Regular exercise improves the quality of life and improves the well-being of any person. But for people with diabetes who are on insulin therapy or using antidiabetic drugs, be aware that exercise can significantly, and sometimes drastically, lower blood glucose levels. Fortunately, this moment can be controlled by understanding the mechanics of the development of hypoglycemia from exercise , using continuous monitoring of blood sugar (BC) or a glucometer .
How exercise leads to hypoglycemia
When muscles are actively working, they need less insulin to absorb more glucose from the blood. Figuratively speaking, the cells “open wider” from the usual amount of insulin. There are a lot of muscles in the human body. And if all of them are actively working, then a large amount of glucose can disappear (pass into the muscles) from the blood in a short time. In a person without diabetes in this situation, the body produces less insulin, and the liver releases more glucose into the blood – so the CK remains normal.
In a person with diabetes, there can be no automatic decrease in the amount of insulin in the body – it is already injected under the skin and is gradually absorbed from there. That is, if the amount of insulin and food remain the same, but physical activity is added, hypoglycemia may develop.
It is also important to know the general rule for people with diabetes of any type:
You can not start training if blood sugar is above 13 mmol / l! This can cause even more hyperglycemia and the appearance of acetone in your body.
If you are using an insulin pump
To avoid hypoglycemia during training, reducing the dose of basal insulin by 25 – 100% will help. Choose the level of base change that suits you empirically. For intense and prolonged loads, you need to reduce more. For stretching and exercises with weight – less.
Also, if a workout (or other physical activity ) lasts more than an hour, you need to check your blood glucose levels after 40 minutes. And if it is 5.5 mmol / l or lower, eat an additional 10-30 grams of carbohydrates.
If you plan to exercise less than 2 hours after a meal, the dose of bolus insulin (per meal) should also be reduced by 10-30%.
And if the training was in the evening and quite intense, it is also recommended to reduce basal insulin at night by 20-50% – also depending on the level of SC at the moment and on your experience.
Basis bolus regimen (use of long and short insulin)
For those who plan to exercise regularly, it makes sense to switch to a new generation of insulins – analogues. They are much more convenient to keep blood sugar under control during exercise . The following recommendations apply specifically to these insulins.
If you plan to exercise within 2 hours after eating, then you need to reduce the amount of bolus (per meal) insulin by 10-50%, and increase the amount of carbohydrates by 10-30 grams.
If physical activity is more than 2 hours after eating and injecting short insulin, then you need to eat 15 gr. carbohydrates if the SC is now 8-5 mmol / l. If below 5 mmol / l – then 30 grams of carbohydrates.
After intense and prolonged training in the afternoon, you should reduce the dose of basal insulin at night by 20-30%. But training for stretching and with weight most often does not require changes in the regimen of insulin administration.
Oral (tablet) hypoglycemic drugs
If you have compensated diabetes, that is, the dose and type of hypoglycemic drugs are correctly selected, it is unlikely that your sugars will drop sharply and unexpectedly from physical activity. But nevertheless, in order to better understand your body and the impact of sports on it, doctors recommend in the first month of starting training or in case of changing the treatment regimen:
- measure SC levels before and after exercise,
- keep a diary of a diabetic at this time – so you will immediately notice the trends of changes.
If your workout (though it could be walking or cleaning the house) lasts more than 45 minutes, eat 15 grams of carbohydrates. Even non-diabetic athletes eat or drink orange juice during competitions or long workouts to keep their blood sugar from dropping to critical levels.
But if you’ve been hypoglycemic more often since you started exercising regularly , talk to your doctor about it. Most likely, he will advise you to reduce the dose or type of hypoglycemic preparations .