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Type 1 Diabetes Intense Exercise

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 >>

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 >>

Diabetics Develop Higher Blood Sugar During Exercise

Diabetics Develop Higher Blood Sugar During Exercise

insulin after intense exercise rather than less, contrary to conventional wisdom. A new study, published in the November issue of the Journal of Clinical Endocrinology and Metabolism, shows that insulin-dependent diabetics, known as type 1 diabetics, are likely to see an increase in their blood sugar, not a decrease, after an intense bout of physical exertion. It is healthy for blood sugar to rise during exercise because the muscles need the excess fuel to compensate for the increased demand placed upon them. But in most people the body will adjust after exercising and bring the blood sugar levels back to normal. That is not the case for a type 1 diabetic, because their bodies will not circulate enough insulin, which is required to convert the sugar in the blood. "Anyone who is competitive, who is doing a sprint, playing hockey, [playing] basketball ... is at significant risk of developing high sugar as a consequence of their exercise," study investigator Errol Marliss, MD, tells WebMD. Marliss is professor of medicine and director of the McGill Nutrition and Food Science Center at the Royal Victoria Hospital in Montreal. "There's a big difference in the blood [sugar] response depending on the intensity of exercise," Marliss says. "The classic teaching about [exercise by a diabetic] who is insulin-treated is, 'Look out, because your blood sugar is going to go down; you may have to either take extra carbohydrate or less insulin.' [But] a lot of very athletic, type 1 diabetic people have been telling their doctors for years, 'Look, Doc, I'm getting [too much blood sugar] when I exercise,'" Marliss says, "and that is a predictable consequence of higher intensities of exercise." "Intense exercise makes you put out anti-insulin hormones," says Stanley Feld, MD, chairman of t 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 >>

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 >>

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 >>

7 Things You Need To Know About Exercising With Diabetes

7 Things You Need To Know About Exercising With Diabetes

If there’s one thing people with diabetes know, it’s that regular exercise requires more than just discipline and hard work. Mismanaging your blood sugar, diet and exercise intensity levels can have adverse and unpredictable effects on your body. This month, we spoke with Dr. Jonathon R. Fowles, an exercise physiologist at the Centre of Lifestyle Studies at Acadia University, to help answer some common questions about exercising with diabetes: 1) How often should I exercise? “Regardless of whether you have type 1 or type 2 diabetes, the CDA recommends 150 minutes a week of moderate to vigorous exercise,” Fowles says. “You should be combining both aerobic (running, swimming etc.) and anaerobic (resistance training, weight lifting) activity.” 2) What are the benefits? “People with type 2 diabetes can expect to lower their AIC levels after a couple months of meeting the guidelines, and drastically reduce the progression of their diabetes, as well as their cardiovascular risk,” Fowles says. For people with type 1 diabetes, Fowles says the benefits are a little different. “The combination of exercise with insulin can be quite dramatic. People with type 1 diabetes should communicate openly with their diabetes educator or physician, to learn the interaction between exercise, food and insulin," he says. “The evidence isn’t quite as strong for glucose regulation for people with type 1 diabetes, but it’s definitely beneficial for their cardiovascular risk reduction, overall health and quality of life.” 3) Why is anaerobic exercise important? While the treadmill or tennis court may be tempting if you’re looking to lose weight, Fowles says building muscle is essential for all people with diabetes, especially as they age. “Most of your blood glucose is 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 >>

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 >>

Intense Exercise In Type 1 Diabetes: Exploring The Role Of Continuous Glucose Monitoring

Intense Exercise In Type 1 Diabetes: Exploring The Role Of Continuous Glucose Monitoring

Intense Exercise in Type 1 Diabetes: Exploring the Role of Continuous Glucose Monitoring Ludovic Jean Chassin , Ph.D., Malgorzata E. Wilinska , Ph.D., and Roman Hovorka , Ph.D. Department of Paediatrics, University of Cambridge, Addenbrooke's Hospital, Cambridge, United Kingdom Correspondence to: Ludovic Chassin, Ph.D., Department of Paediatrics, University of Cambridge, Addenbrooke's Hospital, Hills Road, Level 8, Box 116, Cambridge CB2 0QQ, United Kingdom; email address [email protected] Copyright 2007 Diabetes Technology Society This article has been cited by other articles in PMC. Development of the external artificial pancreas (AP) is anticipated to be incremental, starting with simple and progressing to more complex applications incorporating exercise periods of various duration and intensity. Most studies investigating the effect of exercise on glucose excursions in subjects with type 1 diabetes either explored moderate exercise, which exerts different effects compared to intense exercise, or did not adopt continuous glucose monitoring combined with frequent plasma glucose measurements. Such studies could provide vital information. Performance of continuous glucose monitors during intense exercise could be evaluated to a greater extent. Frequently sampled blood glucose would facilitate better understanding of the relationship between intense exercise and metabolic processes, providing helpful information to patients with type 1 diabetes, clinicians, and researchers involved in the development of the AP. Keywords: artificial pancreas, continuous glucose monitoring, exercise, hyperglycemia The artificial pancreas (AP), consisting of a continuous glucose monitor (CGM), a control algorithm, and an insulin pump, is the subject of much research benefiting from a 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 >>

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 >>

Basal Insulin Delivery Reduction For Exercise In Type 1 Diabetes: Finding The Sweet Spot

Basal Insulin Delivery Reduction For Exercise In Type 1 Diabetes: Finding The Sweet Spot

, Volume 59, Issue8 , pp 16281631 | Cite as Basal insulin delivery reduction for exercise in type 1 diabetes: finding the sweet spot Exercise poses significant challenges to glucose management in type 1 diabetes. In spite of careful planning and manipulation of subcutaneous insulin administration, increased risk of hypoglycaemia and glycaemic variability during and after exercise may occur as a result of inherent delays in insulin action and impaired counter-regulatory hormone responses. Various strategies to mitigate this issue have been advocated in clinical practice, including ingestion of supplementary carbohydrate prior to exercise, reducing background and pre-meal insulin bolus and performing bouts of resistance/high intensity exercise before aerobic exercise. Insulin pump therapy, considered the most physiological form of insulin replacement for type 1 diabetes allows modulation of basal insulin delivery before, during and after exercise. However uncertainty remains regarding the optimal strategy to reduce basal insulin delivery and its efficacy. In this issue of Diabetologia, McAuley and colleagues (DOI: 10.1007/s00125-016-3981-9 ) report on the impact of a 50% reduction of basal insulin delivery before, during and after moderate-intensity aerobic exercise. Results from this study may contribute to a better understanding of the effects of basal insulin delivery manipulation and may aid in devising therapeutic approaches for glucose management during exercise. Insulin pump therapy is widely considered to be the most physiological form of insulin replacement for people with type 1 diabetes. It facilitates flexible modulation of basal insulin requirements and allows the user to temporarily change basal insulin delivery before and during periods of enhanced or redu 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 >>

Exercise

Exercise

Exercise is an important part of your general health, but it also helps you to maintain good type 1 diabetes management Adjusting food and insulin around exercise can be tricky, as different types of exercise can have a different effect on you. You’ll need to find the right plan that works for you before, during and after exercise. It’s best to speak to your healthcare team about this. Before you exercise Having too much active insulin before you exercise can cause a hypo, as it reduces the amount of glucose the liver can add to blood. Exercising with too little insulin stimulates glucose production from the liver, which can cause a hyper. So you may need to reduce your insulin before you exercise, depending on what you’re doing and how long you’re doing it for. Speak to your healthcare team to get help to create the right plan for you. Carbohydrate intake before exercise Whether you need to eat carbohydrate immediately before exercise will depend on your blood glucose level, the type of exercise you plan to do, its duration and its intensity. Everyone’s carbohydrate requirements for exercise are different so checking your blood glucose before, during and after exercise will help you develop your own plan. During exercise In general, sustained and moderate exercise (like hiking) will result in a slow drop in blood glucose levels. Intense, sprint-like exercise that really gets your heart pumping (like a game of football or netball) might cause your blood glucose level to rise. This is because your body releases high levels of adrenalin that trigger your liver to break down stored glucose and release it into your bloodstream. It will be exaggerated if your insulin levels are too low at the time of exercise. Carbohydrate intake during exercise If you are exercisi Continue reading >>

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