Why is the risk of hypoglycemia increased | Blood glucose before exercise | Exercise duration | What to do to prevent hypoglycemia with short-term physical activity | Long-term physical activity should be planned in advance
Physical activity improves the quality of life but is not a method of hypoglycemic therapy for type 1 diabetes. At the same time, physical activity increases the risk of hypoglycemia during and after exercise, so the main task is to prevent hypoglycemia associated with exercise.
Why is the risk of hypoglycemia increased
Actively working muscles require less insulin to absorb glucose from the blood, that is, their sensitivity to insulin increases (cells – “keyholes” are better opened by insulin – “key”). Muscles occupy a rather large volume in the human body. Therefore, a large amount of glucose can disappear from the bloodstream within a short time if many muscle groups are active at the same time. In response to this, a healthy person has a decrease in the production of insulin by the pancreas and an increase in the release of glucose from the liver, and the level of glucose in the blood remains within normal limits.
Healthy person has a decrease in the production of insulin by the pancreas and an increase in the release of glucose from the liver
In a person with type 1 diabetes, there is no automatic decrease in insulin in the blood, since it is introduced from the outside and continues to be absorbed from under the skin. Thus, if the dose of insulin and the amount of carbohydrates in food remain the same, and physical activity is higher than usual, hypoglycemia may develop.
From this it becomes clear that glucose in the blood is reduced not by physical activity, but by insulin. Therefore, physical activity in itself should not be used as a hypoglycemic in the treatment of type 1 diabetes mellitus, it only needs to be taken into account in order to avoid hypoglycemia.
What factors should be considered when exercising:
- Baseline blood glucose
- The intensity of physical activity
- Duration of physical activity
Blood glucose before exercise
Physical activity is not recommended for decompensation of diabetes mellitus, in particular with glycemia above 14 mmol / l.
Exercise duration
The duration of physical activity can be divided into short-term (up to 1 hour) and long-term (more than 1 hour). Physical activity can include not only playing sports within the specified time, but also homework (cleaning the apartment, washing, gardening, etc.).
What to do to prevent hypoglycemia with short-term physical activity
Since a short-term load is most often unplanned, it is not always possible to reduce the dose of insulin in advance. Therefore, it is more convenient to take 1-2 bread units before its beginning, as a rule, in the form of products containing slow-digesting carbohydrates (bread, fruits). In some cases, for example, with a very intense sports exertion, it is necessary to use digestible carbohydrates, and even in liquid form (a glass of juice before the start of the competition).
Long-term physical activity should be planned in advance
As a rule, prolonged physical activity leads to a greater decrease in the body’s need for insulin, so it is necessary to reduce the dose of insulin on time.
If a person with type 1 diabetes will consume the previous number of bread units, the dose reduction can be 30-50% of both short-acting and prolonged insulin.
It should also be noted that after the end of prolonged physical activity (for example, which lasted all day), its “hypoglycemic” effect can be observed for some time – within the next 12-24 hours (at night, the next morning). Consequently, it will be necessary to reduce the doses of insulin administered after the load (sometimes by the same 30-50%).
Constantly monitor your blood glucose!
Unfortunately, it is impossible to say exactly how much the level of glucose in the blood will decrease after this or that physical activity. Accordingly, one cannot be completely sure by lowering the dose of insulin or by eating extra carbohydrates that hypoglycemia will be prevented. Therefore, it is imperative that you have with you a sufficient supply of easily digestible carbohydrates, and with prolonged workload, not for one hypoglycemia. And most importantly, constantly monitor your blood glucose!