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October 21, 2006

Exercise and Sports, Hyperglycemia and DKA

Question from Pleasanton, California, USA:

Three days a week, I do Pilates or aerobics for about an hour. I have been able to stop the lows during exercise, but post exercise highs over 300 mg/dl [16.7 mmol/L] have been occurring. How can I prevent these highs? I have increased my basal after exercise and I eat a protein bar and a meal about one hour before exercise.

Answer:

Upsetting the balance of blood sugar levels is very easy to do when exercising. Trying to prevent lows during exercise can easily cause high blood sugars after practice. Eating a meal and a protein bar within an hour of exercise can be challenging to keep good blood sugar levels during and after exercise. Too much protein can cause high blood sugars several hours after ingesting. Carbohydrates are more important prior to exercise than protein anyhow.

Ideally, a meal should be eaten two to three hours prior to exercise for best results. That does not mean that food cannot be eaten within an hour but, for best results, a meal needs time to digest and provide fuel for exercise.

If blood sugar levels climb into the 300s mg/dl [over 167 mmol/L], most likely more insulin is needed. This may mean starting a basal increase during the exercise or lowering the target prior to the start, for example, from 180 mg/dl to 140 mg/dl 10.0 to 7.8 mmol/L]. Increasing water intake is always recommended when blood sugars are high. This will help wash away any ketones as well as aid in lowering blood sugar levels.

RP