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May 7, 2007

Daily Care, Exercise and Sports

Question from Upland, California, USA:

I'm 42 and I was just diagnosed with diabetes and high lipids this week. My doctor put me on Glucophage twice a day for my diabetes and lovastatin for my cholesterol. I am checking my fasting blood sugar levels, but I am hearing that when they are this high that going to the gym is not advised. I intend to do 45 minutes of weight lifting and 45 minutes on a stationary bike. So far, my blood sugars have been 229 mg/dl [12.7 mmol/L] on Thursday at 11 a.m.; 164 mg/dl [9.1 mmol/L] on Thursday at 6 p.m.; 212 mg/dl [11.8 mmol/L] on Friday at 7 a.m.; 249 mg/dl [13.8 mmol/L] (no lunch) on Friday at 5:30 p.m.; and 173 mg/dl [9.6 mmol/L] on Saturday at 7 a.m. I'm already scared and confused about my situation since my readings are all over the place and my fasting target range is suppose to be less than 120 mg/dl [6.7 mmol/L]. I've already started a very strict diet per the ADA, but I'm confused about the not exercising. I can't make any sense out of this. Can you shed some light on what I should and shouldn't be doing right now?

Answer:

Medical rehabilitation and cardiac rehabilitation centers have very rapidly picked up on the fact that when exercise occurs with blood sugars above 250 mg/dl [13.9 mmol/L], the blood sugars tend to go up. That is because your body relies on the production of adrenaline and similar hormones to increase cardiovascular response to exercise. The adrenaline counteracts the effects of insulin. The key is to be adequately in control going into the exercise. It is also important to consider the amount of exercise you are doing. Harder exercise increases adrenaline more than less strenuous exercise. I generally tell my patients not to exercise with blood sugars above 250 mg/dl [13.9 mmol/L]. You will note that blood sugars may rise after exercise, but they come down later on when the sugars are not too high. There is still a net benefit to exercise, even though this sounds all too complicated.

JTL