Hello everyone,
I have a question I’m totally flummoxed about… I recently went to a biokineticist who knows all about my diabetes, and we’ve worked out a strengthening program - a couple of stretches and a few exercises to do 4 times a week so that I can strengthen up for my upcoming travels. About an hour of exercise all in all, including a 20 min warm-up walk.
What I don’t understand, though, is that I’ve gone high after every exercise session so far… I expected to go low, and I’m having the opposite effect. How is this possible?
Has anyone else had this? Is it to do with adrenalin? (they’re pretty intense exercises.) Any advice, please?
Thanks so much!
Bridget
Yes! I have a problem with going high during and/or after high intensity exercise! It’s so hard to wrap my brain around because it’s hard to keep my intensity exactly the same every workout, so I’m not always sure what I’m going to get. But more often than not, I’ll peak in the middle of it, start dropping immediately after or during cool down, and then spike maybe 20-30 minutes after I’m done.
Where as on the other hand, if the exercise is not very intense, my blood sugar will just get low! XD
My pump and CGM are what save me with exercise because I get to pinpoint exactly what my body is doing at each moment and discover trends–as best I can. When I first started working in an intense exercise routine, I was on MDI and had a severe problem with spiking anywhere from 200-400mg/dl after exercise. Time of day has a lot to do with it in my case as well. I exercise first thing in the morning, and mornings are tough for me blood sugar-wise anyway. But, changing the time of day of my workout just wasn’t an option. I’m making it work though! Just with lots of monitoring.
I have been told that strength-training will make your BS rise, and aerobic exercise will make it drop. For me though, I really relate it more to intensity, because I have days where I’ll rise while running because the running is super tough.
Good luck!
Will I did have the same situation caused by eating pizza before exercising and disconnecting my pump!
I have the same thing! I haven’t figured it out yet either. Do you eat before you exercise?
I am on an insulin pump and I reduce my basal insulin to 50% about a half hour before I exercise and leave it there for an hour. I exercise (rollerblading or running) for 45 minutes to an hour.
When I get back, usually my blood sugar is great, but goes high in the next half an hour. So I started taking insulin as soon as I get back.
I will be curious to read the other answers!
This happens to me all the time, particularly with intense aerobic exercise, but less so with weight training. During the exercise, BG goes down. As soon as it stops, it goes up, often dramatically. It was explained to me that the adrenalin rush caused by the exercise can trigger a release of glucagon from the liver, which increases BG as soon as the exercise stops using the BG that you have. For me, when I go low after exercise, I do not correct it, because I know I will be ok within a half hour. As a pumper, I use a reduced basal rate before the exercise to get myself a little high so I don’t get too low during the workout. Then, as soon as the exercise begins, I use a higher basal rate to keep myself from going up too high after the exercise.
Happens to me all the time…especially in the mornings when the hormones are all haywire. What time are you doing your workout?
Hmm… fascinating! Thanks.
I’m exercising in the morning, before breakfast, but I’m on insulin injections (pumps haven’t really reached South Africa yet!)
I thought it might be the adrenalin thing, I’m going to do half the number of reps tomorrow and see what happens. Otherwise up the insulin.
Thanks everyone!
Yes Bridget, me too. This happens to me when I exercise before breakfast and I’m on shots too 
If I do very intense weight training in the morning with no breakfast, the sugar shoots up by a lot. Frustrating!!!
Try eating some carbs and taking a little fast acting insulin pre-workout. I think because your body is out of food before breakfast, the stress from your early morning workout is causing your liver to pump out glycogen. Of course, don’t forget to bring your monitor and glucose to the gym, you’ll probably want to see how things progress throughout your workout.
This method has helped me a little, but its still hit or miss.Let me know what works, I’m very interested as I’ve just about given up on morning workouts. I’ve had much better success working out during the afternoons and evenings.
After strenuous exercise, the liver release glycogen, because during exercise you depleted carb storage. This happens more on aerobic exercise like running ect. That happens to my always after a give an 1hr Spinning class. My nutritionist recommended to take 15gm of fast acting carbs, like example 4oz juice, the ones that comes in little boxes, the ones that you use for your kids snack. This will help replenish the carb storage that is depleting due to exercise, and preventing but not at all the glycogen release from the liver. So your BG may go up, but not as high, and will be easier to bring it down with a correction shot. I snack 1hr or 30 min before giving my Spinning class 15gm carb and a protein, this helps too. But be sure to test before, during if possible and after.
It’s actually any exercise that releases a large amount of stress hormones. Running can do it, but it has to be a very strenuous run. In Type 1s, the hormone that signals the liver to stop releasing glycogen is not present, as it is produced by the islet cells which we don’t have. A Symlin injection right after exercise can do the trick. Once the release of glycogen has begun I don’t know that it can be stopped by ingesting more carbs. That hasn’t been my experience, anyway. In any case, exercise is a fine balancing act, especially strenuous exercise.
Since I’m doing the carb ingestion my numbers after the Spinning session still goes up, but less quickly, giving more time to insulin to work. My endo told me that BG is supposed to come down after the raise, but I haven’t experience this, I always have to take a correction shot after Spinning. How about you Jason? how it works for after exercise? Have you tried Symlin after exercise?
I sometimes need a correction like you do but not very often. I don’t do spinning but for cardio I do high intensity interval training which is similar in some respects. I also do a lot of strength training, weightlifting, that sort of thing. Symlin definitely works to control the post-exercise upswing but timing is important. It is far easier to prevent it than it is to turn it around.
For sure is far easier to prevent it than it is to turn it around, I will talk about it to my endo. Thanks Jason.
I’ve had the same problem off and on for a while now. Some times I finish my workout low, in the high 60s or low 70s. I’ll have one of those little juice boxes to bring it up and I’ll be right around 100 for a while, but 1.5 hrs or so later I’m creeping up to near 200. The last few work outs I’ve been showering after my cool down ( I need a break to make sure I don’t over eat) then taking my time to eat a small snack like a piece of fruit and then sightly overbolusing and I’ve been seeing pretty good numbers. I had a small plum of about 7g last night and bolused as if it was about 15g. I’ve only done this 3 times, but that’s a start of a solution.
I’ve also been using a dual wave bolus on my pump b/c I usually eat dinner before my workout. But that wouldn’t help you.
Alright I’m 110 right now…took 1 unit Humalog bolus and 8g glucose tab + whey protein shake (3g carb). Gonna go play bball for an hour which at times takes me up 100 points on its own. I’m a little scared of going low, but I think I’ll be fine. I’ll post my post-exercise #s when I’m done.
That is perfectly normal for many people. I was shocked when I first developped diabetes when X-country skiing 6 miles and the BG went up. My friend Dr. Cox said what did you expect? i said for it to go down. He said unlikely because of the cortisol and the epinephrine ( british for adrenaline). I would ignore the problem the benefit of the exercise surpases the temporary increase. If you have energy to spare you could continue for another 20 minutes of cardio and the BG will go down.
I’m T 2 only on metformin, so I don’t use insulin. I find if I exercise in the morning my numbers will go up regarless of what I ate. I usually play 2 hours of tennis and I think cortisol kicks in and spikes bg. My doctor isn’t concerned becuase he says exercise is better in the long run.
your story sounds familiar- ive been doing intense training 2/3 hours and usually around the 3rd or 4th hour after i start my workout my blood sugar goes through the roof. (this is usually about 11pm) so i take enuf humalog to cover
then around 12-2a i have low sugar
and then starting around 4a my sugar divebombs again
so i reduced the humalog at 11p and that has helped a bit, been having to wake up at 4.30a to check BG and possible injection
and have also reduced lantus from 20u down to 15 (i take lantus about 11p)
i asked my endo’s nurse about it the other day and she said the same thing about “fight/flight” hormones raising BG and i assumed she was talking about adrenals. are these also involved??
any ideas/suggestions?
Post game glucose was 170. Maybe I leave out the glucose tabs next time. Any suggestions on what might work here?
This is a common issue for any of use Diabathletes who engage in strenous exercise. Lots of good explanations and advice here which, if I can summarize, is basically:
- Carb up before exercise
- Monitor frequently
- Carb up during lengthy exercise
- Monitor frequently for the first hour or two aftewards
This basically gives your body ‘something to chew on’ besides your onboard glucose. That’s how I look at it.
For myself, I have had good results by starting exercise with an elevated BG, close to 200, or eating first. (I’m either running or doing intensive body weight/crossfit work). I check my BG every 30 minutes. If I’m trending down fast or I’m under 120 I add some carbs (glucose tabe, or sports drink, or gels). Check again at the end, and adjust accordingly.
If you’re on the pump, DO NOT DO NOT DO NOT DO NOT DO NOT turn off your pump to avoid going low. Repeat DO NOT TURN OFF YOUR PUMP. Other people don’t remove their pancreas so do not turn off your pump. The reason is that it doesn’t have any immediate affect anyway, and two hours after you’ve turned it off you’ll have NO insulin on board. That’s due to the two hour peak time of most fast acting insulins. Instead of turning it off, lower your basal rate by some increment - 25%, 50% - experimenting is in order - and lower it about 1.5 to 2 hours BEFORE you start to exercise. I only do this if I’m exercising more than one hour BTW. Return to your normal basal rate immediately after exercising. You can likely program a temporary basal rate into your pump to do this.
As with all things diabetic, YMMV. Keep trying things and you’ll find something that works.
Then in a few months it will stop working and you’ll have to find a slightly different variation. C’est la vie.
Good luck,
Terry
(did I mention not to turn off your pump?)