Exercise and Diabetes. Exercising with an Insulin Pump
Any diabetes management plan should include exercise regimen. Exercise is highly beneficial for people with diabetes mellitus. The use of an insulin pump can ensure that insulin will be delivered in right amount and dangerous hypoglycemia (low blood glucose level) after exercise be avoided.
As exercise begins, free fatty acids are released from the adipose tissue (fat tissue) as an initial source of energy for muscles. Within 10 minutes of beginning exercise, the liver accelerates the production and release of glucose, which provides our muscles with a needed source of energy. Because of this, exercise can result in initial hyperglycemia (high blood glucose level), followed by postexercise hypoglycemia. An insulin pump can be very helpful in this instance because in already hyperglycemic people with diabetes who have blood glucose level more than 240 mg/dl, exercise-induced ketosis may occur. Using an insulin pump this people can administer a small insulin bolus at the beginning of exercise.
People with diabetes should always check the blood glucose level before beginning exercise and every 30 minutes during exercise to establish how a given exercise might affect their blood glucose control. After that, the blood glucose level should also be monitored immediately after exercising as well as 4 hours after completing exercise in order to control delayed hypoglycemic response to the exercise. Person with diabetes should maintain blood glucose level in the target range of 120 mg/dl to 180 mg/dl during the exercise program.
All exercise must be carefully planned and basal insulin delivery through insulin pump should be adjusted accordingly to exercise regimen. Adjustments in basal insulin delivery are very individualized. A well-conditioned athlete who is participating in the same exercise regimen for which she has been training rarely needs any adjustments in insulin delivery and don’t need to suspend the insulin pump while exercising. On the other hand, a poorly conditioned person with sugar diabetes using insulin pump who beginning intensive exercise will need to reduce the insulin delivery while exercising or even suspend it.
When exercising before breakfast or more than 4 hours after the last meal, the basal insulin infusion rate is initially reduced by half. Afterwards, the adjusted temporary basal insulin infusion rate of the insulin pump is adjusted according to self-monitoring blood glucose. With prolonged endurance exercise such as walking, cycling, jogging, or hiking, a “steady state” develops, and individual with diabetes maintain plasma glucose levels within a predictable range while balancing carbohydrate intake and exercise. A general guideline for carbohydrate consumption while exercise is 15 to 30 grams every 30 to 60 minutes. With improved fitness level less insulin and fewer calories are required.