I am severely overweight, I have type 2 diabetes treated with insulin, and I have been following a tough exercise routine for five months. I have noticed that, for about one to two hours afterwards, I feel energized and up, but after that I am back to feeling sluggish even though my blood sugar is no higher than 130 mg/dl [7.2 mmol/L]. In addition, I also have not lost any weight, so I feel that I am just wasting my time on a false hope. Do you have any suggestions?

Do not give up. You have already started to do something that can change your life. I would suggest you speak with your physician as a next step. Issues such as eliminating excess insulin, reviewing calorie intake, evaluating your exercise regimen, and effects of other medications need to be reviewed.

JTL

[Editor’s comment: It may be that some tissue that used to be fat has now turned to muscle which weighs more. You might ask your doctor and/or dietitian to evaluate this. Another thing to keep in mind is that many people (especially those who are overweight) who have type 2 diabetes, have difficulty with glucose and also gain weight. It seems like you been able to gain glucose control and maintain your weight. Congratulations!!

You probably feel energized right after exercise because of an epinephrine surge during the activity. Your sluggish feeling later is normal as this hormone level decreases or it may also be due to hypoglycemia. I suggest that you check some blood sugars when you feel this way to see what’s happening. If they are low, they should be treated with fasting-acting carb. You also may need to decrease the insulin that is working during your exercise time or have a snack beforehand.

Please, as Dr Lane has suggested, make an appointment to discuss your concerns, and, above all, keep up the good work!

SS]

[Editor’s comment: Another thought: be sure to be tested for possible hypothyroidism.

WWQ]