# Exercise Effect



## Tanyam82 (Oct 8, 2018)

Hello,

I am currently walking for 40 to 60 minutes around 6am every morning. I eat porridge and inject for that. Around 12pm I will then get low sugars which I think is an effect of the walk as I have only experienced this since walking.

Does anybody else have a delayed reaction to exercise? How do you prevent getting too low blood sugar?


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## Matt Cycle (Oct 8, 2018)

Hi Tanya.  It doesn't say if you're T1 or T2 but I assume you mean injecting insulin.  The effects from or reaction to exercise can be difficult to predict and are often very individual.  The only way is through trying it and with lots of testing.  Certainly a delayed and/or prolonged reaction is possible.  Again this would depend on the individual and on the type, intensity and duration of the exercise.  After a long cycle ride in the day I use a temporary basal on the pump throughout the night and sometimes into the next day as my muscles use glucose released by the liver to replace glycogen.  

As the low you're experiencing is around 12pm the bolus from your breakfast should be finished by then.  In terms of preventing low blood sugar the easiest option would be to eat some slower release carbs (without bolusing) - e.g. malt loaf etc during the morning.  If the walking is going to be a regular thing then you could look into reducing your basal (this assumes you're on a basal/bolus regime) but you may need to speak to your team about this.  Unfortunately there is a fair bit of trial and error involved but good luck as the end result is worth it.


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## Northerner (Oct 9, 2018)

Hi Tanya, I see from your previous posts you were originally diagnosed Type 2, but the possibility was then raised you were Type 1. Are you now injecting insulin, and what sort? It helps us to know so that we can give better advice. Fundamentally, the advice that Matt gives is correct whatever your treatment regime - as you are learning how your body responds to increased activity you need to do lots of testing, and perhpas either top up with extra carbs if needed, or reduce your medication if that is a possibility - something you need to discuss with your nurse or doctor.

Exercise makes your body's cells more sensitive to insulin so they are able to use more of the glucose in your blood, and more efficiently  If you imagine a cell as normally having a couple of doors which the insulin can unlock and let glucose in, then what happens when you exercise is that all the windows can also be opened by the same insulin 'keys'  In medical terms, each cell has a number of insulin receptors on it and exercise increases the number of these receptors (in Type 2 diabetes, where 'insulin resistance' can be a problem, you can imagine that the door locks are a bit rusty, so don't work very well, but again exercise will 'oil' the locks making them open more easily  I hope that explanation isn't too Peppa Pig, but it's something I heard soon after diagnosis and I found it really helpful in understanding the processes involved  

Not only does exercise increase the number of receptors, but regular exercise will mean that the effect of this lasts not just for the time you are exercising, but up to 24 hours afterwards, so you need to be mindful of this and try and plan your medication accordingly  As Matt says, this can affect people differently so it's important to do lots of testing and recording of results so you can learn how you are affected. After a while it becomes second nature


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## n1ck (Oct 9, 2018)

Hi Tanyam,

As Matt and Northerner have pointed out...it is different for everyone even though the physiologically process is still the same.

I've been Type 1 for 14 years and, although i manage it well, i'm still having 'trial and error' periods. In general, for me, with my usual routine/volume/type of exercise i can manage my sugars to the point where i only need my glargine on the evening and no daytime 'novarapid' throughout the day. To get to this point though has been tough with numerous hypo's and food adjustments for pre/post workouts to find the right level of insulin that would allow me to exercise whilst ensuring i don't dip into 'hypo' city. 

It does become second nature...just takes a bit of practice


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## Lizzzie (Oct 29, 2018)

Yes!  Im.luvky enough to be on an insulin pump and turn the pump (background insulin) down after exercising because my metabolism speeds up.

  Or if you don't have the luxury of doing that, but know the dip's going to happen, to have a mid-morning biscuit / apple / whatever without insulin to pre empt it?


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