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How Does Exercise Affect Type 1 Diabetes?

Exercise In People With Type 1 Diabetes

Exercise In People With Type 1 Diabetes

Exercise is recommended for everyone with diabetes. In people with type 1 diabetes exercise provides many benefits—improved cardiovascular health, a psychological lift, stronger bones, stronger muscles and more restful sleep. It evens aids in weight loss and improved insulin sensitivity. In fact, there have been studies that demonstrate that people with type 1 who exercise have lower mortality rates. But one thing it hasn’t been proven to do is decrease A1C levels. When people with type 2 diabetes engaged in regular exercise, their A1C levels drop. The research looking at exercise benefits in terms of glucose control for people with type 1 isn’t as sanguine. The reason there isn’t always a positive impact on A1C has to do with the ever present risk of hypoglycemia and hyperglycemia whenever a person with type 1 diabetes exercises. Both exercise-related hypo- and hyperglycemia occur in people with type 1 diabetes because the physiology of exercise works a bit differently. When we exercise we need more glucose to fuel our muscles. So in people without diabetes, glucagon is activated and causes the liver and muscles to breakdown glycogen in a process called glycogenolysis . At the same time, the liver starts to replenish its glucose stores from amino acid backbones through gluconeogenesis, so it can have backup glucose for extended periods of activity. Concurrently the level of insulin declines, weighing the hormonal milieu away from energy storage to energy generation. In people with type 1 diabetes, insulin levels, injected exogenously, don’t decline. This blunts glucogenolysis and continues to enhance glucose uptake by the muscles. While the muscles need glucose, too-rapid consumption depletes the glucose in the blood stream. If production of glucose by the li Continue reading >>

Nutrition And Insulin Management Guidelines For Exercise In Type 1 Diabetes

Nutrition And Insulin Management Guidelines For Exercise In Type 1 Diabetes

Nutrition and Insulin Management Guidelines for Exercise in Type 1 Diabetes Nutrition and Insulin Management Guidelines for Exercise in Type 1 Diabetes Patients with type 1 diabetes and their providers should recognize how the form and intensity of exercise affects glucose control, according to a recent consensus statement published in the Lancet Diabetes & Endocrinology. "Regular exercise has long been known to be beneficial from a cardiometabolic perspective for people living with type 1 diabetes. It has also been known to make glucose control more difficult," Michael C. Riddell, PhD, professor and graduate program director at the School of Kinesiology and Health Science at the Muscle Health Research Centre at York University in Toronto, Ontario, Canada, told Endocrinology Advisor in an interview. "This recent consensus document highlights the known beneficial effects of regular exercise in type 1 diabetes and how different forms and intensities of exercise impact immediate glucose homeostasis." Dr Riddell and colleagues performed a PubMed search of nutrition and glycemic-based terms for studies involving patients with type 1 diabetes or insulin-dependent diabetes between January 1990 and July 2016 in which physical activity or exercise was involved. The review of the literature was divided into sections involving management of glycemia, exercise, and nutrition, as well as goals for exercise, contraindications of exercise, and tools for exercise management in patients with type 1 diabetes. "Acute aerobic exercise [typically causes] increases in glucose disposal that cannot be matched by increased hepatic glucose production in type 1 diabetes because circulating insulin levels do not drop rapidly enough at the time of exercise," Dr Riddell told Endocrinology Advisor . Continue reading >>

Exercise And Type 1 Diabetes

Exercise And Type 1 Diabetes

Type 1 diabetes is a disease that affects the body’s ability to use sugars, starches, fats and proteins. Because the body needs various fuels for energy, this disease disrupts normal energy metabolism both at rest and during physical exercise. Following digestion, a hormone called insulin is released into the blood from the pancreas. Among insulin’s primary roles is its ability to allow carbohydrates (absorbed in the form of glucose) and proteins to enter muscle cells, where they are stored or used for energy. Individuals with type 1 diabetes are unable to produce enough—or even any—insulin to allow this process to occur. Consequently, glucose is unable to enter cells and builds up in the blood. Because people with type 1 diabetes have insufficient insulin production, daily insulin injections are required to maintain glucose levels as close to normal as possible. Thus, individuals with type 1 diabetes are considered insulin-dependent. It is imperative for those with type 1 diabetes to regulate their blood glucose (blood sugar) levels to help reduce complications associated with this disease. If glucose levels remain unchecked for extended periods, people with type 1 diabetes run the risk of developing heart disease, kidney failure, blindness and nerve dysfunction. Therefore, people with type 1 diabetes must always be careful about the amounts and types of foods they eat, as well as when they exercise and what types of physical activity they perform. How does exercise help? Because exercise uses glucose as a fuel, it is an effective way to control blood sugar levels. Exercise has an insulin-like effect on glucose, enhancing its uptake into cells and counteracting elevated blood glucose levels that frequently occur after eating. With exercise, the amount of insuli Continue reading >>

A Promising New Exercise Solution For Type 1 Diabetes

A Promising New Exercise Solution For Type 1 Diabetes

Exercise is good, but for type 1 diabetics, it can be very, very bad. Spontaneous exercise in particular can drive blood sugar to dangerously low levels. However, wearable electronic devices are putting increasingly detailed metabolic information within easy reach of the general public. The study discussed here considers how that technology can help give type 1 diabetics the freedom that non-diabetics take for granted. Blood Sugar Complications In type 1 diabetes, the patient’s pancreas produces little or no insulin. Without a natural supply of the hormone responsible for mediating blood sugar concentrations, a type 1 diabetic depends on regular insulin injections instead. "Diabetes management involves carefully balancing insulin injections and carbohydrate consumption to maintain a blood sugar level in between these two extremes." Excessive blood sugar increases the risk of diabetic complications, including retinal and peripheral nerve damage, which can lead to blindness and the loss of digits, respectively. Low blood sugar is equally dangerous, potentially causing dizziness, confusion, and unconsciousness. Diabetes management involves carefully balancing insulin injections and carbohydrate consumption to maintain a blood sugar level in between these two extremes. Exercise and Glucose Exercise can play an important role in maintaining this balance. It burns glucose and improves insulin sensitivity. Moreover, diabetics derive the same exercise-related improvements in mental wellbeing and cardiovascular health that non-diabetics do. Unfortunately, exercise also poses unique risks for diabetics. The glucose burned during exercise may not be replenished quickly enough, leading to hypoglycemia and its associated risks. The longer the exercise duration, the greater the ris Continue reading >>

Type 1 Diabetes: Exercise Often Raises Blood Glucose In Type 1 Diabetes

Type 1 Diabetes: Exercise Often Raises Blood Glucose In Type 1 Diabetes

Regular physical activity and exercise are recommended for the general population for overall improved health. However, exercise of moderate intensity increases the risk of hypoglycemia during and following exertion in those with type 1 diabetes mellitus (T1DM). Accordingly, exercise guidelines for T1DM focus on prevention of exercise-induced hypoglycemia. The risk of hypoglycemia may discourage some with T1DM from exercising. Children and youth may be embarrassed by the temporary reduction in coordination and physical performance associated with hypoglycemia and by the fear of letting teammates down while playing. Some parents may discourage their children from normal participation in physical activity and from playing competitive sports because of concern about severe hypoglycemia. However, this fear may reduce a child’s physical activity, which may lead to reduced overall health, reduced enjoyment from exercise, and restricted confidence in meeting the demands imposed by living with a chronic health condition like diabetes. As a result, long-term exercise habits as well as personal growth and psycho-social development may be blunted. Concern with hypoglycemia from exercise is probably even more heightened in those with hypoglycemia unawareness, or the absence of symptoms during hypoglycemia. However, some of these concerns might be allayed by the realization that vigorous exercise tends to raise blood sugars rather than lower it. The fact that vigorous exercise tends to raise blood sugar appears to be relatively unknown to many with T1DM. However, the effect has been confirmed in a number of studies. These studies have identified an exercise threshold that elicits this response. The threshold exercise intensity occurs at or above 80% of a person’s maximum exercis Continue reading >>

Type 1 Diabetes

Type 1 Diabetes

Type 1 diabetes (insulin dependent diabetes, juvenile) is a condition in which the body stops making insulin. This causes the person's blood sugar to increase. There are two types of diabetes, type 1 and type 2. In type 1 diabetes, the pancreas is attacked by the immune system and then it cannot produce insulin. In type 2 diabetes the pancreas can produce insulin, but the body can't use it. Causes of type 1 diabetes are auto-immune destruction of the pancreatic beta cells. This can be caused by viruses and infections as well as other risk factors. In many cases, the cause is not known. Scientists are looking for cures for type 1 diabetes such as replacing the pancreas or some of its cells. Risk factors for type 1 diabetes are family history, introducing certain foods too soon (fruit) or too late (oats/rice) to babies, and exposure to toxins. Symptoms of type 1 diabetes are skin infections, bladder or vaginal infections, and Sometimes, there are no significant symptoms. Type 1 diabetes is diagnosed by blood tests. The level of blood sugar is measured, and then levels of insulin and antibodies can be measured to confirm type 1 vs. type 2 diabetes. Type 1 diabetes is treated with insulin and lifestyle changes. Specifically, meal planning to ensure carbohydrate intake matches insulin dosing. Complications of type 1 diabetes are kidney disease, eye problems, heart disease, and nerve problems (diabetic neuropathy) such as loss of feeling in the feet. Poor wound healing can also be a complication of type 1 diabetes. Type 1 diabetes cannot be prevented, however, keeping blood sugar at healthy levels may delay or prevent symptoms or complications. There is currently no cure, and most cases of type 1 diabetes have no known cause. The prognosis or life-expectancy for a person with Continue reading >>

5 Tips For Exercise With Type 1

5 Tips For Exercise With Type 1

A diabetes life coach shares her secrets for good blood glucose control while working out. Throughout July, we’re featuring excerpts from Ginger Vieira’s new book, Dealing with Diabetes Burnout. In this final edited excerpt from the book, the longtime life coach and diabetes advocate shares the lessons she’s learned from years of exercise with Type 1 diabetes. There is no doubt that exercising with diabetes is about one million times more challenging than exercising without diabetes, particularly if you take insulin. Low blood sugars and high blood sugars are major party-poopers in the middle of a walk, yoga, spinning class, tai chi, or strength-training. I’m here to tell you that it can be done and you can enjoy exercise, but it takes a little work, a little more effort, and a bunch of self-study. sponsor When I personally started to become really active and committed to exercising regularly, I was working really hard to balance my blood sugar during things like Ashtanga yoga, strength-training, and various forms of cardio like power-walking and the stairmaster. And it wasn’t easy, but at the very same time I was learning with the help of my trainer, Andrew, about what was literally going on in my body during different types of exercise. Learning about this basic science, taking a deep breath, and viewing my body as a science experiment is the only reason I am able to exercise happily and confidently today. Read “25 Facts to Know About Exercise and Type 1 Diabetes.” Here are five lessons I’ve learned on balancing blood sugars during exercise: 1. Understand What Type of Exercise You’re Doing Jogging and strength-training will both have very different impacts on your blood sugar, even though your heart rate may rise during both. Cardiovascular or aerobi Continue reading >>

How To Counsel Type 1 Diabetes Patients Who Exercise?

How To Counsel Type 1 Diabetes Patients Who Exercise?

How to Counsel Type 1 Diabetes Patients Who Exercise? This feature requires the newest version of Flash. You can download it here . Anne L. Peters, MD: Hi. I'm Dr Anne Peters. I am here today with Dr Bruce Bode to talk about exercise as part of the treatment for diabetes. Let's start the discussion. You and I both take care of lots of athletes. How do you teach someone how to take care of a person who is taking insulin? Bruce W. Bode, MD: As you know, exercise is an insulin sensitizer; it makes insulin work better. In type 2 diabetes, you always want to get your patients to walk because it improves insulin action. In type 1 diabetes, they don't make insulin, so they need to take insulin to survive. You have to balance the insulin with their food intake. When they exercise, you're going to need less insulin because they will have improved insulin action and sensitivity. For people with type 1 diabetes who want to exercise, and especially those who want to get into extreme exercise like running a marathon, you have to help them and guide them. You have to balance the insulin with glucose levels. You have to have the right amount of insulin and match it with carbohydrates as best as you can. The rule of thumb is that you always start exercise when your glucose level is above 90 mg/dL and preferably don't start exercise if your glucose level is above 250 mg/dL because that means you are relatively insulin-deficient. If you are starting at 90 mg/dL, you might want to take 10-20 g of carbohydrate before you start, even juice or something. Then, the key is that you need to monitor the glucose in response. If somebody is doing aerobic exercise like running or walking, and over time they start to fall, that means that they have too much insulin on board. You have to cover that Continue reading >>

Sports And Exercise: The Ultimate Challenge In Blood Sugar Control

Sports And Exercise: The Ultimate Challenge In Blood Sugar Control

by gary scheiner, MS, CDE Sometimes, it amazes me how smart the pancreas really is. It always seems to know what to do to keep blood sugars in range, even under the most challenging circumstances. Having an argument with your partner? It churns out some extra insulin to offset the “fight or flight” response (make that flight only, if you’re smart). Upset stomach keeping you from eating the way you normally eat? Insulin secretion drops off a bit. Can’t resist the aroma of a fresh bagel (something that, in my opinion, was forged by the Diabetes Devil himself)? Pancreas cranks out just enough to cover it. Participation in sports and exercise presents a special challenge. That’s because physical activity can affect blood sugar in multiple ways. With increased activity, muscle cells become much more sensitive to insulin. This enhanced insulin sensitivity may continue for many hours after the exercise is over, depending on the extent of the activity. The more intense and prolonged the activity, the longer and greater the enhancement in insulin sensitivity. With enhanced insulin sensitivity, insulin exerts a greater force than usual. A unit that usually covers 10 grams of carbohydrate might cover 15 or 20. A unit that normally lowers the blood sugar by 50 mg/dl might lower it by 75. Some forms of physical activity, most notably high-intensity/short duration exercises and competitive sports, can produce a sharp rise in blood sugar levels followed by a delayed drop. This is due primarily to the stress hormone production or “adrenaline rush” that accompanies these kinds of activities. Let’s take a look at these two different situations in greater detail. aerobic activities Most daily activities and aerobic exercises (activities performed at a challenging but sub-m Continue reading >>

Don’t Sweat It! Exercise And Type 1 Diabetes

Don’t Sweat It! Exercise And Type 1 Diabetes

The benefits of exercise are wide ranging. Regular physical activity can help people manage their weight, sleep better, reduce the risk of some diseases, including type 2 diabetes (T2D) and heart disease, and improve overall quality of life—among other proven benefits. People with type 1 diabetes (T1D) can gain the same benefits from exercise as anyone else. Yet studies show that many people with T1D do not engage in regular physical activity owing to a fear of hypoglycemia, or dangerously low blood-glucose levels. Exercise scientists and athletes with T1D alike say that people with T1D can exercise safely and effectively. It’s a matter of observing how your body responds to exercise, learning to balance insulin, food, and physical activity, and using research-supported strategies to minimize the risk of hypoglycemia during and after exercise. Managing hypoglycemia associated with exercise Sheri Colberg-Ochs, Ph.D., professor of exercise science at Old Dominion University in Norfolk, VA, has both professional and personal interests in understanding the risks and benefits of exercise for people with T1D. As an exercise physiologist, Dr. Colberg-Ochs studies the relationship of exercise to diabetes and lifestyle management. She has also lived with T1D for 44 years, while staying fit and active. Dr. Colberg-Ochs notes that the risk of hypoglycemia during and after exercise can be managed. “There’s not a tried and true method that works for everyone. It’s very individual, based on the type of activity and your normal diabetes regimen,” she says, “but you can certainly reduce the frequency of hypoglycemia that’s associated with being physically active.” The risk of hypoglycemia is affected by the type, duration, and intensity of physical activity. Aerobic a Continue reading >>

Guidelines On Safe Exercise For People With Type 1 Diabetes

Guidelines On Safe Exercise For People With Type 1 Diabetes

Exercising safely with type 1 diabetes can be quite a challenge. A paper from JDRF funded experts has acknowledged these challenges and published useful exercise guidelines for type 1 diabetes patients and providers. These JDRF experts are part of an international team of 21 researchers and clinicians led by York University Professor Michael Riddell. The paper, called “Exercise management in type 1 diabetes: a consensus statement” which has been published in The Lancet Diabetes & Endocrinology provides guidelines on how to exercise safely and effectively with type 1 diabetes. Aaron Kowalski, Ph.D., JDRF Chief Mission Officer and report contributor said in a press release, “Exercise has tremendous benefits for people with T1D, but it can be hard to predict how it will affect their blood glucose and how they feel during and following physical activity,” and that “The lack of reliable information on how to exercise safely has created obstacles for people with T1D who want to maintain a healthy lifestyle. These consensus guidelines, as well as JDRF’s new PEAK program, are breaking down those barriers.” The T1D PEAK program (Performance in Exercise and Knowledge) is an initiative by JDRF to help educate people with type 1 as well as their caregivers and healthcare providers on how to exercise safely. Riddell, the lead author speaks to some of these benefits and barriers of exercise, “Regular exercise can help individuals with diabetes to achieve their blood lipid, body composition, fitness and blood sugar goals, but for people living with type 1 diabetes, the fear of hypoglycemia, loss of glycemic control, and inadequate knowledge around exercise management are major barriers,” In order to create the guidelines, Riddell and team reviewed observational studi Continue reading >>

Type 1 Diabetes And Exercise

Type 1 Diabetes And Exercise

Exercise is an absolutely vital part of type 1 diabetes treatment. Staying fit and active throughout your life has many benefits, but the biggest one for people with diabetes is this: it helps you control diabetes and prevent long-term complications. Exercise makes it easier to control your blood glucose (blood sugar) level. Exercise benefits people with type 1 because it increases your insulin sensitivity. In other words, after exercise, your body doesn't need as much insulin to process carbohydrates. If your child has type 1 diabetes, making sure he or she gets enough exercise is not only a great way to help manage his or her diabetes but also instill healthy habits from an early age. To learn more about how to safely incorporate exercise into your child's routine, read our article about physical activity for children with type 1 diabetes. Exercise can also help people with type 1 diabetes avoid long-term complications, especially heart problems. As you can read about this in our article on type 1 diabetes complications, people with diabetes are susceptible to developing blocked arteries (arteriosclerosis), which can lead to a heart attack. Exercise helps keep your heart healthy and strong. Plus, exercise helps you maintain good cholesterol—and that helps you avoid arteriosclerosis. Additionally, there are all the traditional benefits of exercise: Lower blood pressure Better control of weight Leaner, stronger muscles Stronger bones More energy One person who certainly understands the benefits of exercise in managing type 1 diabetes is Jay Cutler, quarterback for the Chicago Bears. He was diagnosed with type 1 diabetes in 2008, but the disease hasn't interfered with his football career. To learn more, read our article about Jay Cutler's experience with type 1 diabete Continue reading >>

Type 1 Diabetes And Exercise

Type 1 Diabetes And Exercise

During activity, injected or pumped insulin cannot be 'shut off' like the body's own insulin, so too much glucose is taken up by both muscle contractions and the high levels of insulin, says Sheri R. Colberg, Ph.D., professor of exercise science at Old Dominion University in Norfolk, Virginia. To avoid hypoglycemia when doing physical activity, monitor your blood sugar before and after exercise. Here are some other guidelines from Colberg and the American Diabetes Association: Eat a small carbohydrate-containing snack before exercising if your blood glucose is 100 mg/dl or lower. Wait about 10 to 15 minutes before starting your activity. Eat a snack if you plan to exercise for more than 60 minutes, plan to do a more intense workout than usual, or if the weather is warmer or cooler than usual. Always carry a small snack that's high in sugar or carbohydrate. The average 150-pound adult needs 20 grams of carbohydrate for every half-hour of moderate exercise. Some snack choices include sports drinks and gels and easily absorbed carbohydrate sources, such as jelly beans and energy bars. Watch for symptoms of hypoglycemia during exercise. If you feel weak, lightheaded, cold, or clammy, stop and check your blood glucose. If it's low, treat it with a pure source of glucose, such as glucose tablets or gel. Become familiar with the ways different activities affect your blood sugar levels. Measure blood sugar before and after exercise. Keep a written record of what the activity was, how long you did the activity, what you ate, and blood glucose levels before and after. Over time, you'll better understand how activity affects your blood sugar levels and insulin doses. For insulin pump users, lower basal insulin if you're planning more than 90 minutes of activity. Shorter bouts of e Continue reading >>

Physical Activity And Type 1 Diabetes

Physical Activity And Type 1 Diabetes

Sheri R. Colberg , PhD, FACSM,1 Remmert Laan , BA, MBA,2 Eyal Dassau , PhD,3 and David Kerr , MBChB, MD, FRCPE2 1Human Movement Sciences Department, Old Dominion University, Norfolk, VA, USA 2William Sansum Diabetes Center, Santa Barbara, CA, USA 3Department of Chemical Engineering, University of California, Santa Barbara, CA, USA Sheri R. Colberg, PhD, FACSM, Human Movement Sciences Department, Old Dominion University, Norfolk, VA 23529, USA. Email: [email protected] Copyright 2015 Diabetes Technology Society This article has been cited by other articles in PMC. While being physically active bestows many health benefits on individuals with type 1 diabetes, their overall blood glucose control is not enhanced without an effective balance of insulin dosing and food intake to maintain euglycemia before, during, and after exercise of all types. At present, a number of technological advances are already available to insulin users who desire to be physically active with optimal blood glucose control, although a number of limitations to those devices remain. In addition to continued improvements to existing technologies and introduction of new ones, finding ways to integrate all of the available data to optimize blood glucose control and performance during and following exercise will likely involve development of smart calculators, enhanced closed-loop systems that are able to use additional inputs and learn, and social aspects that allow devices to meet the needs of the users. Keywords: exercise, technology, insulin, artificial pancreas, physical activity, type 1 diabetes Physical activity (PA) for people of all ages living with type 1 diabetes (T1D) is associated with many well-established health benefits, including improved cardiovascular fitness, better bone-health and enh Continue reading >>

Exercise

Exercise

Everybody benefits from regular exercise. If you have diabetes, or are at risk of diabetes it plays an important role in keeping you healthy. For a person with diabetes exercise helps: Insulin to work better, which will improve your diabetes management Maintain a healthy weight Lower your blood pressure Reduce your risk of heart disease Reduce stress. Warning- Don’t take part in strenuous physical activity if you are feeling unwell or have ketones present in your blood or urine. Before commencing a regular exercise program see your doctor for a full medical examination. Initially take it slow - you don’t want to start off too hard, if you are not used to the exercise you will be sore the next day and this will not make exercising a fun experience! Over time, you can slowly increase the intensity of the exercise. If you have any diabetes complications like retinopathy, nephropathy, you should talk to your doctor or an accredited exercise physiologist before you start increasing the intensity of your exercise. Anything that gets you moving. Here are some suggestions for you to discuss with your doctor: Walking Swimming Cycling/ exercise bike Dancing Gardening Golfing Weight training Tai Chi Water aerobics Increasing your general physical activity is also helpful, e.g. taking the stairs instead of the lift, getting up to change the TV station instead of using the remote control, housework, and gardening. Avoid watching too much TV or sitting at the computer for a long time. For good health, you should be doing about 30 minutes of exercise every day. If this is not possible, then this time can be divided in 3 x 10 minutes sessions. You can break up exercise throughout the day. If you need to lose weight, 45-60 minutes everyday. You do not need to puff to gain the benefi Continue reading >>

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