Blood sugar INCREASING with workout

I wonder if dehydration could cause somewhat false test results? If there is less water in your blood, then there is an apparent higher concentration of other things in it, relatively speaking. Does anyone know how dehydration may affect blood tests?

I did a little bit of searching on the net, looks like there is some mention of dehydration affecting blood glucose levels, apparently especially in the type 2 diabetis. I found this article kind of interesting: www.guideline.gov/.../summary.aspx Perhaps you will be able to find more literature about that with little more in depth search.

From reading your post, SwimsWitha Fist, you are monitoring your diabetes well. Congratulations. And you are keeping an excellent exercise routine as well. Do you test your sugar levels before you begin to exercise? (Your glucometer should be like the master card ad, 'never leave home without it'. An easy way is to bring it is in a ziplock bag with a small face cloth to dry your hands and leave it on the pool deck). If your sugar levels are over 225, and you have ketones, exercise will actually cause your levels to go even higher. Ideally, to be able to use your blood sugars when exercising, they need to be around 160. When they are high,(over say 225 or 12.5) it makes a person feel sluggish and inefficient in the water. This is partly due to the fact that your cells cannot get the energy and are now breaking down either fat an/or muscle. The reason you would 'feel' hungry is because your body has been working hard without fuel, as the circulating sugars are not able to get into the cells. Insulin is like a key to unlock the door ie your cells. In type 2, you have lots of keys, just that they are like putty and won't turn the lock. Hence the medication. Are you eating a Low Glycemic Index diet? There is an excellent place where diabetics exchange amazing amounts of knowledge. www.joslin.org. The online library is a real treasure, and the discussion boards are incredible. You should also remember that different workouts will affect your blood sugar levels. High end sprints will elevate levels and high effort as well. Sometimes heavy weight training,(when you are in the phase of your weight training where you are pushing your maximum for 1-2 repeats), can also alter blood sugar levels. Plus competition also throws the levels way off. This is because the hormone adrenalin is released, along with other hormones like cortisol. What this does is stimulate the body into a stress like situation. (Stress also raises blood sugar levels)The reaction is fight or flight. We need to be excited about racing and working hard, and must therefore be prepared for the management and sucessfull ability to reach our swimming goals. The website that Conniekat8 has posted is a good source as well. Dehydration is definietly a cause for elevating blood sugars. If you are drinking caffinated beverages, make sure you also drink equal amounts of water. Is your coach aware of your needs? Let your coach know your numbers before training if they are high. The coach can adjust the warmup so you can work down the numbers a bit. Or alter where the speed part, high effort will be. For those on insulin, your coach should also be aware of your numbers. And when your last shot of insulin was. It can be difficult given training times and pool avaliability to time a shot so the peak is over before training begins. Exercise plus circulating insulin will result in low levels once the food is used up. And for females, pre menstrual cycle will also push numbers up. Menopause complicates it even further. Hope this helps. "To motivate, add water" "Fear is a reaction, courage is a decision"

Hmmm. BG raising with exercise. Well better to be a bit high then too low when exercising. The real question is how is your long term control? High 200's are one thing if you are down under 140-150 most of the day or at least under 200 as opposed to being up over 200 all the time. High BG can hurt you over time but so can low/ high HDL-LDL ratios in some people. Exercise should raise your HDL-C which with type II can be depressed as you may know and may contribute to heart trouble so you do need exercise. Have you tried Avandia ? Its not for people with serious liver trouble but does a good job with lots of people with type II DM. It is good in a sense as it keeps BG from going too low . Well your Dr. knows your situation best. Now if you are doing a BG check right after exercise it may not go down especially after you have eaten if you did. Also with some meds BG may not come down that much with exercise alone if you are eating enough.

It can happen. My boyfriend is diabetic (type 1), and sometimes when he exercises his bloodsugar levels do rise. One thing he has recommended to other diabetics is to try to have bg level between 115-140 before beginning practices. I remeber one time this past summer we were swimming and he felt off and tested and he was high. Some of it can be from addrenaline or possible dehydration as mentioned in a previous reply. Just keep monitering your bg levels, and you can always try different things to see what is causing it. ( such as try drinking more water, ect.) while you work out. Just sure to always have suger on hand (incase you drop low) and insulin (if you use it) for when you are high. (Although you may know this already) Make sure that people that you swim with know of your diabetes and know what to do if you pass out from either being too high/low, and all that fun stuff! (sorry, I am acting like a controling person, but hey, I'd rather be annoying and have you safe, than not and not have you safe!)

I hesitate to make much of a reply, as I am confused too. I manage diabetic patients (primary care) and have some experience with the disorder. I am a little fascinated by your glucose findings. My very first initial thought is to make sure your glucometer is properly calibrated. Next, you say that you don't eat for several hours before a workout, and only consume water during. If so, then elevated glucose is unlikely to be from anything exogenous (ie eaten) after your exercise, especially if your glucose was normal (assuming you mean less than 150 or so) before your exercise. That leaves gluconeogenesis (your body making its own sugar) as the sole cause of the elevated blood sugar. Generally with type II DM, you have resistance to insulin which then leads to both elevated insulin levels and elevated glucose levels both. The other hormones that promote use instead of storage of sugar then become relatively overpowered. You can usually see this in action best with your fasting (first thing in the morning) glucose readings, which I would bet $10 are some of your highest sugars (owing to overnight gluconeogenesis). Looking at this in a similar way, the imbalance between insulin resistance and the other counter regulatory hormones are what is leading to your high blood sugar after exercise, since your body is currently more sensitive to the other hormones (glucose raising) versus insulin (glucose lowering). Over time, metformin (glucophage) and exercise are known to lower this insulin resistance, so you are doing the right thing for sure. I doubt dehydration is doing this, although it is possible when your glucose gets over 200, as then you lose sugar in the urine, which causes an increase in fluid loss. This takes more time, though -- hours to days. This is still kinda weird. Wish I had an easy answer, but if you were my patient I would be delighted that you are exercising!

Thanks to all for the helpful info and advice! Reading your posts got me to once again search the net for any articles relating to this, and I finally found one that mentions BG increasing with exercise as a possibility at www.physsportsmed.com/issues/1999/04_99/white.htm. For the record, my BG is generally very well controlled. When I was first diagnosed, I found that my fasting BG was > 125 (in the diabetic range) about 25% of the time. After being on metformin for 6 months or so, that went down to about 5% of the time. My HbA1C numbers have always been well within the normal range ('m much more likely to test after such a workout (150 after a sprint workout this morning :(, but an actual post-workout decrease to 104 earlier this week after an easier sprint workout :)).

This is kinda neat. I read the article, and the small blurb which seems to agree with my idea (relative imbalance of insulin versus other counterregulatory hormones) leading to elevated glucose. The other thing that also corresponds is that your elevated glucose after exercise should dimish over time, since you are effectively diminishing your insulin resistance with continued diet/exercise. Yes, it can get to the point of non diabetic, but I have only seen that in a few (very few) people before. Your numbers you list kick butt, man. Keep it up; if everyone did as well as you, I would be happily out of a job.

Swimswith a fist, Thanks very much for that excellent link. Lots of valuable information. You are doing an excellent job managing your diseas. Diabetes definitely doesn't manage you. Keep up the fantastic work aschueler, thanks to for all your input. It is a puzzle how the blood sugar levels can be so affected. Increased effort, 85%+, is a given. Competition too. I was adding to the possibilites for swimswithafist; overtraining, an infection somewhere. I appreciate your posts, especially as a primary care person. There is nothing easy about this delicate juggling and balancing act. It's a complicated numbers game. I know, I am a type1 diabetic, and also a marathon open water swimmer. Despite careful and diligent monitoring and measuring I have to miss some training sessions due to unexplained high levels. However, I am very thankful on the days I can train, and so I work hard at every opportunity that I get.

Here is an explanation for those who are trying to figure out how exercise affects blood sugars. As we know, it is a delicate balancing act to keep blood sugars in a normal range. It is even more of a challenge when exercising. When exercising large muscle groups, the uptake of blood glucose may result in hypoglycemia during or following exercise. If circulating levels of insulin are high at the beginning of exercise, hypoglycemia will result. However exercising with high blood sugars and ketones will cause sugars to go even higher. There are variables that affect your blood sugar response> The time of day you exercise, timing of insulin doses and types of insulin, the time you ate, your sugar levels when exercising, the type and duration and intensity of the exercise, environmental temperatures, illness, hormones and hydration. And how your body is used to this activity, ie if it is a new activity. Basically the way energy is used during physical activity affects blood sugar levels. How fast you move, how much force you produce and how long the activity. There are three energy systems to supply your muscles with these demands. Studies of people with type 1 and type 2 diabetes have shown that very intense exercise such as resistance training, weight training, or near maximal aerobic exercise will cause an immediate rise in blood sugar levels due to the body’s hormonal release of several hormones to the workload. Intense exercise causes the release of hormones that increase the liver’s production of glucose and reduce the muscles’ uptake of blood sugars. These hormones include adrenalin, norepinephrone, as well as glucagons, growth hormone and cortisol. The effects of these counter regulatory (glucose raising) hormones will exceed your body’s immediate need for and use of glucose because high intensity exercise cannot be sustained for long periods of time. Consequently a state of insulin resistance is induced, which can last for a few hours after exercise. You may require insulin or meds to lower this. During aerobic activity or sustained medium effort activity, the fuels used by your body are primarily carbohydrates. Protein is usually only utilized during very prolonged endurance activity. Keep in mind that carbohydrate use increases rapidly when you begin to exercise, and increase with additional increments. High intensity activity uses 100% carbohydrate and zero fat. Muscle glycogen is used along with blood glucose. However for activity of mild to medium activity, carbohydrates are used as well the hormone epinephrine mobilizes fats from your adipose stores which then circulate as free fatty acids. This fat source and carbohydrates are used more extensively during mild to moderate activity. During recovery from exercise the predominate fuel source is fat. The actual aerobic fuels you use do depend on your training, your diet before and during the activity, the intensity and duration of the activity, your circulating levels of insulin and the degree of activity that your body is used to. For example when beginning a new activity you may require more carbohydrates than when you are more sports specific fit. If you swim and then take up cycling as well, then you may require carbs to begin with until your body becomes efficient and more fit in this activity. I have more information if anyone is interested.