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fitness
THE WARM-UP
It’s time to get your heart pumping.
As you start to move, your muscles
use their own stored sugar as well as
sugar from the bloodstream to make
an energy compound (called ATP)
that helps them contract. And soon,
your hungry muscles need more
sugar to make that fuel. So your
body gradually lowers insulin levels
and raises glucagon levels to release
more stored sugar (from your liver)
into your bloodstream for muscles.
At rest, muscles require insulin to
absorb glucose, so how does that
released sugar enter active muscle
cells with only a small amount of
insulin? First, working muscles place
more transporters on the surface
of their cells that act like doors for
insulin to deposit sugar into. The
more doors, the more sensitive
cells are to insulin, even with less
of it floating around. Second, active
muscles can also absorb glucose on
their own without insulin, so less
insulin is needed. Both pathways
prompt muscles to absorb excess
glucose, helping to lower high BGLs.THE WORKOUT
At this point you’re in the swing of
your activity, be it dancing, walking,
swimming or a body-weight circuit.
To keep your muscles happy, your
body releases other hormones, such
as adrenaline, that free even more
stored glucose from the liver.
During intense activities (think:
short sprints with little downtime
or a hard lifting session), adrenaline
may release more sugar than your
muscles can use, which can raise
blood sugar for up to 2 hours
post-exercise. This temporary spike
is common and typically does not
impact your HbA1C, though it
may need to be balanced through
food or medicine (see Working
Out with Insulin, top right).How muscles use glucose
during exercise is the same for
all people. But people with type
1 and those who take insulin
often need to take extra steps
to avoid swings and lows
during activity. This may mean
adjusting insulin or eating
a source of glucose before or
during exercise. If BGLs rise
after a hard effort, it may seem
intuitive to treat raised levels
with an insulin dose, but thisWhile you cool down, catch your breath and sip water, your muscles
and liver are still hard at work absorbing sugar out of the blood to
replenish their stores for next time. And those good effects that
happened during exercise – improved insulin action and sensitivity- may remain enhanced for up to 48 hours post-sweat!
Heart-pumping aerobic activities aren’t the only form of exercise
that’s beneficial: resistance training can also increase glucose uptake
and reduce insulin resistance. That’s why combo workouts (think:
water aerobics, body-weight circuits or even walk-then-lift sessions)
may be the most effective for blood glucose management. ■
rise is temporary and taking
insulin could increase the
risk for a delayed low.
Navigating your body’s
response when on insulin
can be frustrating, but finding
a regular exercise routine that
works for you is possible. Have
patience with yourself and take
the necessary precautions:
check your BGLs beforehand,
pack a source of glucose and
listen to your body.DURING^ EXERCISE
Working Out with InsulinAFTER^ EXERCISE
diabetic living JULY/AUGUST 2019 107