If you’re a diabetic exerciser, then you know that exercise can cause hypoglycemia, which means that you’ll have to eat extra carbs to treat it. Consuming extra carbs before, during, and/or after exercise, however, may eventually contribute to excess caloric intake and weight gain. To replace carbs optimally without gaining weight and to achieve your optimal athletic performance, you should avoid getting low blood sugars by combining a lesser carbohydrate intake with a reduction in your insulin doses.
Staying adequately hydrated is also important to athletic performance. As a rule of thumb, to prevent dehydration, drink no more than six to eight ounces of cool, dilute fluids (e.g., water or sports drinks) every 10 to 15 minutes during prolonged activities, particularly in warm or hot environmental conditions. Drinking too many fluids can result in hyponatremia, otherwise known as “water intoxication,” which is potentially deadly.
Athletes are known for taking various ergogenic supplements to possibly enhance their athletic performance. Some of these nutritional supplements, however, can cause potential harm to an athlete with diabetes. For example, protein and amino acid supplements add extra stress on your kidneys due to the required excretion of excess amounts of nitrogen released when these supplements are metabolized. Such excretions can cause additional strain on kidneys with any pre-existing damage from long-term diabetes. Similarly, creatine monohydrate supplementation can harm already damaged kidneys, particularly during the initial creatine loading period, although the actual effect has not been tested in humans.
Athletes with and without diabetes also frequently use caffeine to enhance their performance. You must be careful when using it, though, as its use prior to exercise may cause excessive water loss and dehydration in a hot environment if you don’t drink adequate fluids. It can also increase your level of insulin resistance. When taken during exercise, however, its diuretic effect is not evident, nor is its impact on insulin action, making it an effective ergogenic for most exercisers.
Athletes with diabetes, like their non-diabetic counterparts, frequently utilize the practice of carbohydrate loading prior to competition. However, with insulin users doing so can cause hyperglycemia before, during, and/or after exercise if you don’t cover the carbs with an adequate amount of insulin. Recent studies have shown that athletes loading with a diet comprised of 50 percent of the calories from carbohydrate intake actually maintain better glycemic control and have greater glycogen stores than those who take in a 60 percent carb diet. Adequate liver glycogen repletion is also linked to tighter blood glucose control. Moreover, carbohydrate loading before and after exercise reduces the body’s formation of glucose transport proteins (GLUT4) and insulin sensitivity.
Conversely, you can end up hypoglycemic if you take in carbs before exercise along with excess insulin to compensate. As prevention for, and treatment of hypoglycemia, athletes should always carry a supply of rapidly-absorbed carbs (e.g., glucose tablets, glucose polymers, sports drinks, juice, regular soda, and hard candy) that can be easily consumed before, during, and after physical activities.
In my next blog, I’ll finish the discussion on nutrition for type 1 diabetic athletes.