Diabetes And Exercise
What is diabetes
Diabetes is a medical condition in which your body doesn’t produce enough insulin. Insulin is the hormone that tells your body to use the glucose that is floating around in your blood. To be clear, blood sugar and blood glucose are the same thing.
So people with diabetes have higher blood sugar. Why is that an issue? High blood sugar can lead to severe health problems such as eye damage, strokes, kidney damage, cardiovascular complications amongst the most common.
The shitty thing is that having LOW blood sugar can also have complication if done improperly. If you recall this post about the keto diet, you remember that low blood sugar can be safe if done the right way.
There are two type of diabetes: type 1 and type 2.
Type 1 is hereditary and stems from you autoimmune system wrongly attacking the insulin producing system. Type 2 is the development of insulin resistance through unhealthy lifestyle. Insulin resistance means that your body doesn’t recognize insulin cells anymore. This leads to your body's inability to use the glucose in your blood.
Having diabetes is most often not an extreme problem, you simply have to pay a lot more attention to controlling your blood sugar than people without diabetes do.
There are 3 main ways of controlling it:
1. Taking medication, such as insulin.
2. Diet. Watching what you eat becomes extremely important
3. Exercise. This post will focus on exercise’s role with blood sugar
Exercise and hormones
When you exercise, your body needs to produce a molecule called ATP. We have a very, very limited store of ATP in our body so we are constantly in need to make ATP. And boom what do we use to fabricate ATP in our bodies? You guessed it: GLUCOSE! We have glucose in our muscles, blood and liver.
When you exercise, you deplete your ATP stores, your body then says “we need more ATP or else your gonna fall flat on your ass”. So it uses glucose. We store glucose in our muscles and liver. So we deplete our glucose reserves. Then your body says “We need more glucose or you’re gonna fall on your ass”. That’s when insulin comes in like “Yo I got you!!!!” and signals your body to use the glucose that’s circulating in your blood. You can see why having issues with insulin can be cause chaos in your body.
Now that your blood glucose is low, another guy pokes his head around: glucagon. Glucagon tells your liver to release it’s glucose stores to go help out the diminishing blood stores.
There are more intricacies to this system but for now that should give you a good visualization. People with type 1 diabetes, that don’t produce insulin, will usually need to take medication to make sure this system works properly.
People with type 2 diabetes benefit from exercise because it increase insulin sensitivity. Insulin sensitivity is you body’s capability to react to it. So when you become insulin resistant with type 2 diabetes, you can counter this effect with exercise.
How does that affect working out?
People with diabetes can workout in the exact same way that regular people do, granted they take the appropriate measures.
The challenging part is that there are very difference responses between individuals with type 1 diabetes to exercises “As a result of a variety of unpredictable factors, exercise may cause either hypoglycemia or hyperglycemia in persons with type 1 diabetes."
Why would it cause hypo glycemia? Without the insulin to tell your body to use up the glucose, your body will demand that your liver and muscles release more glucose, which in turn will not be used and be disposed off.
The other challenge comes in when you do intense exercises (more than 70% of your VO2max) which raises your catecholamines. Huh? who the hell are they?
Catecholamines are your fight or flight hormones. They kick in when you do intense stuff and tells your body to haul ass because it may be in danger (catecholamines can't tell whether you are smashing squats in a gym or getting chased by rabid wolves). This just increases glucose secretion by the liver and muscle which is why some people notice a spike in blood glucose after intense exercise.
And as if all of this wasn’t complicated enough, a typical workout or sport activity usually includes both moderate and intense periods of exercise making prediction on glucose utilization very difficult.
What can you do about it?
There is always an option guys.
If you have diabetes, you CAN workout like someone that doesn’t have diabetes. It is recommended that you use certain devices that are available on the market to monitor your blood glucose level before, during and after exercise.
There’s the self monitoring blood glucose approach (SMBG) in which you take samples of your blood during exercise period. This technique is not the best one recommended, and the continuous glucose management (CGM) option is preferred.
This technique involves devices that go into your body and give continuous readings of your glucose levels. Yes it’s kind of science fiction stuff but you will not turn into a cyborg and no you will not feel anything once everything is set up properly.
Here is a list of the currently available devices
Carrying sugar pills on you or insulin tablets is a way to make sure you can prevent hyper or hypo glycemic if something comes up.
There are current studies that are looking at certain low carb diets, such as the ketogenic diet (embed link to keto) as a way to reduce blood glucose fluctuation. However it seems that further studies are required to confirm these beliefs.
Glucose uptake varies greatly between individual and encompasses a lot of variables. You need to think about your nutrition pre workout, the type of workout you are doing and the type of diet you are following.
There is technology out there that can help yo track your blood glucose very precisely. The important thing is if you have diabetes is to know how your body reacts to your diet and exercise, and with all the technology and information out there, you will do just fine.
If you have any more questions about the subject, you can email me here to chat in further details!
ISSA Personal Trainer Book