Ask a Dietitian

As seen on BCTV Noon News

Athelets Living with diabetes

There are two types of diabetes, known as type 1 and type 2 diabetes. While type 1 is insulin dependent type 2 may or may not require insulin. Both type 1 and 2 require careful management in order to avoid complications. Management of diabetes can include insulin therapy, oral hypoglycemic agents, nutrition and exercise. Because exercise is an integral part of management and overall health, it is important for individuals with diabetes to be aware of their nutritional needs before, during and after exercise in order to benefit from the exercise and reduce potential complications.

*Note: For both type I and II diabetics it is advised to have a medical examination before starting a regular exercise regime

1. Type 1 diabetes nutrition recommendations for exercise

Many individuals with type I diabetes have competed successfully at high levels. However, the risk of hypoglycemia is a limitation for type 1 diabetics, for both blood glucose management and performance. Therefore it is important for the athlete to understand what their insulin and nutrition requirements are to prevent hypoglycemia from occurring. 

Before Exercise

· A low glycemic index carbohydrate meal (such as oatmeal with fruit, whole grain bread with peanut butter) is recommended for consumption 1-3 hours before exercise.

· A reduced insulin dose is also recommended prior to exercise

During Exercise

· When glucose is not consumed during exercise, hypoglycemia can be the unfortunate result

· Research has found that 40-80 g/h of glucose is sufficient for blood glucose maintenance depending on the individual

· It is important to gage yourself and bring sufficient fast absorbing carbohydrates for training and competition

· It is important to reduce your intensity or stop exercising when situations of low blood glucose arises, until it can be normalized

· Examples of foods one can bring to the training session are bagels, bananas, raisins and Gatorade

After Exercise

· In most types of exercise re-synthesis of glycogen (storage form of glucose) is very important

· It is recommended to eat a high glycemic index carbohydrate snack together with insulin directly after exercise to assist maximum glycogen storage in the muscles and liver

· In addition, if extensive training has occurred later in the afternoon some individuals set an alarm to measure blood glucose during the night or may want to have a protein and carbohydrate snack before bed.

· Examples of foods immediately after exercise: bananas, bagels, Gatorade, rice cakes, carrots, English muffins, pretzels

2. Type 2 diabetes nutrition recommendations for exercise

For type II diabetics, exercise is recommended to improve insulin sensitivity and to reduce body weight. Insulin sensitivity can improve blood glucose regulation after a meal, which is important for metabolic control. The following nutrition recommendations are more focused on health rather then just performance.

Before Exercise

· Eat your regular meal or snack no sooner than 1-2 hours before exercise to allow for adequate digestion.  Moderate to low GI foods would be good choices here.  See the article on the Glycemic Index for a list of foods and their GI.  No extra energy is needed before exercise, however individual medications need to be considered

During Exercise

· Risk of hypoglycemia is much lower than in type I diabetics due to a lower rate of metabolism and therefore reduces the need for carbohydrates during exercise.  Therefore it is not necessary to eat during exercise lasting one hour or less with Type II.

· However, those on aggressive type 2 therapy must have carbohydrates available (consult a dietitian in regards to whether this applies to you)

After Exercise

· The capacity for type 2 diabetics to store excess glucose as muscle glycogen is greatly reduced

· However, exercise can be beneficial by lowering glycogen stores until the next meal and then ideally the next meal will store the glucose as glycogen

· Glycemic index (GI) is a consideration for type 2 diabetics, as the general every day consumption of low GI foods is associated with improvement of weight regulation (eg. Legumes, yogurt, most fruits and vegetables)

The Bottom Line:  Staying active is very important for every person, including those living with Diabetes.  The key is to monitor your symptoms and come prepared with food in the event of a low blood sugar.  Always tell someone where you are exercising and when you will be back or exercise with a friend.

Watch for the Eating for Energy segment every Tuesday on BCTV’s Noon News Hour!