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September 18, 2006

Exercise and Sports, Hyperglycemia and DKA

Question from Wichita, Kansas, USA:

I am writing on behalf of my 31 year old daughter who was diagnosed with type 1 diabetes at age 19. Currently, she is on an insulin pump and doing well. As a police officer, she participates in exercises called "ground fighting," which include cardiovascular and resistance training. However, when she exercises vigorously for several hours, usually two, she experiences very high blood sugars despite using the suggestions her doctor gives her. In turn, she is ill that day and the next. She has participated in team sports since she was four years old and does not want to stop now. She is very frustrated that she cannot workout like she enjoys. I am hoping we can find a doctor that specializes in diabetic athletes so she can continue to participate in her sport of choice.

Answer:

Intense exercise can cause blood sugars to rise. The body recognizes exercise as a “stress,” so counter-regulatory hormones are released signaling the liver to release glucose. Increasing water intake and possibly insulin are techniques used by many. When using a pump, a temporary increase prior to intense exercise can be used as long as the healthcare team is okay with it. Many times after the exercise is completed, blood sugars will return to normal or lower so a plan needs to be in place to use food, decrease insulin or both to prevent a low blood sugar.

RP