PLEASE READ (not serious just want some information ha ha)


(Billy) #1

I play every year at school (its a tradition) and this is the first year with my diabetes, what do i do?


(Anonymous) #2

Play?


(Billy) #3

whoops sorry, i play dodgeball, but its to late now we played today, our team got 1st!!! I'm happy we were like not a very good team, just a funny team, and yea we got 1st, but my bs was crazy... 49 before playing (my hands were like really sweaty) and 265 when i finished playing, i had 2 4oz glasses of apple juice, plus a gaterade, plus a 15 carb granola bar to correct it, and a bag of skittles so it wouldnt get low, whoops ha ha


(GingerVieira) #4

Hey Billy,

 

I'm Ginger Vieira, from www.diabeteens.com. I'm a personal trainer, yoga instructor and spend most of days being pretty active without drastic lows very often, but it's all about figuring out your own body!

You are totally still able to play dodgeball, but you're right, you're going to need to keep carbs handy and sip on something throughout the game. If this kind of activity becomes really regular for you, you probably won't need to consume carbs as much to maintain your blood sugar, but this is all about trial and error and paying attention to the little details. You have to figure out what your pre-exercise blood sugar can be before a game of dodgeball (or basketball, or weightlifting, etc.) and what amount of carbs you need after that to maintain yourself.

 

Check out a few links on diabeteens that discuss this issue!

Exercise and Diabetes

Different symptoms of hypoglycemia

Type 1 Management Quiz

Preventing Hypoglycemia

Interview w Tennis Player/Coach with diabetes!

 

Ginger

 


(Anonymous) #5

Ah-hah.
I hate when that happens -- all my doctors are big on making me wait for my blood sugar to come back up if I'm low before I do anything, I find extremely annoying at times. My blood sugars go high after treating before exercise, too. Between treating because I'm nervous I will go low during the exercise and physical activity affecting my bg hours after I'm finished, it usually doesn't end well.
J


(Billy) #6

Yea at about 2 (after i posted last) i checked my blood sugar again and i think the excersise took its effect because i was just shaking so bad i clould barly get the blood on the strip, i dont know why i was shaking so bad it was 48 and like i said at school it was 49 or watever and my hands were just a little sweety, well alot a sweaty but still felt ok and everything so idk


(rmeadowsaprn) #7

You were probably dropping further with an already low BG which would explain your shaking then vs. with a similar reading in the past. All diabetics are different and it's really a matter of figuring out what your body is doing. The best way to do this is close monitoring during exercise. I have to check my daughter every 10-15 minutes, even with automatically fueling her with 10-15 carbs every 10-15 minutes. It really stinks, but 1. she has hypoglycemic unawareness and 2. we're hoping to get a CGM to help limit her fingerstick frequency. Fueling up prior to exercise is important to prevent drops as prior messages stated. Don't get frustrated if you have difficulty in the beginning. You also have to remember if your body is changing (growth, stress, etc.) even once you figure it out, the rules can change, so you have to keep monitoring and adapting. I know it's tough. Hang in there.


(Jadeen) #8

Even if my bs is ideal before exercise, it always ends up going higher or staying the same after the workout. I don't drink any sugared beverages (only water) and don't eat anything if my bs is in a good range for exercise. My endo. says that my adrenaline during a workout raises my bs. Does that happen to anyone else?


(joes_girl1231) #9

[quote user="Jadeen"]

Even if my bs is ideal before exercise, it always ends up going higher or staying the same after the workout. I don't drink any sugared beverages (only water) and don't eat anything if my bs is in a good range for exercise. My endo. says that my adrenaline during a workout raises my bs. Does that happen to anyone else?

[/quote]

 

 

i dont really physically do any actual sports............but anyway, i do plays (like musicals and stuff) and so i know that even if im like 70 before it starts expecially on opening night, usually i would drop really low really quickly, but right after I am usually like 180-220 and then about 2-3 hours later (after the adrenaline wears off) I am usually around 50-60, so ya it raises with adrenaline and drops with exercising, bad combo!!!


(rmeadowsaprn) #10

How is this for complicated, ha ha. Read it if you want to. It may help with understanding. Or it may confuse you more.

Children and Adolescents with Type 1 Diabetes

Why does glucose change with exercise

 

Diabetics may rely even more on fat and less on carbohydrates with exercise.  In individuals with T1DM, the pancreas does not regulate insulin levels in response to exercise, making normal fuel regulation nearly impossible. Moreover, there can be deficiencies in the release of epinephrine and glucagon that would normally help facilitate glucose production and release by the liver. As patients soon discover, they may have either increases (hyperglycemia) or decreases (hypoglycemia) in blood glucose levels during exercise.

Many find that intensive insulin therapy helps with glucose management during exercise, because it allows for frequent changes in insulin dosages, particularly if they use an insulin pump.  Intensive insulin therapy (i.e., ‘tight’ control) attempts to mimic the natural pattern of insulin secretion.  Although most believe it to include higher insulin dosages, it simply requires closer blood monitoring and more frequent insulin injections or an insulin infusion pump to prevent extreme glucose excursions.  The move toward more aggressive insulin therapy to prevent long-term complications from diabetes increases the risk of exercise-associated hypoglycemia for some active people with diabetes, especially young patients. It has recently been stated that hypoglycemia is the most severe acute complication of intensive insulin treatment, with exercise being a frequent cause. Nonetheless, such aggressive insulin therapy should be considered because it helps to prevent long-term complications from the disease and because physical performance and aerobic capacity are related to the degree of metabolic control.

Most children and adolescents with type 1 diabetes who exercise for prolonged periods (i.e., >30 min) experience a significant drop in blood glucose levels. There appears to be a strong positive correlation between the drop in glycemia and the pre-exercise value. In addition, severe postexercise late-onset hypoglycemia (i.e., up to 36 h after exercise) may be particularly prevalent in active children with T1DM, possibly because proper insulin and nutritional strategies are not adopted while muscle and liver glycogen (sugar) stores are being replaced. Patients and parents should be particularly cautious therefore if exercise is performed before bedtime.

In addition to intensive insulin therapy, there are other factors that contribute to over-insulinization and hypoglycemia during exercise:

(i) The absorption of injected insulin increases withexercise. The increase insubcutaneous tissue and skeletal muscle blood flow and rise in body temperature is associated with a concurrent increase in insulin absorption and acceleratedhypoglycemia .

(ii)        Plasma insulin levels do not decrease and may even increase during exercise [see (i) above]. A failure in the ability to lower insulin levels during exercise, as would normally occur in a non-diabetic individual, causes a relative hyperinsulinemia that impairs hepatic glucose production and initiates hypoglycemia, usually within 20-60 min after the onset of exercise.

(iii)       Exercise causes enhanced muscle insulin sensitivity via increased activation of non-insulin sensitive glucose transporters. During exercise, the dramatic increase in non-insulin-mediated glucose disposal considerably reduces the need for circulating insulin levels. Because the increase in insulin action persists after the end of exercise in children with diabetes, probably to help replenish muscle and liver glycogen stores, patients are at increased risk of hypoglycemia after the completion of exercise.

Hypoglycemia during exercise may also result from an impaired release of counterregulatory (defensive) hormones caused by previous exposure to either exercise or hypoglycemia . The mechanisms for impaired counterregulation are unclear, but repeated episodes of either hypoglycemia or exercise appear to degrade the body’s ability to mount a counterregulatory response to either stressor.  This finding of a blunted counterregulatory response to exercise is similar to the scenario that occurs in intensively treated patients with diabetes who develop defects in counterregulatory responses to hypoglycemia .

Not all forms of exercise are associated with hypoglycemia, and some patients frequently report hyperglycemia immediately after heavy exercise, probably because of an inability to secrete insulin to compensate for elevations in catecholamine (adrenaline, noradrenaline and dopamine) levels . Indeed, intermittent high-intensity exercise, which reflects field and team sports, does not appear to increase the risk of hypoglycemia in patients with T1DM, probably because of increases in catecholamine levels.

In children with poor metabolic control, exercise can cause an additional increase in blood glucose and ketoacidosis. The rise in blood glucose is caused by exaggerated hepatic (liver) glucose production and impairment in exercise-induced glucose utilization by muscle (Fig. 1C). Increased ketone body production results from elevated FFA release from adipocytes (fat) and possibly from an increase in intrahepatic ketogenic efficiency (ability of the liver to break down ketones). Hyperglycemia and ketosis during exercise is particularly undesirable because it causes dehydration and may decrease blood pH, both of which impair exercise performance.  Heavy exercise (i.e., >60-70% VO2max or >75-85% of maximal heart rate) may particularly aggravate this condition, because increases in catecholamines and glucocorticoids will further exaggerate the elevations in glucose concentrations and ketone production.


(Billy) #11

Thanks for all the replies, now i'm trying to get in shape (after i got diagnosed i've been kinda scared to run and do alot of heavy excersising, so i've been just been sitting around) so this should help alot. I have a program and everything so it should all work out good.