Besides realizing the amazing accomplishments people can achieve despite having Type-1 Diabetes, my second favourite Diabetes aspect to write about are my pet peeves. And there are many of them. People have a lot of pre-conceived notions about Diabetes, what causes it and what the realities of dealing with it may be.
One of the worst pre-conceived notions I often hear about, is that Diabetes control only involves two things: exercise and insulin to lower blood sugar, and eating sugar to increase blood sugar. It’s actually much more complicated than that and the amount of attention that needs to be paid to all the “little” details would boggle your mind.
Let’s start by taking a look at the above image. This is a screen shot of my FreeStyle Libre from last week. Ignoring the painful fact that I only spent 46% time “in range” that day, you may notice that cute little spike in blood sugar levels during mid-day. This was right around the time that I was logging a 50-kilometre bike ride. So, what does this mean? Shouldn’t my blood sugar drop, if I’m performing strenuous exercise?
Not necessarily. In fact, strenuous exercise can often INCREASE your blood sugar, depending on the type of exercise and the accompanying rush you get. When under stress (me), in response to low blood sugars or when getting a rush of adrenaline, the body will release something called Glycogen, which is a secondary fuel source for the body.
So, what is Glycogen you ask? Or maybe you didn’t, but I’m going to tell you anyway. According to an article posted by Diabetes.co.uk, “In a healthy body, the pancreas will respond to higher levels of blood glucose, such as in response to eating, by releasing insulin which will lower blood glucose levels by prompting the liver and muscles to take up glucose from the blood and store it as Glycogen.”
Think of it as a spare battery for your body. In a normal human being, Glycogen will be released when the body needs extra glucose or energy, such as during strenuous exercise. The problem with someone with Type-1 Diabetes, is our pancreas doesn’t produce the insulin required to adjust for the high blood sugars that may result from a sudden release of Glycogen. Hence, the spike in my blood sugars.
Glycogen is actually pretty important towards keeping your muscles fuelled and helping you through physical exertion. In fact, low blood sugar after physical exertion will often happen because the body is trying to replenish its Glycogen stores by sapping the glucose in the blood. This is why exercising means adjustments to my basal rates, blousing in response to sudden spikes, staying properly hydrated and consuming fast-acting carbohydrates.
Nice, eh? A little more to it than just taking insulin or eating glucose. It’s just one more of those aspects related to my condition that requires monitoring and/or control. So the next time you see someone you know with Diabetes, wolfing down a donut or complaining of high blood sugars after an intense workout, you’ll know just a little bit more about the process. It’s a constant roller coaster of control… ☯