Have you ever wondered why you feel hungry a short while after having a feed full of carbs? The problem is, while your blood sugar levels are dropping down after the carb rush, your hunger starts to kick in. Dr Andreas Eenfeldt (The Food Revolution video) performed his own tests on himself regarding blood glucose levels (see attached image). Meal 1 : Piece of non-lean steak and veggies (all fried in butter) with Bernaise sauce (egg yolk and butter sauce).
As you can see by the graph (Click the thumbnail to see a larger version), Meal 1 (the Low Carb, High Fat meal) kept his blood sugar at a steady, even level, right where it should be. These are some of the reasons there is a swing in the medical profession (those who are still not completely set in their ways, or not willing to deviate from the current nutrition beliefs) towards a Low Carb, High Fat food lifestyle. Most daily activities and aerobic exercises (activities performed at a challenging but sub-maximal level over a period of 20 minutes or more) will promote a blood sugar drop due to enhanced insulin sensitivity and accelerated glucose consumption by muscle cells.
When exercise is going to be performed within an hour or two after a meal, the best approach is usually to reduce the mealtime insulin. When adjusting mealtime insulin, both the dose to cover food and the dose to cover a high reading are made more effective by exercise and need to be reduced.
For example, if you take a leisurely 20-minute bike ride after dinner (consider it “low intensity”), multiply your dinner insulin dose by .90, which reduces the dose by 10%. Not only do activity multipliers help you to avoid hypoglycemia, they also enable you to lose weight more effectively. If you take medication other than insulin for your diabetes, you may or may not need to reduce or eliminate the dose.
If you take a medication that can cause hypoglycemia, continue to take it prior to your first couple of exercise sessions and see what happens. Under certain conditions, extra food intake will be necessary to prevent hypoglycemia during exercise. The best types of carbohydrates for preventing hypoglycemia during exercise are ones that digest quickly and easily, better known as “high glycemic-index” foods (for a review of the glycemic index, see Learning Curve from diaTribe #14).
Granted, there is no way of knowing exactly how much you will need, but the chart below should serve as a reasonable starting point.
Of course, if your blood sugar is already elevated prior to exercising, fewer carbs will be necessary. The best way to determine the optimal size and frequency of your workout snacks is to test your blood sugar before and after the activity.
Anaerobic exercises are high-intensity and often are performed in short “bursts” – such as weight lifting. It is not unusual to experience a blood sugar rise at the onset of high-intensity exercise. To determine how much extra insulin to take before a high-adrenaline-type event, consider how much your blood sugar normally rises. If you are nervous about giving insulin before exercise, check your blood sugar more often than usual (perhaps every half hour or so), and have glucose tablets or some other form of fast-acting carbohydrate nearby. Ever finish a workout with a terrific blood sugar only to go low several hours later or overnight? If you take injections, you can counter delayed-onset hypoglycemia by having a low-glycemic-index snack before bedtime – such as peanut butter.


Editor’s note: Gary Scheiner MS, CDE is Owner and Clinical Director of Integrated Diabetes Services, a private consulting practice located near Philadelphia for people with diabetes who utilize intensive insulin therapy.
Our mission is to help individuals better understand their diabetes and to make our readers happier & healthier. Our mission is to help individuals better understand their diabetes and to make our readers happier and healthier. You are full straight away, but an hour or two later you are looking for a snack to tide you over until the next meal.
The carbs are quickly absorbed into the blood stream sending your Blood Glucose levels sky high. He recorded his blood sugar levels over a 6 hour period after eating two completely different kinds of meals.
It always seems to know what to do to keep blood sugars in range, even under the most challenging circumstances.
This is due primarily to the stress hormone production or “adrenaline rush” that accompanies these kinds of activities. To prevent low blood sugar, one can reduce insulin, increase carbohydrate intake, or a do combination of both. If you exercise at a time when rapid-acting insulin is not particularly active, such as upon waking, before meals or midway between meals, it is best to consume extra carbohydrate prior to the activity. If you plan a much more intense 90-minute ride up and down hills (consider it “high intensity”), multiply your dinner dose by .50.
Reducing insulin means that your body will store less fat and break more down for use as energy.
Only certain medications can cause hypoglycemia; medications that do not have the potential to cause hypoglycemia should not be changed. For example, when exercise is going to be performed before or between meals, reducing the insulin at the previous meal would only serve to drive the pre-workout blood sugar very high. The harder and longer your muscles are working, the more carbohydrate you will need in order to maintain your blood sugar level.
To use the chart, match up your approximate body weight to the general intensity of the exercise. This is caused by a surge of stress hormones that oppose insulin’s action and cause the liver to dump extra sugar into the bloodstream. Or better yet, start using a continuous glucose monitor to track your blood sugar minute-to-minute.
Many aerobic activities (particularly those that are long or intense) and most anaerobic exercises cause blood sugars to drop several hours later.
This is often due to the delayed digestion of food that was consumed prior to the workout, or the effects of disconnecting from a pump or having injected mealtime insulin absorb too quickly.
Managing your blood sugars effectively before, during, and after physical activity will ensure that you feel good, stay safe and perform your best.
He is the author of several books, including Think Like A Pancreas: A Practical Guide to Managing Diabetes With Insulin. Ready for the next meal to have the body go through that whole blood sugar rollercoaster ride again. For activities lasting more than two hours, it can also be helpful to reduce long-acting or basal insulin.


A better approach would be to take the normal insulin dose at the previous meal and then snack prior to exercising.
The amount is also based on your body size: the bigger you are, the more fuel you will burn while exercising, and the more carbohydrate you will need. The grams of carbohydrate represent the amount that you will need prior to each hour of activity.
Remember at the beginning of this article when we were praising our pancreas for its ability to manage blood sugar even in the face of an adrenaline rush? With some experience, you will develop greater confidence and have the ability to fine-tune your correction doses. The best way to deal with it is to first keep records of your workouts so that you can learn when it happens (After what types of activities? Whatever the cause, a dose of rapid-acting insulin right after the workout will usually remedy the situation. It’s worth a few moments to plan out your blood sugar management strategies before exercise, because nothing will screw up a good workout like a high or a low. He and his team of Certified Diabetes Educators work with people throughout the world via phone and the internet. Name Email WebsiteSubmit Comment Recent Posts One Size May Not Fit All on GI Foods Low GI Foods May Help You Sleep What Exactly Is the Glycemic Index Diet? They drop so far that they go below the normal recommended levels, then slowly rise back up. It churns out some extra insulin to offset the “fight or flight” response (make that flight only, if you’re smart). This enhanced insulin sensitivity may continue for many hours after the exercise is over, depending on the extent of the activity. There are two reasons why this takes place: prolonged, enhanced sensitivity to insulin, and the need for muscle cells to replenish their own energy stores (called glycogen) following exhaustive exercise. An exercise physiologist by trade, Gary has had type 1 diabetes for 25 years and serves on the Board of Directors for the Diabetes Exercise & Sports Association. The more intense and prolonged the activity, the longer and greater the enhancement in insulin sensitivity. If you will be exercising for two hours, take the full amount at the beginning of each hour. However, when taken along with rapid-acting insulin prior to exercise, they can lead to severe hypoglycemia that may be very difficult to treat - it is generally not a good idea to take either with insulin right before exercising. And give it about half an hour beforehand so that it will keep you from being too high when the activity begins. Can’t resist the aroma of a fresh bagel (something that, in my opinion, was forged by the Diabetes Devil himself)?
If you take injections, you can lower your long-acting insulin by 20-25% or have a low-glycemic-index snack before bedtime, without insulin coverage.



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