• Exercise and the Insulin-Dependent Diabetic

If you are an insulin-dependent diabetic, understanding how exercise affects your body can help you avoid hypoglycemia and hyperglycemia. Either can result from exercise if you do not plan your schedule care full. If insulin-dependent, you will find that you must adhere more closely to your daily schedule than a non-insulin-dependent diabetic. Generally, just as you plan to eat your meals and take your insulin at the same time each day, you will also want to schedule your exercise routine with regularity.
Exercise increases your muscles' demands for glucose because working muscles use more energy that relaxed muscles. This energy is derived from the glucose circulating in your blood stream. In this way exercise helps lower your blood sugar level.
If you take insulin injections, the kind of exercise you do may influence your insulin injection site because exercise can increase the rate of absorption of insulin by your body from the injection site. Researchers have found that when insulin is injected into an exercising limb, such as your leg, as you are walking or running it is absorbed faster. This is not desirable because the fast absorption may actually cause the injected insulin to act too quickly on your system. There fore, after planning your exercise program, your physician will suggest injection sites in parts of your body not being exercised.
In many cases an increased sensitivity to insulin is beneficial, as it may decrease the amount of insulin you have to take. If you are taking insulin, however, you should carefully balance the insulin with the food you eat and the amount of exercise you get. When you exercise you will learn to adjust either your insulin injections or the amount you eat. If you are overweight, however, your doctor may recommend that you lower your insulin injections rather than increase your food consumption. This way you will burn more calories and eat no extra food, so you should be able to reduce your weight. Because the kind and duration of your exercise cannot always be anticipated, it may be easier to increase your food intake before exercising.
When is the best time to exercise? Usually the best time is 15 minutes to two hours after a meal, since your blood sugar is higher then at any other time. If you think you need extra food, try to eat it about 15 minutes before you exercise. If you exercise vigorously for extended periods of time, you may require some extra food about every half hour. Occasionally after you finish exercising you may still notice signs of hypoglycemia; at those times you may also require food. Especially during all-day activities, such as hiking or a long bicycle ride, you will want to be well prepared with extra food. You can easily carry a concentrated form of high energy snacks. Sugar cubes, hard candies, and orange juice are examples of foods that can raise blood sugar that has been reduced too much by exercise. If you do become hypoglycemic, eat extra food until your symptoms subside or your blood sugar returns to normal. After your blood sugar has returned to normal, if it5 is not near mealtime, it may be advisable to eat some complex carbohydrates (such as bread, cereal, or other starchy food) to keep your blood glucose level stabilized.
In determining a time for exercise, consider when the action to your insulin peaks. Insulin may peak anywhere from about 2 to 12 hours after the injection, depending on the kind you inject. Exercising at the time that your insulin peaks is not a good idea because the combination of exercise and high insulin level could reduce your blood sugar too much, causing hypoglycemia.
Patients on insulin pumps may need to reprogram their pumps for exercise.