Let’s get physical and avoid hypos! 2 December 2014 Regardless of whether you have type 1 or type 2 diabetes – it is important for everyone to keep physically active. In fact Australia’s physical activity guidelines recommend adults do at least 30 minutes of moderate exercise, five days a week. If you are new to the exercise game and are still working on your plan of attack you’ll need to decide what activities you would like to do, how long you want to do them for and how often. But before that, consider how your new exercise regime will affect your blood glucose levels (BGLs). You may not know this, but exercise is actually a wonderful way to assist in the management of your BGLs because it increases the body’s sensitivity to insulin. When you exercise more glucose can move out of the blood stream and into the cells where it can be used for energy. This means exercise normally results in decreased blood glucose levels. (Note: some very high intensity activity can temporarily raise blood glucose levels). Diabetes Queensland dietitian and exercise physiologist Kathryn Kirchner said physical activity will affect everyone’s BGLs differently, depending on the medications you are taking, and the duration, type and intensity of activity you’re doing. “If you are taking insulin or medications that stimulate insulin release (sulphonylurea), you may be at risk of having a low blood glucose level or ‘hypo’ during or after exercise because of the combined glucose lowering effect of the medication and exercise,” she said. “For this reason, it is important you check your BGLs before, during and after exercise when you’re beginning a new activity – this way you can monitor how the new activity affects your BGLs.” A safe blood glucose range for exercise is approximately 6-15mmol/L. But you should talk with your GP regarding your individual target range for exercise. “If you are taking a sulphonylurea or insulin, monitoring your BGLs before and after each activity session is recommended,” Kathryn said. “The increased insulin sensitivity from exercise can also mean blood glucose levels are lowered for up to 48 hours after exercise. Keep an eye on your blood glucose levels the evening after exercise. Check your BGL before bed to ensure it is above 7mmols before going to sleep. This will help prevent overnight hypos. You may also choose to check you BGL during the following day.” Kathryn’s checklist to get you started Have a check-up with your GP: they can advise you on exercise safety and any specific precautions you may need to take, they can also organise any exercise pre-screening Consult with an exercise physiologist: they can give you individualised advice on different types of exercise and come up with a graded exercise program for you to achieve your fitness goals, whether that be strength, flexibility or weight loss Make a plan: set out what you are planning to do, how often you are wanting to do it and for how long. Setting a guide will help you plan how your new exercise program is going to fit into your daily life Set some goals: sit down and make some goals and make them SMART -Specific, Measurable, Achievable, Realistic and Time specific. Having a goal to simply lose weight or improve fitness is too simple. Try something like: “Be able to walk briskly for one hour by Christmas.” Blood glucose monitoring: check in with your GP or credentialled diabetes educator to discuss when is the most useful time to monitor your BGLs to reduce the risk of hypoglycaemia and to see the daily blood glucose lowering benefits of your exercise plan You may need to consider having extra carbohydrate foods or fluids before during or after your exercise particularly if you are being physically active for a long time Finally, if you are taking insulin, talk to your GP or credentialled diabetes educator about how to prevent overnight ‘hypos’ and if required how to adjust your dose depending on the type and length of activity you want to undertake If you have any concerns about how your levels are affected by physical activity speak to your GP, credentialled diabetes educator or call our Helpline on 1800 637 700 and ask to speak to our exercise physiologist.