Exercise Stuff

Exercise is good for you and part of your diabetes management plan.

REGULAR EXERCISE MAKES YOU

Insulin sensitive so your insulin works better
Lower your blood pressure
Lower your cholesterol
Keep your weight in the normal range for your age and height
Create a sense of well being
Strengthen your heart and lungs

THINGS THAT AFFECT BLOOD GLUCOSE LEVELS DURING EXERCISE:

Carbohydrate foods
Insulin levels
Intensity of the exercise
Duration of the exercise
Recent high or low blood sugars
Timing of exercise to recent food and insulin
Blood glucose before you start
Adrenaline in competitive sport

GETTING STARTED (NOW THAT YOU HAVE DIABETES)

If you have just been diagnosed with diabetes or are starting a new activity or just getting off the couch the more likely it is that your blood sugars will go low and you will need less insulin. Talk to your diabetes nurse or doctor for advice!
FUEL SOURCES
First fuel available for exercise is glucose which is quickly used up
Second source is release of glucose from the muscle and then the liver
Third source is fat – stored energy – which is used when the insulin level falls

Blood glucose	Effects of glucose and insulin on metabolism	Impact on performance
	Too much insulin and not enough glucose available for the cells	Tired, poor performance. Correct low blood glucose before starting exercise.
4-10 mmols	Efficient fuel flow	Maximum performance
>10 mmols	If insulin level is OK then blood sugars will fall	Performance may be reduced but ok to do exercise
>15 mmols	Glucose likely to rise as not enough insulin on board	Tired, poor performance, check for ketones, have insulin and wait before exercising

INSULIN LEVEL

If you have too much insulin on board when starting to exercise your blood glucose level will rapidly drop. You will need to have a carb snack before exercising or you will need to stop to eat or drink during the exercise.

If you have high blood sugars before starting exercise you don’t have enough insulin on board. It makes it difficult for glucose to get to your muscles so you will not do well at exercise and you will have even higher blood sugars afterwards.

If you are between 5-10mmols you will be able to access body fat for fuel and keep your blood sugars stable.

AVOIDING LOWS AFTER EXERCISE

Test before and after exercise
Keep a log book so you can see what you did last time you exercised
Have some glucose and snacks with you
Talk to your diabetes team about lowering insulin and increasing carb before and after exercise
Strenuous or long duration of exercise can cause delayed hypos, often during the night
Don’t forget to drink! Talk to your diabetes team about sports drinks and their appropriate use

GOOD RECOVERY DRINK RECIPE:

trim milk / 2 spoonsful of skim milk powder / 2 spoonsful of flavouring e.g. Nesquik

shake it up and drink it down within 30 minutes of finishing exercise. It will replenish your energy stores really quickly and help prevent hypos later.

GOOD REFERENCE SOURCES

John Walsh author of “Pumping Insulin” has excellent exercise notes in this book for people with type 1 diabetes. He has type 1 himself and is on a pump but the exercise principles apply if you are on a pump or daily injections