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EXAMPLE 6.6 A TYPE 2 DIABETIC WALKING TO CONTROL DIABETES
Maria is 54 years
old and has been Type 2 diabetic for the last 12 years. She
switched to insulin shots a few months ago. She is now
researching on how to organize her after-meal exercise and she
conducted the following experiment:
She jotted down the
current odometer reading from her car as 125,455.5 miles. She
drove her car in the neighborhood until the odometer reading
moved to exactly 125,456.0 miles. That means the distance
traveled is exactly ½ mile. She noted the address of that spot
so that she would remember. She continued in this way for 2
miles, stopping at every ½ mile and noting down the exact
address of that spot. From this information, she would know the
exact distance to walk ½ mile, 1 mile, 1 ½ miles, and so on from
her home.
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Home
------------------------------------------------------- 1 mile
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 Destination |
Maria decided to study the
combined influence of insulin (Humalog) and exercise (walking)
on after meal glucose levels. Here are the data she collected:
6:00 pm Monitored her
glucose level and injected 4 units of Humalog.
Consumed a major meal of 800 Kilocalories (130 gm of carbo).
6:30 pm Monitored
after-meal glucose level (see table below).
Walked ½ mile and came back home in 20 minutes.
6:50 pm Monitored
glucose level (see table below).
Spent 5 minutes for monitoring and record keeping.
Repeated the same 2 more times to complete 1 hour of exercise.
Speed: 3mph; Calories lost: 244 Kcal
Table 6.4
--------------- Walking
-------------
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Time |
6:00 pm |
6:30 pm |
6:50 pm |
7:15 pm |
7:40 pm |
|
Glucose (mmol/L) |
5.9 |
12.9 |
8.5 |
6.8 |
5.2 |
|
Glucose (mg/dL) |
106.2 |
232.2 |
153 |
122.4 |
93.6 |
She walked 3 miles altogether at normal pace in one hour. Her
weight is 155 lb.
So she lost 244 kilocalories (see Table 6.1). She lowered
her after meal glucose level to normal within 2 hours. Her
glucose levels remained normal till midnight and till the
morning.
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Walking Exercise Program
Figure 6.3
A Diabetic Woman Walking to Lower Her After-meal Glucose Levels. |
EXAMPLE 6.7
A TYPE 1 DIABETIC WALKING TO
CONTROL DIABETES
Ervin is a 51-year-old Type 1 diabetic. After every major meal
his blood glucose level rises above 18 mmol/L (324 mg/dL). His
hemoglobin A1c is over 9.8%. During the past 2 years, he has
been experiencing heart disease, angina and kidney disease.
He has been injecting too much insulin (25 units of Humalog) to
lower his high blood sugar levels without exercise. He has read
a lot about diabetes and insulin. He learned that too much
insulin stimulates the brain so that a person feels hungry and
eats more and also causes the liver to add fat in the belly. He
decided to optimize the insulin dose for the evening meal by
implementing 1 hour of exercise. His diabetes control
strategy is described below with his one-evening activity:
5:30 pm Prepared a
major meal of 900 kilocalories (150 gm of carbo).
6:00 pm Monitored
fasting glucose (see table below); consumed major meal.
6:30 pm Monitored
blood glucose level (see table below).
He should not exercise if his level is over 13 mmol/L or 234
mg/dL.
Injected 6 units of Humalog to bring his level down to 13
mmol/L.
Refer to page 10 for insulin dose calculation.
7:00 pm Blood glucose
level dropped to 12.5 mmol/L or 225 mg/dL.
7:00 pm Injected 4
more units of Humalog, and started walking.
Walked precisely 7 ½ minutes, carefully looking at his
wristwatch.
Came home by walking another 7 ½ minutes (total 15 minutes).
Monitored
his glucose and spent 5 minutes for record keeping.
Repeated the same 3 more times to complete 1 hour of exercise.
Table 6.5
--------------- Walking --------------
|
Time |
6:00 PM |
6:30 PM |
7:00 PM |
7:15 PM |
7:35 PM |
7:55 PM |
8:15 PM |
|
Glucose (mmol/L) |
6 |
19.4 |
12.5 |
8.5 |
7.6 |
6.1 |
4.7 |
|
Glucose (mg/dL) |
108 |
349 |
225 |
153 |
136.8 |
109.8 |
84.6 |
For 150 gm of carbohydrate in a meal, it would require 19 units
of Humalog (1 unit for every 8 gm). But Ervin lowered his level
to normal with 11 units only, cutting Humalog dose by 47%. He
has controlled his after-meal glucose levels and minimized his
Humalog insulin dose every day diligently for 6 months. His
hemoglobin A1c has dropped from 9.8% to 6.7%. Erwin is now a
happy man. He no longer suffers heart disease, angina or kidney
disease. He now monitors only 2 or 3 times a day. He
became a self-taught master of diabetes control.
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Walking Exercise Program
Figure 6.4
A
Diabetic Man Walking to Lower His After-meal Glucose Levels
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