Guest post by Robert Turp & Michelle Stevens
There are 29 million Americans currently living with diabetes. It’s frequently described as one of the biggest health issues of the 21st Century, with those diagnosed with type II diabetes growing every year. Learning how to manage this illness is something that is very important. It’s a chronic illness that can have a big impact on someone’s life.
But how does diabetes affect sport? What happens if you dream of sporting success but currently live with this illness?
Contrary to what people may believe, diabetes (both type I and II) doesn’t need to be an obstacle to enjoying or excelling at sports and fitness. Men and women with diabetes are common in sports at all levels and have achieved some of the highest awards available on the planet. If you think diabetics can’t achieve greatness, just look at Steve Redgrave, one of the most decorated Olympians of all time. He won Olympic gold after being diagnosed with diabetes. Did his training change? Yes, of course. Did it affect his success? No.
Steve Redgrave, one of the most decorated Olympians ever
Sport, or exercise of any form, is highly recommended for all people with diabetes because it provides a wide range of health benefits -- including improved sensitivity to insulin. Because of this, it’s important for diabetics to monitor their blood sugar before, during, and after activity in addition to their current management routine. Keep in mind that the increased insulin sensitivity from exercise can affect blood sugars for up to 48 hours. In these situations, it’s incredibly helpful to wear a glucose sensor, if possible, to see the body’s response to exercise, as blood sugar can change rapidly during and in response to exercise.
Management of diabetes and exercise depends on many factors, including type of exercise, intensity, and the length of workout session. Different workouts affect the body in different ways. For example, brisk walking and continuous jogging will usually lead to a reliable lowering in blood glucose levels. By contrast, high intensity workouts, whether cardio or strength focused, can initially lead to a rise in blood sugar followed by a drop if the exercise session is long enough. Sports will affect individuals differently, as well. Individuals must take time to experiment with their own bodies to determine their unique response to various stimuli.
The effect of a training session on blood sugar will also depend on current levels of blood sugar control, activity, and types of medication (oral medication, insulin injections, or insulin pump). Consulting a doctor or diabetes educator for recommended changes to medications is a must. Managing diabetes and exercise requires both patience and trial and error while adjusting to new levels of activity and learning the idiosyncrasies of the body. In addition, target blood sugar ranges may be different around times of physical activity to stay safe and have the energy to perform at a high level.
Case Study: Swimming
Based on Travis’s swimming background, let’s use swimming as an example. Swimming is a great form of exercise, whether you’re competing at a high level or simply for the enjoyment. It’s a great way to improve cardiovascular fitness, and there’s a lot less stress on your joints compared to other sports. It also uses both upper and lower body muscles, which is a beneficial alternative to weight bearing exercise for people with diabetic neuropathy while still providing cardiovascular benefits. If you play a highly physical sport, then a weekly pool session can help relieve pressure on your body while simultaneously getting a good cardio session in.
So how can you manage diabetes when swimming?
Swimming once or twice a week may not require anything extravagant in terms of management. Test blood sugar leading up to exercise, during sessions lasting longer than 20-30 minutes, and after the training session. For individuals needing to disconnect from an insulin pump in order to swim, balancing insulin needs during exercise and avoiding rebound highs afterward may take extra attention.
What about if you want to swim competitively? Diabetes and swimming may go together better than you think.
Gary Hall Jr. was a 5-time Olympic champion with type I diabetes.
Whether swimming professionally, training for an event, or looking to improve fitness, regular swimming will require frequent blood testing and keeping plenty of glucose on you at all times. When training, glucose should be consumed every 30 minutes or so, but this may not be possible when performing in a race or event with a set time or distance that lasts longer.
For longer, intense events, a dramatic decrease in insulin could be necessary in the build-up to the event. Training days and match days, such as marathon open water events, may require different reductions of oral medications or insulin leading up to the event. Be sure to keep carbohydrate-containing sports drinks, energy chews/gels, and/or glucose tablets nearby. Also consult a doctor or diabetes educator for recommendations.
[People at risk for hypoglycemia (low blood sugar) looking to take up swimming on a regular basis are especially urged to see their doctor beforehand to assess their current health state and outline initial goals.]
If the body is unfamiliar with consistent swimming (or consistent activity in general), the intensity of an hour-long session can lead to lows during and after a session. For this reason, beginners should never swim alone, especially if they have trouble identifying symptoms of high and low blood sugars.
Trial and error will determine each individual’s ideal target range for blood sugars in relation to physical activity. Proper preparation can prevent low blood sugar while staying safe and performing at a high level. When blood sugar is low, consuming glucose tablets or several sips of a glucose drink can provide the necessary sugar boost to continue. When the session is finished, be sure to have a meal containing carbohydrates and protein to promote recovery.
Though checking blood sugar and being this vigilant may not be enjoyable, in many cases, the constant management can also be seen as a secret weapon. By physically checking blood sugar and mentally checking in with the body’s energy and performance levels, we ensure we’re performing at our absolute best. Many non-diabetics don’t pay this any attention (because they don’t really need to), but the interesting question is this: would a non-diabetic increase their performance by adopting a diabetic’s attitude towards training and the practice of monitoring their health status with such a watchful eye?
Like many other illnesses, it’s actually the psychological implications of diabetes that can have more of an impact than the actual physical limitations. As a diabetic, it’s about understanding how the illness can impact goals and how the challenges can be overcome.
Like anyone trying to compete at the highest level, diabetics need support and assistance. If you’re diabetic and looking to add more physical activity to your lifestyle or compete in sports, talk with your doctor or diabetes educator to discuss a plan for adjusting insulin and food before, during, and after activity. Online forums and communities also offer plenty of support and advice. There are many other diabetics that are living healthy and active lifestyles and sharing their stories, especially on social media.
Remember, you’re never alone in managing diabetes. Keep an eye on your blood sugars, move towards your goals one day at a time, and never put a limit on your athletic potential -- disease or not. You dictate your life, not the disease.
And who knows? Just maybe you’ll turn out to be the next Redgrave or Hall Jr. Or maybe not. But at the very least, it’ll be fun and beneficial to your health to find out.
About the Authors
Robert Turp is a fitness writer from Fitness Drum, a blog dedicated to helping people understand health and fitness better.