Pulse during Exercise

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Question:

The rebound hormones are released during a normal workout just as they are when you go hypo. This can actually cause an *increase* in bG as a result of exercise. I started a program this summer and this is what happened to me. After several months of no regular exercise, I started riding my bike everyday. For the first month or so my bG would plumet after a 1/2 hr workout. I would have to turn off my insulin pump for about an hr before and eat some thing before and after exercise. Then for the next 2-3 wks, I found that if I did nothing, my bG remained fairly level through the workout. After that, I actually had to take 1.5 – 2u of insulin 1/2 hr before I started a ride to keep my bGs from rising during the workout. I think that because I was out of shape, my muscles were inefficient and therefore need much more sugar for a given amount of exercise. As my muscle tone got better, they got more efficient and didn’t use as much sugar, and my bGs dropped less. The only difference is when a hypo is brought on by to much insulin. In this case the muscle tissue does NOT need any glucose, since none was burned. Hence, your blood sugar raises after a hypo eposode. Totally normal. Effects can last up to 20 hours just as a normal person. The wrong thing to do on a rebound caused by a insulin hypo is to take more insulin. You went hypo because you have to much already! This is the way you start becoming unstable. I have seen this through my own experiences. Best way is work off the high BG level. Excellent description of rebound! For some reason the important info doesn’t seem to be widely spread. Another comment about trying to cover a rebound with insulin: the counter regulatory hormones will shut off *some time* within the 24 hrs following a hypo. When this happens, the extra insulin taken to "treat" the rebound will drive the bG down and cause another rebound. Exactly when the counter regulatoroies shut off is highly variable. The best way to treat rebound is to avoid them. BACK OFF on the insulin, avoid the hypo, and the rebound won’t happen. A excellent book that I was given by my diabetic educator is "Staying Healthy with Exercise" (don’t have it here so I not real sure of the name) This book details the Hormone processes of your body and gives you the knowlegde needed for excellent control. I’ll keep my eye open for it. Thanks for some very useful info. I’m saving it for future reference. //// | Dyslexics | |–00 | of the world | C ^ | UNTIE! | | |—–3

Response:

I spend a lot of time exercising, normally 3 to 5 hours a week is normal. My control is excellent and insulin intake is minimal (< 25 units 3000 cal/day) I have been type I now for three years. My OTII average reading for today is 101. I do alot of maintenance runs, so I call them. I just run 2 miles at 8-10 miles an hour only takes 15 minutes to warm up and cool down. I do these when my sugars are over 150. In the 15 minutes I normally drop down to 70-80’s within the 15 minutes. Just over thanksgiving I was 185 at 10:30pm. I went for a quick two miles came back at 74. The largest change I had was from 325 to 90 in 15 minutes. Dropping into the 70’s for a light workout is NORMAL. In a non-diabetic this 70’s level remains until the body replenishes the glucose through the livers production of glucose. This can take upto 4-20 hours depending the duration of the exercise. I target the 70’s for all of my workouts. Did you ever test one of your friends you work out with. I’ll bet they are in the 70’s also. For a heavy workout mid 60’s is normal. The blood sugar level must drop inorder to start the FAT burning process. Entering the low 60’s means you have to much insulin in your blood and fuel intake is required. The rebound hormones are released during a normal workout just as they are when you go hypo. The only difference is when a hypo is brought on by to much insulin. In this case the muscle tissue does NOT need any glucose, since none was burned. Hence, your blood sugar raises after a hypo eposode. Totally normal. Effects can last up to 20 hours just as a normal person. The wrong thing to do on a rebound caused by a insulin hypo is to take more insulin. You went hypo because you have to much already! This is the way you start becoming unstable. I have seen this through my own experiences. Best way is work off the high BG level. Lower drops in BG levels are directly releated to insulin in the blood. Example 1: 5 units R at meal time + big meal, High BG level + exercise = Big drop. Because you have plenty of insulin in your blood the BG level will drop at a much faster rate. Example 2: No insulin taken for 6 hours, high BG + exercise = Low drop Since your insulin level is already low your body preserves your glucose level and burns more fat. The drop is BG is smaller. A excellent book that I was given by my diabetic educator is "Staying Healthy with Exercise" (don’t have it here so I not real sure of the name) This book details the Hormone processes of your body and gives you the knowlegde needed for excellent control. rick

Response:

Does anyone experience severe drops in Blood Glucose level during exercise? I find that I have to be at around 240 mg/dl in order to start exercising or else I have to stop in the middle and drink juice(which gives me a stomache ache) When I start exercising at 240 mg/dl after a 60 minute step aerobics class I will be anywhere from 65 mg/dl to 130 mg/dl. Did you just start exercising recently? I found that after a long sedentary period (months), that exercise will drop my bG throw the floor for about the first month that I get back to it. Then, as my muscles get in shape and become more efficent, the drop is less severe. Try shorter workouts (like 30 min) for a while. Then work up to an hour. Also try glucose tablets or gel during exercise. It take less volume and works faster. Might upset you stomach less. Hope that’s help. Don’t give up the exersice. //// | Dyslexics | |–00 | of the world | C ^ | UNTIE! | | |—–3

Response:

<text deleted Does anyone have any information on this? Is this unhealthy? Thanks, Sarah Bunkenburg

Usually excercise lowers your BG (although, sometimes, at first, it may raise it, for reasons that I shall not go into now). One solution is to measure your BG from time to time, while excercising and take glucose tablets from time to time during the excercise, when your BG gets low. (Take BG measures also some time after the excercise.) I noticed that when I excercise, starting at 130, my BG gets down to 115 mg/dl. I therefore solve it for myself differently: I take a slice of bread about 30 min before the excercise so that it will start being digested during the excercise, thus keeping my BG normal throughout. You, certainly, should act differently, since your drop is much more. You need experimenting to learn how your body reacts. Rachel

Response:

Unfortunately, you don’t say anything about the type of diabetes you have nor what you are taking and in what pattern. Almost all answers in diabetes are dependent on those factors. I had a similar problem when I, a type I, was taking 2 shots of NPH. The idea behind NPH and similar insulins is to obtain a, more or less, constant insulin input. This can cause a problem in prolonged aerobic exercise. When a normal body starts exercising, insulin production goes down. Yes, it sounds backwards to me too. It turns out that during strong muscle demand it doesn’t take much insulin to get the glucose into the muscles. The fall in insulin level stimulates the liver to start producing glucose and pumping it into the blood. This is why normal people don’t run out of glucose when they exercise. The NPH delivery is not affected by your exercise, so the liver is inhibited from providing additional glucose and you run out. I was unable to run farther than about 4 miles when taking all my insulin as NPH. I tried sucking candy as I ran, eating glucose tablets, all kinds of stuff. I just couldn’t keep my BG up. I switched to an intensive regime with NPH just for basal requirements and regular for meals. Since then I have been able to run 6 miles/day 5 days/week without a single BG problem (note – that is a goal not a reality). I substitute my run for my lunch insulin and it works out fine. I do have to make sure I am above around 150 and that all the previous meal’s insulin is gone and I am not near my NPH peak. This is not necessarily a good solution for everybody, but it demonstrates some of the things you have to think about. — Practice Random Kindness And Senseless Acts of Beauty.

Response:

Does anyone experience severe drops in Blood Glucose level during exercise? I find that I have to be at around 240 mg/dl in order to start exercising or else I have to stop in the middle and drink juice(which gives me a stomache ache) When I start exercising at 240 mg/dl after a 60 minute step aerobics class I will be anywhere from 65 mg/dl to 130 mg/dl. I am afraid that this may be related to the fact that my pulse gets kindof high while exercising. My pulse, which is taken with a 6 second count beginning with 0, will be anywhere from 190 to 210 beats per minute. I realize that this is above my training target zone, but do not feel out of breath or very tired, and do not have a problem finishing an hour class. Even when I try to get my heart rate down(by not using my arms, and not doing the power moves) it still is up at 170-180. Does anyone have any information on this? Is this unhealthy? Thanks, Sarah Bunkenburg

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