I had previously been told by a CDE that my daughter should not do any physical exercise at 240 or higher. to make her drink water and rest at that point. However we have been noticing a trend at PE time that if her BS is in a little high range In the upper 100’s and she does PE her BS shoots up in the upper 200’s. This sends her to the Nurse to drink water and rest. SInce this time we have seen our Endo who informed us that sometimes Adrenaline causes your Blood sugar to raise. She also advised us not to correct with insulin and just to let it naturally come down. Does this make sense to anyone? I wonder if that is what has been causing our ping pong days. Any advice?
Many years ago, I was told not to exercise if I was below 80 or above 240. I do, every once in a while, exercise anyway of I am over 240, but always with lots of fluid.
I’ve also experienced a yo-yo effect with exercise – the exercise brings the BG down, but, as soon as the exercise is over, it starts heading up again. And quickly. My experience was that the BG would not come down naturally for many hours, so it was necessary to find a way to keep from going up.
As a pumper, it is not difficult for me to make appropriate adjustments – if I know I am going to be doing heavy exercise, I will reduce my basal rate by 25% beginning 2 hours before the exercise. This lets me ride a little higher during the exercise, letting the activity moderate the BG without having to worry about going too low. Then, shortly before the beginning of the exercise, I increase the basal to 25% over normal to prevent my BG from soaring when the exercise is done. I still go up when the exercise is done, but not as much, and certainly not to the upper 200s.
I do not think it is prudent to let a BG in the upper 200s go untreated.
There is a lot of discussion about this in the Diabetes, Sports & Fitness. Stress and intense exercise will raise her BS temporarily, but not necessarily every time from glycogen from her liver.
http://tudiabetes.com/forum/categories/diabetes-sports-and-fitness/listForCategory
Ok, the nurse’s question to me is that she has always been told to have the diabetic child move around and exercise to use up the sugar in their bodies. This is from her email: "From my knowledge students should continue to exercise to help their blood sugar decrease. Do you want me to have her rest and drink water in my office if blood sugar is >250 or should I have her continue to participate in PE to help decrease her blood sugar."
I was told the exact opposite by the CDE.
Dave: I like your response, but I am still learning about bolus and basal…currently she is on shots and not on a pump. Does this make a difference? She does take 2 different types of insulin - Humalog during the day and Lantus at night.
So I need to know if she has eaten before PE and see if it is just the carbs causing the jump and the activity is not brining it down, correct? Sorry to sound stupid, but I am still learning about all of this stuff and so is she. ITs a steep learning curve. 
THanks for all of the help!
Why Does My Sugar Go Up After Exercise?
Kris Berg, EdD
Jun 1, 1994
Question: Why does my blood glucose (BG) sometimes rise after exercise?
Answer: If an inadequate amount of insulin is present in the blood allowing the BG to rise to about 250 to 300 mg/dl, then exercise may cause a further rise in BG rather than the expected drop. Low insulin coupled with physical activity stimulates the secretion of several other hormones such as epinephrine, norepinephrine, cortisol, glucagon, and growth hormone. Collectively these hormones trigger the liver to release glucose into the blood, thereby increasing the BG rather than decreasing it. The hormones also increase the breakdown of fat but limit the uptake of fat by muscle cells. The liver converts some of the fats to strong acids called ketones. The ketones may build up in the blood producing a state called ketoacidosis. This event is far more likely to occur in people with type I diabetes.
To prevent the problem the BG should be checked before exercise and if the level exceeds 250, then exercise should be delayed until it decreases well below 250. The urine should be checked for ketones and if they are present, exercise at this time will exacerbate the problem.
A second cause of the rise in BG during and after physical activity is highly vigorous exercise. The more intense exercise is, the greater the secretion of glucose from the liver. During the strenuous session, stress hormones will be secreted in large quantities which will then stimulate the liver to release glucose. This is an interesting paradox: the more vigorous the exercise the more glucose released by the liver with a likely rise in BG rather than a fall. To make matters worse, the level of stress hormones in the blood may be elevated for several hours after intense exercise causing the liver to continue the outpouring of sugar. Thus, the rise in BG may last for a number of hours once the exercise is completed. Additional BG monitoring may be needed until the values have stabilized.
Athletes who workout strenuously on a regular basis may not need to eat as large a feeding as expected before strenuous sessions. Also, as the body adapts to intense training, the hormonal secretion decreases when the same intensity workouts are done. Consequently, an intense workout at the beginning of a season that caused a surge in BG may cause a lesser rise in BG at mid-season.
In summary, monitor BG before exercise, during exercise if the sessions last beyond an hour, and after exercise one or more times. For non-athletes, high-intensity exercise isn’t needed to improve fitness, health in general, and improve BG control. It even tends to make BG management more difficult and increase the risk of injury, sore muscles, and heart attack, and may discourage you from sticking with your exercise regimen.
When my BG is that high after exercise I do correct with insulin AND drink a lot of water. But you should follow your Endo’s advise.
The nurse seems to be ill-informed. Exercise should bring some high’s down, but the really high, highs, probably not (see article referenced above). I don’t see anything wrong with keeping her moving, but no strenuous exercise.
As others have suggested, get more data and report back to the endo. Is she eating before PE? If so, what? Is she being tested before PE, during? after?
Terry
Thank you.
- I don’t think that she eats before PE (I will ask).
- We have been correcting w/insulin and drinking with water, until our dr. appt.
- I agree with you about the nurse. I will send her the link that article.
- She does test before PE, if her numbers are 250 or higher she goes to nurse, tests keytones, and drinks water, if it goes down, she returns to PE and reg. exercise. She does test after PE, thus how we caught the trend of the major highs.
I am going to keep closer touch with her and see if she is maybe rebounding from something that she ate before PE, or it could just be the PE causing the jump. She did tell me that they are doing tumbling right now. So I wouldn’t think that is too strenuous, but its her body and it might be for her? not sure. THanks for the suggestion and the article.
I hate to sound picky but we prefer to call them BG for blood glucose. I’m afraid BS has already been taken with a rater bad conotation. 
Sorry. 
its a habit, DD uses BS in txting. Ill be sure to change to BG. THanks.