A portable metabolic system K5; COSMED, Rome, Italy was worn intermittently to estimate substrate utilization 6 , and the rate of perceived exertion Borg 0—10 scale was recorded every 15 min during exercise.

Saliva was collected pre- and postexercise to measure free cortisol Cortisol Saliva ELISA; Crystal Chem, Elk Grove Village, IL. Plasma capillary samples were also collected at 0, 65, and min of exercise for glucagon levels Glucagon ELISA; Mercodia, Uppsala, Sweden.

On the basis of a two-sided type I error level of 0. A one- or two-way repeated-measures ANOVA was used where appropriate. All data are presented as mean ± SD unless otherwise stated. A total of 15 adults 36 ± 15 years, 9 females, BMI Diabetes duration was 17 ± 12 years, and total daily insulin dose was 0.

Participants covered 7. Carbohydrate intake was 0. A : Insulin basal rate profile and absolute carbohydrate intake amounts across treatment strategies. B : Absolute whole-blood glucose concentrations during exercise across three strategies. Dashed lines denote the target glycemic range.

The change in glucose during exercise was greater in those with higher baseline glucose levels Supplementary Fig. However, time in range for 24 h postexercise was similar among strategies.

Performing a basal rate reduction before exercise in the postabsorptive state is the standard of care for people with type 1 diabetes on CSII 3 , 7.

Unfortunately, the majority of individuals on CSII do not do this for usual exercise, relying more on carbohydrate feeding 8. Carbohydrate feeding in the 2nd hour of prolonged exercise may not be required if the basal rate reduction is set at exercise onset, since we found that glucose levels begin to rise when the two strategies are combined.

While the Combo strategy had the most glycemic stability during exercise, it also had the lowest time in range since it tended to elevate glucose postexercise Supplementary Fig. An individualized approach to insulin management and carbohydrate feeding for exercise is needed for people with type 1 diabetes 3.

Some individuals may do well with basal rate suspension for some forms of exercise 9 or with a basal rate reduction set closer to exercise 10 , Carbohydrate needs are also highly variable because of a number of factors, including exercise intensity, insulin regimen, and performance goals 3.

Nonetheless, we found that carbohydrate intake of 0. This, along with the reduction in insulin delivery, was associated with higher lipid use and ketone production, which may help with fat loss In summary, the more proactive approach to reduce basal insulin delivery 90 min pre-exercise for individuals on CSII may eliminate snacking needs and effectively increases fat oxidation, thereby increasing net energy expenditure.

Future studies should determine whether this approach is favorable for weight control and glycemic stability when exercise of different forms and intensities occur. The authors thank all of the participants for the time and dedication to the study. Duality of Interest. This study was funded by Insulet Canada Corporation and Insulet Corporation.

has received speaker honoraria from Medtronic Diabetes and Ascensia Diabetes Care. and T. are both employees and shareholders of Insulet Corporation.

has received speaker honoraria from Medtronic Diabetes, Insulet Corporation, Ascensia Diabetes Care, Novo Nordisk through JDRF T1D Performance in Exercise and Knowledge Program , Xeris Pharmaceuticals, Lilly Diabetes, and Lilly Innovation.

No other potential conflicts of interest relevant to this article were reported. Author Contributions. was responsible for data collection, interpretation of data, and analysis.

contributed feedback and revisions for the final manuscript. designed the study and wrote the manuscript. assisted in the data collection. American Diabetes Association. Colberg SR, et al. Palermi S, et al. The complex relationship between physical activity and diabetes: An overview. Journal of Basic and Clinical Physiology and Pharmacology.

Scott SN, et al. Clinical considerations and practical advice for people living with type 2 diabetes who undertake regular exercise or aim to exercise competitively. Diabetes Spectrum.

Zaharieva DP, et al. Practical aspects and exercise safety benefits of automated insulin delivery systems in type 1 diabetes. Aerobic, muscle- and bone-strengthening: What counts for school-aged children and adolescents?

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Sign up for free e-newsletters. About Mayo Clinic. Choose the correct type of training to deplete your glycogen stores such as resistance training to take full advantage of the increased storage space and improve your metabolic flexibility. One of the biggest roadblocks preventing metabolic flexibility for most is being physically inactive.

Having good metabolic flexibility means your body can easily switch between breaking down carbs or fat for fuel. Different types of workouts assist in your body becoming more metabolically flexible. Mitochondria play a vital role in determining metabolic flexibility, and exercise helps increase the number of mitochondria you have.

Exercise also promotes anabolic flexibility better ability to store or use glucose , which again, leads to improved metabolic flexibility. Regardless of the type of exercise, staying physically active can help improve metabolic flexibility and protect against the development of metabolic disease.

The relationship between exercise and blood sugar is a positive one. That is clear to see. But, this relationship does change depending on the type of exercise you do and if you have diabetes. Strength training includes exercises like weightlifting free or machine , bodyweight exercises, and resistance bands to build muscle strength, mass, and endurance.

Strength training is anaerobic. When you work out anaerobically, your body uses glucose as your primary energy source. It breaks down glucose without using oxygen.

This provides you with high bursts of energy over short periods. The American Diabetes Association advises that anaerobic exercise improves blood sugar control and insulin sensitivity.

Research published in the International Journal of Cardiology suggests that strength training can provide more effective blood sugar regulation than cardio in people with type 2 diabetes.

Additionally, engaging in strength training helps to build our lean muscle mass. Glycogen, that glucose storage space we touched on earlier, can be stored in only the liver or the skeletal muscle. So the more muscle mass you have, the more potential storage capacity you have for incoming glucose.

This equals out to lower and more controlled blood glucose values. Keep in mind, though, that intense strength training is one of the activities that can cause your blood sugar levels to rise post-exercise.

Remember that this rise is not a negative thing, and glucose values will usually go down again about an hour later. In the end, the benefit of the anaerobic exercise far outweighs the glucose spike.

Zone 2 is aerobic exercise. Aerobic exercise is cardiovascular training that increases your heart rate and breathing for sustained periods.

Zone 2 training is a type of heart rate training. It uses your maximal heart rate MHR as a guide for the intensity of the activity. There are five zones in total, ranging from very light to very hard intensity.

When training in zone 2, your body optimizes using both fat and glucose for fuel. It achieves the highest amount of fat-burning for energy and improves the function of mitochondria. You get the maximum effect of this type of cardio training by doing it regularly.

The effect is cumulative, and over the long term, it significantly helps blood sugar control. High-intensity interval training HIIT combines both aerobic and anaerobic forms of exercise.

It alternates more extended periods of cardio with short bursts of high-intensity activities. In other words, HIIT gives you the best of both worlds!

Thanks to the wide variety of exercises available under the HIIT workout umbrella, you can easily tailor this method to suit your lifestyle while reaping the benefits of glucose control and shedding abdominal fat. Never discount the positive effect a stroll in the park can have on your health.

Walking causes your heart to beat a little faster and your breathing rate to increase. This is going to promote your muscles to use more glucose and helps regulate your blood sugar levels.

In fact, a study published in Diabetes Care shows that three short minute walks a day are as effective at lowering blood sugar levels as one long minute walk at the same pace.

The same study states that completing a short walk after your evening meal has the most significant effect on regulating your blood sugar levels. Remember, exercise does not have to be vigorous to be impactful. Walking is an effective physical activity to help control your blood sugar levels. So, even a brisk walk after dinner can make a big difference to your metabolic health.

Stability exercises improve flexibility and balance. These types of exercises include yoga, tai chi, stretching, and balance training.

These activities can certainly have a positive effect on blood sugar control. As discussed in the International Journal of Yoga Therapy , studies have shown that yoga, in particular, is very beneficial in reducing blood sugar levels.

This is due to its combination of anaerobic exercise mixed with stress-relieving practices. It helps to reduce rising levels of cortisol, therefore controlling the rise in blood sugar levels.

The positive effects of exercise on blood sugar control are clear. But, are there negatives that you need to consider? In short, not really.

However, there are a few things to keep in mind to exercise safely. If you are healthy and have no underlying health conditions or concerns, all exercise types are beneficial.

That is a fact. There are a couple of things to look out for to maximize your performance and metabolic health. As mentioned, high-intensity workouts can cause a blood sugar spike.

However, time in range for 24 h postexercise was similar among strategies. Performing a basal rate reduction before exercise in the postabsorptive state is the standard of care for people with type 1 diabetes on CSII 3 , 7. Unfortunately, the majority of individuals on CSII do not do this for usual exercise, relying more on carbohydrate feeding 8.

Carbohydrate feeding in the 2nd hour of prolonged exercise may not be required if the basal rate reduction is set at exercise onset, since we found that glucose levels begin to rise when the two strategies are combined.

While the Combo strategy had the most glycemic stability during exercise, it also had the lowest time in range since it tended to elevate glucose postexercise Supplementary Fig. An individualized approach to insulin management and carbohydrate feeding for exercise is needed for people with type 1 diabetes 3.

Some individuals may do well with basal rate suspension for some forms of exercise 9 or with a basal rate reduction set closer to exercise 10 , Carbohydrate needs are also highly variable because of a number of factors, including exercise intensity, insulin regimen, and performance goals 3.

Nonetheless, we found that carbohydrate intake of 0. This, along with the reduction in insulin delivery, was associated with higher lipid use and ketone production, which may help with fat loss In summary, the more proactive approach to reduce basal insulin delivery 90 min pre-exercise for individuals on CSII may eliminate snacking needs and effectively increases fat oxidation, thereby increasing net energy expenditure.

Future studies should determine whether this approach is favorable for weight control and glycemic stability when exercise of different forms and intensities occur. The authors thank all of the participants for the time and dedication to the study.

Duality of Interest. This study was funded by Insulet Canada Corporation and Insulet Corporation. has received speaker honoraria from Medtronic Diabetes and Ascensia Diabetes Care. and T. are both employees and shareholders of Insulet Corporation.

has received speaker honoraria from Medtronic Diabetes, Insulet Corporation, Ascensia Diabetes Care, Novo Nordisk through JDRF T1D Performance in Exercise and Knowledge Program , Xeris Pharmaceuticals, Lilly Diabetes, and Lilly Innovation.

No other potential conflicts of interest relevant to this article were reported. Author Contributions. was responsible for data collection, interpretation of data, and analysis.

contributed feedback and revisions for the final manuscript. designed the study and wrote the manuscript. assisted in the data collection. assisted with assays. is the guarantor of this work and, as such, had full access to all of the data in the study and takes responsibility for the integrity of the data and the accuracy of the data analysis.

Prior Presentation. Parts of this study were presented in poster form at the 80th Scientific Sessions of the American Diabetes Association, 12—16 June Sign In or Create an Account.

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Novel Communications in Diabetes December 16 Carbohydrate Requirements for Prolonged, Fasted Exercise With and Without Basal Rate Reductions in Adults With Type 1 Diabetes on Continuous Subcutaneous Insulin Infusion Sarah M. McGaugh ; Sarah M. This Site. Google Scholar. Dessi P. Zaharieva ; Dessi P.

Rubin Pooni ; Rubin Pooni. Ninoschka C. Todd Vienneau ; Todd Vienneau. Trang T. Ly ; Trang T. Michael C. Riddell Corresponding author: Michael C. Riddell, mriddell yorku.

Diabetes Care ;44 2 — Steffie Simpinano Solin, Sp. PD Internal Medicine Specialist at EMC Cibitung Hospital. Untuk informasi lebih lanjut dan menjawab segala pertanyaan anda, Bisa hubungi melalui Call Center atau Whatsapp kami berikut ini:.

Care Plus Detail Home Care plus Care Plus Detail. Avoid Hypoglycemia When Fasting in the Following Ways! Written By: dr. Symptoms of hypoglycemia while fasting There are several symptoms commonly experienced by hypoglycemia sufferers when fasting, including: Dizziness and pain in the head Feeling tired and lethargic A cold sweat Dizzy eyes or visual disturbances Body shaking or convulsions Confusion or difficulty in thinking and speaking Increased appetite Fast and irregular heartbeat Mood changes such as restlessness, anxiety, or irritability How to prevent hypoglycemia while fasting There are several ways you can do to prevent hypoglycemia while fasting, such as: Consult with a doctor If you have diabetes or other health problems that affect blood sugar levels, consult your doctor before deciding to fast.

Your doctor can help you create a fasting plan that's safe for your body and give you advice about dosages of your diabetes medications and timing of meals. Choose the right fasting time Choose a fasting time that suits your health. Avoid fasting if you are sick, stressed, or physically weak.

Eat the right foods when breaking the fast Choose foods rich in complex carbohydrates such as whole wheat bread, brown rice, potatoes and vegetables to help the body maintain stable blood sugar levels. Avoid foods that are high in sugar, such as candy or sugary drinks.

Drink enough water Drinking enough water while fasting can prevent dehydration which can affect blood sugar levels. Routinely monitor blood sugar levels Monitor your blood sugar levels regularly while fasting.

If you feel sick or symptoms of hypoglycemia appear, immediately check your blood sugar level and immediately drink water or eat foods that contain complex carbohydrates.

Avoid strenuous exercise Avoid strenuous exercise while fasting, as this can accelerate the decrease in blood sugar levels. Exercise is recommended to be done at the time of breaking the fast or after dinner.