05 Nov Type 1 Diabetes & Exercise – Managing the Post Exercise Blood Glucose Spike
Diabetes & Aerobic Exercise – Paul Coker & Dr Rob Andrews discuss approaches to managing type 1 diabetes after aerobic exercise. In this short video Paul asks Dr Andrews what causes blood glucose levels to climb quickly after he crosses the finish line of a long run and asks what the research shows us about managing this.
Introducing Dr Rob Andrews
In this short video Dr Rob Andrews, a world leading clinical expert on diabetes and exercise, shares some incredible insights and guidance on the latest research into Type 1 Diabetes & Aerobic Exercise.
What is Aerobic Exercise?
Exercise that you can do for more than a minute or two is said to be aerobic. Aerobic exercise includes sports like running for more than 400m, cycling, swimming. Gardening, cleaning the car, or the house might be aerobic exercise and perhaps, like me, you have noticed that you have a low blood glucose level when you do some of these daily chores. Dr Andrews says that during aerobic exercise it is common for blood glucose levels to drop quickly in people who have type 1 diabetes and in this video Dr Andrews shares some strategies on how to stop this from happening if you plan your exercise.
What will I learn?
Dr Andrews helps elite athletes and olympians who have type 1 diabetes to excel in sport, you may or may not be an elite athlete but you can be certain that you will get information that has helped people with diabetes to exercise safely at the highest levels on the planet. With this video to learn some of the amazing secrets about diabetes and exercise that Dr Andrews shares with elite athletes.
Paul Coker was diagnosed with type 1 in 1977 and even with 40 years of experience of living with type 1 diabetes and he says that in this interview he learned new diabetes management tools. If you or a loved one have type 1 diabetes that this video has lots of important tips and advice, even if you think that you do not exercise.
Be Part of the Research
Dr Andrews leads a team of researchers who define and explore exercise guidelines that other Doctors share with their patients around the world. Dr Andrews is also a key member of the Exercise with Type One Diabetes (EXTOD) team. EXTOD are looking for people, like you, who have type 1 diabetes who exercise or are thinking about exercising to take part in an important study. Why not take part? You can learn more about how you can take part in this study at the EXTOD website.
Many of Us with Type 1 Diabetes Notice a Post Exercise Blood Glucose Spike, What causes this and What are the Best Strategies to Deal with It?
Paul Coker here from 1BloodyDrop.com. I’m interviewing Dr. Rob Andrews in a series of videos about diabetes and exercise and metabolism. This very short video is a special one for people who are long-distance runners like half marathon events and marathons. Dr. Andrews, this question is coming out of the blue, and you’re not expecting it, but in the previous video where we were talking about how you manage your diabetes after aerobic exercise you were talking about there being a golden window of an hour to replenish your glycogen stores in your muscles to improve your performance on the next event, and that sounds absolutely great, but speaking personally and I know of other runners who have Type 1 diabetes experience this as well the moment that I cross the finish line my blood glucose level has climbed astonishingly quickly.
I believe it’s because of all of the hormones that are flying around in my body that make the insulin resistant while I’m exercising to protect me, and suddenly I’m no longer exercising, so I no longer have that protection of exercise, and my blood glucose level has climbed quickly, so how should I manage that, and for me eating in that first hour or two after exercise isn’t possible because it just makes my blood glucose actually excursion even higher.
Dr. Andrews: Actually, probably the reason why your blood sugars go up is that what happens is as you get towards the end of an event you’re pushing yourself for your time, so what’s happening is that some of that end event you’re actually running anaerobically you’re building up an oxygen debt, and when you run anaerobically you don’t completely burn your glucose and you build up lactate, and what happens is when you stop an event having not completely burned the glucose is the rest of the glucose that should have been burnt during the event gets burnt now you got oxygen, so you return the glucose to the blood, and that’s the reason why the glucose goes up. Most people who are doing an event that they’re trying to get a time what happens is that their glucose can tend to go up after the event, and that’s the returning of you breaking down the lactate that you built up in the event.
Lactate Build up In the Muscles May be Responsible for Post Exercise Blood Glucose Spikes – What are the Best Strategies to Deal with This?
Paul Coker: Perhaps, would a good strategy then be to go for a gentle warm-down jog?
Dr. Andrews: Yeah, and the key thing for that is that what you want to do is, and that’s the easiest way of managing a blood sugar that’s gone up with exercise, or that goes up after the exercise is just to prolong your warm-down or do a proper warm-down, and that will actually bring it down from that point of view. The other thing that stops the lactate going, but lots of people don’t want to do it, but what athletes do is getting into a cold bath, so you’ll see the tennis players as soon as they get off the court they have a nice cold bath.
Paul Coker: I’d always assumed that the ice cold bath was just to reduce inflammation.
Dr. Andrews: Yes, that as well.
Paul Coker: I hadn’t realised that there was a connection to lactate as well.
Dr. Andrews: Yeah, but from the eating point of view I totally understand that it can be really, really difficult. I mean from the marathon point of view having done an event you’re unlikely to run again that distance again, so it only becomes a problem if you’re doing the world championship thing that you were doing of doing a continuous number of marathons in a year then we have to really make sure that we work out how to get you that fueling, but for the majority of people it doesn’t matter if they miss out on that one fueling event provided in their training they’re always doing the fueling.
Paul Coker: Excellent. I think that the important thing there was really how to manage that blood glucose spike after an event I think that the eating would nice to do so that my performance improves, but actually how do I manage that blood glucose excursion after an event, and my previous strategy has always been just to walk gently further for 10 or 15 minutes, and actually the moment I cross the finish line I also give a half a unit of insulin, and whilst it doesn’t actually stop my blood glucose levels from climbing it stops them getting into the 20’s and only into the mid-teens.
Be Very Conservative with any Insulin Corrections Immediately After Aerobic Exercise
Dr. Andrews: Yeah, and you brought up another point is mined-out for that correction within an hour of an event because it generally comes back and stings you. It gets you two, three hours later that you have a low blood sugar.
Paul Coker: Yeah, and I think that that’s actually a really important point in terms of any aerobic exercise. If you’re experiencing a high blood glucose level post exercise then be very conservative about treating it.
Dr. Andrews: Yeah.
Cushoining Blood Glucose Falls by Eating Complex Carbohydrates Can Really Help
Paul Coker: My own view through 40 years of experience of living with Type 1 diabetes is always be conservative with giving insulin. If my blood glucose levels are 14, 16, 18 I can come along and can give a huge big correction dose to bring them down quickly, but once I’ve given insulin I can’t take it away, so if I’ve over corrected it then becomes a problem, and my blood glucose levels crash, and my own strategy is to give a few units and start watching it come down, and then as it starts to come down then leave a couple of hours maybe two or three hours, and then give some more because my view is I’m better off to bring my blood glucose levels down in a slow glide than a fast crash.
Dr. Andrews: Yeah, and the other way you can do is what’s called cushioning, so if you’ve taken some insulin if you take some food that’s slow release than you cushion the fall, so you stop that fall continuing by actually knowing that some of your nutrients is going to be related later on, so that’s why another reason for eating afterwards is if you are going to be doing a correction let’s make sure you get some food onboard and cushion that fall.
Paul Coker: Yeah, okay, so thank you Dr. Andrews. Again, your insights are just incredible and I’m learning so much, which for me after 40 years of living with Type 1 diabetes to sit here and say that is just incredible, so I just can’t thank you enough for the information you’re sharing with us today. In the next video we will be talking about anaerobic exercise, which has as I understand a completely different model for managing diabetes, so we’ll see you on the next video.