In 1994, when Colby Smith decided to climb Mount Kilimanjaro, one of the highest mountains in the world, he didn’t let his diabetes hold him back. During the trip up the 19,340-foot-tall mountain in Kenya, all of Smith’s insulin medication froze unexpectedly, as did the device he used to measure his blood sugar. He became dehydrated and vomited several times from high-altitude sickness. But all through the expedition with several friends, Smith kept his wits about him. He reached the mountaintop without any life-threatening diabetic symptoms because he regularly took glucose tablets.
“As a mountain climber I have faced things I could not prepare for–avalanches and being caught without food–but I’ve never let my diabetes limit me,” says Smith, a litigation lawyer in Juneau, Alaska, who has type 1 diabetes.
Exercise Reduces Diabetes Risk Factors
Not all of us can be mountain climbers like Smith, but an increasing amount of research and anecdotal evidence is now revealing that those with diabetes can lead an active physical life–even be top athletes–without ill effects. Research is pointing to the important role exercise plays in preventing type 2 diabetes, the most common variety, and in making it more easily treatable. Exercise may also reduce the risk of some diabetic complications, such as heart disease.
“Studies show that the more you exercise, the less chance you have of developing type 2 diabetes–mainly because exercise reduces the underlying factors associated with diabetes, such as excess weight and fat,” says Bruce Zimmerman, MD, endocrinologist at the Mayo Clinic and president of the American Diabetes Association (ADA). “Regular exercise also helps keep blood sugar under control in people who already have diabetes, and in some cases makes it possible to reduce medication.”
In most diabetics, the body either does not produce enough insulin or does not properly use it. Insulin is a hormone that’s needed to “unlock” the cells of the body–that allows glucose to enter and fuel them. Glucose is the cellular fuel our body uses that is provided by sugars, starches, and other foods we eat. When the disease is untreated, glucose collects in the diabetic person’s blood and urine and the body’s cells literally starve to death.
Exercise usually benefits someone with diabetes by reducing their high blood sugar, just as changes in diet and taking insulin shots or oral medications do. But since most diabetics regularly take medication and monitor their diet to maintain healthy blood sugar, exercise also poses a danger. Without regular testing of blood sugar and adjustments in diet and medication, exercise can reduce the blood sugar too much, bringing on hypoglycemia.
Ironically, if the diabetic person’s blood sugar is very high and their insulin reserve is low, exercise in rare cases has the opposite effect–raising blood sugar and possibly bringing on hyperglycemia (too much glucose in the blood).
Diabetic Athletes Form Grassroots Organization
With today’s easy-to-use and almost instantaneous blood sugar testing devices, careful blood sugar monitoring is not difficult. 4That’s why more physicians are encouraging diabetics to exercise and helping diabetic athletes compete. The International Diabetic Athletes Association, a grassroots education organization headquartered in Phoenix, Arizona, and formed in 1985, now has more than 3,000 members in 15 countries.
One of these members is Marjorie Foy, a marathon runner who has qualified to run in the Olympic Games trials in February 2000. “I’m new to marathon running, so I probably don’t have a chance to make the Olympic team this year. But I hope that by 2004 I will,” says Foy, 35, of Hillsborough, North Carolina, who was diagnosed with type 1 diabetes 3 years ago. Foy has finished among the top five in several national marathon races, and in an international race in Chicago this year placed 12th among the American runners.
Another diabetic athlete is Craig Bushey, 51, who was diagnosed with type 2 in October 1999. At 5 feet 10 inches and 160 pounds, he runs at least 60 miles a week, weight trains, and practices karate regularly. “When I went to see a diabetes specialist recently, he told me that if I had not been so active, I would have been diagnosed 10 years earlier or I would have been dead by now,” says Bushey of Nepean, Ontario, in Canada. Heart disease, hypertension, and diabetes run in his family, making him at high risk for diabetes and its complications.
Exercise and Diabetes: A Balancing Act
If you have diabetes and want to exercise, you should consult a physician first. Then you need to carefully monitor your blood sugar when beginning your exercise program, because blood sugar response to exercise varies from person to person. With your doctor’s advice, you’ll need to adjust your insulin dose and add a carbohydrate snack before exercise to keep blood sugar from falling to dangerous levels.
“You need to know what the ballpark change in your blood sugar will be from taking on exercise–how much a certain amount of exercise will drop your blood sugar–in order to correctly adjust your medication and diet,” says Anne Daly, vice president of healthcare and education for the ADA.
The change in blood sugar that exercise causes can last from several hours to 24 hours afterward, depending on intensity and length of exercise, so careful blood sugar monitoring, medication, and diet changes may need to continue through the next day. “That may mean taking an extra snack before going to bed and continuing to adjust your insulin dose,” says John Walsh, a diabetes educator and author of several books on diabetes including Stop the Roller Coaster (Torrey Pines Press, San Diego, California, 1996).
Other important precautions:
* Get a thorough physical at your doctor’s office to test for silent heart disease and other diabetic complications before beginning exercise.
* Stay away from weight training if you have some complications of diabetes such as serious nerve disease or retinopathy, a retinal eye disease. If you have nerve disease and drop a weight on your foot, you may not feel the injury, and it may easily fester and become infected. If you have serious retinopathy, you can easily burst blood vessels in your eyes during weight training.
* Make sure your shoes are comfortable and adequate for your sport to reduce the chance of blisters and sores and resulting infections.
Article By: Barbara Boughton, Medical Writer