Type 1 Diabetes: More Info
Amy Kubal shot me an interesting link talking about the dramatic increase in type 1 diabetes. It’s both scary and sad. The increase is going to be dramatic, the fix is completely in our control. Avoiding grain and dairy exposure in our kids would virtually eradicate this disease. these bozo’s are hand wringing about a “need for more observation and research” when the mechanism is well understood. Yeesh.
Shifting gears but still on the topic of Type 1 diabetes. You might recall from a previous post on this topic that I cautioned people with Type 1 that high intensity exercise might play havoc with blood glucose levels due to exercise induced hepatic (liver) glucose release. I knew this was facilitated by the release of adrenal hormones such as epinephrine and norepinephrine, but I was unclear about the magnitude of the release, what types of exercise produce the largest release and a few other issues. Well, thanks to one of our clients who is an ex-phys grad student at CSU Chico, Martin Freigard (thanks dude!) I have a pretty solid resource and support for my caution. In the book Exercise Physiology by Brooks, Fahey and Baldwin all aspects of integrated fuel metabolism are considered including hormonal and substrate (in this case fuel) consideration while exercising. Pages 193-194 have the information we need to make some informed decisions about trainign around Type 1 diabetes. Here they are:
1-Untrained individuals see a marked increase in glood glucose levels at both high and low intensity training (as measured against % VO2 max).
2-Trained individuals see little increase in blood glucose in response to training at low-moderate intensities (below 70% VO2 max).
3-Trained individuals see a markedly LARGER increase in blood glucose levels in response to training up to 100% VO2 max, and an even greater response at sprint intensities that are above 100% VO2 max (anaerobic).
So…what does all that mean for the Type 1 diabetic? It explains why we have seen Type 1′s who have a rocky time regulating blood sugar after CrossFit WOD’s. They are ALL anaerobic. The information referenced in the book is from people sitting on a bicycle. The authors make the point that running elicits and even larger blood glucose response because its harder. I suspect a Fran or Helen would be even larger in this regard and this does seem to be what people are seeing.
What to do?
1-For the health and longevity minded Type 1 I’d keep the lions share of your training in the low-moderate intensity range. Lift weights, to CF style met-cons but keep things at about a 60-70% intensity, perhaps far less. Eat a largely ketogenic paleo diet and map your blood sugar response to exercise so you have a solid picture of what exercise doe what. Endeavor to use the absolute bare minimum of insulin by smart diet and training (ie. do stuff that DOES NOT crank you blood sugar through the ceiling).
2-You’re Type 1 and you are going to train CF no matter what. Well, try to keep your carbs as low as you can handle them, and just try to figure out what training does what (mapping again). Understand that what your doctor is ok with, high blood sugars, higher than normal A1c’s and all that are not good for your long term health. It’s your call, be informed, make decisions based on your goals.
Hey Theresa- Here’s your reference.