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Type 1 Diabetes And High Intensity Exercise

Ramp Up Your Type 1 Diabetes Workout

Ramp Up Your Type 1 Diabetes Workout

If you’re bored with your workout routine and feel like you can’t possibly jog or bike around your neighborhood one more time, it’s time to shake things up. Exercise is essential for managing type 1 diabetes well, so keep it interesting by keeping your workout fresh and fun. “It's good to do a variety of different activities to prevent injuries and keep your workouts fresh,” says Sheri Colberg-Ochs, PhD, a professor of exercise science in the human movement sciences department at Old Dominion University, an adjunct professor of internal medicine at Eastern Virginia Medical School, both in Norfolk, Va., and the author of The 7-Step Diabetes Fitness Plan: Living Well and Being Fit With Diabetes, No Matter Your Weight. The only caveat is to check in with your doctor before you ramp up your fitness plans to make sure you're taking a safe approach. Type 1 Diabetes Safety When Switching Workouts With type 1 diabetes, the challenge when changing from an existing exercise routine to a new activity is keeping track of the way your body responds. Follow these steps to stay safe and in control: Test your blood sugar before, during, and after exercise to learn how different activities affect you. Dr. Colberg-Ochs says that when you try a new type of exercise with diabetes, your blood sugar is likely to be higher than normal until your body gets used to the exercise. You also risk a deeper blood-sugar low later in the day or at night after your new workout. Pay attention to your diet and insulin, and adjust them according to your workout plans. If your blood sugar is low before starting an activity, have a small carbohydrate snack to lower your risk of low blood sugar (hypoglycemia). Keep fast-acting carbs such as fruit juice or glucose tablets with you at all times. If yo 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 >>

Type 1 Diabetes And Vigorous Exercise

Type 1 Diabetes And Vigorous Exercise

Type 1 Diabetes and Vigorous Exercise: Applications of Exercise Physiology to Patient Management Michael C. Riddell, PhD, Department of Kinesiology and Health Science, York University, Toronto, Ontario, Canada Bruce A. Perkins, MD MPH, Division of Endocrinology and Metabolism, Department of Medicine, University of Toronto, Toronto, Ontario, Canada This manuscript is based in part on a presentation given at the 8th Annual Canadian Diabetes Association Professional Conference and Annual Meetings, October 27–30, 2004, Quebec City, Quebec, Canada ABSTRACT Special considerations are needed for the physically active individual with type 1 diabetes mellitus. Although regular activity is beneficial for all patients, vigorous exercise can cause major disturbances in blood glucose. The glycemic response depends largely on the type, intensity and duration of the activity, as well as the circulating insulin and glucose counterregulatory hormone concentrations. This review highlights a number of strategies to optimize blood glucose levels in patients with type 1 diabetes who exercise vigorously. Despite decades of improved insulin therapy and significant advancements in blood glucose (BG) monitoring, large excursions in BG concentration remain a major challenge for the active person with type 1 diabetes mellitus.The purpose of this review is to highlight the benefits and risks associated with vigorous exercise, discuss the possible metabolic responses to various forms of exercise and suggest management strategies for patients who participate in vigorous exercise. BENEFITS AND RISKS OF EXERCISE IN DIABETES MANAGEMENT Even before the 19th century, it was known that BG concentrations typically decrease with endurance-type exercise in most individuals with diabetes (1). In the 1950s, Continue reading >>

High-intensity Exercise In Men With Type 1 Diabetes And Mode Of Insulin Therapy.

High-intensity Exercise In Men With Type 1 Diabetes And Mode Of Insulin Therapy.

High-intensity Exercise in Men with Type 1 Diabetes and Mode of Insulin Therapy. Gawrecki A, et al. Int J Sports Med. 2017. Department of Internal Medicine and Diabetology, Poznan University of Medical Sciences, Poznan, Poland. Int J Sports Med. 2017 Apr;38(4):329-335. doi: 10.1055/s-0042-123046. Epub 2017 Mar 2. The purpose of this study was to evaluate the impact of high intensity exercise on glucose levels and risk of metabolic decompensation in males with type 1 diabetes (T1D), depending on the method of insulin administration. The study comprised 29 males (aged 25.35.1 years; duration of diabetes 10.33.2 years) treated with continuous subcutaneous insulin infusion (CSII) or multiple daily insulin injections (MDI). Treadmill exercise test was performed twice in each patient until subjective exhaustion as maximum according to the Borg scale. All the patients achieved 85% of the maximal heart rate. Distance during the test was 4 5001 400 m and 4 4731 559 m in the MDI and CSII groups, respectively, which was achieved in 318 min. During the test and in the 6 h after, no clinically significant episodes of hypoglycemia occurred. Mean glucose levels did not exceed 10 mmol/L in most patients. The risk of the composite endpoint (hypoglycemia<3.8 mmol/L, hyperglycemia16.6 mmol/L, ketones0.6 mmol/L, and lactate>2.2 mmol/L) was higher in patients treated with MDI than CSII (OR3.75, 95%CI:1.22-11.52, p=0.02). In conclusion, planned high intensity physical effort in men with well-controlled T1D is metabolically safe. CSII shows greater metabolic advantage over MDI during and after high intensity exercise in men with T1D. Continue reading >>

Just Exercise Harder For Less Time, Or Not?

Just Exercise Harder For Less Time, Or Not?

Home / Therapies / Exercise / Just Exercise Harder for Less Time, or Not? Just Exercise Harder for Less Time, or Not? Have a question for Dr. Sheri Colberg? Please use the form at the end of this articleto submit your question. She will respond to selected comments in a future post. Everyone is confused about what types and amounts of training people with diabetes should be doing for optimal blood glucose control and health. When I last wrote about this topic, the latest exercise research was older adults with type 2 diabetes enduring six sessions of high-intensity interval training (HIIT) done on a cycle ergometer over two weeks (1). The training sessions, which were typical of some of the latest HIIT, consisted of 60 seconds of cycling done 10 times at ~90% of maximal heart rate, interspersed with 60 seconds of restfor a total of only 10 minutes of actual exercise and 10 minutes of recovery. So, that protocol involved almost an all-out sprint for a minute at a time, repeated 10 times with very little rest in between. Some call this low-volume, high-intensity interval training (HIIT); others call it pure torture, even though it did lower overall and after-meal blood glucose levels in these participants. While interval training is routinely used by sports teams and athletes, is this type of training beneficial for most individuals with diabetes? It certainly saves timewho cant fit in 10 minutes of exercise three days per week?but would it benefit weight control in the average person? It simply doesnt burn that many calories. Actually, it doesnt save that much time either: when you add in rest intervals and a warm-up and cool-down period, it still takes at least 25 minutes per session and 75 minutes per week. Interval training does have some benefits. The latest researc Continue reading >>

Safe Exercise Options For People With Diabetes

Safe Exercise Options For People With Diabetes

Safe exercise options for people with diabetes Connecticut Valley Hospital, 1000 Silver Street, Middletown, CT 06457, USA People with diabetes can tame post-meal glucose surges in real time by doing a 30 min moderate aerobic exercise starting 30 min after the start of the major meal(s) of the day. Although glycogen-depleting high-intensity activities offer many health benefits, including insulin sensitivity improvement through muscle glycogen replenishment, these can also result in wide glucose fluctuations signified by post-exertion hyperglycaemia and delayed hypoglycaemia. Data obtained in previous studies, viewed holistically, strongly indicate that a short bout (10 min) of high intensity exercise before the daily aerobic activity during the mid-postprandial period three times a week can lead to better health without jeopardizing glycaemia. Long duration pre-meal exercises have resulted in glycaemia improvement: light walks for 120 min improve fasting glucose and high intensity interval (the fast/slow design) exercises of long duration (>60 min) looks promising for overall glycaemia. When healthy people exercise, it does not matter much whether they do so pre-meal or post-meal, or at what intensity or for how long. Blood glucose remains steady except for a small bump after meals. Pre-breakfast exercise where insulinto- glucagon ratio is low uses free fatty acids, endogenous glucose and muscle glycogen as fuels. Training during fasting increases glycogen content and GLUT-4 protein levels and improves body composition and physical health through molecular adaptations. Exercising post-meal, when insulin-to-glucagon ratio remains high blood glucose is the main fuel until the exogenous supply becomes low. At that point human body reverts to using endogenous glucose along Continue reading >>

High-intensity Exercise And Endothelial Function In Type 1 Diabetes(hiit-t1d) (hiit-t1d)

High-intensity Exercise And Endothelial Function In Type 1 Diabetes(hiit-t1d) (hiit-t1d)

Study Description Study Design Arms and Interventions Outcome Measures Eligibility Criteria Contacts and Locations More Information To study the effect of 8 week high-intensity interval training (HIIT) compared with moderate intensity (MCT) interval training and sedentary patients(CON) with type 1 diabetes. Adult T1DM patients without known complications are randomised in blocks into these 3 groups according to their baseline flow mediated dilation (FMD). After 8 week exercise training, the main outcome, FMD, is re-evaluated. Additional variables such as VO2 peak for cardiovascular fitness, oxidative stress and endothelial independent vasodilation to study vascular rigidity are also evaluated. Type 1 Diabetes Mellitus Endothelial Dysfunction Behavioral: High Intensity Interval Training Behavioral: Moderate Continuous Exercise Training Other: Non-exercise In a randomized controlled open trial, 36 adult type 1 diabetes mellitus (T1DM) patients without known complications were randomized into 3 groups: HIIT n=12; MCT n=12 and a sedentary control group (CON) n=12. Total sample size was calculated to a power of 80% alha 0.05 and a difference in mean FMD of 2%. Before randomisation, flow mediated dilation (FMD) and maximal exercise capacity (VO2 peak)is determined. Block Randomisation based on FMD rank values are done to equalize baseline FMD. Exercise sessions are performed in cycle ergometers during 40 minutes, 3 times a week, along 8 weeks. HIIT protocol, intensity vary from 50 to 85% of the maximum heart rate (HRmax), while in MCT, HR remained stable at 50% HRmax. Endothelial function was measured by flow mediated dilation (FMD) for endothelium-dependent vasodilation (EDVD) and smooth-muscle function was measured by nitroglycerine mediated dilation (endothelium independe Continue reading >>

First-ever Guidelines On Safe Exercising With Type 1 Diabetes!

First-ever Guidelines On Safe Exercising With Type 1 Diabetes!

As a person with type 1 diabetes who exercises regularly, I can tell you it's pretty much of a guessing game. I have some strategies that I use to keep my glucose in range for my spin class, aerobics, kick box, hiking and other workouts, but they are far from fool-proof -- and I've yet to find any really solid advice on BG management during these sweat-fests. So I for one am really intrigued to see the first-ever official guidelines on managing exercise with T1D published in The Lancet journal last week as a 14-page report titled “Exercise management in type 1 diabetes: a consensus statement.” This comes on the heels of the ADA's sweeping 2017 Standards of Diabetes Care, which we just reviewed yesterday. The new info-packed paper honing in on exercise was compiled by an international team of 21 researchers and clinicians, including some familiar names like JDRF's Artificial Pancreas lead Aaron Kowalski, and Drs. Bruce Bode of Atlanta Diabetes Associates, Anne Peters of USC Keck School of Medicine, and Lori Laffel of Joslin Diabetes Center. It offers "guidelines on glucose targets for safe and effective exercising with T1D, as well as nutritional and insulin dose adjustments to prevent exercise-related fluctuations in blood sugar." So what did these experts come up with? Well, let me just say that it's a comprehensive and informative paper -- explaining everything from the physiology of diabetes and exercise and the body's differing metabolic responses to aerobic vs. anaerobic activity, to sports energy drinks and the relative benefits of a low-carb, high-fat (LCHF) diet. Disclaimers, and a Green Light The authors are careful to make a few important disclaimers, first and foremost that one-size recommendations do not fit all, so strategies should be built around exer Continue reading >>

Payperview: Exercise For People With Type 1 Diabetes - Karger Publishers

Payperview: Exercise For People With Type 1 Diabetes - Karger Publishers

Royal Berkshire NHS Foundation Trust Centre for Diabetes and Endocrinology I have read the Karger Terms and Conditions and agree. Exercise in people with type 1 diabetes (T1DM) can produce large changes in blood glucose, with hypo- and hyperglycaemia before and following exercise. Different exercise types, intensity and duration have significantly different effects on blood glucose control, and on the endocrine response to exercise. Exercise performance can also be impaired in T1DM. There have been significant recent improvements in the knowledge of what underlies these changes and in the appropriate management to support the maintenance of euglycaemia. Further advances in insulin infusion pump therapy and continuous subcutaneous glucose monitoring are likely to be useful in the management of people with T1DM who want to exercise. Thow JC, Johnson AB, Fulcher G, Home PD: Different absorption of isophane (NPH) insulin from subcutaneous and intramuscular sites suggests a need to reassess recommended insulin injection technique. Diabet Med 1990;7:600-602. Sindelka G, Heinemann L, Berger M, Frenck W, Chantelau E: Effect of insulin concentration, subcutaneous fat thickness and skin temperature on subcutaneous insulin absorption in healthy subjects. Diabetologia 1994;37:377-380. Koivisto VA, Felig P: Effects of leg exercise on insulin absorption in diabetic patients. N Engl J Med 1978;298:79-83. Freckmann G, Hagenlocher S, Baumstark A, Jendrike N, Gillen RC, Rossner K, Haug C: Continuous glucose profiles in healthy subjects under everyday life conditions and after different meals. J Diabetes Sci Technol 2007;1:695-703. DAFNE Study Group: Training in flexible, intensive insulin management to enable dietary freedom in people with type 1 diabetes: dose adjustment for normal eat Continue reading >>

Why Some Types Of Exercise Can Make Your Blood Sugar Increase

Why Some Types Of Exercise Can Make Your Blood Sugar Increase

Have you ever wondered why your blood sugar falls during certain types of exercise whilst roaring to sky-high levels during and after other types of exercise? If you’re curious about the scientific explanation of the relationship between exercise and blood sugar, read on. I rarely come across scientific studies that explore how exercise affects blood sugar in people living with Type 1 diabetes, so when I recently got my hands on just such a research paper, I dug in with great interest (they specified Type 1 diabetes, but I would think that the results are applicable to anybody using insulin). Well actually, Google and I dug in. This research paper is heavy reading. You know those scientific papers where you feel like you need an advanced degree (plus a whole lot of Googling) just to understand the introduction? This is one of them. The paper is titled “Effect of intermittent high-intensity compared with continuous moderate exercise on glucose production and utilization in individuals with type 1 diabetes”, and is written by a team of scientists from Australia. It was published in the American Journal of Physiology – Endocrinology and Metabolism in 2007 (not exactly new research, but peer reviewed research nonetheless, which means it’s legit). Anyway, I thought that the subject was relevant and interesting enough to spend the time reading and understanding it. So, since I’ve done the heavy reading, let me share what I’ve learned with you. Exercise and blood sugar impact So why do some types of exercise make our blood sugar drop like crazy while others hardly have any impact? I know from my own experience that I really have to watch my blood sugars if I do steady state cardio, while an interval training session will have little impact or even make my blood s Continue reading >>

My Personal Approach: Hiit Training With Type 1 Diabetes

My Personal Approach: Hiit Training With Type 1 Diabetes

I run a couple of times per week; I weight train a couple of times per week, and I also do high intensity interval training (HIIT) a couple of times per week (or more on certain weeks – depending on my frustrations of that particular week). I am not perfect and I make mistakes. I get frustrated. However, nearly every time I exercise I learn something new about myself. As I learn something new, I use it and try to not make the same mistake twice. In my story below, I am not promoting any one type of exercise or ways to incorporate exercise into someone’s life with diabetes. I’m telling my story of how I made and make adjustments based on my own personal information. Anyone else’s experience will be different. My hope is this example provides some background on conducting, “your diabetes science experiment.” What is High Intensity Interval training (HIIT)? This group of exercises includes alternating periods of intense exercise periods with lower intensity recovery periods. The intense periods bring you into the anaerobic exercise zone. Anaerobic exercise is different than aerobic exercise in that the period of intensity is in short bursts (ex: sprinting) rather than a steady pace (ex: jogging for 30 minutes). The anaerobic exercise zone is where heart rate is 80-95% of maximum, and in this zone, you cannot breath fast enough or deeply enough to catch your breath. A goal is to exercise to (short-term) exhaustion – take a quick break and jump back into the intense exercises, repeat. Also known as intervals. The intense sessions typically last two to three times as long as the recovery sessions. During the “recovery” sessions, the goal is to bring heart rate down to 40-50% of maximum and breath as deeply as possible to get ready for the next intense period Continue reading >>

Want To Cure Diabetes? Intense Exercise Is The Answer

Want To Cure Diabetes? Intense Exercise Is The Answer

Want to CURE Diabetes? Intense Exercise is the Answer (function(){var aa="function"==typeof Object.create?Object.create:function(a){var b=function(){};b.prototype=a;return new b},m;if("function"==typeof Object.setPrototypeOf)m=Object.setPrototypeOf;else{var n;a:{var ba={a:!0},ca={};try{ca.__proto__=ba;n=ca.a;break a}catch(a){}n=!1}m=n?function(a,b){a.__proto__=b;if(a.__proto__!==b)throw new TypeError(a+" is not extensible");return a}:null} var da=m,p=this,ea=function(a){var b=typeof a;if("object"==b)if(a){if(a instanceof Array)return"array";if(a instanceof Object)return b;var c=Object.prototype.toString.call(a);if("[object Window]"==c)return"object";if("[object Array]"==c||"number"==typeof a.length&&"undefined"!=typeof a.splice&&"undefined"!=typeof a.propertyIsEnumerable&&!a.propertyIsEnumerable("splice"))return"array";if("[object Function]"==c||"undefined"!=typeof a.call&&"undefined"!=typeof a.propertyIsEnumerable&&!a.propertyIsEnumerable("call"))return"function"}else return"null"; else if("function"==b&&"undefined"==typeof a.call)return"object";return b},ha=function(a,b){var c=Array.prototype.slice.call(arguments,1);return function(){var b=c.slice();b.push.apply(b,arguments);return a.apply(this,b)}},ia=Date.now||function(){return+new Date};var ja=Array.prototype.forEach?function(a,b){Array.prototype.forEach.call(a,b,void 0)}:function(a,b){for(var c=a.length,d="string"==typeof a?a.split(""):a,e=0;eb?null:"string"==typeof a?a.c 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 >>

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 >>

High Intensity Interval Training (hiit)

High Intensity Interval Training (hiit)

Interval training has been shown to be particularly beneficial for people with type 2 diabetes Interval training is a flexible form of training that has also been shown to be particularly beneficial for people with type 2 diabetes. High intensity interval training has made positive headlines thanks to research showing that relatively small amounts of interval training can be as beneficial to health as longer periods of conventional cardiovascular exercise, such as continuous jogging. A key advantage of interval training is that it can be fit into the day before work, before lunch or any convenient free moment, even for those of us that lead busy lifestyles. Short bursts of activity with rest breaks in between each bout of exercise. The activity periods should increase in intensity with each new session. Each bout of exercise should work the heart and leave you breathing deeper. One form of High intensity interval training is the PACE routine. PACE stands for Progressively Accelerating Cardiopulmonary Exertion ad was designed, by American Physician Al Sears, to be beneficial for the heart and metabolism. High intensity interval training is suitable for most people, from those that have not exercised in years through to athletes. HIIT has been found to be a useful and effective form of exercise for people with type 2 diabetes or with heart disease . If you havent been exercising regularly, or have a chronic health condition in addition to your diabetes, check with your doctor before commencing interval training. As with any good exercise routine, HIIT has benefits for your heart, blood glucose levels and mental well being. The following benefits are particularly associated with interval training: Can be undertaken in as little as 10 minutes Is very flexible a wide range Continue reading >>

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