Diabetics - Glucose Levels Pre/Post Ride

[flymango]

Please help. This morning again (as has happened on several occasions before on an early morning ride), my post-ride glucose levels are HIGHER (14.1) than my pre-ride levels (8.2 - overnight), notwithstanding NO carbohydrate intake. I'm thoroughly confused. How is this physiologically possible?

[An3]

Please help. This morning again (as has happened on several occasions before on an early morning ride), my post-ride glucose levels are HIGHER (14.1) than my pre-ride levels (8.2 - overnight), notwithstanding NO carbohydrate intake. I'm thoroughly confused. How is this physiologically possible?

 

Do you take any insulin prior to your ride?

[craig82]

What insulin are you using and what times do you take your long acting insulin?

[funjunkie]

Your body has released cortisol, adrenaline, glucagon, growth hormine all of which has increased your blood glucose. All these hormones are relased in time of stress and their effect is to increase blood glucose.

Just be careful that you dont go hypo after your excercise.

Also, as the other posts have listed, what meds are you on and when did you take the prior to your ride.

[imagedee]

In theory as u are starting your ride above normal range and continue to exercise you do not have enough insulin in your system to account for the hormones that are released during exercise and this therefore leads to the elevated glucose reading. If you are on an insulin regime you need to plan your pre ride meals with your insulin in take. It also depends on your level of fitness as well as the length of time you ride and diabetic status. This must be discussed with your diabetic caregiver as there are so many factors to consider.

[flymango]

I'm on a basal bolus regime of Lantus and Humalog. Before most morning rides (90% +), I eat oats and use short-acting, with the amount of units depending on my overnight levels. However, on this particular ride, my overnight levels were elavated, and hence no carb intake or short acting. I cycle about three times a week, but certainly don't see myself as fit ot unfit. I'm definately 10kg's heavier than I'd like to be. Thanks for all your comments thus far.

[alexp]

Wow - lots of responses. Are you guys diabetic or just knowledgeable about it?

 

My understanding is that the hormones that will push up your blood sugar readings are only released under high intensity sessions. Lower intensity should be very healthy for you - increasing your insulin sensitivity and burning the sugar in your blood stream.

 

My experience is I have to really push the intensity to get into a situation where my sugars go up. Its very rare.

 

Perhaps not enough long acting insulin? But then I think you'd be higher than 8 when you wake up.

[Trapper]

An added effect to remember and control is that insulin resistance is higher in the morning than other times of the day. Add to this the exercise - if strenuous, it will elevate your sugars. If the exercise times are short, there is not enough stress to actually move your body to the region where it becomes more sensitive to insulin.

 

I had teh same problem for long time (I was using basal/bolus like you). I'm not on a pump, and therefore set my pump to cater for exercise times and requirements, makes it much easier - but still sometimes things just dont work like they are supposed to.

[flymango]

A lot of what is written above makes sense, except on the given day I was purposely on an easy ride and my HR never went above 70% during the 90 minute ride. I'm seeing my specialist in a fortnight for my six-monthly check-up. Will give feedback.

[An3]

I'm Type 1

[alexp]

I'm always interested in other diabetics cycling and doing endurance sport. Did you see the Accu-check cycling gear again at this year's 94.7? Its great to be involved with them.

[dagwood123]

Is Hammer Gel a safe carbohydrate for diabetic endurance athletes?

Physician endurance athlete, Dr. Marty Reynolds M.D., recently shared an interesting "case study" for appropriately answering this question:

 

My wife is a Type I diabetic (on an insulin pump) that is running her first half-marathon in Austin in February. We tested ALL gel products, and found Hammer Gel to be the most reliable and consistent in providing carbohydrate to keep her blood glucose level normal during a run (we tested almost every alternative product we could obtain, such as____,______,____, <snip>). A friend of ours that also has diabetes (on an insulin pump too), who has successfully completed four Ironman Triathlons, has told us that she has found your gel products to be the best for her glucose control. If you ever receive any queries from athletes with diabetes that would like to talk to someone about Hammer Gel for glucose control, I'd be happy to respond to their e-mail. This data was obtained by measuring blood glucose after taking Hammer Gel when my wife Paula, diabetic athlete, was NOT exercising. She and I have even gone to the extreme of taking a unit dose of the gel, then measuring blood glucose levels (which will rise in a diabetic in direct correlation to carbohydrate absorption, when insulin is not given to cover) every 15 minutes for two hours to plot out phamacodynamic curve of Hammer Gel. This interesting data shows that the Hammer Gel begins absorption approximately 30-45 minutes after ingestion, then supplies carbohydrates at a steady state for the next approximately 45 minutes, and then tapers off. Knowing this alters how I take the gel (i.e. I take the first gel at the start of the run, and I won't take any during the last hour of a run as it makes no sense to do so, unless you are relying on it for glycogen repletion after exercise has terminated...

 

Here is how Hammer Gel affected my wife’s blood glucose levels taken during rest:

HAMMER GEL EFFECTS DIABETIC I GLUCOSE LEVELS AT REST

 

Time (minutes)

Glucose mg/dl

 

103

 

15

113

 

49

146

 

68

185

 

81

191

 

104

199

 

 

Note: at time 0 a Type I diabetic with a stable blood glucose level ingested one serving of Hammer Gel and no additional insulin was given to cover this carbohydrate intake, blood glucose levels were then measured periodically over the next two hours.

 

 

 

1. Hammer Gel glucose mg/dl 0-104' curve diabetic I female (at rest)

 

The above figures were taken during rest (not during exercise when blood sugar turnover rate is higher), which is why the recorded rise in blood glucose was modestly above the ideal glucose values. If my wife had been exercising during that time, her blood glucose would have been normal and stable. In fact, she recently completed a two-hour run using Hammer Gel with her blood glucose at the end of exercise being a healthy normal 112 mg/dl. This shows that Hammer Gel is virtually perfect for keeping blood glucose levels NORMAL and STABLE. The dose amount and timing should be worked out for each individual. For her, at 57 kg body weight, when performing at a moderate intensity rate (heart rate ~ 70-75% of maximum), a single packet of Hammer Gel works out just perfect. Athletes with diabetes with different body weights or doing exercise with different intensity levels may need to adjust the dose amount.

 

Therefore, I adopted the following guidelines for taking Hammer Gel during exercise:

 

"Take one dose of Hammer Gel approximately 30 minutes prior to beginning exercise. This one dose alone will cover an exercise session of 45 minutes or less. If the exercise session is planned to continue beyond 45 minutes, then another dose of Hammer Gel is taken at the beginning of exercise. The dose is subsequently repeated every 45 minutes (frequency can be decreased to once an hour during prolonged exercise of > 2 hours). No additional doses of Hammer Gel should be taken when the exercise session is expected to end in less than 75 minutes. When following this protocol, blood glucose values are normal at the start of exercise (between 120-140 mg/dl) and remain stable throughout the exercise sessions (+/- 15% of the starting value), and continue normal through to the end of exercise (usually between 120-140 mg/dl). This is ideal for diabetic blood sugar control and athletic performance.

 

If any type I diabetic patients that need more information, an excellent source is the book, Pumping Insulin, by John Walsh & Ruth Roberts. Chapter 18 and 19 discuss the gram amount of carbohydrate intake required based upon athlete weight, exercise intensity, and exercise duration. The only thing missing from their discussion is what commercially available carbohydrate formulations provide a steady state glucose absorption over time, and what timing should be used for their intake so that a diabetic athlete's blood glucose level can be maintained in a steady state. This is the final piece of information that Paula and I had to derive by word of mouth from other diabetic athletes, as well as trial and error, and our mini-experiment. However, doing this has allowed her to successfully complete a half-marathon and begin training for a full marathon using your company's product."

 

Sincerely,

 

Marty Reynolds, M.D.

 

marty@firstssw.com

 

COMMENT: This remarkable "case study" reports how a diabetic athlete controlled blood sugar using Hammer Gel during exercise. This does not conclude that everyone with a blood sugar disorder will enjoy the same results using the same frequency and dose. However, these guidelines help diabetics to determine how much Hammer Gel to take and how often for generating a healthy blood glucose response during exercise. I wish to thank Dr. Reynolds and his wife, Paula, for sharing this report.

[Naeem Sonpra]

I'm always interested in other diabetics cycling and doing endurance sport. Did you see the Accu-check cycling gear again at this year's 94.7? Its great to be involved with them.

Contact Corine at Accu-Check if you are a diabetic. You will be provided with this kit.I also wore the same kit at 94.7.

[flymango]

Great post dagwood123. I'm a firm believer in Hammer Gel for short rides (< 2 hours) and Perpeteum for longer rides (> 2 hours). Haven't ventured to try 32GI yet. I wish they'd approve CGM in SA (continuous glucose monitors). I would love to know how they help manage the level and trend of blood glucose levels.

[Naeem Sonpra]

I'm a Type 1. I use Hammer Heed or water on short training rides and Hammer Perpetuem together with 32GI on longer training or race rides.

I also use Hammer Gel.

 

Flymango, the CGM would be excellent!!

Edited November 24, 2010 by TeamType1