Exercise - Good or Bad?

In my last blog post I discuss the effect exercise has on our ability to manage blood glucose levels Exercise - Good or Bad?Please view it to see my opinion.

Also:

How do you manage your blood glucose levels when exercising? Do you find exercise makes it harder for you to manage diabetes? What tips or adjustments do you do before/after exercise?

Cheers! From Three 2 Treat

I think that exercise has tremendous psychological value. Even light to moderate exercise is likely to be more than most people w/o diabetes will be doing as you get older. The endorphins from exercise are a great boost. For me, the extra challenge in figuring out insulin adjustments, BG monitoring adjustments and food adjustments is more than offset by the fun of having a goal of one sort or another. I have a blurb on “my page” about the stuff I’ve done but I think that the main thing isn’t to run races or distances or kill yourself but to find something to do that you can do consistently. I think that there may be some BG benefits to pushing yourself as I noted that last summer, I switched from running to bicycling for a while and my BG went down, which I didn’t expect since biking is “easier” (although I usually ride as fast as I can…whee!) but, as I kept at it, I noted I didn’t get as much BG bang for my buck and made some adjustments back.

A friend of mine has done some research showing that students who do math (which many people with diabetes will do, even if haphazardly cough cough) after they go outside and experince exercise outside in nature will do better than students who don’t. Blood sugar is challenging but, in the second 1/2 marathon I ran (#1 was a very fast “runner” crowd and there were no casualties…) there were people barfing, people passing out in hosta beds, etc. I dunno if they were hypo or just dehydrated or what?

Light to moderate exercise smooths out the blood sugars in a 24 hour period. Fairly intense exercise, such as skating, swimming, trampoline causes problems in the overnight period following the exercise. By “fairly intense” I mean one hour of ice skating or two hours of swimming, an hour on the tramp or biking. Do not prohibit the exercise or in any way frown on it, just that we must adjust for it and be very careful. Extreme exercise, such as swimming on the Swim Team, etc., triathelons would cause a huge issue. If she wanted to participate in these types of activities, we would have to work out a way. It would be challenging. Fortunately, Swim Team practice started 6am in the summer; that alone was not doable for her.

Thanks for the links in your Blog Trev. Lot’s of info to sort through but, like you said in your blog, it’s good to see stuff specifically for Type 1s who exercise.

I think general guidelines are a good place to start, but like everything else about diabetes, it really has to be personalized for each individual by each individual. For me, in the short term for each work-out session, diabetes is much more difficult to manage with exercise, no question about it. Just for diabetes management though, in the long run it pays off with higher insulin sensitivity and steadier BGs for the 22 hours a day I’m not working out.

Thanks for the feedback. You bet, it does help out in the long run once you’ve figured out your own individual plan. Cheers!

One thing I’d add, that I learned while studying Tae Kwon Do, is that helps to have some expectations of making incremental progress too? If you expect to lose a ton of weight quickly or to be able to run a long race in a month (I’ve seen those training guides for 1/2 marathons but the weather here is too unpredictable so I figure on doubling the preparation time…) you can get disappointed but I think that if you make a broader decision to exercise most of the time and to stick with it, you will achieve a better result?

I’d sort of disagree with Jan’s comment that “we must adjust for [the exercise] and be very careful” because, to a certain degree, you have to be careful all the time anyway so exercising just involves anticipating that it will send you low and making adjustments, such as the exCarbs plan laid out in Pumping Insulin? You can always get a different result but people w/ diabetes will likely have carbs around anyway and you should make a decision to exercise based on trying to feel good about exercising, not being shy about diabetes? I think that some people are inclined to blow it off because it can be work but, before I started exercising, I did a lot of work to sit on my butt on the couch too!!

Exercise is good. May raise the BG in some type 2 during but still improves insulin sensitivity.

I have found that even a short walk will lower my blood sugars. I mainly do a half hour walk in the morning with my dog, then I will do a little tai chi as well. There was a comment made that it is harder to exercise as you get older, I am over 70 and am easily able to walk and I teach tai chi, including the Tai Chi for Diabetes form. In my class I have several 80 year olds, and when I feel grumpy and don’t want to exercise I remember these ladies and how keen they are to keep fit. I can go low towards the end of my walk, so I carry glucose tablets, one will usually help me get home safely.

Oh, and Trev, I am hopeless at math! LOL

I hate math! I totally wing it at math. Maybe once every three months I’ll decide to eat a bowl of cereal and actually calculate the ratio for how many carbs are in some fractional serving?

Although I just started insulin in December, I’m already finding that the hardest part is adjusting insulin levels to handle exercise. It is one thing to figure out the right levels during and immediately after exercise, but I have found that my basal levels are affected enough over at least the next 24 hours that I have to make adjustment in my basal. I appear to need different overnight levels that differ by perhaps 25% depending on my exercise during the day and how hard I exercised.



I still believe that exercise has benefits, but one has to question the difference between a consistent daily modest level of exercise (like 1/2hr - 1 hr) with consistent blood sugars compared against an aggressive exercise program (weight training/running every other day or two) and the variability in blood sugar that comes with it.

The variability in BG comes with an aggressive exercise program when basal insulin rates cannot be varied to go along with your exercise program. That definitely could be the limiting factor for most diabetics. With a pump and CGM, steady BG levels are achieveable as long as there is consistencey with the exercise program.

Ah, there you get to the heart of the matter. Consistency. My life is constantly disrupted. And using MDI makes it even more of a challenge, once you have take your basal injection, that is it. So maybe what I need to do is force more consistency at least in the days that I workout, even if I can’t be consistent about the intensity.

I exercise at the gym daily and hard, usually around the same time. Just test your BG first and I adjust the basel accordingly, perhaps half to no basel. Be sure to have glucose to cover before driving home. Oh, and I have a pump so I can shut it off if necessary.

I’m type one over 50 years, on a pump for about 8 years.

It’s also harder to be consistent w/ R/N because they are inherently inconsistent. Hopefully you will have compiled enough data for your doctor to hook you up with the good stuff.