Balancing your blood sugar during exercise can be challenging. Everything from a simple walk at the mall to a 100-mile cycling race can have a significant impact, and it isn’t always predictable what that impact will be, or whether trouble will come from hypoglycemia or hyperglycemia.
Many athletes with Type 1, be they weekend warriors or dedicated competitors, spend years growing frustrated with a lack of BG control during exercise. That frustration leads them to let their blood sugar run high while breaking a sweat, says Nancy Eastman, a Ironman competitor with Type 1.
“Many people start these intense athletic events with their blood sugar in the 300s because they know they’ll drop…but you don’t have to do that and you shouldn’t,” Eastman says.
Worse, others avoid exercise altogether. There are answers out there for why one type of exercise may raise your blood sugar while another lowers it; the biggest challenge is finding them. Many doctors don’t have the time or the knowledge-base to provide good advice for managing BG during intense athletic training, and regular personal trainers might not understand the complexities of Type 1 exercise physiology. Athletes with Type 1 often must learn from their peers through social media channels, or from athletic coaches who specialize in diabetes management.
Facing that kind of frustration many years ago, Eastman signed up for the Diabetes Training Camp—one of the very first camps of its kind that focuses on teaching insulin-dependent people with diabetes how to balance their BG more effectively. The camp was founded by Matt Corcoran, an endocrinologist and Certified Diabetes Educator (CDE) who became passionate about the subject after his niece was diagnosed with Type 1.
The camp, held once a year in Lancaster, Pennsylvania, mixes the theoretical and the practical. Attendees listen to lectures about what’s happening in their bodies during exercise, then put that knowledge to practice with physical training. It’s open both to diehard athletes who want to train and those looking to stay in shape.
A veteran of marathons, cycling events, and Ironman competitions, Eastman says her diabetes management isn’t always perfect, but she acknowledges that learning and understanding why her BG trends the way it does during exercise has been invaluable both for her training and for her daily life. She says she’s not alone in this experience.
“You could talk to anyone who’s been through that camp and hear about the life-changing experience they’ve had,” she says.
Not every athlete with Type 1 can train, and even those who can still need support from their peers long after camp closes. Luckily, social media has made it much easier to stay connected. Through Facebook, Eastman keeps in touch with fellow diabetic campers, and other female athletes with Type 1 from past events. Lindsay Riffe, a CDE with Type 1 who competes in endurance events, says Facebook continues to be a crucial part of her training support network.
“In 2008, I was part of a group of 20 women with Type 1 diabetes training for the same Ironman Event. We had conference calls and emails through 9 months of training,” Riffe says. “It was the conference calls …where I truly gained the value of my diabetes online community.”
Another option for athletes with Type 1 is to enlist the help of Type 1-focused trainers to help you navigate your exercise regimen and ensure good BG. For example, Integrated Diabetes Services, a diabetes self-care consulting service, and Insulindependence, a non-profit that organizes and encourages outdoor activities and events for people with diabetes, is teaming up to offer a coaching package called “Diabetes Dynamics: Leveraging Glucose Control to Optimize Your Sport & Fitness Performance.” It includes 3 months of comprehensive diabetes education and glucose regulation specific to the client’s sport of choice. Members will work with a team of CDEs specializing in exercise and intensive insulin therapy, says Jennifer Smith of Integrated Diabetes Services.
“Essentially, our service for athletes will cover education to initially ensure that basal rates and insulin-to-carbohydrate ratios are set up correctly, and then we’ll provide in-depth education in the athlete’s specific sport to help them adjust their insulin and nutrition for optimal performance,” says Smith, a CDE and registered dietician who also has Type 1.
Another exercise consultant is Marcey Robinson, a CDE who coaches athletes with diabetes across the globe through her company, Achieve: Health & Performance. Robinson doesn’t have Type 1 herself, but her in-depth knowledge and compassion for the subject would fool any PWD into thinking she does. Robinson says that since people with diabetes are the day-to-day experts at their own blood sugar management, they must be in the driver’s seat for putting together any training regimen. Fueling your performance during an athletic event or simply keeping your blood sugar in a safe range during exercise is about much more than balancing carbohydrates, she says.
“Often times doctors and people with diabetes think it should be easy and straight-forward and get frustrated when it’s not. Just like diabetes management is individualized from person to person, the blood sugar management strategy changes from exercise session to exercise session,” Robinson says. “There are multiple variables at play and knowing that they exist and how to adjust for them is half the battle.”
You don’t need to have aspirations of becoming an elite athlete to benefit from such coaching. Scott Johnson, a Type 1 diabetes blogger, certainly wouldn’t have described himself as much of an athlete just a few years ago. Today, thanks to working with both Smith and Robinson, he signs up regularly for cycling events, plays basketball weekly, and is training to run a half-marathon in 2014. In 2012, Johnson did a 100-mile Tour De Cure cycling event, and was awarded the Insulindependence 2013 Athletic Achievement Award for his incredible progress as a regular guy with Type 1 who is working hard to take care of his health. Johnson says that the fundamental knowledge base he gained while working with Type 1-focused trainers has been invaluable.
“If you can learn some of the physiology principles behind your diabetes with exercise, you can apply those same things to different types of exercise,” he says. “I’m not trying to set Olympic records, I’m just out there to feel good and have fun.”
Like Eastman, Johnson also uses social media to stay in touch with other T1 athletes for ideas and encouragement, and to find training buddies. He’s learned little details thanks to Facebook conversations, like how to mount a glucometer on the handlebars of his bicycle so he doesn’t have to stop to test his blood sugar, or how a specific bicycle computer’s wireless signal actually interferes with the signal of his continuous glucose monitor. Most importantly, connecting with other athletes and trainers with Type 1 daily gives him the inspiration to stay healthy and train hard.
“Simply knowing that there are people out there, through social media, doing this type of thing let’s me know it’s possible, and I know they’re doing it well,” he says. “They’re kicking ass with it! If they can do it, I can do it.”
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