Exercise and Glycemic

Exercise-related glycemic management means anticipating, detecting, and responding to changes in blood glucose around physical activity. Working muscle uses more glucose, and sustained aerobic activity commonly lowers blood glucose. Aerobic activity can also increase insulin sensitivity during recovery. In type 1 diabetes, the effect of prolonged aerobic exercise on insulin sensitivity can persist for up to 48 hours, which helps explain a low that occurs overnight or the next day rather than during the activity itself. [1][6] The direction of change is not identical for every activity. Brief, intense activity, resistance exercise, and high-intensity intervals can raise blood glucose temporarily in some people with type 1 diabetes. The pattern also depends on circulating insulin, recent carbohydrate intake, illness, the duration and intensity of activity, and the person’s previous response. A single value therefore has meaning only when it is interpreted with symptoms and context. [1] Risk is greatest when glucose-lowering medication continues acting while exercise increases glucose use. Insulin and insulin secretagogues, including sulfonylureas and meglitinides, are the therapies most directly associated with hypoglycemia in the current Diabetes Canada hypoglycemia...