Tips on Avoiding Low Blood Sugar while Exercising

July 16, 2012By 2 Comments

Ask any diabetic who is trying to stay fit and healthy and they will tell you that one of their biggest challenges is keeping their blood sugars in normal range while trying to burn calories.  It’s one of the major frustrations we battle with this disease.  There is nothing more annoying than just burning 250 calories on the treadmill only to have to consume a 100 calorie juice box and 4 peanut butter crackers equaling around 150 calories.  I have tried to be slick and outsmart my diabetes, by suspending my pump, or eating my lunch first and not bolusing for it before going to the gym, and then I end up with a blood sugar of 280 and absolutely no energy for my work-out.

Here are some tricks of the trade and things to try to help avoid lows while you are exercising or even before participating in sports:

  • If you are a pump user, set your temp basal for 80% one hour before you exercise, and keep the temp basal on for 3 hours.  So if you are working out for one hour, you will now have a lower basal rate an hour before and an hour after to help avoid the lag effect exercise has.  Experiment with how low you should go on your temp basal, as we all have different insulin needs, and for some 90% may be enough or for others you may need to go as low as 50%.  It will also depend on what your blood sugar is before working out, so of course, always check before you begin.  If you are not on a pump, than I highly recommend going on one when you are ready, as I can recall how difficult and almost impossible working out was when I had unpredictable Lantus peaks (even though it is supposed to be a ‘peakless’ insulin, nothing is perfect).
  • Always check your blood sugar an hour before you work out.  I know a lot of my diabetic friends say they like to be around 180 or 200 before they work out, and this is fine.  However, make sure you don’t have ketones or even work out at all if you are over 250 as this is very unhealthy to do.  If you have ketones and you are working out, you are only creating more ketones and your kidneys will NOT thank you.  This is dangerous!
  • Keep in mind that strength training of any kind can often make your blood sugar go up.  Your muscles use stored glucose, and as your muscles use up that glucose, your body will create more glucose to replace the lost stores, so this can cause a temporary spike.  If you want to do some strength training, it may be a good idea to end your strength training with a 15 min. cardio cool-down to help naturally get your blood sugar back down.  I have spoken with fellow diabetics and Endocrinologists who do not recommend taking a correction dose for a slight high that occurs after strength training, as your blood sugar will most likely come down on its own.  As always, check your blood sugar often when you are working out to keep an eye on it and to see if you do need a small bolus.
  • I’m sure we’ve all heard it from our diabetes educator or dietitian, but it’s true; if you eat something with a mix of carbs, protein and fat an hour or two before you work out, it should help sustain you through your work-out.  Now, keep in mind, if you happen to be on a downward spiral after breakfast for whatever reason, or if you mis-counted your carbs and over-bolused, than even the perfect snack may not always do the trick.  A yogurt or some kind of bar like a Luna Bar, Pria bar or even a Nature Valley bar will help.  A banana and a cheese stick is a staple of mine.  You may want to only bolus for ¾ of the amount of carb in it or spread the bolus out over an hour.  This is something you will need to work out through trial and error.
  • It’s also not a bad idea if you’re doing a long cardio work-out or a Zumba class to keep a sugary sports drink like a regular Vitamin water or Gatorade on hand so you can stay hydrated and help keep your blood sugar at bay.
  • As difficult as it may be for a lot of us to try to work out at the same time every day, for those of you who have a more regimented schedule and can do this, you should be able to figure out exactly what works for your work-outs when it comes to food, time of day, activity and keeping your blood sugar in check.  For those of us who don’t know when we are coming or going, wearing a CGM, even if it’s a loaner from your doctor’s office, will help you gain deeper insight into what exactly goes on with your numbers during various intensity work-outs and strength training.
  • Do your best to NOT overtreat! As tempting as it may be to continue eating until the low feeling goes away, you may just have to call your work out a wash.  If you overtreat, you will most like battle a yo-yo of rebound blood sugars for the rest of the day.  Test often and make informed decisions.
  • Don’t try to grunt through your work-out and ignore your low.  This is a recipe for diaster!  Wear your medical alert bracelt always, so in case of emergency someone else can help you.

Exercise is an integral part of being a healthy diabetic.  People with diabetes who exercise regularly on average are able to take less insulin because their bodies utilize the insulin they have on board more efficiently.  I don’t exercise with a goal of being model thin, I do it because it helps relieve stress and keeps my diabetes in tip top shape.  When I am not able to go for a walk or do any activity for more than 2 days, I can see a significant increase in corrections I need to make for high blood sugars and I can also see a change in my mood.

Managing diabetes and exercise is no simple task, but the benefits sure outweigh the frustrations.  As always, double check my advice with your own doctor because what you may be taking for insulin or how you are taking it can affect how you should manage activity differently from the next person with diabetes.

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Comments (2)

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  1. Beth Shapiro says:

    Curious…is it more forgiving/easier to maintain one’s blood sugar levels by practicing more “low impact” physical activities like some styles of yoga or Pilates?

    • Diabetes says:

      Good question! It might be slightly easier to predict what will happen to blood sugar during lower impact activities, as there is less variability of the blood sugars during a Yoga class for example. However, because you are still using your muscles in lower intensity workouts, there can still be a significant effect on glucose levels. Unfortunately, if your a diabetic and you have to move and breath, there will always be some variability to your numbers!

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