Oh yeah, it introduces uncertainty to our internal diabetes algorithm. But, so does coffee and most of us have found ways to incorporate that habit into our lives.
Last weekend, I enjoyed giving a presentation, The Sports Performance Guide To Diabetes, at OKC’s JDRF TypeOneNation Summit. During the talk I outlined the fundamentals that allow us to manage the uncertainty introduced by exercise, and harness the massive benefits of movement (will be outlined below). In today’s post, my thoughts are combined with what I learned from discussions with parents and other PWD.
FUNDAMENTAL 1: Exercise is not a detriment to diabetes management, it is the foundation.
In the past, we’ve discussed how exercise and insulin do similar things to the cell in regard to getting sugar inside the cell. Fundamentally, exercise lowers blood sugar. It makes counting carbs more manageable. You come down off of highs quicker. If you forget a bolus, the effects aren’t as harsh. Plus, when it comes to our 10 year mortality, it appears that the best predictor of health is our VO2 max (cardiovascular fitness level), not our chronic disease. It’s important for me to remember these ideas when I find motivation to move. We’ve got more on the line than vanity.
FUNDAMENTAL 2: 90% of the time movement of any kind will result in blood sugars trending down.
Unless of course you are an olympic powerlifter who squats 400 lbs or happen to be an olympic sprinter, most of us do aerobic exercise (running, walking, swimming, cycling, etc.). Aerobic exercise makes the blood sugar decrease as the muscles use glucose for fuel. Keeping this in mind before a practice, workout, or game is critical, especially in deciding whether a blood sugar is high enough to buffer the inevitable drop (for example, starting a 5K race at 175 vs 105).
FUNDAMENTAL 3: Limit the total amount of insulin on board prior to practice or the game.
Novolog is active in the body for 3 to 5 hours. Having a relatively low amount of insulin in the system is critical to exercise blood sugar stability. Whether this means getting up 3 hours prior to a marathon to eat breakfast, scheduling workouts greater than 3 hours after lunch, or not bolusing for a halftime snack, the importance of this idea cannot be understated.
FUNDAMENTAL 4: Develop an awareness to low blood sugar cues.
Recognizing a low before it becomes a “full on low” is a nice tool in the belt. That means we can intervene with a lower amount of carbs during the game, practice, or race. This may not sound like a huge deal but it’s a whole lot easier to eat a few sugar tabs during a marathon that it is to down a Clif Bar. Plus, if you know you’re low, like really know without having to test, that’s a time saver (not be used consistently due to us being human and our hunger reflex imitating lows).
FUNDAMENTAL 5: Practice makes perfect when it comes to the right snack.
Sometimes you’re looking to maintain blood sugar. Sometimes you’re looking to get back quick. Sometimes you’re just hungry and end up eating your low snack. Things happen. If it’s an in-game low and a quick fix is necessary, I opt for the glucose tabs, Gu’s, Hammer Gels, and Clif Blocks. If it’s a longer event and I know that I need a more sustained blood sugar, I snag a Clif Bar, Larabar, or a PB&J.
Have a philosophy that works for you? Drop it in the comments and we’ll be sure to share!