Blood sugar control for athletes -
Protein consumption ranging from 1. If total energy intake is adequate to maintain body weight, adequate protein can be obtained solely through the diet, without fortification from protein supplements.
Fat is critically important in athletic diets because it provides energy, fat-soluble vitamins, and essential fatty acids for daily activity and health.
Strength and power athletes attempting to increase lean mass should consume sufficient amounts of energy to support muscle growth. Numeric estimations of energy intake, the authors noted, are somewhat crude in approximating the energy requirements of individual athletes.
However, any athlete must consume enough energy to maintain desirable weight and body composition while training for and competing in specific sports. Though some diets have become popular in weight-loss circles e. Some of these strategies, in fact, promote low or very low consumption of carbohydrates, with the stated intent of producing ketoacidosis, the mobilization of ketone bodies for metabolism.
Ketoacidosis, however, is a serious metabolic disturbance, and its detrimental effects in people with diabetes have been well established. It is,therefore, recommended that athletes with type 1 diabetes avoid carbohydrate-restricted diets.
These recommendations for nutrition were developed for athletes without special consideration for type 1 diabetes. Strength-trained athletes with diabetes require adequate amounts of protein just like all other individuals engaged in resistance exercise.
While the needs of resistance-trained athletes and individuals engaged in chronic intense exercise are higher than those of sedentary individuals, this need is usually met by eating a balanced diet that is higher in energy intake. There is evidence that indicates that large amounts of protein i.
Athletes often turn to nutritional supplements in the belief that performance will be improved. Competitive athletes with type 1 diabetes should recognize which products may result in harmful effects as well as those that are likely to be a waste of money.
Some of the popular nutritional supplements include fat burners, thermogenic enhancers, boosters, ephedra, chitin,medium-chain triglycerides, creatine monohydrate, and androstenedione. These supplements and their use in diabetes management have been previously described in detail.
Anabolic steroids are synthetic derivatives of testosterone. Though access to anabolic steroids is restricted to specific medical interventions, their use in sports remains widespread in the United States, perhaps involving as many as 3 million athletes.
Available studies have used untrained men taking both pharmacological and suprapharmacological doses of the drug.
Whereas most investigations examining pharmacological administration have shown little if any improvement in body composition or strength, some studies employing suprapharmacological doses have indeed shown beneficial changes in lean mass, strength, and performance.
Anecdotal evidence indicates that suprapharmacological administration of anabolic steroids in competitive athletes definitively improves performance.
Reports of adverse side effects associated with anabolic steroid use have been documented and included cardiovascular disease, hypertension, hepatic disease, hormonal dysfunction, abnormal lipoprotein changes increased LDL cholesterol, decreased HDL cholesterol , and personality disorders.
No evidence, even anecdotal reports, of the effects of anabolic steroid use in athletes with type 1 diabetes is available. However, because of the known systemic disturbances associated with anabolic steroid use, it is clear that athletes with type 1 diabetes should not experiment with this class of drugs.
Competitive sports are generally safe for anyone with type 1 diabetes who is in good metabolic control and without long-term complications. The examination should attempt to identify whether the athlete is at increased risk of orthopedic injuries, back or neck injuries, and dental trauma and should also include visual acuity and hearing screening.
For long-term complications of diabetes, the exam should focus on signs and symptoms of disease affecting the heart and blood vessels, eyes, kidneys, feet, and nervous system. A formal graded exercise test is usually not necessary but may be helpful if the athlete has one of the following:. Autonomic neuropathy 2.
The most common acute risks for competitive athletes with diabetes are exercise-induced hypoglycemia and deterioration of hyperglycemia and ketosis brought on by physical activity during periods of hypoinsulinemia. Blood glucose is relatively unchanged during exercise in individuals without diabetes because glucose uptake by skeletal muscles is precisely matched by glucose released from the liver.
One important control over this mobilization of fuel is a reduction in circulating insulin. People with type 1 diabetes must rely on exogenous insulin and are unable to reduce circulating insulin at the onset of exercise.
This frequently results in hypoglycemia because there is an imbalance of increased glucose uptake by skeletal muscles with inadequate hepatic glucose release. When insulin is not available to assist in the transport of glucose into skeletal muscles during exercise, glucose uptake is decreased, glucose release from the liver is increased, and there is a rise in blood glucose.
Without adequate insulin, skeletal muscles will be forced to rely on fat as fuel, and eventually this can lead to an increase in ketone bodies. Individuals with diabetes should not exercise if insulin is inadequate. There are a number of recommendations for strategies that may be useful in the management of competitive athletes with type 1 diabetes, but they are not well supported by the scientific literature.
org may be a valuable resource for any athlete with diabetes who is interested in sports competition. Of those investigations that have examined athletes with diabetes, one study reported blood glucose responses for two consecutive years in athletes using different diet and insulin adjustments while competing in a km cross-country ski race, 34 and another reported fuel homeostasis and insulin sensitivity in 11 athletes with diabetes from a variety of endurance and power sports.
These findings suggest that athletes with type 1 diabetes are not achieving good blood glucose control. This may be because athletes are intentionally competing with high blood glucose levels to prevent exercise-induced hypoglycemia, or diet and insulin strategies are simply not yet good enough to achieve tight control.
The Diabetes Control and Complications Trial conclusively demonstrated that the risk of development or progression of long-term complications can be reduced by intensive treatment resulting in a reduction in A1C.
It is likely that many athletes with type 1 diabetes are chronically hyperglycemic to avoid exercise-induced hypoglycemia. Questions remaining to be answered include the following:. It is likely that poor control of blood glucose increases susceptibility to infection.
It is important for athletic training personnel to be aware of athletes with type 1 diabetes and to pay special attention to any injury that is susceptible to infection. It is also important for athletic training staff to be aware of treatment modalities that may alter absorption of injected insulin.
These may include massage therapy, ice therapy, or heat and whirlpool therapy. The management plan for athletes with type 1 diabetes must attempt to anticipate blood glucose responses to sports training and competition.
Ideally, blood glucose will be monitored and recorded before and after each meal, as well as before, during, and after each training session and athletic contest. It is also helpful to have descriptions of the exercise performed with the type, duration, and intensity of exercise, as well as any significant environmental conditions.
If sports training is just beginning, or if training is dramatically increased, blood glucose should also be monitored at a.
Appropriate blood glucose targets can be established based on the pattern of blood glucose responses and the ability of the individual athlete to make appropriate adjustments to keep glucose in the target range. Reductions may be needed in both short- or rapid-acting insulin and intermediate- or long-acting insulin.
The site and timing of insulin injection can affect the glucose response to exercise. If subcutaneous insulin is injected over muscles that will be actively contracting, insulin absorption will be accelerated.
Changing the region of the injection site thigh vs. abdomen, for example is generally not recommended because this may also alter the time course of insulin absorption.
The general recommendation is to rotate the injection sites within the same region rather than to alter the region that is used. Once the athlete is accustomed to training, most adjustments to prevent exercise-induced hypoglycemia will be made by dietary supplementation with carbohydrate.
Typically, this will involve a specified amount of carbohydrate at an appropriate time to match the anticipated reduction in blood glucose. The amount of carbohydrate required is usually 15—60 g. Actual amounts are easily determined from the labels. Sport activities by their nature are unpredictable.
A tennis match that is expected to take 40 minutes may turn into a 2-hour contest. The glucose response to exercise is affected by factors such as exercise intensity,exercise duration, time of day, environmental conditions, emotional stress or excitement, and absorption of insulin and dietary supplements.
When the management plan does not adequately adjust for the glucose response, there should be a plan for appropriate compensation. Rapidly absorbable carbohydrate should be readily available. Coaches, athletic trainers, team physicians,teammates, and parents should be familiar with signs of hypoglycemia, be trained to monitor blood glucose, and be able to assist athletes in case of hypoglycemia.
A successful early experience in competitive sports can be an important foundation for a lifetime of active living. Sports can improve health,fitness, psychological well-being, and social interaction.
Safe participation is possible for the large majority of athletes with diabetes. Most of these individuals have a strong drive to make the most of their abilities, and a properly devised management plan can be an important tool to help them reach their competitive performance goals.
Guyton Hornsby, Jr. Chetlin, PhD, CSCS, is an assistant professor of occupational therapy in the Department of Human Performance and Applied Exercise Science at the School of Medicine of West Virginia University in Morgantown.
Sign In or Create an Account. Search Dropdown Menu. header search search input Search input auto suggest. filter your search All Content All Journals Diabetes Spectrum. Advanced Search. User Tools Dropdown. Sign In. Skip Nav Destination Close navigation menu Article navigation. Volume 18, Issue 2.
Previous Article Next Article. Energy Demands of Sports Competition. Goals of the Athlete. Minimizing Risky Behaviors. The Management Plan. Article Navigation. Management of Competitive Athletes With Diabetes W. This Site. Google Scholar. Robert D. Chetlin, PhD, CSCS Robert D.
Chetlin, PhD, CSCS. Diabetes Spectr ;18 2 — Connected Content. Although there are a few exceptions to the rule, such as fat-adapted or ketogenic training, carbohydrate feeding has been the fueling foundation for endurance athletes.
The right type of fuel is also needed, and at the right time. You can't put low octane fuel in a race car, and you definitely better not wait until the car is running on fumes to refuel.
Eventually, the car will roll to a stop and the engine may need to be serviced before the next race. But on the trail, as an athlete, you get used to just guessing at your fuel levels based on feeling. Meet the Abbott Libre Sense Glucose Sport Biosensor: The first continuous glucose monitor adapted for athletic performance.
One of the most important for in-competition performance? Your feel and performance in different glucose ranges. Your optimal fuel range will vary based on your individual body, the type of activity, and the type of adaptation you are seeking. After monitoring your glucose data with the Supersapiens app for a little while, you'll be able to determine your optimal fuel range—your Glucose Performance Zone.
Training or racing outside of your Glucose Performance Zone may negatively impact athletic performance. With real-time visibility, you're able to make real-time adjustments.
Personal records all around. Eat a banana. See immediately how your body reacts to it. From this, you can discover which foods provide the most stable and sustainable energy. Hint: It may or may not be a banana. Look at the two graphs below. This is about limiting the steep "spikey" nature of the line on the graph—stable and sustainable optimal means relatively flat.
The goal would be to find fuel sources that result in the graph on the right. So you eat a banana. Then you analyze your training sessions. Compare your workouts. Then, fine tune your fueling strategy.
Once you've discovered your Glucose Performance Zone, you need to maintain it throughout competition to sustain your peak performance. Simple: Monitor your glucose levels and maintain your Glucose Performance Zone.
While there are basic guidelines for when and how much to consume during any particular activity—such as grams of carbohydrates per hour or about calories—the optimal timing of when to eat to ensure glucose stability, maintain optimal fuel levels, and sustain peak performance on an individual basis has been a bit of a black box.
So it should be no surprise that managing your optimal fuel levels is nearly impossible without real-time visibility to your own glucose levels. With your Live Glucose Reading and Trend Arrow, you not only know where your fuel levels are right now, but also where they're headed.
And you can make real-time fueling adjustments accordingly. In other words, with a quick glance, you can see your Live Glucose Reading and Trend Arrow, and know if you need to eat now or not.
We call it your GPZ. For example, you may see your levels temporarily increase without additional fuel intake due to an adrenaline or other hormone-induced glucose response. Live Glucose Reading at the lower bound of your Glucose Performance Zone? indicating that your fuel levels are dropping quickly Then your fuel levels are dropping.
And you know you need to refuel because your glucose is headed out of your GPZ. For more information on Supersapiens and stories from our athletes, follow us on Facebook, Instagram, and Twitter: supersapiensinc.
That changes with continuous glucose monitoring CGM and real-time glucose visibility. But it's time to change the way you carbohydrate. The takeaway: Driving or pushing your limits on empty is never a good idea.
Blopd searching for: Clntrol healthNutritionSports science etc. Blood sugar control for athletes your training and sophisticated gear, your fueling strategy sugae as the caloric restriction and diabetes prevention or breaker of Blood sugar control and liver health athletic activity. When you ahhletes out, think of your body as a high-performance race car and glucose as the fuel — the primary source of energy for your brain, muscles and other organs. How does the body source this energy? One of the precursors of a healthy glucose range is a balanced diet that includes proteins, fats, and carbohydrates. Your blood sugar levels can either undermine or improve your workouts.Blood sugar control for athletes -
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Download references. The Department of Physiology, Nutrition and Biomechanics, The Swedish School of Sport and Health Sciences, GIH, 33, Stockholm, Sweden.
You can also search for this author in PubMed Google Scholar. Correspondence to Mikael Flockhart or Filip J. Open access funding provided by Swedish School of Sport and Health Sciences GIH. The Swedish Olympic Committee and the Swedish Research Council for Sport Science provided funding for the research.
L is a co-founder of svexa, a company that, in part, develops algorithms using wearable technology data, including continuous glucose data, to provide advice to coaches and athletes. The potential conflict of interest has not influenced the impartiality of the research and the opinions expressed here are the personal opinions of the author.
F declares no competing interests. F wrote the first draft of the manuscript and finalized it together with F. L is coordinating the studies on CGM in elite athletes mentioned in the manuscript. F and F. L created the figures. Both authors read and approved the final version.
Open Access This article is licensed under a Creative Commons Attribution 4. The images or other third party material in this article are included in the article's Creative Commons licence, unless indicated otherwise in a credit line to the material.
If material is not included in the article's Creative Commons licence and your intended use is not permitted by statutory regulation or exceeds the permitted use, you will need to obtain permission directly from the copyright holder. Reprints and permissions. Flockhart, M. Continuous Glucose Monitoring in Endurance Athletes: Interpretation and Relevance of Measurements for Improving Performance and Health.
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Download PDF. Abstract Blood glucose regulation has been studied for well over a century as it is intimately related to metabolic health.
However, to date there are no published studies showing CGM is correlated with any dietary changes or positive health outcomes for those without diabetes.
That feeling of legs turning into cement blocks and the inability to form a coherent sentence comes down to a lack of fuel going to the muscles and nervous system. Just like a car when it runs out of gas, when your body runs low on glucose no amount of grit or determination will allow you to continue on.
This is because during high-intensity exercise our muscles rely heavily on glycogen as a fuel source. Glycogen, the storage form of carbohydrate in the body, is broken down into glucose to provide a quick and accessible fuel source to power muscles. Unfortunately, the amount of glycogen our bodies can store is limited to enough to power roughly 90 to minutes of exercise.
Hence the recommendation to consume exogenous forms of carbohydrates in the form of gels, sports drinks, gummies, and the like during prolonged activity.
In theory this is where CGM could help. However, there is a big discrepancy between the theoretical and real-world application. The effect glucose levels have on athletic performance is complicated.
Although glycogen serves as the predominant fuel during high-intensity exercise it is not the only fuel being used. Fat is also a fuel source for working muscles.
The degree to which fat versus glycogen is used is determined by a number of factors, the most significant of which is exercise intensity. Go for a leisurely walk and glycogen hardly factors in as fat provides nearly all the necessary energy to put one foot in front of the other.
Take that walk up a notch to an easy trot and the body starts to rely a bit more on glycogen, but only to a small degree. As exercise intensity gradually increases, the body shifts to relying more on glycogen and less on fat.
Break into an all-out sprint and almost instantly glycogen becomes the go-to fuel source with fat just lending an assist.
While that may not seem so complicated it is far from the whole story. Another factor is how long you are exercising. Blood glucose, which as discussed earlier is kept in a pretty tight range by the body, is largely unaffected during short-duration activity.
That's because a person could be seriously hurt if he or she has low blood sugar levels while doing these sports. Your doctor will help you learn what blood sugar levels make it a good or bad time to exercise.
He or she will also explain how to take action and get back in the game. If you notice any of the signs listed below, stop exercising and follow your diabetes management plan. Also, keep an eye on any cuts, scrapes, or blisters, and talk to your doctor if they're really red, swollen, or oozing pus — these could be signs of infection.
By being prepared and knowing how to follow your diabetes management plan, you'll be able to prevent diabetes problems during exercise. After all, professional athletes follow a training and nutrition program to keep them playing their best — just think of your diabetes management plan as your own personal roadmap to exercise success.
KidsHealth For Teens Sports, Exercise, and Diabetes. en español: Deporte, ejercicio y diabetes. Medically reviewed by: Steven Dowshen, MD. Listen Play Stop Volume mp3 Settings Close Player. Larger text size Large text size Regular text size. How Exercise Helps People With Diabetes Exercise offers many benefits.
It: strengthens bones and muscles reduces your risk of heart disease and some types of cancer improves coordination, balance, strength, and endurance can increase your energy level helps insulin work better in the body, which helps blood sugar levels stay in a healthy range burns calories, which helps you reach and stay at a healthy weight teaches you about teamwork, competition, and courage helps boost self-esteem and confidence relieves tension and stress, relaxes you, and boosts your mood, too can even help you clear your mind and focus your attention better All exercise is great — whether it's walking the dog or playing team sports.
What Happens During Exercise? Getting Ready to Exercise All teens — not just those with diabetes — need to get a physical before they play a sport. P Exercise Tips for People With Diabetes These tips can help you avoid diabetes problems during exercise: Test yourself.
Your doctor will tell you when to test your glucose levels — often you'll need to check them before, during, and after exercise. Take the right dose of insulin. Your doctor might recommend adjusting your insulin dosage for exercise or sports.
If you inject insulin, you might not want to inject a part of your body used for your sport before exercise like injecting your leg before soccer. This could cause the insulin to be absorbed too quickly.
Eugar is essential for everyone—especially arhletes people Blood sugar control for athletes diabetes. Being active Blood sugar control and liver health Protein for energy of the week sugag you healthy by reducing long-term health risks, improving insulin sensitivity, and enhancing mood and overall quality of life. Most of the time, working out causes blood glucose blood sugar to dip. But some people, after certain types of exercise, notice that their glucose levels actually rise during or after exercise. Fear not! There are steps you can take to avoid this.
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