Diabetic Athlete's Handbook: Your Guide to Peak Performance by Sheri R. Colberg, PhD (Continued)
Anyone with type 2 diabetes who still makes insulin is also more likely to have glucose levels drop if exercising after breakfast or another meal (as opposed to before) because of the insulin that is released in response to eating that elevates the levels. Keep in mind, though, that if you exercise long enough without eating, whether you have diabetes or not, you can develop hypoglycemia because of running low on fuels and liver glycogen after not eating overnight, so running a marathon without eating anything beforehand isn't a good idea.
Regulating Insulin Levels During Exercise
Physical activity is one of the main causes of hypoglycemia in people with tightly controlled diabetes. Exercising with low levels of insulin is indeed a much more normal physiological response. To lower yours, you may need to lower (if possible) your premeal insulin doses. Table 2.4 gives some general recommendations for insulin changes but refers primarily to rapid- or short-acting insulins, not basal ones. (Basal insulins can also be reduced, but for guidelines on doing so, refer to the recommendations for individual sports in part II.)
How much insulin you have in your system between your exercise sessions can also affect how well you do during the next workout. You may end up restoring less muscle glycogen after exercise (or any time) if you don't have enough insulin or your insulin action is diminished. Although your muscles can take up glucose and restore glycogen mostly without insulin for the first hour following an intense or long bout of exercise, after that time, you need to have enough insulin available to continue stimulating glucose uptake and glycogen storage. If you end up not storing as much glycogen, the next time you exercise your body may depend on greater use of fat, which will lower your ability to exercise and likely cause you to fatigue much more quickly, especially if having low glycogen levels causes you to take up more blood glucose. Keeping your blood sugars closer to normal after exercise also helps you restore glycogen more effectively than if your sugars run high during that time. So, you'll likely need some insulin after exercise for any carbohydrate that you eat, albeit it a reduced amount.
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As I mentioned in an earlier post, one of the benefits that made it cost-effective for me to go with the real healthcare (HSA) plan rather than the phony (HRA) plan is that my company is now covering "preventative" medicines at $0 copay. The formulary for these, as stated by CVS/Caremark (my pharmacy benefits provider), covers all test strips, lancets, and control solutions. I dutifully get my doctor to write up prescriptions for all of my testing needs, submit...