Effect of exercise

[OhJoy]

Hi everyone, I am wondering about how exercise helps with T2. I know that it does but I don’t get the mechanics. If the problem is that our bodies are unable to utilise the glucose in our blood then why/how is it reduced by exercise? I have read on the forum that some people prefer to not take medication but just exercise when their BG spikes to reduce it.
would be very interested if anyone could explain.

 

[harbottle]

Exercise causes the muscles to take up glucose without insulin, so it can reduce blood sugar. It’s also good for improving insulin sensitivity.

Intense exercise can raise it, though, as it stimulates the creation of glucose for energy.

 

[OhJoy]

Ok that helps, thank you

 

[helli]

Intense exercise can raise it, though, as it stimulates the creation of glucose for energy.

Intense exercise can temporarily increase blood glucose but over the next 48 hours, you can find it reduces blood glucose.

 

[Proud to be erratic]

Exercise causes the muscles to take up glucose without insulin, so it can reduce blood sugar.

Not sure this is strictly correct. Harsh reality is we need insulin to transfer glucose out of our blood stream and into our cells and I understand that only our brain is capable of using glucose without insulin. Can certain muscles achieve the transfer without insulin?

It’s also good for improving insulin sensitivity.

Yes, this is certainly correct and moderate exercise can greatly improve that sensitivity to a point where a little insulin goes a long way!

Intense exercise can raise it, though, as it stimulates the creation of glucose for energy.

Again , fully agree. I've read that the high intensity exerrcise triggers an innate "fight or flight" response - but that could be fanciful embolishment by that author; but it certainly elevates my BG.

 

[OhJoy]

Not sure this is strictly correct. Harsh reality is we need insulin to transfer glucose out of our blood stream and into our cells and I understand that only our brain is capable of using glucose without insulin.

So if I think hard enough I can lower my BG

 

[Deleted member 21371]

Not sure this is strictly correct. Harsh reality is we need insulin to transfer glucose out of our blood stream and into our cells and I understand that only our brain is capable of using glucose without insulin. Can certain muscles achieve the transfer without insulin?

No.

You're not a type 2 are you?
Type 2 is mostly insulin resistance, not a complete cessation of producing insulin. Any potential rise in BG is mostly negated by the decrease in insulin resistance hard exercise brings with it, and the decrease does last for days after.

As a type 2, losing weight, and retraining my body to use carbs effectively through exercise was part of my reversing the type 2 diabetes.

 

[helli]

Typically, long constant cardio exercise will reduce blood glucose and increase insulin sensitivity.
Stop start, shorter exercise will raise blood sugars.

This was explained to me as: when our body notices we are exercising, our liver releases extra glucose to give us the required energy ( this is probably the “fight or flight” reaction). Then our muscles ”take up insulin” and our body because more efficient at using insulin.

If we do “stop start” exercise such as weights or HIIT, the liver dump starts but the improved insulin efficiency mode isn’t reached.
As I mentioned previously, there are other thing such as comfort and stress that affected insulin resistance/sensitivity. For example, another of my regular exercises is climbing. This is stop start and adrenaline producing so my levels rise.

But the comfort/stress thing can also mean the affects of an exercise can change as we become fitter at that activity.

I think of the longer term effects in terms of glucose in liver available to drip/dump throughout the next 48 hours. Through the glucose dump to give us energy when we start exercise, our liver glucose reserves are depleted. We have less available to drip/dump so our liver “consumes” more glucose from the carbs we eat.
I definitely find my Dawn Phenomenon is significantly reduced after exercise which I put down to the lower live reserves.

I should caveat all of this with “I have Type 1 diabetes and, typically, do some sort of exercise 5 days most weeks.”

 

[harbottle]

Not sure this is strictly correct. Harsh reality is we need insulin to transfer glucose out of our blood stream and into our cells and I understand that only our brain is capable of using glucose without insulin. Can certain muscles achieve the transfer without insulin?

Even with impaired insulin uptake exercise reduces BG in T2s due to increased absorption via a different pathway.

Skeletal Muscle Glucose Uptake During Exercise: How is it Regulated? | Physiology

The increase in skeletal muscle glucose uptake during exercise results from a coordinated increase in rates of glucose delivery (higher capillary perfusion), surface membrane glucose transport, and intracellular substrate flux through glycolysis. The mechanism behind the movement of GLUT4 to...

journals.physiology.org

In individuals with type II diabetes, a single bout of exercise can reduce blood glucose concentrations (83) mainly because the exercise-induced increase in skeletal muscle glucose uptake is intact (79) even when insulin action is impaired. Thus the molecular mechanism resulting in increased muscle glucose transport during exercise is recognized as a clinically relevant alternative pathway to increase glucose disposal in skeletal muscle in states of insulin resistance.

 

[Lucyr]

So if I think hard enough I can lower my BG

Yep. My bg is lower after an intense day of thinking at work than on an easier day

 

[OhJoy]

So… exercise does cause the take up of glucose despite impaired insulin action and also improves sensitivity to insulin. Clearly beneficial
thank you everyone

 

[trophywench]

Yep. My bg is lower after an intense day of thinking at work than on an easier day

Well Lucy, there's thinking and then there's thinking. Because my job involved intense mental concentration the additional concentration required to calculate and solve T1 conundrums was almost like having a bit of a rest for 10 minutes I spose - BUT having entirely wiped the work thing from my normal life by now, this last 2 years I've found the concentration required for the D - Too Hard.

 

[Hardy1945]

When I was first diagosed with T2 nearly 20 years ago, the DB nurse advised: sensible eating (forget the word diet, this is for life) and regular exercise. At the time I was overweight but not obese at 76kg, my waistline 36" and my chloresterol 7.8. She pulled a graph out to show my likely life expectancy if I took no action. It didn't look too good. As a matter of discipline therefore, I immediately cut out some of the naughty things, but otherwise applied the regular exercise and sensible eating approach. Blood tests at the time also revealed that my kidneys were not in the best of shape at 57 so I started on ramipril, which as well as controlling blood pressure, being an ACE inhibitor, in my case helped to protect the kidneys. 12 months later my weight was down to 63kg the waistline 32" and the chloresterol 3.5. For the record each day I try to walk for about 3/4 hour at a briskish pace, which can be a bit 'sweatty' on hot suumer days. The point is, don't push it too hard. Due to the constant nagging of the DB nurse, I recently started on metformin 500mg though I haven't noticed any changes arising from this. One final piece in the jigsaw, acting on further advice, I was advised to drink at least 2L of water each day, which I try to do. Latest GFR results indicate that my kidneys are currently at 73. Still shy of the normal level but a decent move from where they were. So there's the advice, forget the technicalities, just try to discipline yourself to regular daily walks and sensible eating. NB I am currently 77.

 

[EmmaL76]

So if I think hard enough I can lower my BG

Well I dropped 2 points just pondering over that

 

[Deleted member 21371]

When I was first diagosed with T2 nearly 20 years ago, the DB nurse advised: sensible eating (forget the word diet, this is for life) and regular exercise. At the time I was overweight but not obese at 76kg, my waistline 36" and my chloresterol 7.8. She pulled a graph out to show my likely life expectancy if I took no action. It didn't look too good. As a matter of discipline therefore, I immediately cut out some of the naughty things, but otherwise applied the regular exercise and sensible eating approach. Blood tests at the time also revealed that my kidneys were not in the best of shape at 57 so I started on ramipril, which as well as controlling blood pressure, being an ACE inhibitor, in my case helped to protect the kidneys. 12 months later my weight was down to 63kg the waistline 32" and the chloresterol 3.5. For the record each day I try to walk for about 3/4 hour at a briskish pace, which can be a bit 'sweatty' on hot suumer days. The point is, don't push it too hard. Due to the constant nagging of the DB nurse, I recently started on metformin 500mg though I haven't noticed any changes arising from this. One final piece in the jigsaw, acting on further advice, I was advised to drink at least 2L of water each day, which I try to do. Latest GFR results indicate that my kidneys are currently at 73. Still shy of the normal level but a decent move from where they were. So there's the advice, forget the technicalities, just try to discipline yourself to regular daily walks and sensible eating. NB I am currently 77.

Exercise and sensible eating.
Is there anything else to be said?

 

[Proud to be erratic]

Even with impaired insulin uptake exercise reduces BG in T2s due to increased absorption via a different pathway.

Skeletal Muscle Glucose Uptake During Exercise: How is it Regulated? | Physiology

The increase in skeletal muscle glucose uptake during exercise results from a coordinated increase in rates of glucose delivery (higher capillary perfusion), surface membrane glucose transport, and intracellular substrate flux through glycolysis. The mechanism behind the movement of GLUT4 to...

journals.physiology.org

Thank you, answers my question.

The Skeletal Muscle Uptake is a new concept to me; need to read it again, more slowly and get my mind more into deciphering some of it. Interesting that the paper was written in 2005, I wonder how much further they've been able to take this research since then. Neither Gary Scheiner nor Ragnar Hanas seem to pick up on this in their more recent editions of their books - but I suppose they are both focused on T1 diabetes, or at least insulin dependent diabetic people and not particularly invested in subtle physiological mechanisms.

 

[Deleted member 21371]

Thank you, answers my question.

The Skeletal Muscle Uptake is a new concept to me; need to read it again, more slowly and get my mind more into deciphering some of it. Interesting that the paper was written in 2005, I wonder how much further they've been able to take this research since then. Neither Gary Scheiner nor Ragnar Hanas seem to pick up on this in their more recent editions of their books - but I suppose they are both focused on T1 diabetes, or at least insulin dependent diabetic people and not particularly invested in subtle physiological mechanisms.

Never trust people that peddle books.
Just do stuff that works for you, and gives you the lifestyle that you want.

 

[Bruce Stephens]

Interesting that the paper was written in 2005, I wonder how much further they've been able to take this research since then.

Here's one from 2013:

https://www.researchgate.net/profile/Erik-Richter-7/publication/253647606_Exercise_GLUT4_and_Skeletal_Muscle_Glucose_Uptake/links/5475f0880cf2778985af4523/Exercise-GLUT4-and-Skeletal-Muscle-Glucose-Uptake.pdf

 

[Drummer]

I found that exercise increased my blood glucose, and I could see over 10mmol/l if I went out and rode my bike for half an hour before the 2 hour after meals test when I'd be under 8 or even 7 pottering around the house.
It might have been due to the alarmingly bad driving around here of course, but after a couple of weeks I gave up on the idea and switched to using the trampoline in the garden in peace and quiet.

 

[Deleted member 21371]

I found that exercise increased my blood glucose, and I could see over 10mmol/l if I went out and rode my bike for half an hour before the 2 hour after meals test when I'd be under 8 or even 7 pottering around the house.
It might have been due to the alarmingly bad driving around here of course, but after a couple of weeks I gave up on the idea and switched to using the trampoline in the garden in peace and quiet.

I'm not a pottering person.
I put the effort in, and take the result afterwards.
It's not always an instant hit.
Diabetes is about the long game.