# blood sugar goes low after exercise-Help!



## Kareen_butterfly (Oct 30, 2011)

Hello peeps,

I have been diabetic for a little while but want to take control and be really healthy. I haven't really exercised regularly before as I find it lowers my blood sugar. I'm a little overweight and would really like to lose weight. I always find though, that when I exercise I end up eating more as my blood sugar goes low afterwards or a bit later on-in the evening or night. I don't see the point in exercising if I'm going to eat more-as I put on weight rather then lose it. I would really love any help I can on this subject. 

Thanks Kareen


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## Robster65 (Oct 30, 2011)

Hi kareen. Welcome. 

Depending on which insulin regime you're on, the idea is to lower your insulin dose before and after by just enough to offset the lowering of your BG.

If you're on MDI (basal/bolus) or a pump it's fairly straightforward. If you're on two a day with mixed insulins, it's a bit more tricky.

Rob


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## Northerner (Oct 30, 2011)

Hi Kareen, welcome to the forum  Exercise can be a tricky thing to get right, and much of it is building up experience through trial and error. What insulin regime are you on? If you are on a slow and a fast acting insulin (4-5 injections a day) then you might need to reduce your pre-and post-exercise doses to try and stop yourself from going low and needing to treat it with extra food. You would need to test before exercising and then test at regular intervlas. If you find you are going low fairly quickly then try reducing your pre-exercise insulin dose. Exercise will make you more sensitive to insulin, but when this sensitivity kicks in can vary from person to person, and may last anything from 10-48 hours! It really is very individual.

Try not to worry about 'topping up' with sips of energy/sugary drinks if you need them. The effects of regular exercise will speed up your metabolism and you will continue to burn calories long after you have finished your exercise session. Also, many people find that as they get fitter they are more stable and it is only when you then step up a gear that you need to start watching your levels closely again.

I am a runner and when I was diagnosed I got an excellent book Diabetic Athlete's Handbook, which is great for explaining how exercise affects you as a person with diabetes. Another good book is Think Like a Pancreas.

So, test so that you can build up a picture of how your chosen exercise affects you, then you will be able to limit the lows and get the most from your exercise. An added bonus is that, in becoming more sensitive to insulin, you will need less of it and this in itself can help!


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## Kareen_butterfly (Oct 30, 2011)

*Thanks*

Thanks for your help. Recently, I have been adjusting my insulin on days I have been exercising. I havent been doing it for long so I guess it is a case of trail and error and noting down what works and when. Sometimes I seem to get it right and others I get it very wrong-today I was really high afterwards. I think I need to get into the habit of testing myself before and afterwards rather than just afterwards.

Thank you-lots to think about.

Kareen


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## Kareen_butterfly (Oct 30, 2011)

Thanks northener,

Good to have some advice from an experienced diabetic exerciser. I will be less afraid to top up on energy drinks etc if I need them. I have felt frustrated when I need to exercise as I feel like it has all been nothing. I think lots of monitoring is the answer-at least I know it isn't forever. I inject with each meal and then have another injection to help keep me stable through out the day.

Thanks kareen


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## Robster65 (Oct 30, 2011)

Kareen_butterfly said:


> Thanks northener,
> 
> Good to have some advice from an experienced diabetic exerciser. I will be less afraid to top up on energy drinks etc if I need them. I have felt frustrated when I need to exercise as I feel like it has all been nothing. I think lots of monitoring is the answer-at least I know it isn't forever. I inject with each meal and then have another injection to help keep me stable through out the day.
> 
> Thanks kareen


 
It's what's generally known as basal/bolus kareen. The basal is the once a day (or sometimes twice) and the bolus is the quick acting before meals.

Testing and keeping a food/insulin/blood glucose diary is the main key. From that you'll know what your normal ratios are for carbs:insulin and you can then adjust to maybe 75% bolus for your exercise, or whatever you find works. It is very tricky.

Rob


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## Copepod (Oct 30, 2011)

It's difficult to get it right. As others have said, it's good to reduce insulin before exercise, probably both long acting (easier and more effective if you take 2 doses per day) and short acting, both before and after exercise. It also helps to time your exercise to several hours after your last short acting shot. Personally, I find that in addition to particularly active exercise, usually running, orienteering or canoeing or rarely swimming, my regular walking and cycling (several miles a day) helps to keep my levels relatively stable. 

If you do need extra sugar, it's usually only a few jelly babies, which don't have many calories. So don't beat yourself up if you need a few. 

More detailed physiology etc here, if you want it: http://www.runsweet.com/StartingSports.html plus many other pages on Runsweet website - it's not just about running.


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## Northerner (Oct 30, 2011)

Copepod said:


> ...It also helps to time your exercise to several hours after your last short acting shot....



I usually try to exercise within 2-3 hours of my fast-acting insulin and meal, much longer than that and I don't have sufficient circulating insulin and my levels climb.


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## Copepod (Oct 30, 2011)

That's you Northerner, but Kareen said her problem was going too low after exercise, so that's why I mentioned it. Fuller information on Runsweet.


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## trophywench (Oct 31, 2011)

You should definitely test before exercise as well as after, Kareen.  You need a decent cushion before you start otherwise you'll hypo halfway through.  But then you shouldn't be too high either (is it above 13?) otherwise you'll go higher still, then plummet which makes you feel utterly vile and is absolutely pants, and quite tricky to handle thereafter without over-reacting and your BG see-sawing.

Good luck!


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## Northerner (Oct 31, 2011)

trophywench said:


> You should definitely test before exercise as well as after, Kareen.  You need a decent cushion before you start otherwise you'll hypo halfway through.  But then you shouldn't be too high either (is it above 13?) otherwise you'll go higher still, then plummet which makes you feel utterly vile and is absolutely pants, and quite tricky to handle thereafter without over-reacting and your BG see-sawing.
> 
> Good luck!



I think 17 mmol/l is the absolute upper limit, so if you are even approaching that you need to take care. If I was that high I would take a correction and wait for levels to come down first. Thankfully, for me it's never a problem - I think the highest I have been before exercise was 11, I am normally around 7-8 mmol/l.


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## Cumbrianlass (Oct 31, 2011)

Hi Karen

Its really frustrating when you're trying to exercise to lose weight and it makes you hypo - so you feel like your eating even more. When I was on MDI, and taking Humalog I was told to only have 50% of my dose of insulin if this was within 2 hours of exercising. I would also need to reduce my insulin dose slightly for my next meal. I don't know if you have done DAFNE, but I reduced my ratios.

As already suggested if my BG was above a certain level it would rise. So if at the start of my exercise it was 12 / 13 or above, I would have a unit of humalog insulin before I started to make sure it brought it down. If it was really high eg 17, I would cancel my exercise as I knew it would just make it go higher.

It is trial and error and you will be able to see for yourself what works best. I also found that the more I did exercise and lost weight the more insulin sensitive I became and I ended up on much lower ratios and also on really low amounts of Lantus - but everyone is different.

Good luck and happy exercising!


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## Kareen_butterfly (Oct 31, 2011)

*useful advice*

Thanks everybody-lots of useful advice. I hadn't heard of basal/bolus before so thats good to know. I started keeping a diary last week, so I know I just need to keep at it. Sometimes I get frustrated if I don't get it right straight away but I know it's important to keep at it. I really want to be healthier and exercise some more and I guess some exercise is better than none so I'm determined not to give up-even if I have to eat a few jelly babies or whatever afterwards. 

I will keep at it and I will look at the blogs/books recommended to me.

Thanks everyone,

Kareen.


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## Copepod (Oct 31, 2011)

You've summed it up perfectly - don't give up exercise and have a few jelly babies if you need them 

I'm a bit biased, as I really it, but orienteering really is good with diabetes, as you can start when you like (within a window of a couple of hours), except at really big events with pre-assigned start times, and a couple of seconds to get a few jelly babies out of a pocket and into your mouth isn't going to make much difference in a run of around 30 mins to a few hours. Admittedly, you don't know how long you'll be out when you set off, due to the navigation aspect, and distances quoted are as the crow flies, so you'll always do further. But, overall, easier compared to say, road races with fixed start times. Better scenery than a gym  And wanting to improve my placings makes me do some trail / road / park running.


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## Kareen_butterfly (Nov 2, 2011)

*Doing well!*

Thank you everybody! I feel much more in control. I have been keep track of my blood sugar more and also what I'm eating etc and feel much more in control and happy. I'm not getting it completely right but I am doing better-I have even been out jogging twice this week and I'm loving it. I did need a few haribo afterwards but doesn't matter as it is keeping me healthy! I will keep on doing what I have been doing!


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## Northerner (Nov 2, 2011)

Kareen_butterfly said:


> Thank you everybody! I feel much more in control. I have been keep track of my blood sugar more and also what I'm eating etc and feel much more in control and happy. I'm not getting it completely right but I am doing better-I have even been out jogging twice this week and I'm loving it. I did need a few haribo afterwards but doesn't matter as it is keeping me healthy! I will keep on doing what I have been doing!



Great stuff! Keep up the good work!


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## Cumbrianlass (Nov 2, 2011)

Fantastic Karen - so pleased for you. I also want to thank you, as replying to your post on Monday led me to get my own backside into gear, I booked myself into a class and went back to Spinning after not doing it for three months, due to an illness. On a bit of a learning curve myself as this is the first bit of exercise since being on my pump too - but 2 Jelly babies before and 2 during and blood test at the start, mid class and at the end meant I managed fine. So thank you so much for the inspiration.


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