December 19, 2008
Exercise and Sports, Hypoglycemia
Question from Hillingdon, Middlesex, UK:
My eight-year-old daughter has been a type 1 diabetic for four years and has been on an insulin pump for five months. The pump has been very successful with achieving good overall blood sugars. Before the pump, she was regularly high, 10 mmol/L [180 mg/dl] to 15 mmol/L [270 mg/d] and we never had a problem with exercise causing a low blood sugar. We are now finding that because her blood sugars are more often in range, 4 mmol/L [ 72 mg/dl] to 7 mmol/L] [126 mg/dl], any form of unplanned exercise, even walking, causes our daughter to have a low blood sugar. As a rule, we will have two or three lows daily because of this. Is this normal when diabetics are achieving in range blood sugars or are we doing something wrong? Our basals seem correct. It’s just any kind of exaggerated movement causes these lows; we have never suffered with so many.
Answer:
Generally speaking, it is common to achieve lower blood sugar levels when metabolic control gets better. However, I think that you may need to reevaluate anyway the current basal and boluses of insulin pump therapy as it must be not properly settled as it is not normal if even the least intense physical exercise causes a low. Ask your pediatric diabetes team for advice.
MS
[Editor’s comment:
See also our web page on The After Exercise Blues.
BH]
