Post Workout Blood Sugars

Good blood sugars are so important during training, but what about the other twenty three hours of the day?  In my opinion, managing diabetes is actually most frustrating in the hour or two following an intense workout. 

After exercising, the muscles tend to "pull" glucose from the blood to refill their glycogen stores.  Thus, it would make sense that there is an elevated risk of going low after a workout.  Recently, I read this study. According to the study's own conclusion, the "results suggest that after moderate-intensity exercise, it is preferable for young individuals with insulin-treated, complication-free type 1 diabetes to engage in a 10 second maximal sprint to acutely oppose a further fall in glycemia than to only rest."  Therefore, for situations where a post-workout crash is a problem, I recommend trying the approach of the study.  (Make sure you get approval from a doctor.  High intensity work carries a greater risk of strains and pulls). 

Although I have run into this situation with more relaxed forms of exercise, such as tennis, I personally struggle with the opposite problem.  After an intense workout, my blood sugar consistently spikes- sometimes for four hours!

It seems so counterintuitive, but there are a couple possible explanations for the post workout spike.  During exercise, the body releases HGH, or human growth hormone.  The release of this hormone causes the body to burn fat instead of glucose as the main fuel source; sugar from the blood is no longer burned as the primary energy source.  A more general explanation involves the stress that exercise causes to the body.  The body adapts to stress; in one of these adaptations, the liver releases sugar into the blood stream, which will cause the spike.  During intense exercise, the body essentially recognizes the stress and releases corresponding hormones that tell the body to increase the amount of blood sugar available to the muscles. 

I treat the post-workout spike like any other spike- I take a lot of insulin!  I have found that if I am disconnected for a long duration of time during exercise, the spike is worse, so I try to slowly ramp my insulin levels back up to normal in the last twenty minutes or half hour of a workout.  It is important to eat some carbs after exercising; they are necessary to refuel to the muscle glycogen stores.  In anticipation of these post-workout carbs, I always take a bolus of insulin about fifteen minutes before I am done.  However, I use a different carb ratio- I take twice as much insulin as I normally would for that amount of carbs!  It seems crazy, and even a little dangerous, but  I have found that this bolus is very effective in preventing a spike, especially when I take it fifteen minutes before actually eating. 

I feel like I am always running an experiment with my body, testing slight adjustments in fuel and insulin while I train.  It took me many runs to figure out what works the best for me.  Everyone reacts differently, so it is super important to (very carefully) play around with your own fueling strategy.  Every exercise session is an opportunity to understand how the body works and under what conditions it functions best.