Q. I’ve gained 50 pounds since I was diagnosed with type 2 diabetes seven years ago. I used to be more physically active, but in recent years have had less time. But lately, I’ve started to exercise again.
When I wake up, before I take my medication and go to the gym, my blood sugar is between 100 and 150 mg/dl. After my workout, it’s up to 175-250 mg/dl—and that’s before I’ve even eaten breakfast! Should I be worried about the drastic jump in my blood glucose?
A. Exercise is an important therapeutic tool for people with diabetes since it can have an effect similar to insulin and lower blood glucose. It also improves insulin sensitivity, reduces abdominal fat and helps other cardiovascular risk factors that are common in diabetics. But a diabetic has special considerations such as peripheral neuropathy, or decreased sensations in the legs and feet. So it’s important to design a workout carefully.
You don’t mention what type of exercise you do, at what intensity, and for how long, so it’s not entirely clear why you may be experiencing higher blood sugar post-exercise. But all these factors make a difference when it comes to stabilizing your blood sugar during and after a workout.
The American Diabetes Association recommends that diabetics be medically evaluated and screened for diabetic-related complications, especially in the heart and blood vessels, eyes, kidneys, feet and nervous system. Type 1 and Type 2 diabetics may have different needs. You should also measure blood glucose before and after a workout, and during the session if it’s especially intense or longer than 30 minutes.
BLOOD SUGAR LOWS FROM EXERCISE
Usually, a low- to moderate-intensity workout such as walking can help lower blood sugar. How low glucose drops depends on the length of time and duration of the workout, as well as what the starting number was, and whether any food or sweetened drinks were consumed during the exercise session.
Some diabetics can experience hypoglycemia, or low blood sugar, immediately after a workout, or even 4 to 48 hours after a workout. Symptoms can include dizziness, nausea, fatigue, excessive sweating, shakiness, confusion and blurry vision.
Making sure not to exercise when your blood sugar is too low, or when your medications are peaking—and therefore dropping your blood glucose to low levels—can help you avoid drastic drops in glucose.
Also, monitor your energy expenditure. If you exercise too long or too hard without having a carb-based snack during the workout, you can drop too low.
BLOOD SUGAR HIGHS FROM EXERCISE
Type 2 diabetics with hyperinsulemia, or the presence of high amounts of insulin in the blood, may see higher levels of blood glucose after a workout. That’s because intense exercises triggers the release of hormones such as glucagon and catecholamines which in turn stimulate the release of increased glucose to fuel the extra energy of the exercise. This might explain why you are experiencing increases in your blood sugar after your workouts. You should discuss this with your doctor because exercising when blood sugar is overly high (>240mg/dl with ketones present, or >300 mg/dl with no ketones present) is not recommended, according to guidelines from the American College of Sports Medicine.
