Why Does Exercise Raise Blood Sugar?

 Why Does Exercise Raise Blood Sugar?

In practice, most sports are suitable for type 1 diabetics. Only scuba diving, mountaineering, or motorsports are not recommended due to the risk of hypoglycemia. Poor treatment balance for diabetes, as well as possible additional illnesses, can bring their own limitations to the practice of some sports.

It would be helpful for the diabetic to choose a sport that he or she can use to improve endurance (such as walking, running, swimming, or cycling) and to combine it with an exercise that develops muscle fitness (such as gym training). Diabetics are also recommended to exercise to increase stretching and flexibility to maintain good mobility of tendons and joints.

If a diabetic has an extreme passion for a sport and has the motivation and strong will to invest in a hobby as well as to treat diabetes, it is also possible to play extreme sports. But it requires thorough planning and collaboration with the care site.

How Does Exercise Affect Blood Sugar Levels? 

Exercise consumes the body’s energy stores and therefore in most cases, it lowers blood sugar. Prolonged and intense exercise lowers blood sugar for several hours even after physical exertion.

The diabetic's blood glucose levels during exercise are affected by, among other things, the effectiveness of the exercise, the duration, the composition of the meal eaten before the exercise and the amount of insulin injected, the insulin injection site, and the ambient temperature. The most important of these is the level of insulin in the blood during exercise.

Because insulin enters the body artificially in insulin-treated diabetics, the blood insulin level does not fall as the blood sugar falls, but the effectiveness of the insulin is maintained until the end of the action of the injected insulin. Therefore, it is especially important to understand the duration of action of the insulins they use.

How is an exercise taken into account in insulin dosing?

Insulin intake during exercise is important because insulin allows energy (glucose, or sugar in the blood) to enter the cells. During exercise, the energy needs of muscle cells increase manyfold. On the other hand, there should not be too much insulin in the bloodstream during exercise, as too much insulin relative to the need accelerates muscle energy use and prevents the release of stored sugar from the liver. This results in hypoglycemia during exercise.

Finding the right dose of insulin for exercise is not always easy, but you will certainly succeed as you gain experience. To avoid hypoglycemia during and after exercise, you can try the following tips:

- If the exercise is timed to the maximum duration of action of the fast-acting insulin, ie within about two hours of the injection, the fast-acting insulin dose is reduced by 30 to 50% with the pre-exercise meal.

- Before long-term (more than 90 minutes) and exceptionally strenuous exercise, the amount of Levemir injected in the morning of the exercise day or Lantus injected the night before can also be reduced by 20-30%.

- As the insulin-enhancing effect of exercise may persist for several hours after exercise, it may also be necessary to reduce basal insulin at night by approximately 20%.

- If you have an insulin pump, you can reduce the pre-exercise meal bolus by 30 to 50 percent, or you can slow down the flow rate of your basal insulin, such as the basal, by about 50 percent, about an hour and a half before exercise.

- For the night after the exercise day, the basal dose of the insulin pump can be reduced to, for example, six hours, ie until the morning hours. Initially, you can try a 20-30 percent lower for basal dosing.

- If a sport (such as strenuous sports or swimming) requires the insulin pump to be disconnected during exercise, it is good to remember that the pump must not be used for more than two hours. After reinstalling the insulin pump, it is probably necessary to take an extra “correction bolus” to prevent an excessive rise in blood sugar.

How to eat before and during exercise?

It depends a lot on the type of exercise, the duration of the exercise, the strain, the blood sugar level, and the amount/effect of the (quick) insulin injected before the exercise. The longer and more strenuous the exercise, the greater the body's need for energy.

The general recommendation is that a fast-absorbing carbohydrate (such as SiriPir or Glucobooster) should always be included in the exercise. In addition to the food eaten, the body uses its own glucose stores in the muscles and liver as an energy source during exercise.

If your workout is short (up to 30 minutes) or intense (such as a sprint or gym workout) and your amount of fast-acting insulin has been reduced with a pre-workout meal, you may not need extra carbohydrate refueling. In many diabetics, intense exercise raises blood sugar, and blood sugar levels may fall only after exercise. However, you should bring a carbohydrate-rich sports drink to the gym, which can be refueled during or after your workout.

If the exercise is aerobic and lasts more than 30 minutes, and the amount of fast-acting insulin has not been reduced with a pre-exercise meal, carbohydrate refueling may be necessary. For long-term exercise, an additional dose of about 20 grams of carbohydrate is recommended before exercise and every hour during exercise. If long-term exercise is demanding (for example, road cycling or a long ski or running run), the need for extra carbohydrates is higher, about 40 grams per hour.

The extra carbohydrate ingested during exercise should be in an easily absorbed form: sports drinks and sports gels, for example, are good options. Muesli bars or dried fruit can also be packed for a walk or hike.

It is also important to ensure an adequate supply of fluids. If exercise sweats profusely, the body also needs a variety of trace elements. Then sports drinks are good options.

Also, be sure to eat a full meal after exercise to replenish your body’s energy stores.

How can you prevent your blood sugar from falling too low right at the start of exercise? 

This situation is likely to be caused by an excessive effect of insulin on the body. This can happen especially with occasional exercise, where future exercise is not anticipated by insulin dose reduction or supplemental carbohydrates.

If your blood sugar is falling easily, even with a little exercise (such as rushing to the bus or working in the yard), the amount of basal insulin may be too high. To avoid hypoglycemia during exercise, you can try the instructions above.

It is a good idea to always check your blood sugar before you go. For example, if your blood sugar is below 6 mmol / l before your planned exercise, you may want to eat extra carbohydrates. It is safest to wait for the maximum effect of fast-acting insulin to pass and to exercise only two hours after the fast-acting insulin is given.

How often should you measure your blood sugar during the performance?

It is usually sufficient to measure blood sugar before and after exercise. If the exercise is completely new, it would be useful to measure blood sugar during exercise as well. In this way, you learn to recognize different sensations during exercise, and later, even without measurement, you can notice when your blood sugar is too high or low.

Why does exercise sometimes raise blood sugar?

Although exercise usually lowers blood sugar, sometimes blood sugar can stay the same during exercise or even rise under the influence of stress hormones (for example, in competitive sports, competitive situations, or during very intense muscle training).

Even when the effectiveness of insulin is too weak or when no insulin is injected at all, stress hormones such as adrenaline and noradrenaline can act too much and release stored sugar from the liver. As a result, blood sugar can rise a lot during exercise.

Many competitive sports enthusiasts have found that the competitive situation raises blood sugar. An increase in blood sugar during a race can be predicted with a small extra dose of fast-acting insulin before exercise.

Sometimes the increase in blood sugar during exercise may be due to an onset of flu or a blocked insulin pump catheter.

Why not exercise when your blood sugar is high? 

The general recommendation is that if your pre-workout blood sugar level is above 15 mmol / l, your exercise should be postponed. Performance can drop and general fatigue strikes as early as when your blood sugar is just over 10 mmol / l. In addition, as blood sugar rises, the risk of ketoacidosis increases.

When your blood sugar is high before exercise, you should think about the moment, when and what you last ate, when and how much insulin you injected, and how you feel. If it appears that high blood sugar is caused by too little insulin or by forgetting the injection, the high reading can be carefully corrected with a small amount of rapid-acting insulin (approximately 50% of the usual correction dose).

What would help when exercise doesn’t excite because of blood sugar fluctuations?

Coordinating exercise and diabetes is quite a skill. Starting a regular sports hobby requires planning and analysis by the diabetic. Even if you are well prepared for exercise, surprises and miscalculations sometimes come to everyone because blood sugar levels are affected by so many things.

It is a good idea to make notes on your blood sugar, insulin doses, carbohydrate refills, and physical sensations in your follow-up notebook or exercise diary. You can then compare the entries for different days and notice recurring trends.

If high or low blood sugar during exercise is recurrent, there is usually always a cause for it. Think carefully about what and when you have eaten, when and how much insulin you have given, the duration of action of the insulins you are using? Do you think your meal or basal insulin doses are appropriate?

Bring notes to the diabetes clinic. Discuss these questions with your diabetes nurse and doctor. Ask your treatment center if you can use a glucose sensor for a few days. Sensing provides a lot of useful information about how your own blood sugar behaves during and after exercise.

Regular exercise supports the treatment of diabetes in many ways: it promotes physical fitness and mental well-being, and often improves eating and circadian rhythms, resulting in better treatment outcomes for diabetes. Starting an exercise hobby is a great way to learn something new about yourself, it can bring faith and a sense of success in controlling diabetes!