Physical work effects a transitory enhanced affinity of insulin to its receptor in the stressed muscles and thereby a better efficiency. Therefore, in sports lasting for 30 min and more the basal and/or bolus doses of insulin have to be reduced in order to prevent hypoglycemia. An alternative supply of additional carbohydrates prior to physical work is often not practicable. Injections of insulin into areas of the body not involved in muscular work do not give sufficient warranty against hypoglycemic reactions. A new short-acting insulin-analogue (Lispro) shows a reduced effect on blood glucose levels after 3 h as compared to regular insulin. Therefore, it could be of advantage for insulin dependent diabetics doing their exercise at this time.
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