For last week’s practice question, we quizzed participants on why glucose is spiking after exercise. 80% of respondents chose the best answer. We want to clarify and share this important information, so you can pass it on to people living with diabetes and your colleagues, plus prepare for exam success!

Before we start though, if you don’t want any spoilers and haven’t tried the question yet, you can answer it below: Answer Question

Question:

JR is 42 years old with type 2 diabetes and has worked up to brisk walking for 30 minutes on most days.  JR has an A1C of 6.7% and takes an SGLT-2, metformin, and lovastatin along with trying to eat healthfully. JR decided to check blood sugars an hour after exercise and was surprised to see post-exercise blood glucose in the 180’s on two different days. JR asks you why their blood glucose actually rises after exercise.

What is the diabetes specialist’s best response?

Answer Choices:

1. This is most likely due to a low blood sugar from your medications followed by rebound hyperglycemia.
2. Blood sugars normally drop after exercise. When is the last time you performed quality control on your meter?
3. I understand what you are saying. It sounds like this blood sugar elevation is causing you some anxiety.
4. Exercising causes the release of hormones that can temporarily cause your blood sugar to rise.

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Getting to the Best Answer

Answer 1 is incorrect. 6.19% chose this answer, “This is most likely due to a low blood sugar from your medications followed by rebound hyperglycemia.” This answer is tempting, but not accurate. Since JR’s only diabetes medication include metformin and a SGLT-2 inhibitor, they are not at risk for low blood sugar.  Low blood sugar is only associated with sulfonylureas, meglitinides and insulin therapy.

Answer 2 is incorrect. 3.29% of you chose this answer, “Blood sugars normally drop after exercise. When is the last time you performed quality control on your meter?”  In this situation, exercise can decrease hours after exercise, but usually increases immediately after exercise. Which means, JR doesn’t need to  perform quality control on their glucose meter, since it is accurately reflecting blood sugar trends.

Answer 3 is incorrect. 10.41% of respondents chose this answer, “I understand what you are saying. It sounds like this blood sugar elevation is causing you some anxiety.” Although, this is a very compassionate response, it does not answer the question JR is asking, “why does my blood sugar go up after exercise?” For this reason, it is tempting, but not the best answer.

Finally, Answer 4 is correct. 80.11% chose this answer, “Exercising causes the release of hormones that can temporarily cause your blood sugar to rise.”  YES, most of you chose the best answer. With exercise, counterregulatory or stress hormones are activated, which increases insulin resistance and causes blood glucose levels to temporarily rise to feed hungry muscles.  This glucose rise is an expected temporary response and with time, blood sugars get back to baseline.  GREAT JOB.

Thank you so much for reading this “Rationale of the Week”.

We also invite you to join our Online Courses for more information (see info below)
Hope you can join our ADA Standards of Care Webinar Update in February.

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Want to learn more about this question? Enroll in our upcoming

Level 1 | Diabetes Fundamentals 2023 Updates | 9+ CEs

This bundle is specifically designed for healthcare professionals who want to learn more about diabetes fundamentals for their clinical practice or for those who are studying for the Certified Diabetes Care and Education Specialist (CDCES) exam.

Intended Audience: This library of critical information is designed for individuals or groups of diabetes specialists, including RNs, RDs, Pharmacists, Nurse Practitioners, Clinical Nurse Specialists, Physician Assistants, and other health care providers interested in staying up to date on current practices of care for people with diabetes and preparing for the CDCES Certification Exam.

2023 Webinar Updates

1. Recorded & Ready to watch on-demand – Class 1 – Getting to the Nitty Gritty 1.5 CEs
2. Recorded & Ready to watch on-demand – Class 2 – Nutrition and Exercise 1.5 CEs
3. Recorded & Ready to watch on-demand – Class 3 – Meds Overview for Type 2 – 1.5 CEs
4. January 19, 2023 – Class 4 – Insulin Therapy & Pattern Management 1.5 CEs
5. January 24, 2023 – Class 5 – Goals of Care – 1.5 CEs
6. January 26, 2023 – Class 6 – Hypoglycemia, Sick Days, Monitoring, Foot Care 1.5 CEs

All hours earned count toward your CDCES Accreditation Information

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Want an overview of the new 2023 ADA Standards of Care in Diabetes?

Join us live on February 2, 2023, at 11:30 am PST for our

Level 2 | ADA Standards of Care 2023 Update | 2.0 CEs

 

All hours earned count toward your CDCES Accreditation Information

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