it is caused by an adrenline spike. Stinks, in me, entirely different, I need a basal reduction half an hour prior to starting excercise of about 10-30% depending on how long I excersie and intensity. Good Luck, it stinks trying to figure it out.

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Permalink Reply by acidrock23 on January 4, 2011 at 11:40am

My BG goes up pretty regularly when I exercise. I have noticed that these highs seem to be much easier to correct than "I ate too much burrito" highs? I'm not sure that that means they are not 'bad for you' but at least they are easy to get rid of. Or maybe thats the synergy between exercising and BG?

One alternative that seems pretty promising is to have a small snack, like 10-15G of 'regular' carbs and bolus a fraction of the dose you'd ordinarily take? There's a chart in Think Like a Pancreas and Using and Pumping Insulin that has the exact fraction split up for the intensity and duration of the exercise so 'moderate' exercise for an hour and you take 2/3 your usual dose then some still matches the carbs and some matches the exercise and it works better? I did this during a 1/2 marathon when I got nervous beforehand, had OJ for a boost and the CGM said 190 about 2 miles into the race. I used the pump (in a traffic zoo nonetheless...) to calculate a CB but then just took like .4 of it and it got things smoothed out very nicely.

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Permalink Reply by Lila on January 4, 2011 at 1:46pm

I'm not sure I would agree with your last observation. In my carb-counting class we did a practical session on exercise. Two of the group went running. Both regularly work out at the gym (4-5 times a week), both are young and fit and in great shape. After the run, one spiked to 17+ (300+ in mg) and the other also saw a spike though quite so high. The rest of us (not gym bunnies but not couch potatoes either) who opted for a brisk 30 minute walk didn't see any radical BG movements in either direction.

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Permalink Reply by Lila on January 4, 2011 at 3:53pm

Hi John - those two girls *did* run for several miles. Plus they told us that they often had spikes after long workouts at the gym. It did perplex us but as the gym is not my natural habitat, I didn't worry too much about something similar happening.

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Permalink Reply by acidrock23 on January 4, 2011 at 4:03pm

I agree as I've seen spikes on 6 mile runs, 10 mile runs, you name it. It's a work in progress but the magic bullet seems elusive? I still don't mind these spikes as much a since they seem to disappear quickly though.

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Permalink Reply by Bradford on January 5, 2011 at 7:19am

I think I have to agree w/ John on this one. It depends on the intensity of the workout. People can say they "go to the gym and run" several times a week, but the intensity at which they run them is going to determine what sort of metabolic activity is being used to make ATP for energy. If the runners go over their lactate threshold then they will become slightly anaerobic rather than aerobic, and they will not burn glucose directly (like they would if they were aerobic). You throw that on top of the glycogen dump, and that's where you can get the spike from. If someone notices they go high after running 3 miles @ 7 min miles, try running the same distance (all other factors the same as far as glucose eaten, insulin on board, time of day, etc) @ 9 min miles (which may likely be down under the LT) and that person may see more of a drop (or at least a maintenance of BG) rather than a spike.
However because of aaallllllllllllllllll the factors that we deal with every day (from hormones/stress to different foods and different amounts of boluses, etc) it can definitely be a veritable guessing game when trying to figure out where that ideal speed and/or distance is.

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Permalink Reply by acidrock23 on January 5, 2011 at 10:32am

I ran 8.75 @ 6.0 mph today, not perhaps my PR but I rolled an ankle 3 miles into it and was not feeling to hot the rest of the way. BG was about 126 when I started w/ 1.1U of insulin on board from breakfast. 60% temp basal. I tried 5 jelly beans (probably about 5G of carbs...) at 2.5 and 5 miles, as the BG seemed to drift very slightly down and, while I didn't want to crash, I didn't want to blow up either. It stayed nicely in the 110-120 range pretty much the whole way, a couple more whiffs of carbs, one of 7 beans and one 10G swig of Gatorade. BG started dropping as I got closer to home but I held off on the carbs. Temp basal ran out a couple miles from home but, about 15-20 min after, I checked BG w/ CGM @ 95 and it read 113? Probably within the margin of error but to me, that's still a slight spike, depsite low intensity exercise? I don't think I got carried away w/ the carbs, I probably didn't have more than about 20-25G the whole time? Perhaps it can be fine tuned a bit more but I'd rather spike to 120 than 150-60 as it will be much easier to clean up.

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Permalink Reply by Brian (bsc) on January 4, 2011 at 12:23pm

I have found that aerobic exercise brings my blood sugar down, but intense exercise makes it skyrocket. I usually rise more than 100 mg/dl during weight lifting. It comes down afterward, but I've worried that perhaps I should monitor it. For the time being, I just ignore it.

Sheri Colberg advises that you should exercise with insulin on board and with your blood sugar rising. The best way to do that is to have a modest preworkout snack and bolus for it. Exercise without insulin on board is also bad news, that can cause a huge escalation of your blood sugar. If you are on the pump, don't disconnect it and think that you can just go do 2 hours of vigorous activity.

I've come to believe that intense exercise causes stress, releasing adrenaline and cortisol, hormones which signal your body to release glucose to give you energy to deal with the "emergency." You may find that carefully timing and alternating activities like lifting weights and aerobics helps. I found that if I just spend 15 minutes walking on the treatmill I can drop my blood sugar after weight training.

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Permalink Reply by Brian (bsc) on January 5, 2011 at 5:14am

Let me also say that I've now come to believe part of my issue with spiking blood sugar during exercise may in fact be due to insulin deficiency. Since starting insulin therapy in december, I have noticed a major drop in my post exercise glucose levels. It makes sense that if your body becomes insulin deficient, then you won't be able to take up glucose and fuel your exercise. But I had also attributed my blood sugar rise mostly to my weight lifting and the adrenaline/cortisol surge. But perhaps as JohnG notes, it is more about having required levels of insulin on board.

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Permalink Reply by Lynn8110 on July 18, 2011 at 10:31am

I just joined a gym and met with a trainer today. He had me on several weight machines and no cardio. I ate around 32 carbs a half hour before I left. An hour after I got back and approx. 2 hrs. after I had eaten, I did a bg check and it was 131. It would not have been that high, had I not exercised. I am Type 2 and only on Metformin 2x day. Any ideas as to what I should do differently, other than check with my Dr.?

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