Q: I usually run 10 to 14 miles on the weekends but I was recently diagnosed with type 2 diabetes. First, why does exercise seem to raise my blood sugar? What do you suggest eating before, during and after the run to give me the energy needed to complete this? I've always carried the little energy gel packs but I'm not sure this is the wise choice with diabetes.
A: To address your first question, a run of that intensity will certainly first elevate your blood sugar before it lowers. It is suggested to generally wait at least 1 our post-exercise before testing.
Your pre-run snack accomplish 2 things: get quick energy fuel while having some in reserves. The first rule is to eat whole, "real" foods such as pure ground peanut butter. A breakfast shake does very well for many people. You want minimal digestion with maximum absorption. What constitutes the best pre-run meal can vary among individuals, and much depends on how you eat the rest of the time. This means creating a fine balance among carbs, protein and fat so that you have a good access to both immediate and long term fuel. My personal morning preference before a workout is in a shake form. Some people can manage a yogurt based smoothie. Peanut butter stirred into oatmeal (if that appeals to you) is a better carbohydrate source than a bagel because of its fiber types. There are also many meal replacement powders out there: some good; others not so good. Berries and banana are good fruit choices to consider adding in a small amount.
Long runs do require fuel and hydration without upsetting salt balance. Of course, your weather conditions must be factored in. As a general rule, for each hour of exercise, 30-50 grams of carbs are recommended so a gel pack may be appropriate during the run only. After a long run you want immediate carbohydrate replacement like a low-fat yogurt, and then having a meal awhile later. In general, eating legumes, lean "flesh" foods, and veggies on a daily basis can provide the best foundation for overall performance.
No two people with diabetes are alike. You are going to have to "self-experiment" over time to see what works. Diabetes doesn't mean "stop"; it does mean "pay closer attention" and continue to enjoy life.
Q: My girlfriend has type I diabetes and is considering training for a full marathon 10 months from now. She is currently about 40 lbs over weight and is not running. I know she needs special advice from her doctor and possibly a nutritionist, but I don't want to set her up for a goal she cannot accomplish.
A: Jumping right in to run would not be a good thing. The first thing to consider is if her blood sugar levels are in close-to-normal ranges. Hopefully, her physician has given her ranges to target. Exercise for Type 1's needs to be closely monitored, especially when doing longer sessions such as running a marathon. She will also need to be aware that hypoglycemia may actually occur during sleeping hours depending on the duration of the activity and food intake. Good hydration is also a "must". I would suggest that if she is serious, she needs to gets some guidelines from her physician. Daily, she should do a minimum of 45 minutes fast walking, gradually increasing, including stretching before and after. If she is cleared as healthy for a marathon by her physician, she needs to be prepared to monitor her glucose carefully before, during, and after exercise. Be sure she has proper footwear, and checks her feet daily.
Q: Why does my blood sugar increase after exercise? I had a blood sugar reading of 135 first thing in the morning. After a 3 mile walk my reading was 155. I had nothing to eat or drink during this time. I repeated this test and got the same results a few days later (132 and 154).
A: Wait an hour after you exercise and see if you get the same results. Exercise is a stressor, so blood sugar will be higher immediately after your session. Also, blood sugars tend to be higher in the mornings because of hormonal activity during the night.
Q: When I exercise my upper body, my blood sugar goes up and when I exercise the lower part, my blood sugar goes down, why is this?
A: How soon after exercising are you checking your blood sugars? For those not on insulin, I always suggest at least an hour, since exercise will raise your blood sugars initially, then "settle" down. If you are more dependent on insulin, blood sugars may be high several hours later. Lower body exercises generally burn more fuel (sugar) due to increased muscle mass. It may just be that on those days your blood sugars are coming down more quickly. Try consistent timing of testing, and see if you don't notice a change.
Q: I have type 2 diabetes andhave been walking 4-5 miles every night for the past six months. How come I'm not losing any weight?
A: Lean tissue weighs more than fat soyou often won’t see the number on the scale change, but will feel better, have more energy, better glucose levels, etc. In time, the weight number starts to come down. Keep up the exercise. Get assistance with your eating if you are at all unclear about how to manage food intake with diabetes. Usually there is room for improvement here.
Q: I have been doing exercise on the upper and lower parts of my body, when I exercise the upper part my blood sugar goes up and when I exercise the lower part my blood sugar goes down, why is this?
A: How soon after exercising are you checking your blood sugars? For those not on insulin, I always suggest at least an hour, since exercise will raise your blood sugars initially, then "settle" down. If more dependent on insulin, blood sugars may be high several hours later. Lower body exercises generally burn more fuel (which sugar is) due to increased muscle mass. It may just be that on those days your blood sugars are coming down more quickly. Try consistent timing of testing, and see if you don't notice a change.
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