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September 22, 2009

Exercise and Sports, Hyperglycemia and DKA

Question from Hardinsburg, Kentucky, USA:

My 11-year-old son has type 1 diabetes that we manage using insulin injections. He runs cross country with one mile races. I have noticed, over the past several practices and meets, that prior to the start of the meet, his blood glucose is within the 80 to 150 mg/dl [4.4 to 8.3 mmol/L] range. However, after the practices or the meets, his blood glucose has been running between 225 and 290 [12.5 and 16.1 mmol/L]. Does he have exercise induced hyperglycemia? What options are available to me to get these post race readings lower? We do not go to endocrinologist again until November.

Answer:

There are never any simple answers when it comes to diabetes and I wouldn’t want to diagnose the problem too quickly, but it does sound like exercise induced hyperglycemia. Some will actually recommend taking insulin in response to an expected high due to stress hormones or activity that is more anaerobic then aerobic, but this something that shouldn’t be done without consulting your endocrinologist. In his book, Think Like A Pancreas, Gary Scheiner discusses topics exactly like these. It’s a great read and I’d encourage you to get a copy and read through it. Gary speaks at CWD conferences often and he has a presentation Blood Glucose Control with Sports & Fitness Activities that you might find helpful.

One more thought….confirm that the elevated blood sugars you are reporting are only happening during the days he is competing and not during that time of day when he is not. This will rule out a problem with his long acting insulin.

BF

[Editor’s comment: See also Blood Sugar Rises with Exercise for more tips.

BH]