Diabetes is a disease that affects millions of people. Olympic champions such as weightlifter Matthias Steiner and tennis professional Alexander Zverev are also among those affected. However, anyone who suffers from type 1 diabetes like the two athletes must be careful when training.
Type 1 diabetes: This is what those affected need to keep in mind when exercising
“With type 1 there is a high risk of hypoglycemia,” explains physiologist and diabetes expert Othmar Moser from the University of Bayreuth in conversation with inFranken.de. Due to the autoimmune disease, the body produces little or no insulin. However, the hormone is necessary to regulate blood sugar. Sufferers have to inject insulin regularly throughout their lives to prevent metabolic derailment. Since the body needs more energy when exercising, diabetics can experience hypoglycemia more quickly. “The therapy plan definitely needs to be adjusted with the doctor,” advises Moser. The basic rule is: less insulin, more carbohydrates.
Patients should therefore inject less insulin at the last meal before training. The background is that the hormone has a stronger effect when the muscles are active, describes diabetologist Gerhard Schmeisl from Bad Kissingen in the specialist magazine Diabetes Journal.
However, the amount of carbohydrates you consume should be increased before exercise. “For every exercise of shorter duration (e.g. an hour of swimming, an hour of cycling), around 12 grams of additional long-acting carbohydrates should be eaten every half hour,” says Schmeisl. The so-called slow carbohydrates are found, for example, in whole grain bread, nuts, legumes or salad. They are “slow” because it takes a while for them to be broken down into sugar in the digestive tract.
Keep an eye on blood sugar: CGM is so important for diabetics when exercising
Moser also recommends consuming “fast” carbohydrates as needed during exercise. This could be, for example, a banana, a pretzel or fruit juice. The classic glucose is also suitable for this.
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But the most important thing for diabetics when exercising is probably measuring blood sugar. Both before and after training and during it. A “CGM” (Continuous Glucose Monitoring) is best suited for this. The devices continuously measure the glucose content in the tissue using a sensor under the skin. The values are then sent to a receiving device, which is also possible with a smartphone. Almost all diabetes patients now use CGM, says Moser. “We also recommend it to everyone because it significantly improves glycemic control.”
If you always keep an eye on your blood sugar, you can avoid hypoglycemia during or after exercise. This can even happen hours later; Schmeisl speaks of the “muscle replenishment effect”. The body wants to replenish its sugar stores in the liver and muscles, which lowers blood sugar levels. This effect should not be underestimated. It may be necessary to eat slow carbohydrates before going to sleep to avoid hypoglycemia at night. You can read about the symptoms of low blood sugar here.
These are the benefits of exercise for people with diabetes
But if it seems so dangerous for people with type 1 diabetes to exercise, why is it recommended? Through regular exercise, diabetics can save on insulin, as it is a natural way to lower blood sugar levels. In the long term, patients also need less insulin because the body reacts better to the hormone. Even with less insulin, the cells can then be adequately supplied with sugar.
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At the same time, exercise reduces the risk of comorbidities, for example high blood pressure, obesity or type 2 diabetes. The latter is referred to as “double diabetes”. But in contrast to type 1 diabetes, this form can be cured for a short period of time – including through exercise. In type 2 diabetics, insulin resistance has simply developed and the hormone no longer works. Regular exercise and a healthy diet can improve the effect of insulin.
Those affected should still speak to their doctor first and get clearance for sports. In the case of certain comorbidities, a heart check using a stress ECG may be necessary beforehand. However, previous illnesses are usually not a reason against exercising. “So far there hasn’t been a patient for whom we haven’t found anything. Even if you have many, serious comorbidities, we give individual exercise recommendations, you just have to be imaginative,” says Moser from his experience in the diabetes outpatient clinic at the Graz University Hospital.
Which exercise is best for people with diabetes?
His recommendation for all diabetics is at least 150 minutes of exercise per week, divided into around three to four units. “Of course, a combination of endurance and strength training would be optimal,” explains the scientist. However, the type of sport is not crucial in therapy. “We always tell our patients: Try to find something that you enjoy and that you can imagine doing permanently.”
In addition, experts recommend increasing physical activity in everyday life. For example, taking the stairs instead of the elevator or walking or cycling for shorter distances instead of driving. Simply increasing exercise in everyday life is actually not enough for diabetes therapy. “We only do this in an emergency, when people say they don’t have time for sport. It’s better than nothing,” said Moser.
Conclusion: Sport can improve the quality of life of people with diabetes
Sport is a good therapy option for diabetics. People with type 1 diabetes can save insulin through exercise and reduce the risk of comorbidities, such as type 2 diabetes. Those affected by type 2 diabetes can be cured through physical activity, among other things, if the illness lasts for a short period of time. Because exercise improves their insulin resistance and over time it is completely eliminated. Diabetics should seek medical advice beforehand and adapt their therapy plan according to their training. Experts recommend at least 150 minutes of exercise per week, divided into three to four training sessions. A mix of strength and endurance would be ideal. But it’s more important to find a sport that you enjoy. Because if you can’t imagine continuing the training long-term, it’s not suitable for treatment.
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