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So lets work out that someone is running a marathon burning approx 2,500 calories in 4 hours, that equals 625 calories burned per hour. What is needed in the burning of this energy is carbohydrates, as the body will start burning into stored fat once out of glycogen reserves. The more weight the runner carries the more glucose is needed to fuel muscles (and vise versa) and that is without diabetes. In addition, we need the glucose to keep levels afloat! Calculations of body weight can help your maths in working this out, if you weighed 10.5 stone / 66 kgs, in general when running a marathon your body would ideally require 46gs of carbs per hour (body-weight in kilograms x 0.7 grams of carbs per hour) – so that would be your minimum intake. With diabetes the best advice is to add an additional 10gs per hour in order to prevent any risk of hypoglycemia. These can be consumed by energy drinks, gels, tablets, small sweets such as fruit pastels…
If you see all those numbers and workings out and think ‘that’s not my language!’ I get that. The best advice is to test blood sugars as regularly as possible especially when training, learn your body for yourself, and take with you carbohydrates such as the gels or drinks, and keep a note of it. How much carbohydrates did I consume per hour on that run? In doing so, you can keep an idea of what goes on in your own body.
The other key area to consider is less of the carbohydrate pondering and more on the side of INSULIN MANAGEMENT. If in an aerobic activity you know that the levels of exercise is going to be consistent and will lower blood sugars during activity. In light of this your body will require much less Basal Insulin (your background insulin). There are many forms of basal insulin: Levemir, Lantus, Humalog, Humalin, Apidra and Novolog. For those on an insulin pump, effectively the form of insulin that those on injections know as their quick acting bolus, usually Novorapid, is used as your basal insulin per hour. Planning ahead for the exercise and rate it will decrease blood sugar levels is the key to getting the adjustment of Basal insulin correct. Swimming for example will burn at a much quicker rate than walking, as we know. Therefore you will need less Basal insulin in the system during activity when swimming then you would for walking. The more background insulin present during aerobicexercise means the higher risk of hypoglycemia.
The option on injections to go on ‘split’ insulin can lead to a more flexible and effective method of control during activity. Being able to lower the rate of insulin in your system in the morning to suit the activity ahead, working with the energy burned during exercise, can help to keep control during exercise – and to prevent a possible hyperglycemia later, when the background insulin runs short, you can then inject your second dosage of basal to the normal amount (or slightly reduced amount depending on the exercise earlier in the day) to keep strong control.
Consider your insulin and seek advice from a healthcare professional to find further details on your insulin type – such as Levemir basal not being quite as strong as Lantus, meaning you might need less Lantus in the system on a split dosage. And again, the best way to know your body is to test, test, test your blood sugars to see what is going on – and then you can make a more accurate decision to suit your body from there.
Blood sugar level spikes can come into play during activity, even in some of these aerobic exercises such as running and cycling. There are different forms of these sports which can lead to sudden bursts of energy – losing that consistent rate of energy being burned and causing an adrenaline effect, key organs such as liver releasing naturally stored glucose into the bloodstream. The effect can mean that DURING activity blood sugar levels actually RISE high. However, in sports such as running and cycling, you have still burned a high amount of energy and the likely effect is that hours later your blood sugar levels will come falling downwards.
For an example of the different kinds of exercises, within a similar form of activity, running! You can run a 5k race and run the distance of 5km to simply keep fit, and find two very different effects. When racing there is adrenaline, you are competing. The pace is likely to change as you challenge to do your best, you might start slower and save energy and then increase your pace, then finish with a sprint. The outcome is likely to cause that ‘adrenaline effect’ and release the naturally stored glucose from the liver into the bloodstream during the activity. So you could find you finish the run at a higher blood glucose level than what you started it at.
Whereas, in a causal 3.1 mile jog to keep fit, you are not competing. You are simply running at that consistent level again and therefore, although it might be the same distance as a 5km race, you are running in a different style. Blood sugars will therefore gradually decrease during activity.
And a completely different circumstance, yet, still running, is a 100m sprint. Usain Bolt, for example, if he had type 1 diabetes he’s blood sugars are likely to increase without crashing lower too much afterwards. 100m is anaerobic exercise…
Anaerobic exercise counts for high intensity exercises, which are shorter-lasting activities. The exercise isn’t depending on the oxygen supplies, like in aerobic excise, but from the power within the muscles.
This usually entails sudden bursts of energy, as mentioned above with Usain Bolt in the 100m races. This sudden impact triggers the ‘adrenaline effect’ and the body reacts by releasing naturally stored glucose from the liver into the bloodstream. Where we have type 1 diabetes and have to inject our insulin ourselves, this means we cannot counteract the release naturally during activity with insulin and therefore our blood sugar levels increase.
Depending on the level of energy burned up during the activity, the levels can crash lower later on after the exercise. In Bolt’s case, running 100m is a quick burst. He is able to pose like an arrow after catching his breathe. This means it is unlikely the post exercise hypo crash will happen. However, on other sports, it very much can happen and even hours later during the night time, there is a risk of a hypo.
Test the sugars!
A lot of competitive sports account for aerobic exercises in terms of being ongoing endurance for a long time, yet, also include aspects of anaerobic activity. Many of the most popular sports around contain this: football, tennis, rugby, cricket…
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