Silly question about exercise

"Stephanie Kolban" <[email hidden]> wrote in message
"]news:[email hidden]...

Quoted message said:

While I was walking my dogs and pondering life this morning, I realized

that

Quoted message said:

I don't understand "why" exercise lowers sugars. I understand the role of insulin, and I
understand the role of food. (I've been T1 for 20 years.)

Insulin...enables glucose to enter the cells, so that you have energy and

so

Quoted message said:

that the glucose doesn't hang out in the blood, causing ketones and eventually DKA. (Yes, I know I
am oversimplifying.)

Food...amounts and types impact the rate of conversion from food to

glucose.

Quoted message said:

Then, the insulin does it job. (Yes, I am oversimplifying again.)

Exercise...??? I know that when I exercise, my sugars come down. But,

why?

Quoted message said:

Does exercise increase the effectiveness of insulin? Or, does it do something to the glucose
floating around in the blood before it goes into the cells?

Like I said, I've been in this game for 20 years. However, I have never asked why exercise impacts
blood sugar! Thanks. Steph

When you exercise, the cells in your muscles use glucose as fuel.

"Stephanie Kolban" <[email hidden]> wrote in misc.health.diabetes:

Quoted message said:

Exercise...??? I know that when I exercise, my sugars come down. But, why? Does exercise increase
the effectiveness of insulin?

When having T2, exercise _decreases_ the insulin resistance, as it increases the sensitivity of your
cells to respond to your own insulin.

The process that might have given someone the insulin resistance in the first place (sedentary
lifestyle, obesity) is reversed, that is, more insulin receptors on the individual cells start to
work properly again, and the muscle cells you exercise can receive more insuline again.

Your body is able to burn more (bad, abdominal) fat. Even if you don't lose weight with the
exercise, the higher cell receptor sensitivity for insulin improves the regulation of BG's circuling
in your blood with the pancreas pumping out lesser insuline that accomplishes more.

An hour exercise a day, especially endurance like swimming, walking and biking, (The more
muscles are involved the greater the effect) can increase insulin sensitivity with almost 60% as
has been proved.

--
CeeBee

Uxbridge: "By God, sir, I've lost my leg!" Wellington: "By God, sir, so you have!"

Google CeeBee @ www.geocities.com/ceebee_2

Hi Stephanie,

One thing to remember about exercise is that you circulation increases. More blood flow, the
greater the likelyhood that the glucose therin will be absorbed by a cell. (if insulin is present
ofcourse 🙂

--Jeremy

Stephanie Kolban said:

While I was walking my dogs and pondering life this morning, I realized that I don't understand
"why" exercise lowers sugars. I understand the role of insulin, and I understand the role of food.
(I've been T1 for 20 years.)

Insulin...enables glucose to enter the cells, so that you have energy and so that the glucose
doesn't hang out in the blood, causing ketones and eventually DKA. (Yes, I know I am
oversimplifying.)

Food...amounts and types impact the rate of conversion from food to glucose. Then, the insulin
does it job. (Yes, I am oversimplifying again.)

Exercise...??? I know that when I exercise, my sugars come down. But, why? Does exercise increase
the effectiveness of insulin? Or, does it do something to the glucose floating around in the blood
before it goes into the cells?

Like I said, I've been in this game for 20 years. However, I have never asked why exercise impacts
blood sugar! Thanks. Steph

Stephanie Kolban wrote in message ...

Quoted message said:

While I was walking my dogs and pondering life this morning, I realized

that

Quoted message said:

I don't understand "why" exercise lowers sugars. I understand the role of insulin, and I understand
the role of food. (I've been T1 for 20 years.)

Insulin...enables glucose to enter the cells, so that you have energy and

so

Quoted message said:

that the glucose doesn't hang out in the blood, causing ketones and eventually DKA. (Yes, I know I
am oversimplifying.)

Food...amounts and types impact the rate of conversion from food to

glucose.

Quoted message said:

Then, the insulin does it job. (Yes, I am oversimplifying again.)

Exercise...??? I know that when I exercise, my sugars come down. But,

why?

Quoted message said:

Does exercise increase the effectiveness of insulin? Or, does it do something to the glucose
floating around in the blood before it goes into the cells?

Like I said, I've been in this game for 20 years. However, I have never asked why exercise impacts
blood sugar! Thanks. Steph

Exercise "convinces??"/"induces??" the muscles to absorb glucose. c. .it activates the AMPK
system, whatever that is.

AFAIK, the muscles hold a lot of glucose in storage. I think I once read that an average
male holds about a day's worth of fuel as glucose "in-the-muscles". (wish I could find that
site again)

Insulin Resistance is a multi-faceted condition which involves resistance to many of the functions
of insulin. I don't know all of them (e.g. liver doesn't "see" insulin so it dumps because it thinks
you are about to pass out, muscles take up insulin from blood and store it, etc, etc)

It so happens that metformin acts to reduce Insulin Resistance because it somehow "convinces" the
muscles to absorb insulin from the blood. It seems to simulate exercise, or somehow make the muscles
think they have just exercised, e.g.

dundee.ac.ukghardie.htmOpen ↗

This is sorta exciting news since it now means that the research docs can try to tailor make an exercise-
simulator which works better than metformin (metformin drops Insulin Resistance by about 30-35% when
you finally get it working)

Regards
Old Al

Hey Step,

I notice this also, that there's been times, i've been out, like at the mall, or the fair and err
didn't shoot for lunch if i eat a semi light lunch, and walk for miles (lol it seems) i actually
don't get a huge rise like as if i didn't exercise.

but what patch said, the doc's words went right over my head when I asked.. the body uses the
glucose as fuel therefore, it doesn't just sit there making you rise.

rk half dead - but no complications.

"Stephanie Kolban" <[email hidden]> wrote in message "]news:[email hidden]...

Quoted message said:

While I was walking my dogs and pondering life this morning, I realized

that

Quoted message said:

I don't understand "why" exercise lowers sugars. I understand the role of insulin, and I
understand the role of food. (I've been T1 for 20 years.)

Insulin...enables glucose to enter the cells, so that you have energy and

so

Quoted message said:

that the glucose doesn't hang out in the blood, causing ketones and eventually DKA. (Yes, I know I
am oversimplifying.)

Food...amounts and types impact the rate of conversion from food to

glucose.

Quoted message said:

Then, the insulin does it job. (Yes, I am oversimplifying again.)

Exercise...??? I know that when I exercise, my sugars come down. But,

why?

Quoted message said:

Does exercise increase the effectiveness of insulin? Or, does it do something to the glucose
floating around in the blood before it goes into the cells?

Like I said, I've been in this game for 20 years. However, I have never asked why exercise impacts
blood sugar! Thanks. Steph

"Stephanie Kolban" <[email hidden]> wrote in message
"]news:[email hidden]...

Quoted message said:

While I was walking my dogs and pondering life this morning, I realized

that

Quoted message said:

I don't understand "why" exercise lowers sugars. I understand the role of insulin, and I
understand the role of food. (I've been T1 for 20 years.)

Insulin...enables glucose to enter the cells, so that you have energy and

so

Quoted message said:

that the glucose doesn't hang out in the blood, causing ketones and eventually DKA. (Yes, I know I
am oversimplifying.)

Food...amounts and types impact the rate of conversion from food to

glucose.

Quoted message said:

Then, the insulin does it job. (Yes, I am oversimplifying again.)

Exercise...??? I know that when I exercise, my sugars come down. But,

why?

Quoted message said:

Does exercise increase the effectiveness of insulin? Or, does it do something to the glucose
floating around in the blood before it goes into the cells?

Exercise increases your insulin sensitivity, so you need less insulin for a given amount of glucose
in your blood, or more glucose for a given amount of insulin if you're not to have a low BG epeisode

If you're burning the energy provided by the glucose, by exercising, then there's less glucose
floating around in your blood (coz it's now in your muscles). Result: Your BG is lower. Glucose
can't be burned AND hang around in your blood giving you high BG's.

Quoted message said:

Like I said, I've been in this game for 20 years. However, I have never asked why exercise impacts
blood sugar!

Well now you have :-))

Beav

"Stephanie Kolban" <[email hidden]> wrote in
:"]news:[email hidden]:

Quoted message said:

While I was walking my dogs and pondering life this morning, I realized that I don't understand
"why" exercise lowers sugars. I understand the role of insulin, and I understand the role of food.
(I've been T1 for 20 years.)

Insulin...enables glucose to enter the cells, so that you have energy and so that the glucose
doesn't hang out in the blood, causing ketones and eventually DKA. (Yes, I know I am
oversimplifying.)

Food...amounts and types impact the rate of conversion from food to glucose. Then, the insulin
does it job. (Yes, I am oversimplifying again.)

Exercise...??? I know that when I exercise, my sugars come down. But, why? Does exercise increase
the effectiveness of insulin? Or, does it do something to the glucose floating around in the blood
before it goes into the cells?

Like I said, I've been in this game for 20 years. However, I have never asked why exercise impacts
blood sugar! Thanks. Steph

There are no silly questions. Attached is my standard introduction to the question of exercise and
type 1 diabetes which should answer your questions.

Charly Coughran [email hidden]

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H960@8GD@=&AE($%M
<97)I8V%N($1I86)E=&5S($%S<V]C:6%T:6]N+BP" ` end

Stephanie:

Quoted message said:

Exercise...??? I know that when I exercise, my sugars come down. But, why? Does exercise increase
the effectiveness of insulin? Or, does it do something to the glucose floating around in the blood
before it goes into the cells?

There is within the muscle cells glucose transporters of that move from within the cells to the cell
surface to more or less open the door for glucose to enter. One is abbreviated GLUT4. Since you are
a type 1, your situation is probably different then a type 2 unless you have more insulin resistance
in your muscles than a typical type 1. I rearranged some of the abstract and introduction of the
following article. You will see that in the last sentence of this exerpt agrees with what Old Al
said in his post. There are also links to four other articles supporting this finding. I have listed
two of them below the following exerpt in case you want to get into the nitty gritty.

"Insulin and exercise have been shown to activate glucose transport at least in part via different
signaling pathways. Insulin resistance characterizes patients with type 1 diabetes (1,2).
Contraction increases glucose uptake independent of insulin. For example, contraction results in
recruitment of GLUT4 to the cell membrane, activation of glycogen synthase, and induction of
hexokinase II gene expression independently of insulin. These data raise the possibility that
exercise increases glucose uptake normally in skeletal muscle of insulin-resistant subjects. This
has indeed been shown to be true in soleus muscles from muscle-specific insulin-receptor knockout
(MIRKO) mice. Although exercise and insulin can stimulate glucose uptake independently, the two
stimuli also seem to have synergistic effects on glucose uptake.... We compared the abilities of
insulin and isometric exercise to stimulate muscle blood flow and glucose uptake in 12 men with type
1 diabetes in 11 age- and weight-matched nondiabetic men... The patients with type 1 diabetes
exhibited resistance to both insulin stimulation of glucose uptake and also to the exercise-induced
increment in glucose uptake. We conclude that the ability of exercise to increase insulin-stimulated
glucose uptake in vivo is blunted in patients with insulin-resistant type 1 diabetes compared with
normal subjects. This could be caused by either separate or common defects in exercise- and insulin-
stimulated pathways. ... Regarding exercise-stimulated signaling pathways, an AMP-activated protein
kinase (AMPK) has recently been proposed to be one potential regulator of GLUT4 translocation in
response to muscle contraction. AMPK is activated by an increase in the AMP-to-ATP ratio and by a
decrease in phosphocreatine." Source: Resistance to Exercise-Induced Increase in Glucose Uptake
During Hyperinsulinemia in Insulin-Resistant Skeletal Muscle of Patients With Type 1 Diabetes -
diabetes.diabetesjournals.org1371Open ↗

Translocation of myocardial GLUT-4 and increased glucose uptake through activation of AMPK by AICAR
ajpheart.physiology.orgH643Open ↗

Contraction-induced Changes in Acetyl-CoA Carboxylase and 5-AMP-activated Kinase in Skeletal Muscle
jbc.org13255Open ↗

Frank

Check out this site for a study an a good explaination.
healthandage.comgid1=1199Open ↗ Barry

"Stephanie Kolban" <[email hidden]> wrote in message "]news:[email hidden]...

Quoted message said:

While I was walking my dogs and pondering life this morning, I realized

that

Quoted message said:

I don't understand "why" exercise lowers sugars. I understand the role of insulin, and I
understand the role of food. (I've been T1 for 20 years.)

Insulin...enables glucose to enter the cells, so that you have energy and

so

Quoted message said:

that the glucose doesn't hang out in the blood, causing ketones and eventually DKA. (Yes, I know I
am oversimplifying.)

Food...amounts and types impact the rate of conversion from food to

glucose.

Quoted message said:

Then, the insulin does it job. (Yes, I am oversimplifying again.)

Exercise...??? I know that when I exercise, my sugars come down. But,

why?

Quoted message said:

Does exercise increase the effectiveness of insulin? Or, does it do something to the glucose
floating around in the blood before it goes into the cells?

Like I said, I've been in this game for 20 years. However, I have never asked why exercise impacts
blood sugar! Thanks. Steph

Stephanie Kolban said:

While I was walking my dogs and pondering life this morning, I realized

that

Quoted message said:

I don't understand "why" exercise lowers sugars. I understand the role

of

Quoted message said:

insulin, and I understand the role of food. (I've been T1 for 20 years.)

Insulin...enables glucose to enter the cells, so that you have energy and

so

Quoted message said:

that the glucose doesn't hang out in the blood, causing ketones and eventually DKA. (Yes, I know I
am oversimplifying.)

Food...amounts and types impact the rate of conversion from food to glucose. Then, the insulin does
it job. (Yes, I am oversimplifying again.)

Exercise...??? I know that when I exercise, my sugars come down. But,

why?

Quoted message said:

Does exercise increase the effectiveness of insulin? Or, does it do something to the glucose
floating around in the blood before it goes into the cells?

Like I said, I've been in this game for 20 years. However, I have never asked why exercise impacts
blood sugar! Thanks. Steph

concatenated

"CeeBee" <[email hidden]> wrote in message
"]news:[email hidden]...

Quoted message said:

"Stephanie Kolban" <[email hidden]> wrote in misc.health.diabetes:

Quoted message said:

Exercise...??? I know that when I exercise, my sugars come down. But, why? Does exercise
increase the effectiveness of insulin?

When having T2, exercise _decreases_ the insulin resistance, as it increases the sensitivity of
your cells to respond to your own insulin.

The process that might have given someone the insulin resistance in the first place (sedentary
lifestyle, obesity) is reversed, that is, more insulin receptors on the individual cells start to
work properly again, and the muscle cells you exercise can receive more insuline again.

Your body is able to burn more (bad, abdominal) fat.

The more insulin your body "sees" (either injected, or secreted) the LESS chance you have of losing
weight. Insulin is a very effective mechanism for stopping the burning of fat.

Beav

I've done that to. If I am going to be active, and my sugars are around 100, I will skip my lunch
Humolog (my Lantus will still be active then because I take that in the morning) drink a low carb
drink (3 gr of carbs), and at dinner my sugars will only be around 150. It works beautifully...plus
I get to skip a shot!

Glad to see you are still around. I've missed your posts. Are you okay? Steph

"]news:[email hidden]...

Quoted message said:

Hey Step,

I notice this also, that there's been times, i've been out, like at the mall, or the fair and err
didn't shoot for lunch if i eat a semi light lunch, and walk for miles (lol it seems) i actually
don't get a huge rise like as if i didn't exercise.

but what patch said, the doc's words went right over my head when I asked.. the body uses the
glucose as fuel therefore, it doesn't just sit there making you rise.

rk half dead - but no complications.

"Stephanie Kolban" <[email hidden]> wrote in message
"]news:[email hidden]...

Quoted message said:

While I was walking my dogs and pondering life this morning, I realized

that

Quoted message said:

I don't understand "why" exercise lowers sugars. I understand the role

of

Quoted message said:

Quoted message said:

insulin, and I understand the role of food. (I've been T1 for 20

years.)

Quoted message said:

Quoted message said:

Insulin...enables glucose to enter the cells, so that you have energy

and

Quoted message said:

so

Quoted message said:

that the glucose doesn't hang out in the blood, causing ketones and eventually DKA. (Yes, I know
I am oversimplifying.)

Food...amounts and types impact the rate of conversion from food to

glucose.

Quoted message said:

Then, the insulin does it job. (Yes, I am oversimplifying again.)

Exercise...??? I know that when I exercise, my sugars come down. But,

why?

Quoted message said:

Does exercise increase the effectiveness of insulin? Or, does it do something to the glucose
floating around in the blood before it goes

into

Quoted message said:

Quoted message said:

the cells?

Like I said, I've been in this game for 20 years. However, I have never asked why exercise
impacts blood sugar! Thanks. Steph

I appreciate your thoughts CeeBee. However, as a T1, my pancreas doesn't produce any insulin
regardless of the situation. Also, I personally have not shown any insulin resistance. I am trying
to figure out where the glucose in my blood goes when I exercise, and why exercise lowers the amount
of glucose in my blood. If the glucose is going into my muscle cells for storage and energy, and
since it appears to go there more rapidly when exercising, what exactly is going on here. Is my
injected insulin more effective, or are my cells more receptive? If it is because my cells are more
receptive, does that indicate that I am somewhat resitant to insulin? And, on that same note, why
are T1s (not sure about T2s) told to NOT exercise when sugars are 250ish and higher. I know it has
to do with ketones, but why shouldn't one exercise if it helps to lower sugars? I know, my questions
go on and on and on, etc. I keep talking myself into circles. I have glanced through the responses,
and will try to absorb them over the weekend. Thanks. Steph

"CeeBee" <[email hidden]> wrote in message
"]news:[email hidden]...

Quoted message said:

"Stephanie Kolban" <[email hidden]> wrote in misc.health.diabetes:

Quoted message said:

Exercise...??? I know that when I exercise, my sugars come down. But, why? Does exercise
increase the effectiveness of insulin?

When having T2, exercise _decreases_ the insulin resistance, as it increases the sensitivity of
your cells to respond to your own insulin.

The process that might have given someone the insulin resistance in the first place (sedentary
lifestyle, obesity) is reversed, that is, more insulin receptors on the individual cells start to
work properly again, and the muscle cells you exercise can receive more insuline again.

Your body is able to burn more (bad, abdominal) fat. Even if you don't lose weight with the
exercise, the higher cell receptor sensitivity for insulin improves the regulation of BG's
circuling in your blood with the pancreas pumping out lesser insuline that accomplishes more.

An hour exercise a day, especially endurance like swimming, walking and biking, (The more
muscles are involved the greater the effect) can increase insulin sensitivity with almost 60% as
has been proved.

--
CeeBee

Uxbridge: "By God, sir, I've lost my leg!" Wellington: "By God, sir, so you have!"

Google CeeBee @ www.geocities.com/ceebee_2

Thanks Al. I will study your response and the article over the weekend. Steph

"oldal4865" <[email hidden]> wrote in message -"]news:[email hidden]-
berlin.de...

Quoted message said:

Stephanie Kolban wrote in message ...

Quoted message said:

While I was walking my dogs and pondering life this morning, I realized

that

Quoted message said:

I don't understand "why" exercise lowers sugars. I understand the role

of

Quoted message said:

Quoted message said:

insulin, and I understand the role of food. (I've been T1 for 20 years.)

Insulin...enables glucose to enter the cells, so that you have energy and

so

Quoted message said:

that the glucose doesn't hang out in the blood, causing ketones and eventually DKA. (Yes, I know
I am oversimplifying.)

Food...amounts and types impact the rate of conversion from food to

glucose.

Quoted message said:

Then, the insulin does it job. (Yes, I am oversimplifying again.)

Exercise...??? I know that when I exercise, my sugars come down. But,

why?

Quoted message said:

Does exercise increase the effectiveness of insulin? Or, does it do something to the glucose
floating around in the blood before it goes

into

Quoted message said:

Quoted message said:

the cells?

Like I said, I've been in this game for 20 years. However, I have never asked why exercise
impacts blood sugar! Thanks. Steph

Exercise "convinces??"/"induces??" the muscles to absorb glucose. c.

.it

Quoted message said:

activates the AMPK system, whatever that is.

AFAIK, the muscles hold a lot of glucose in storage. I think I once read that an average male
holds about a day's worth of fuel as glucose "in-the-muscles". (wish I could find that site
again)

Insulin Resistance is a multi-faceted condition which involves resistance

to

Quoted message said:

many of the functions of insulin. I don't know all of them (e.g. liver doesn't "see" insulin so it
dumps because it thinks you are about to pass out, muscles take up insulin from blood and store
it, etc, etc)

It so happens that metformin acts to reduce Insulin Resistance because it somehow "convinces" the
muscles to absorb insulin from the blood. It

seems

Quoted message said:

to simulate exercise, or somehow make the muscles think they have just exercised, e.g.

dundee.ac.ukghardie.htmOpen ↗

This is sorta exciting news since it now means that the research docs can try to tailor make an
exercise-simulator which works better than metformin (metformin drops Insulin Resistance by about
30-35% when you finally get

it

Quoted message said:

working)

Regards
Old Al

Frank, I think you are hitting the points of my questions. I will study your response and the
articles over the weekend. Thanks.

"Frank Roy" <[email hidden]> wrote in message "]news:[email hidden]...

Quoted message said:

Stephanie:

Quoted message said:

Exercise...??? I know that when I exercise, my sugars come down. But,

why?

Quoted message said:

Quoted message said:

Does exercise increase the effectiveness of insulin? Or, does it do something to the glucose
floating around in the blood before it goes

into

Quoted message said:

Quoted message said:

the cells?

There is within the muscle cells glucose transporters of that move from within the cells to the
cell surface to more or less open the door for glucose to enter. One is abbreviated GLUT4. Since
you are a type 1, your situation is probably different then a type 2 unless you have more insulin
resistance in your muscles than a typical type 1. I rearranged some of the abstract and
introduction of the following article. You will see that in the last sentence of this exerpt
agrees with what Old Al said in his post. There are also links to four other articles supporting
this finding. I have listed two of them below the following exerpt in case you want to get into
the nitty gritty.

"Insulin and exercise have been shown to activate glucose transport at least in part via different
signaling pathways. Insulin resistance characterizes patients with type 1 diabetes (1,2).
Contraction increases glucose uptake independent of insulin. For example, contraction results in
recruitment of GLUT4 to the cell membrane, activation of glycogen synthase, and induction of
hexokinase II gene expression independently of insulin. These data raise the possibility that
exercise increases glucose uptake normally in skeletal muscle of insulin-resistant subjects. This
has indeed been shown to be true in soleus muscles from muscle-specific insulin-receptor knockout
(MIRKO) mice. Although exercise and insulin can stimulate glucose uptake independently, the two
stimuli also seem to have synergistic effects on glucose uptake.... We compared the abilities of
insulin and isometric exercise to stimulate muscle blood flow and glucose uptake in 12 men with
type 1 diabetes in 11 age- and weight-matched nondiabetic men... The patients with type 1 diabetes
exhibited resistance to both insulin stimulation of glucose uptake and also to the exercise-
induced increment in glucose uptake. We conclude that the ability of exercise to increase insulin-
stimulated glucose uptake in vivo is blunted in patients with insulin-resistant type 1 diabetes
compared with normal subjects. This could be caused by either separate or common defects in exercise-
and insulin-stimulated pathways. ... Regarding exercise-stimulated signaling pathways, an AMP-
activated protein kinase (AMPK) has recently been proposed to be one potential regulator of GLUT4
translocation in response to muscle contraction. AMPK is activated by an increase in the AMP-to-
ATP ratio and by a decrease in phosphocreatine." Source: Resistance to Exercise-Induced Increase
in Glucose Uptake During Hyperinsulinemia in Insulin-Resistant Skeletal Muscle of Patients With
Type 1 Diabetes - diabetes.diabetesjournals.org1371Open ↗

Translocation of myocardial GLUT-4 and increased glucose uptake through activation of AMPK by
AICAR ajpheart.physiology.orgH643Open ↗

Contraction-induced Changes in Acetyl-CoA Carboxylase and 5-AMP-activated Kinase in Skeletal
Muscle jbc.org13255Open ↗

Frank

Thanks Barry.
Steph
"Barry" <[email hidden]> wrote in message
"]news:[email hidden]...

Quoted message said:

Check out this site for a study an a good explaination.
healthandage.comgid1=1199Open ↗ Barry

"Stephanie Kolban" <[email hidden]> wrote in message
"]news:[email hidden]...

Quoted message said:

While I was walking my dogs and pondering life this morning, I realized

that

Quoted message said:

I don't understand "why" exercise lowers sugars. I understand the role

of

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insulin, and I understand the role of food. (I've been T1 for 20

years.)

Quoted message said:

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Insulin...enables glucose to enter the cells, so that you have energy

and

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so

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that the glucose doesn't hang out in the blood, causing ketones and eventually DKA. (Yes, I know
I am oversimplifying.)

Food...amounts and types impact the rate of conversion from food to

glucose.

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Then, the insulin does it job. (Yes, I am oversimplifying again.)

Exercise...??? I know that when I exercise, my sugars come down. But,

why?

Quoted message said:

Does exercise increase the effectiveness of insulin? Or, does it do something to the glucose
floating around in the blood before it goes

into

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the cells?

Like I said, I've been in this game for 20 years. However, I have never asked why exercise
impacts blood sugar! Thanks. Steph

Charly Coughran said:

*SPECULATION BEGINS HERE* A problem some of us encounter from time to time is a post exercise bg
spike. Blood glucose readings will be reasonable after exercise but sharply elevated a few hours
later. It is my speculation that this represents circulating insulin levels that were adequate
to deal with exercise induced blood glucose demand with its attendant insulin efficiency
increase, but too low to deal with the post exercise demand when insulin efficiency has lowered
somewhat. It has been my experience that post exercise elevated bg levels respond to much less
insulin than would be required in a more normal situation. It appears that insulin efficiency
falls off after exercise at some rate and you can be on the correct side of the curve during
exercise and the wrong side after. This hypothesis is the best of a couple I have come up with.
*SPECULATION ENDS HERE*

Hi Charly,

Just want to add that subcutaneous insulin absorption increases after the start of exercise for NPH
and ultralente, as well as for pumpers using fast-acting R, lispro and Novolog. This is caused by
the inceased blood flow at the injection site from exercise. See:

Dr Jack Davidson's textbook Clinical Diabetes Mellitus, 2nd ed., pp 230-1.

This section is "Hyperinsulinization" in chapter 16: Exercise and Stress in Diabetes Mellitus. Dr
Davidson writes:

"It has been demonstrated in man, the dog, and in the rat that exercise can accelerate the
absorption of subcutaneous insulin injection."

He gives plots of insulinemia for 5 dogs with SC ultralente insulin 8-9 hours before exercising. The
insulin concentrentation spiked about 10 minutes into exercise to 200 uU/ml in two of the 5 and 100
uU/ml in 1 dog and the other two were 30-40 uU/ml from a baseline of 20 uU/ml. He writes:

"A subcutaneous injection of long-acting insulin 8 hours prior to exercise in depancreatized dogs
resulted in a substantial rise in circulating insulin levels and led to a 100 mg/dl fall in plasma
glucose after 60 minutes of exercise, due to a failure of hepatic glucose production to rise
normally. These findings in the depancreatized dog are consistent with those obtained in the IDDM
treated subcutaneously with intermediate-acting insulin 1 hour prior to exercise."
----

The bottom line is basal insulin is probably too low after the exercise period due to the higher SC
absorption of insulin at the start of exercise. This is probably the major cause of a post exercise
BG spike, as all the dogs had elevated insulinemia during exercise leaving less depot insulin post
exercise for basal requirements. The references given were from 1977-9 so this was probably beef
ultralente. The dog model is close to the human physiology so we could expect similar numbers for BG
disposal and insulinemia (200 uU/ml spike).

We can estimate the bolus from Dr Howey's lispro-R Diabetes 3/1994 article that has a 10U R IV bolus
producing an insulinemia spike of 1662.7 uU/ml. So the 200 uU/ml scales to 1.2U exercise-induced SC
insulin release at the start of exercise. But the dogs have elevated insulinemia through the
exercise period as well by about 2-7 times that of basal suggesting 2-7U/h infusion instead of 1U/h
typical basal rate. So the estimate goes to
2.2-7.2U extra insulin release for 60 minutes of exercise.

A loss of 2.2-7.2U basal insulin in a high insulin sensitivity post exercise state would surely
elevate BG (as well as cause hypoglycemia during exercise). The dogs were moderately exercised, BTW.
So heavy training will probably make this worse.

Clearly, the extended release is the major problem. Scale to your basal,
--
Jim Dumas T1 4/86, background retinopathy, rarely hypoglycemic: <1/mo. lispro+R+U+NPH daily,
moderate exercise, typically <6% HbA1c

"Beav" <[email hidden]> wrote in misc.health.diabetes:

Quoted message said:

The more insulin your body "sees" (either injected, or secreted) the LESS chance you have of
losing weight. Insulin is a very effective mechanism for stopping the burning of fat.

Your suggestion that everyone with normal insulin production on this earth or every T1 injecting
insulin is bound to store fat instead of burning it, and will get overweight just by living, is not
thank goodness correct.

As soon as you're seriously _overweight_ or _obese_ this becomes a problem.

In the meantime enough exercise is a great way to burn fat. For overweight T2's it's a great way to
increase insulin sensitivity, even if they don't lose weight.

--
CeeBee

Uxbridge: "By God, sir, I've lost my leg!" Wellington: "By God, sir, so you have!"

Google CeeBee @ www.geocities.com/ceebee_2

Stephanie Kolban wrote in message ...

Quoted message said:

Thanks Al. I will study your response and the article over the weekend. Steph

Then note that I repeatedly typed "muscles take up/absorb insulin" when I meant "muscles take
up/absorb glucose". . .

. . . sigh!

Regards
Old Al