Diabetes in Control has a lessons learned section for health professionals. Although we commonly think of exercise that will lower our blood sugars some insulin users find the opposite occurs. This is the case report.
A man with type 1 diabetes started an exercise program to help him manage his early morning highs. He exercised every evening, at which time his glucose levels would drop during and after exercise. Thinking that exercise would lower his early morning highs, he did not take his insulin before exercise. He was surprised to see his glucose would go up after exercise rather than go down….
He discussed this with his endocrinologist who recommended he take a very small amount of fast- or rapid-acting insulin before exercise. His glucose levels did well. He was surprised to see his levels did not get low, nor were they high after exercise anymore. This became his regular regime.
•Even though exercise makes an individual more insulin sensitive, one still needs insulin for muscles to use glucose. Without enough insulin, glucose levels can rise.
•Individuals can and usually do have different insulin needs throughout the day.
•To lower post-exercise highs, start low and go slow to learn the amount of insulin your patient needs. Some need only one unit.
•Check before, during, and after exercise, or better yet, use CGM and track trends.
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From Diabetes in Control 27 April 2015