Extreme Sports and Extreme Diabetes Management
Being active and staying fit is important in anyones life, but especially for those of us living with diabetes. Keeping blood sugars well managed during a regular workout can take some planning, but what about if youre planning on climbing a mountain? Or snowboarding down one? Tackling extreme sports and keeping diabetes in check can be a challenge, but thankfully there are people we can turn to for advice on what to do.
Delaine Wright, MS, RCEP, CDE is an ACSM Registered Clinical Exercise Physiologist and Certified Diabetes Educator. She has also lived with type 1 diabetes since 1983 and is a Director and Online Coach at Fit4D, so she knows her stuff. Delaine took some time to talk with me about exercise and diabetes, shedding some light on this complicated topic.
Kerri: As a trainer and a person with type 1 diabetes, how do you engage in a rigorous workout while managing diabetes? When it comes to challenging your body physically, what's the best advice you've been given? And what's the best advice you would give?
Delaine: You can do anything you want with diabetes and DESPITE diabetes, as long as you put your mind and muscle to it. That means understanding how your blood sugars respond to that activity via lots of testing and patterning, and knowing what you need (food/fuel and glucose-wise) to keep you safe and performing optimally. Success may involve adjusting insulin dosages (with the support of your healthcare team) or food intake - or both. Diabetes simply becomes a part of the training process for any rigorous activity or sport. I am a fan of understanding and then attempting to mimic what the normal pancreas would do during any particular activity. It is an amazing learning experience and it certainly makes you appreciate the normal working glucose-balancing system.
Kerri: Do you have any advice on keeping numbers stable while doing extreme sports? How do you prepare for an intense workout?
Delaine: Extreme athletes progressively train and practice their sport or skills on a regular basis. For the diabetic athlete, training also means monitoring and adjusting blood sugars during that training. Just as the endurance athlete wouldn't want to try new shoes or new foods the day of the event, the athlete will diabetes will want to have an excellent understanding of (and have practiced) blood sugar control during their sport training sessions, minimizing as many variable as possible just prior to the exercise, For example, if you are engaging in endurance exercises: minimizing heavy carbs loads and large boluses of insulin just prior to starting exercise and choosing instead to provide carb/fuel in smaller amounts but more frequently throughout the exercise, can help to stabilize blood sugars, or at least avoid the spikes and crashes.
Kerri: What kinds of foods do you eat while working out?
Delaine: If my exercise is of short duration (1hr or so), I try not to have to eat while working out. If I need to treat or prevent a low, I will choose a rapid acting and easily digestible glucose source (tabs, gels, or fluid carb source such as juice or sport drink). I go for the smallest amount needed, so that I treat/prevent the low but avoid a rebound high. For long duration extreme exercise, such as Century rides, marathons, and long distance triathlons, the goal is to provide easily digestible fuels/carbs that are easy to carry as well as provide electrolyte and hydration needs. There are too many options to name out there, both commercial and home prepared, but the goal is to try various options and learn what works for YOU!
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Years before I was diagnosed with type 2 diabetes, The Other Half came out of a doctor's appointment with a diagnosis of "borderline diabetes" and an ADA exchange diet sheet. His health insurance agency followed up on the diagnosis with a glucometer and test strips. After a year or so of trying to follow the diet plan and test his glucose levels, things appeared to be back in "normal" range, and stood there until a couple of years after my own diagnosis. Shortly...