2023-08-02 15:58:00
Type 1 Diabetes: Important Considerations for Exercise
Diabetes affects millions of people worldwide, including notable athletes such as weightlifter Matthias Steiner and tennis player Alexander Zverev. However, individuals with type 1 diabetes, like these athletes, must exercise caution during their training routines.
Type 1 diabetes carries a higher risk of hypoglycemia, according to Othmar Moser, a physiologist and diabetes expert from the University of Bayreuth. This autoimmune disease causes the body to produce little or no insulin, which is needed to regulate blood sugar levels. As a result, individuals with type 1 diabetes must regularly inject insulin to maintain metabolic balance. However, during exercise, the body requires more energy, which can lead to faster instances of hypoglycemia. Moser advises working closely with a doctor to adjust therapy plans, with the general rule being less insulin and more carbohydrates.
To minimize the risk of hypoglycemia, patients should reduce insulin intake in their last meal before training. The hormone has a more potent effect when the muscles are active, explained diabetologist Gerhard Schmeisl. At the same time, individuals should increase their carbohydrate consumption before exercise. Schmeisl recommends consuming around 12 grams of additional carbohydrates every half hour during short-term efforts like swimming or cycling. Slow carbohydrates found in wholemeal bread, nuts, legumes, and salad are ideal for sustained energy release.
Moser also recommends consuming fast-acting carbohydrates during exercise, such as bananas, pretzels, fruit juice, or grape sugar. However, the most critical aspect of exercising with diabetes is monitoring blood sugar levels. Regularly measuring blood sugar before, during, and after exercise can help individuals avoid hypoglycemia. Continuous Glucose Monitoring (CGM) devices are recommended for this purpose, as they provide continuous glucose measurements via a sensor under the skin. These values are then transmitted to a receiving device or smartphone, improving glycemic control significantly.
By keeping a close eye on blood sugar levels, individuals can prevent hypoglycemia during and after exercise. This is especially critical as hypoglycemia can occur hours after exercise, leading to a drop in blood sugar levels known as the “muscle replenishment effect.” To avoid lows at night, it may be necessary to consume slow carbohydrates before bed.
Despite the risks, exercise is highly beneficial for individuals with diabetes. It allows them to reduce insulin dependency, as regular exercise naturally lowers blood sugar levels. Over time, the body becomes more receptive to insulin, resulting in an improved response to the hormone. Exercise also lowers the risk of comorbidities like high blood pressure, obesity, and type 2 diabetes. In some cases, type 2 diabetes can even be reversed through physical activity and a healthy diet.
Before engaging in exercise, individuals should consult with a doctor and obtain permission. Some cases may require a heart check using a stress ECG, but overall, pre-existing conditions are not usually a barrier to participation. The general recommendation is at least 150 minutes of exercise per week, spread over three to four sessions. Ideally, a combination of endurance and strength training is advised, but the most crucial factor is finding an activity that is enjoyable and sustainable.
In addition to structured exercise, experts suggest increasing physical activity in everyday life. Taking the stairs instead of the elevator, walking or biking instead of driving short distances, and similar lifestyle changes can make a significant difference. However, it is important to note that simply increasing daily physical activity is not a substitute for dedicated exercise.
Exercise has the potential to greatly improve the quality of life for individuals with diabetes. Those with type 1 diabetes can reduce insulin usage and minimize the risk of comorbidities, while type 2 diabetics may experience a reversal of their condition through increased physical activity. Seeking medical advice and adapting therapy plans accordingly is key to safely incorporating exercise into diabetes management. Ultimately, the most effective exercise routine is one that can be sustained in the long term.]
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