Suggest Ways To Control Diabetes

Posted on Thu, 14 Jul 2016

Question: hi,

I am type 1 diabetic.

My Medication :
8 units of actrapid insulin before breakfast, lunch& Dinner.
12 units of lantus insulin at bed time.

My Question:

Today i was out for running 5 km early morning before breakfast.
But my blood sugar increased rapidly, i would like to know how can i keep blood sugar normal after intense 5 km run.

Fasting Blood Sugar( Before Running 5 Km) - 169 mg
Blood sugar after running 5 km has gone up - 255 mg

how can i control the blood sugar...

Answered by Dr. Dr. Abhay A Mali (49 minutes later)

Brief Answer:
Need to know some more details.

Detailed Answer:
Hi,

Once again happy to answer your query.

As I have mentioned previously during vigorous exercise there may be release of stress hormones (anti-insulin effect) that causes high blood sugar level instead of low blood sugar.
This response may last for initial few days after starting exercise.
Keep monitoring blood sugar levels before, during and after exercise.

I want to know-
1) what had you eaten prior to exercise and with or without insulin?
2) Any symptoms of hypoglycemia during exercise?
3) Had you taken any energy drinks during exercise?
4) Also mention your timings of exercise and morning breakfast.

I may suggest to take small dose of Actrapid 2 to 4 units prior to snacks before exercise (in addition to your routine doses, though minor change in insulin dose prior to breakfast may be needed) with monitoring of blood sugar levels during and after exercise.

Probably after 1 week of monitoring we will be in better position to know your insulin requirement and blood sugar level pattern.

Hope this helps you.
I will be happy to answer your follow up queries, if any.

Regards,
Dr. Abhay Mali.
Diabetologist.

Above answer was peer-reviewed by : Dr. Nagamani Ng

Follow up: Dr. Dr. Abhay A Mali (5 hours later)

I want to know-
1) what had you eaten prior to exercise and with or without insulin?
A) Did not eat any thing since my FBS was already 169.

2) Any symptoms of hypoglycemia during exercise?
A) No Symptoms of hypoglycemia

3) Had you taken any energy drinks during exercise?
A) Drank water after 3km running

4) Also mention your timings of exercise and morning breakfast.
A) Wakup Time : 6:00 AM, Running Time - 6:30 to 7:30 AM, and BreakFast Time : 9:00 AM

Answered by Dr. Dr. Abhay A Mali (2 hours later)

Brief Answer:
Have some snack with insulin prior to exercise.

Detailed Answer:
I may suggest to take some snack like half cup cow milk or tea with 2 marrie biscuits or 1 slice of brown bread with 4 units of Actrapid 20 min prior to snack before going for running.
Rest follow routine dose of insulin and diet pattern.

So your insulin doses will be
4 Units Actrapid 15-20 min before snack prior to exercise.
8 Units Actrapid 15-20 min before breakfast.
8 Units Actrapid 15-20 min before Lunch.
8 Units Actrapid 15-20 min before Dinner.
12 Units Lantus at bed time (10pm).

Monitor
1) Fasting BSL
2) During Exercise if symptoms of hypoglycemia.
3) Before Breakfast.
4) 2 hours after breakfast

All of above 4 plus any one of the following.
1) Before Lunch.
2) 2 hours after Lunch.
3) Before Dinner.
4) 2 hours after dinner.

With close monitoring of symptoms of hypoglycemia and additional blood sugar level reading during episode of hypoglycemia.

Keep this schedule for 1 week.
According to weekly blood sugar chart one can modify your insulin doses and diet pattern if required.

Hope this helps you.

Above answer was peer-reviewed by : Dr. Veerisetty Shyamkumar

Follow up: Dr. Dr. Abhay A Mali (20 minutes later)

Thank you so much for the detailed response.

Answered by Dr. Dr. Abhay A Mali (1 minute later)

Brief Answer:
All the best.

Detailed Answer:
Thanks.

I will be happy to answer your follow up question.
Keep in touch with your treating diabetologist also.

Above answer was peer-reviewed by : Dr. Vaishalee Punj