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[IP] Re: Exercise

Hi Karen...

	Regarding exercise - you are absolutely on the right track with the idea of
checking BS every 30 minutes.  I do also have a few "exercise physiology"
suggestions... most people are always surprised that it actually does
require the presence of insulin to control blood sugars in people with
diabetes during exercise - and this is *especially* true during types of
exercise (such as mountain biking) which have a large degree of "anaerobic"
or high intensity/"power" activity.  During activities such as this, the
body pulls stored glycogen from BOTH muscle and liver stores.  The other
contributor to rising glucose levels during & particularly immediately after
exercise is lactic acid.  Lactic acid (which is produced in larger
quantities during anaerobic/power type activities, as well as during "new"
activities) is eventually converted to glucose, and intended to be stored as
muscle and liver glycogen.  Without enough insulin around that "lactic acid
originated glucose" may be a cause of those post exercise highs.

	My "guess" would be that your 300+ readings after an hr of exercise are NOT
related to "rebounding" from a low during exercise.  I say this because
those "rebound" highs happen when the blood sugar has already begun to rise
following a low.  The reason for this is that the presence of insulin (as
during hypoglycemia) *inhibits* the process of liver glycogen dumping.  So
it isn't until circulating insulin levels decrease that liver glycogen has
the ability to increase BS.  I have a feeling this is not what is happening
in your case.... but I am most definitely interested in hearing your test
results, if you don't mind sharing.  Living with diabetes myself, I have to
say that nothing with DM is impossible!  *LOL*  I would also be very careful
about "pre-loading" prior to mountain biking, especially if you are
typically starting exercise at a BS of 140 (which is a fairly good place to
start, btw).  I would be concerned, with your current ending sugars, that
you would only go higher by adding carbs during exercise to the program.  Of
course, I certainly do agree that always carrying fast acting carbs is
always a great idea.

	Exercise blood sugar management is tough, to say the least.  Definitely a
YMMV situation.  Keep "patterning" by extra testing.  Remember that what
might work for one sport or one activity might not work for another.  I'd be
happy to discuss additional & more specific recommendations with you (or
anyone else) if you think it might be helpful.  :)  Please feel free to
continue discussing via the list, or to email me directly.

Always in health,
Delaine M. Wright, MS, CDE
Clinical Exercise Physiologist
Pumping Since 11/97, Type 1 since '83

>Date: Sat, 15 May 1999 18:11:11 EDT
>From: email @ redacted
>Subject: [IP] exercise

I have recently increased my mountain biking to a two hour work out. I have
tried a variety of approaches. The first month when I was biking for only an
hour I tried taking my pump off for the hour. This seems to work with less
enduring work out but I found every time I finished my ride my blood sugar
started at 140 and I finished in the high 300s. Last week I did an 18 mile
ride and decided to try cutting my basal rate to 50%...the same results
occurred.....very high blood sugars in an hour. I am guessing my blood sugar
is dropping and glycogen from my liver is kicking in. I plan to check my
blood sugar on my next ride every thirty minutes.

Any suggestions?????


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