Exercise

[barbie3]

Am I better to exercise before or after my insulin injection and meal or after please? I am getting conflicting advice. Thank you

 

[Carlos]

Am I better to exercise before or after my insulin injection and meal or after please? I am getting conflicting advice. Thank you

It depends a bit on the exercise intensity, duration, what your levels are. I don't think there's a single answer. What your control is like, and which type also will have a bearing.

In my case I am type 1, with reasonable control. If I am going for a short bike ride at lunchtime and my levels are seven or above I just ride, and inject and eat afterwards. If I am below seven then I have a little snack before the ride, and inject and eat lunch after.

My longer rides are usually in the morning, so I inject a reduced dose of fast acting, have a bigger breakfast and then snack during the ride as needed.

This works for me, and got to this system by seeing what worked and what didn't. Each of us is different.

 

[barbie3]

It depends a bit on the exercise intensity, duration, what your levels are. I don't think there's a single answer. What your control is like, and which type also will have a bearing.

In my case I am type 1, with reasonable control. If I am going for a short bike ride at lunchtime and my levels are seven or above I just ride, and inject and eat afterwards. If I am below seven then I have a little snack before the ride, and inject and eat lunch after.

My longer rides are usually in the morning, so I inject a reduced dose of fast acting, have a bigger breakfast and then snack during the ride as needed.

This works for me, and got to this system by seeing what worked and what didn't. Each of us is different.

Thank you. I walk/run between 3-12 miles five days a week usually first thing in the morning so I will try a reduced dose and bigger breakfast before my exercise

 

[helli]

The reason you are getting conflicting advice is that we are all different and do different exercise.
Unfortunately, this means the best way to find out what works best for you and your type of exercise.
Things to bear in mind
- constant cardio exercise typically makes our body use insulin more efficiently
- resistance exercise and intermittent exercise makes our body resistant to insulin
- we are more insulin resistant in the morning
- we are all different

 

[Callista]

constant cardio exercise typically makes our body use insulin more efficiently
- resistance exercise and intermittent exercise makes our body resistant to insulin
**

Now that's interesting! I'm a newbie, just DX pre-DB, and trying hard to improve before my next HbA1C test (it was 45 - scary)

I know I have to adopt healthier eating (lose weight, fewer carbs/high GI carbs), but exercise is also key, probably more so in respect of the insulin resistance I assume I most likely have already developed?

It's good news to me that cardio can improve insulin sensitivity, but why is it that resistance/weight training does the opposite? Is there an explanation?

I'm currently exploring all this, and there's a LOT to learn - thank you for any help. This whole site, and the forum, is wonderful!

The one thing I am definitely picking up is that it's complicated (and, as you say in your own email, there is an 'individual' element to it as well.)

 

[rebrascora]

constant cardio exercise typically makes our body use insulin more efficiently
- resistance exercise and intermittent exercise makes our body resistant to insulin
**

Now that's interesting! I'm a newbie, just DX pre-DB, and trying hard to improve before my next HbA1C test (it was 45 - scary)

I know I have to adopt healthier eating (lose weight, fewer carbs/high GI carbs), but exercise is also key, probably more so in respect of the insulin resistance I assume I most likely have already developed?

It's good news to me that cardio can improve insulin sensitivity, but why is it that resistance/weight training does the opposite? Is there an explanation?

I'm currently exploring all this, and there's a LOT to learn - thank you for any help. This whole site, and the forum, is wonderful!

The one thing I am definitely picking up is that it's complicated (and, as you say in your own email, there is an 'individual' element to it as well.)

What I find is that exercise which puts my body under a lot of strain... muscle burn, significantly increased heart rate etc will cause my liver to dump glucose into my blood stream. I believe it is a fight or flight response with the liver releasing that extra glucose to give you energy to perhaps save your life in an extreme situation which may be why some people exhibit superhuman strength in times of emergency. This is probably a similar prehistoric feature to Dawn Phenomenon when your liver releases glucose to give you energy hunt or gather your first meal of the day. As diabetics our bodies have difficulty utilizing that glucose, so our levels rise. The liver will later suck glucose back out of our blood to replenish it's stores, so levels will likely drop over the longer term/later in the day or overnight.

With steady aerobic exercise, your cells use up their stores and start to be keener to take the glucose from your blood stream to replenish rather than needing insulin to push glucose into them when they are not working.

 

[Callista]

That definitely makes logical sense. As ever, it seems to be a three way balance in our bodies between food intake (of whatever kind), energy demand (of whatever kind) and then storage/release (glycogen in liver, fat in spare tyres!).

It's getting that three-way balance right that is tricky.

I'm trying to work out how insulin resistance (which I assume is my root problem, pushing me into pre-DB because I can't 'flush' the ingested sugars from my blood stream (using insulin), plays into all of this. I know IR is 'not well understood' (says everything I've read on the I/net so far!) but there is clearly come physiological and molecular mechanism going on/

There's a lot to learn! Thank you for helping me. Much appreciated!

 

[Leadinglights]

That definitely makes logical sense. As ever, it seems to be a three way balance in our bodies between food intake (of whatever kind), energy demand (of whatever kind) and then storage/release (glycogen in liver, fat in spare tyres!).

It's getting that three-way balance right that is tricky.

I'm trying to work out how insulin resistance (which I assume is my root problem, pushing me into pre-DB because I can't 'flush' the ingested sugars from my blood stream (using insulin), plays into all of this. I know IR is 'not well understood' (says everything I've read on the I/net so far!) but there is clearly come physiological and molecular mechanism going on/

There's a lot to learn! Thank you for helping me. Much appreciated!

I know not everybody agrees with his theory but I find Dr Jason Fung's explanation in the book The Diabetes Code makes lots of sense.

 

[Callista]

Thank you - I shall look it up!

 

[Callista]

Just the quickest of Internet searches - the Diabetes Code seems doable, but, but, but....it's the fruit I really, really miss.....at the moment that is the hardest thing for me, rather than missing starch.

I'm really trying to work out which fruits are less bad than others, and again, it's a bit of a minefield. Who'd have thought that Strawberries (SO associated with strawberries and cream!) could be low carb?!

I am trying to keep my very limited fruit intake to after dinner, to try and avoid a sugar spike. It's also then a last-thing-at-night treat!!!

 

[rebrascora]

Strawberries and cream is a good choice as long as you don't eat a whole punnet at once. The cream will help to slow the release of glucose from the fruit and strawberries are one of the lower carb fruits along with my favourite, raspberries and blackberries and blackcurrants. Blueberries are a little bit higher than the other berries but still OK as long as you keep the portion small. A kiwi is about 5g carbs per fruit as is a small clemenitine/satsuma. Apples are about 15g carbs per fruit. I usuall split an apple over 2 days and have it with a nice chunk of cheese.... again, the fat in the cheese slows the release of the glucose. Grapes are a bit higher and part of the problem with grapes is that once you start it is easy to just keep eating them without any portion control. If you can limit yourself to half a dozen it isn't so bad, but personally I would rather have a dozen rasps as half a dozen grapes. Bananas and mangos and papaya and pineapples are usually the highest carb fruits and I tend to reserve them for a very very occasional treat and again, I have a limited portion rather than a whole fruit and either share with my partner or spread it out over several days.

Usually I will have a small portion of berries with my breakfast yoghurt and nuts/seeds and that will be it for the day or I may have half an apple with cheese as my lunch or after my evening meal.

 

[42istheanswer]

Just the quickest of Internet searches - the Diabetes Code seems doable, but, but, but....it's the fruit I really, really miss.....at the moment that is the hardest thing for me, rather than missing starch.

I'm really trying to work out which fruits are less bad than others, and again, it's a bit of a minefield. Who'd have thought that Strawberries (SO associated with strawberries and cream!) could be low carb?!

I am trying to keep my very limited fruit intake to after dinner, to try and avoid a sugar spike. It's also then a last-thing-at-night treat!!!

Commercial strawberries are high in water, that's why they're so big! Home grown strawberries tend to be smaller (but sweeter so probably higher carb for the weight)

 

[Callista]

Thank you! I didn't know cream/cheese slows down the release of the fruit sugar - that's a bonus! (Of course, when it comes to strawbs and cream, what really makes them oh-so-gooooood is the added icing sugar...sigh)

Didn't know commercial strawbs are high in water, but that is a bonus in these circumstances.

I do include blueberries, but will take note of portion. As for grapes, sigh, they are my fave, and yes, I do pick, pick, pick. What I do now is put a little bowl together of a few strawbs, some blueberries, and a strict number of 6 grapes, and have it last thing by the fire/telly.

Good to know satsumas are not totally out, as they are my other fave with grapes. I currently have some very hard kiwi fruits (!) which take a fair amount of chewing, so that's good - but if they are no better than sats I'll stick to sats.

Bananas I seldom eat anyway, but mangoes are so good for Vit C and I used to get them when they were on special offer.

As for fruit overall, it's funny (well, not really, sigh) that something I used to eat to be virtuous (and then hit the icecream!!!!), is now my luxury treat.

 

[Dun]

constant cardio exercise typically makes our body use insulin more efficiently
- resistance exercise and intermittent exercise makes our body resistant to insulin
**

Now that's interesting! I'm a newbie, just DX pre-DB, and trying hard to improve before my next HbA1C test (it was 45 - scary)

I know I have to adopt healthier eating (lose weight, fewer carbs/high GI carbs), but exercise is also key, probably more so in respect of the insulin resistance I assume I most likely have already developed?

It's good news to me that cardio can improve insulin sensitivity, but why is it that resistance/weight training does the opposite? Is there an explanation?

I'm currently exploring all this, and there's a LOT to learn - thank you for any help. This whole site, and the forum, is wonderful!

The one thing I am definitely picking up is that it's complicated (and, as you say in your own email, there is an 'individual' element to it as well.)

Hi Callista,
T2 here, im not sure which exercises are helping me the most but I do 40mins, approx, lifting and pushing weights then 20mins on exercise bike. I eat porridge for breakfast with a scoop of whey, 2 hours after, I test and it's around 12 to 16 mmol. After X my readings come down to below 5, constantly, then creep up throughout the day, 6.5 is,so I am thinking it's both. Oh my fasting levels about 7 sometimes 1 or 2 lower, and I take 2x500g metformin

 

[Spathiphyllum]

constant cardio exercise typically makes our body use insulin more efficiently
- resistance exercise and intermittent exercise makes our body resistant to insulin
**

Now that's interesting! I'm a newbie, just DX pre-DB, and trying hard to improve before my next HbA1C test (it was 45 - scary)

I know I have to adopt healthier eating (lose weight, fewer carbs/high GI carbs), but exercise is also key, probably more so in respect of the insulin resistance I assume I most likely have already developed?

It's good news to me that cardio can improve insulin sensitivity, but why is it that resistance/weight training does the opposite? Is there an explanation?

I'm currently exploring all this, and there's a LOT to learn - thank you for any help. This whole site, and the forum, is wonderful!

The one thing I am definitely picking up is that it's complicated (and, as you say in your own email, there is an 'individual' element to it as well.)

Callista-- Barbie3 is Type 1, and that presents a particular set of challenges with regard to exercise.

You're not using insulin, so you really don't have to worry!! Just get out there and do as much exercise as you can. Preferably a mix of aerobic and resistance exercise, which is what we all should be doing.

 

[Callista]

ust get out there and do as much exercise as you can. Preferably a mix of aerobic and resistance exercise, which is what we all should be doing.
**

Resistance exercise is what I'm good at, and cardio I'm rubbish at - which is probagly a sign that it is the latter that I should be doing more of, not the former (sigh). (This is the good old puritan principle that it is what we don't want to do that is what we should be doing!!!!)

I guess I just wanted to ensure I'm not doing anything that will counter my efforts to crack my pre-T2 insulin resistance!!!

 

[Callista]

Hi Callista,
T2 here, im not sure which exercises are helping me the most but I do 40mins, approx, lifting and pushing weights then 20mins on exercise bike. I eat porridge for breakfast with a scoop of whey, 2 hours after, I test and it's around 12 to 16 mmol. After X my readings come down to below 5, constantly, then creep up throughout the day, 6.5 is,so I am thinking it's both. Oh my fasting levels about 7 sometimes 1 or 2 lower, and I take 2x500g metformin

T2 here, im not sure which exercises are helping me the most but I do 40mins, approx, lifting and pushing weights then 20mins on exercise bike.

**

Gosh, I couldn't do any cardio after resistance exercise!!! I do my cardio first (while I'm fresh) and mainly to get it over with (I do NOT like doing it!), and then I 'treat' myself to the weight machines!!!

 

[Spathiphyllum]

ust get out there and do as much exercise as you can. Preferably a mix of aerobic and resistance exercise, which is what we all should be doing.
**

Resistance exercise is what I'm good at, and cardio I'm rubbish at - which is probagly a sign that it is the latter that I should be doing more of, not the former (sigh). (This is the good old puritan principle that it is what we don't want to do that is what we should be doing!!!!)

I guess I just wanted to ensure I'm not doing anything that will counter my efforts to crack my pre-T2 insulin resistance!!!

Here’s a very useful academic article, published last year—a group of academics, on behalf of the American College of Sports Medicine, summarising recent research on exercise, in general and various different types, for people with Type 2: https://www.ncbi.nlm.nih.gov/pmc/articles/PMC8802999/

Loads of handy-- and highly motivating-- information! But the most important thing is the summary in the introduction:

“During any type of physical activity (PA), glucose uptake into active skeletal muscles increases via insulin-independent pathways. … Improvements in systemic, and possibly hepatic, insulin sensitivity following any PA can last from 2 to 72 h, with reductions in blood glucose closely associated with PA duration and intensity. Additionally, regular PA enhances β-cell function, insulin sensitivity, vascular function, and gut microbiota, all of which may lead to better diabetes and health management as well as disease risk reduction.” [I’ve added the underlining and removed footnotes.]

There’s a little confusion around resistance exercise; resistance exercise does not increase insulin resistance!

Undoing the confusion requires a good deal of explanation! But, if you’re interested—the explanation, as I understand it, is as follows:

As you probably know, most of your cells most of the time need insulin in order to take up glucose, the main fuel for cells. You can picture the cell as having a little door to let in glucose-- but the door is locked, and insulin is the key.

Muscle cells, though, have ‘glucose doors’ that can be unlocked either by insulin or by exercise. When muscle cells start contracting rhythmically, after a little while that little ‘door’ opens, and they start sucking up glucose—no insulin needed.

With moderate-intensity aerobic exercise (like brisk walking or slow running), this will tend to make your blood glucose level go down. For non-diabetics and Type 2s who are not insulin dependent (i.e. not injecting artificial insulin), this is not a problem. Your beta cells will be putting out a bit of insulin most of the time; and real, natural insulin is very fast-acting and very short-acting. So—whenever your system senses that your BG is going too low, your beta cells will just stop putting out insulin for the time being; so you won’t become hypoglycaemic.

For Type 1s (and, I think, insulin-dependent Type 2s) though: Even the so-called ‘rapid acting’ artificial insulins are slower to take effect and hang around in the system longer than natural insulin. So, if we have artificial insulin in our system, and our BG is lowish, and then we go for a long, brisk walk: our muscles will start sucking up glucose, AND we’ll have insulin in our system inappropriately making our other cells also suck up glucose—and we are likely to go hypo. So we have to manage this carefully.

With resistance exercise, or high-intensity aerobic exercise: While you’re doing it, the effect of your muscles sucking up glucose may be counteracted by another factor. When you do resistance exercise or high-intensity aerobic exercise, your body tends to start putting out cortisol (a stress hormone); and cortisol triggers your liver to release stored glucose. So, while you’re doing the exercise, your BG may go up rather than down. And this may continue for a little while after you stop the exercise; you’ll see the article mentions “transient post-exercise hyperglycemia”.

But, a little while after you’ve done your resistance exercise or HIT, your body stops pumping out cortisol, so your liver stops releasing glucose, and the effect is then the same as the post-exercise effect of moderate-intensity aerobic exercise: your muscles keep sucking up glucose for hours afterwards. The benefits of this hugely outweigh any short-term rise in BG during resistance exercise or HIT.

Again, this can be tricky for Type 1s: with resistance exercise or HIT, we have to think about how to manage any hyperglycaemia during or shortly after the exercise without increasing our risk of hypoglycaemia in the following hours! But Type 2s who are not on any medication are not at any risk of hypoglycaemia, so you don’t have to worry about this.

I hope this helps, and all best wishes!

 

[Spathiphyllum]

I do my cardio first (while I'm fresh) and mainly to get it over with (I do NOT like doing it!), and then I 'treat' myself to the weight machines!!!

When I used to go to a gym, I felt much the same! Doing aerobic exercise on a treadmill or stationary bike or rowing machine, bleh.

But-- a brisk walk or gentle jog in a park, or even in a neighbourhood where people have nice front gardens, is lovely. Especially at this time of year! Aerobic exercise is so important for our general health. Do some experimenting; try walking or jogging or cycling in different places, or swimming, or a dance class ... I'm sure you'll find something you can really enjoy, enough that it can become a lifelong habit.

 

[helli]

I order cardio/resistance at the gym based on my levels.

• If my levels are in the 7s or 8s, I will start with cardio to bring my levels down
• If my levels are in the 4s or 5s, I will start with resistance to raise my levels.
• If my levels are higher than 9, I will not exercise as any exercise adds stress and raise my levels further.

But we are all different so you need to find what works for you.