Silly question about exercise

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

Quoted message said:

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.

Hi Stephanie,

I assumed that you asked about insulin resistance, because you talked about "insulin being more
effective". So I thought you refered to that.

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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.

What you ask is a bit like: "why does the fuel tank in my car slowly gets empty when I drive my
car?" Well, I guess you have a hunch. But it might be that you don't know how fuel is reversed to
energy. Of course that happens by burning (exploding) it in the cylinders. In that case the question
is "how does the fuel power my car."

BG is the _fuel_ your body uses. Your BG is not some exiting stuff without purpose, it is needed to
fuel your cells your body is made of. It is burned by your cells to grow and maintain themselves,
and reproduce or replace themselves when needed.

The "burning" of BG in your cell is a chemical process that basically reverses BG into cell tissue.
It's also called "metabolizing".

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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?

Your insulin is not "effective" or "less effective" with exercise, insulin just is the key needed to
"unlock" the cell to let the blood glucose in. It's a hormone that acts as an intermediate between
the cell and the BG through insulin receptors to pass the cell membrane.

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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.

If you have a high BG as T1 you have insufficient insulin in your blood. When starting to exercise,
your brain gives a signal to the body that it needs more blood glucose because of the higher pace of
your metabolism. This extra BG is stored in your liver, and released (a "liver dump"😉. Because you
have insufficient insulin, it is not being processed, and your BG's rise.

Ketones can form when fatty acids break down at high speed, and the level is increased when you're
starving. In a way having high BG's is starving as well, because your body is not able to supply
fuel (BG) to the cells (e.g. in the muscles).

--
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.. missed posting :-)

yeah lol the key word is "i'm alive" i'll shoot ya off a email tomorrow ..

maybe we should just become advid walkers and skip all the shots.. lol

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

Quoted message said:

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),

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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

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"]news:[email hidden]...

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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]...

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

realized

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that

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

role

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of

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

years.)

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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,

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why?

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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

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asked why exercise impacts blood sugar! Thanks. Steph

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

Quoted message said:

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

Quoted message said:

of glucose in my blood.

The glucose enters your muscles and the exercise burns it. It's just fuel after all. As a T1, you'd
be unable to use that fuel without your insulin, but as you inject it, there's no problem using the
fuel. The fuel isn't inexhaustable either, so when you exercise, eventually you'll burn it all and
at that point you're hypo. Somewhere between eating the food that provides the glucose and gpoing
hypo, your BG will be lowered.

If the glucose is going into my muscle cells for

Quoted message said:

storage and energy, and since it appears to go there more rapidly when exercising, what exactly is
going on here.

Your sensitivity to insulin has increased and you've burned the fuel. Exercise soen't JUST address
insulin RESISTANCE, it also addresses insulin sensitivity.

Is my injected insulin more

Quoted message said:

effective, or are my cells more receptive?

Your cells are.

If it is because my cells are

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more receptive, does that indicate that I am somewhat resitant to insulin?

Not at all. it indicates that your body isn't completely bollocksed that's all :-)))

Quoted message said:

And, on that same note, why are T1s (not sure about T2s) told to NOT exercise when sugars are
250ish and higher.

It depends on WHY their sugar is so high. If it's because they have a LACK of insulin, they they
definitely SHOULDN'T exercise at those levesl, but if they DON'T have a lack of insulin, there
really shouldn't be a problem.

I know it has to do with

Quoted message said:

ketones, but why shouldn't one exercise if it helps to lower sugars?

You SHOULD. What you said in the previous paragraph (why are T1s (not sure about T2s) told to NOT
exercise when sugars are 250ish and higher) isn't the same thing as (but why shouldn't one exercise
if it helps to lower sugars?)

Ketones will be present if you're not using sufficient insulin, so keep the level of insuoin correct
and IF yu have a high BG epeisode (due usually to eating too many carbs), then exercising to lower
the level is perfectly acceptable.

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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

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over the weekend.

No glancing in here sir, it's all got to be read on pain of a clip round the ear :[))

Beav

Jim Dumas <[email hidden]!mindspring.com> wrote in
:"]news:[email hidden]:

Quoted message said:

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,

Thanks for the pointers. I wrote my primer on exercise a number of years ago and it looks like I'll
have to revisit it. When I next get a chance to get to the med library, I'll chase them down. As I
reall, there were 3 or 4 alternative explanations at the time of writing and that was why I marked
that section as speculative. Given the wide variability of response to exercise, my guess is the
answer as in so much of diabetes is ultimately multi-factorial and complex.

Charly Coughran [email hidden]

.

Jim Dumas <[email hidden]!mindspring.com> Pharma Watchdogs Anonymous;

In:misc.health.diabetes Thread:Re: Silly question about exercise - 1 attachment said:

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.

What is 'basal' insulin? Are there other kinds/categories? What are they? How do they differ?

Thank You One & All... Quirque

In tribute to the US of A, Israel & Great Briton (Among others), bastions of backbone in a world
filled with strife and terrorism.

Jim Dumas <[email hidden]!mindspring.com> wrote in message news:<[email hidden]>...

Quoted message said:

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.

I have heard some people talking about a company called SportSmith. I quess you can by things for
your stairmaster there. Has any one heard of this company and are they a reliable source for
stairmaster products? I own a staimaster and was just curious. I think their website is
www.sportsmith.net Has any one bought products for their stairmaster at this place? Any info would
really help as I am in need of a part and I don't know anything about this company.

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

Quoted message said:

"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.

a flame fest)

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

Rubbish. Insulin doesn't tknow whether you're fat or thin, it just does what it does and one of the
things it does well, is to stop you burning fat.

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In the meantime enough exercise is a great way to burn fat.

Yep, specially if you go to the gym with a shedful of carbs and a bucketful of insulin.

For overweight

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T2's it's a great way to increase insulin sensitivity, even if they don't lose weight.

They WILL lose weight if they reduce their insuoin resistance, because THEN, they won't produce
insulin in the same amounts and guess what?? That's right, they'll be more able to burn fat.

Beav

kay lane said:

What is 'basal' insulin? Are there other kinds/categories? What are they? How do they differ?

Hi Kay,

Normals typically require 50% of total daily insulin to be a slow flat basal profile. The other 50%
of total daily insulin is used to cover meal requirements.

Pumpers set a constant infusion of fast-acting insulin to set up this flat basal insulin
requirement. The older conventional insulin therapy uses slowly absorbed insulin, like zinc loaded
ultralente insulin to achieve the same goal. The newer "de$igner" basal insulin is Lantus and it is
almost flat for 24 hours. Another basal insulin is lente, a mixture of 70% ultralente and 30%
semilente insulin. NPH is still another insulin that has been used for basal requirements but is
not really a flat long-acting insulin. A new designer insulin that has yet to be approved by the
FDA is Novo's Detemir insulin. It has a very flat profile but also has high losses so you will need
larger doses to achieve the same results. Examples of synthetic human insulin action profiles from
Lilly are at:

j_dumas.home.mindspring.comlilly human insulins1992.pdfOpen ↗

The beef and many of the pork insulins on the second page of this pdf are no longer available. This
has been a problem for many type 1s lately. But this will give you an understanding of the variety
of insulins. Then add the superfast analogues for meal requirements: Humalog and Novolog that do not
occur in nature. So there are many types of insulin.

HTH,
--
Jim Dumas T1 4/86, background retinopathy, rarely hypoglycemic: <1/mo. lispro+R+U+NPH daily,
moderate exercise, typically <6% HbA1c

"kay lane" <[email hidden]> wrote in
:"]news:[email hidden]:

Quoted message said:

Jim Dumas <[email hidden]!mindspring.com> Pharma Watchdogs Anonymous;

In:misc.health.diabetes Thread:Re: Silly question about exercise - 1 attachment said:

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.

What is 'basal' insulin? Are there other kinds/categories? What are they? How do they differ?

An individual's insulin requirement is often divided into two components which to a fair degree
correspond to the way insulin is released by the pancreas.

Your basal requirement is the background metabolic requirement requirement independent of eating. It
is more or less constant over 24 hours, but does vary slightly for many in a circadian rhythm, and
represents order half of your daily insulin requirement.

Your bolus requirement is that insulin required to metabolize food.

A basal insulin is that insulin taken to satisfy the basal requirement. A bolus insulin is that
insulin taken to satisfy the bolus requirement.

In a 1 insulin regimen the two requirements are met by a single insulin, usually NPH or Lente but
slower insulins are used by some. With a pump, both are again met by a single insulin, usually
Humalog or Novolog, but delivered via different programing functions in the pump.

In insulin regimens of 2 (or occasionally more) insulins you can either have a regimen which tries
to separate the two requirements and deal with each of them with 1 of the 2 insulins, or you can
have a regimen which is a modified 1 insulin regimen where the second insulin is just some fine
tuning of the first. In general, in a 2 insulin regimen you cannot say which is the case without
more information than just the insulin names.

In regimens that try to fully separate the two requirements, the basal insulin is usually a long
acting insulin ( Lantus, Ultralente, or Lente). The bolus requirement is usually met with a rapid
acting insulin (Humalog or Novolog).

Charly Coughran [email hidden]

Sigh back at you : ) Thanks.

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

Quoted message said:

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

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meant "muscles take up/absorb glucose". . .

. . . sigh!

Regards
Old Al

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

Quoted message said:

starting a flame fest)

Start to formulate properly before you accuse someone of "starting a flame fest".

Quoted message said:

Rubbish. Insulin doesn't tknow whether you're fat or thin, it just does what it does and one of
the things it does well, is to stop you burning fat.

If you have diabetes, as T1, but especially as T2 and you're overweight, the insulin does not "do
what it does". It does not do anymore what it's supposed to do, that is: working as a hormone to
open up the cell membrane and let BG enter.

I fail to see the need to become so excessively rude like you do in your responses. Is normal
discussion out of scope for you?

Trying to bully is not the same as holding wisdom. Behaving like an *sshole is not the same as
knowing what you're talking about. Shouting harder doesn't mean you're more right.

--
CeeBee

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

Google CeeBee @ www.geocities.com/ceebee_2

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

Quoted message said:

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

Quoted message said:

Quoted message said:

starting a flame fest)

Start to formulate properly before you accuse someone of "starting a flame fest".

Quoted message said:

Rubbish. Insulin doesn't tknow whether you're fat or thin, it just does what it does and one of
the things it does well, is to stop you burning fat.

If you have diabetes, as T1, but especially as T2 and you're overweight, the insulin does not "do
what it does". It does not do anymore what it's supposed to do, that is: working as a hormone to
open up the cell membrane and let BG enter.

As soon as meds are introduced it does, and that's when it stops you burning fat if you use
enough of it.

Quoted message said:

I fail to see the need to become so excessively rude

EXCESSIVELY?? You've not learned a thing in your life have you?

like you do in your

Quoted message said:

responses. Is normal discussion out of scope for you?

Only with stupid people.

Quoted message said:

Trying to bully is not the same as holding wisdom. Behaving like an *sshole is not the same as
knowing what you're talking about. Shouting harder doesn't mean you're more right.

And being wrong doesn't make you right either.

Beav

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

Quoted message said:

Quoted message said:

I fail to see the need to become so excessively rude

EXCESSIVELY?? You've not learned a thing in your life have you?

like you do in your

Quoted message said:

responses. Is normal discussion out of scope for you?

Only with stupid people.

It wasn't necessary, but I appreciate your going to great lenght to show you're an uncivilized twit.

<plonk>

--
CeeBee

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

Google CeeBee @ www.geocities.com/ceebee_2