Blood Sugar Question

[Kooky Korky, BSN, RN]

Fasting sugar 136

After no breakfast and about 1/2 hour of mild swim 205.

Is this due to breakdown of glycogen? Other reason?

It would seem to suggest eating at least a few carbohydrates before exercising. I know lots of people say they eat protein before exercising.

What do the experts know about this topic?

[klone, MSN, RN]

Samogyi effect?

[KatieMI, BSN, MSN, RN]

No, it is not Somogui. That would be due to previous HYPOglycemia through glucagon peak and very quick synthesis through liver storage of glycogen (takes a few minutes, intended for severe stress). It is gluconeogenesis + PERIPHERAL insulin resistance.

Diabetes means no insulin - either not enough of molecules, or enough but for some reason they do not work where and how they supposed to be. Either way, it means that, doesn't matter how much glucose you have in blood and how it got there, it stays there. With no insulin, it cannot get into cells and be used.

You woke up, started to do things, then swam. Your muscles (the biggest eaters of glucose overall) asked for energy, so your liver listened and made some glucose. Muscle glycogen was one source, another one was fatty acids from your body fat through aceCoeA going into gluconeogenesis and amino acids through piruvate (for knowing which one prevailed, it is needed to know your body physiologic characteristics like age, gender, % body fat, etc, but it is not, in fact, that important). The process, unlike "quick" gluconeogenesis from liver glycogen, takes 30 min at best and probably longer. The problem is that you still do not have insulin to use that newly made glucose, therefore it just swims in blood and eventually gets mostly peed out. It is made, but cannot be delivered where it is needed when it is needed.

Peripheral glucose receptor uptake activator like metformin and vicious fight with insulin resistance (diet, exercise, stress reduction, repeat) will help.

[Kooky Korky, BSN, RN]

No, it is not Somogui. That would be due to previous HYPOglycemia through glucagon peak and very quick synthesis through liver storage of glycogen (takes a few minutes, intended for severe stress). It is gluconeogenesis + PERIPHERAL insulin resistance.

Diabetes means no insulin - either not enough of molecules, or enough but for some reason they do not work where and how they supposed to be. Either way, it means that, doesn't matter how much glucose you have in blood and how it got there, it stays there. With no insulin, it cannot get into cells and be used.

You woke up, started to do things, then swam. Your muscles (the biggest eaters of glucose overall) asked for energy, so your liver listened and made some glucose. Muscle glycogen was one source, another one was fatty acids from your body fat through aceCoeA going into gluconeogenesis and amino acids through piruvate (for knowing which one prevailed, it is needed to know your body physiologic characteristics like age, gender, % body fat, etc, but it is not, in fact, that important). The process, unlike "quick" gluconeogenesis from liver glycogen, takes 30 min at best and probably longer. The problem is that you still do not have insulin to use that newly made glucose, therefore it just swims in blood and eventually gets mostly peed out. It is made, but cannot be delivered where it is needed when it is needed.

Peripheral glucose receptor uptake activator like metformin and vicious fight with insulin resistance (diet, exercise, stress reduction, repeat) will help.

Sounds right to me. thanks.

You are so right about the vicious fight that must be waged against DM. Well, there are worse diseases, eh?

Thanks again.

[Kooky Korky, BSN, RN]

Samogyi effect?

Maybe that would account for the initial mildly high fasting sugar, I think. But I was wondering about the higher one after no meal was eaten before mild workout. I don't Somogyi would explain that.

See KatieMI's response. I think she's got it.

I do appreciate you replying, Klone.

[blondy2061h, MSN, RN]

If he has type 2 diabetes it could absolutely be a somogyi effect. Insulin is present and the exercise acted as a catalyst to increase insulin sensitivity. Then, a quick drop in blood sugar and resultant spike from a glycogen dump.

[Kooky Korky, BSN, RN]

If he has type 2 diabetes it could absolutely be a somogyi effect. Insulin is present and the exercise acted as a catalyst to increase insulin sensitivity. Then, a quick drop in blood sugar and resultant spike from a glycogen dump.

Hmm... that doesn't fit with what I read, but I am not an expert and did not do extensive research.

What do you figure is the best way to prevent the problem, no matter what the cause is?

And how can we know the cause for sure? Somogyi or KatieMI's explanation?

Thanks.