blood sugar management with heavy weight-lifting

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Deb Posted: Wed, Feb 3 2010 11:18 AM

I am a 44 year old female, physically very active, type 1 diabetic on Lantus and Novolog.  I have good success managing my blood sugars with cardio activity but have recently started heavy weight-lifting (over the last 4 weeks) 6 days/week.  Since this new routine I have had 3 serious hypoglycemic reactions, hours after completing my work out, and all 3 have been while driving and with absolutely no warning.  I have not really changed my diet, which is pretty well balanced and consists of 3 regular meals and late morning/late afternoon snacks.  I am concerned that I am going to end up hurting someone, especially as I have had no warning and the reactions have been very quick (for example I was at an MD appt for 30 minutes, feeling fine.  Got in the car fully capable and within 5 minutes I was experiencing problems, drove for 15 minutes and ended up in a location with no memory of how I go there or where I was.  After 6 glucose tabs I still wasn't aware enough to even check my sugar, drove home, checked and had a sugar of only 28).    I would love anyone's input as to how to better monitor myself (I already check my sugar at least 8x/day), how to consider changing my diet for better glycemic balance, and any input as to why these events are occuring so many hours after my workouts.  I am acting as a training partner for a friend who is in a body building competition so my lifting has gotten very aggressive and is now 6 days/week when it was only 3 days before.  I still do intense cardio 3days/week for 30-45 min but am not sure my hypoglycemia is really related to those days.  Need to keep a better record of that, for sure.

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kat replied on Thu, Feb 4 2010 11:38 PM

Hi, Deb -

Good for you for doing all the exercise.  You say "I have not really changed my diet."  With all the exercise you're doing, would diet not be a place to start.  You  have to be burning more carbs than you were before you began heavy weight lifting.  I have no specific suggestions, but in general would suggest either consulting your CDE or dietician if you have one and checking (or re-checking) one of the several books about diebetes and athletics.  Good luck. 

T2, diagnosed 12/98.  Diet and exercise 2/03 - 11/08.  Now back on metformin 500 ER.

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zrebiec replied on Thu, Feb 11 2010 10:04 AM

When performing resistance training, muscles require a significant amount of energy (glucose) during and post session to replenish themselves. This means that glucose continues transporting into the muscles for 24-48 hours post exercise. Therefore, it is very common to experience delayed hypoglycemia following resistance training programs, especially when performed 6 days per week.

It would be recommended to reduce meal/snack time insulin by 10-30% pre and/or post session. Long acting insulin can be reduced by 10-20% as well, based on trial and error. Also it would be recommended to eat a snack/meal following the session that includes carbs and proteins within a window of 60 minutes from completion of the session.

Jackie Shahar, Med, RCEP, CDE

Joslin Clinic

Exercise Physiologist

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