1. Diabetes Edutool: Tutorial 4 The effect of exercise and insulin on blood glucose

2. Insulin is needed to allow the glucose in our blood to enter the cells in our body The glucose can then be stored, or used for energy in the cells Glucose Insulin

3. When we exercise, glucose in our cells is used for energy We also need insulin to let more glucose into our cells

4. If insulin is not available, sufficient glucose cannot enter the cells …and there will not be energy for exercising

5. Let’s use Edutool to illustrate this: In this example, Arnold will: Start off with a blood glucose level in the normal range He is going to exercise, and is aware of possible low blood glucose Therefore he eats a slice of cake before starting to exercise, but does not inject any insulin to balance this

6. We start off with a blood glucose level within the normal range Normal blood glucose is close to 5 mmol/L

7. Arnold first eats the cake (11 ). This results in his blood glucose rising to 12 mmol/L

8. Now add the same amount of exercise (11 ). Notice what happens to his blood glucose level

9. His blood glucose did not return to normal. It dropped slightly from 12 to 10 mmol/L while exercising His blood glucose level is still very high

10. Remember, when no insulin is available, glucose cannot be absorbed by the cells Glucose stays in the blood, even though glucose is required for the exercise

11. Because of a lack of insulin, the liver keeps on releasing glucose… even though there is enough glucose in the blood The glucose can only stay in the blood because the cells are locked

12. Insulin is needed to unlock the cells and let the glucose in. Without insulin, glucose levels will stay high

13. Just 1 U of insulin was needed to lower Arnold’s blood glucose to the normal range Normal blood glucose

14. During exercise, our bodies become more insulin sensitive. This means less insulin is needed to do the same job 1 U of insulin is sufficient in this scenario to achieve blood glucose in the normal range

15. Lessons: - When we exercise, our cells use glucose - Insulin is needed to let glucose into our cells - If there is not enough insulin, glucose will stay in the blood - Exercise then becomes difficult as energy is not available - We need insulin to let the glucose into the cells to use as energy during exercise -- End of Tutorial 4 --