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Diabetes Motion: Expert Advice from Dr. Sheri
Everything you need to know about exercise, healthy lifestyles, diabetes, and aging well!
To search articles by topic, please see "Categories" section at the bottom of this blog's main pages.
Diabetes Motion: Expert Advice from Dr. Sheri 
Hi Dr. Colberg,
Do you have any info on the interaction between amylin, insulin, and glycogen during and after exercise? I was wondering whether symlin might help me manage some of the highs and lows associated with exercise (I’m a type 1). I can’t seem to find any good resources to tell me what amylin actually does.
Thank you for your wonderful blog! -Katie
Katie, There isn’t any official research on this topic that I know of. Anecdotally, I have heard that “symlin lows” that you have trouble treating are more likely to occcur if you take symlin BEFORE exercise (within a few hours), so this would not be advised. Amylin (of which Symlin is a synthetic form you inject) is a natural hormone that is normally co-released with insulin in people who make their own. It has antagonistic effects on insulin, meaning that it slows down absorption of carbohydrates you eat (making insulin able to better keep up in a non-diabetic person). It also has other effects around the body, but that is the main one contributing to the “symlin lows” I mentioned. Sheri
Sheri Colberg, PhD, Author of Books on Exercise, Diabetes, and Health
Katie,
There isn’t any official research on this topic that I know of. Anecdotally, I have heard that “symlin lows” that you have trouble treating are more likely to occcur if you take symlin BEFORE exercise (within a few hours), so this would not be advised. Amylin (of which Symlin is a synthetic form you inject) is a natural hormone that is normally co-released with insulin in people who make their own. It has antagonistic effects on insulin, meaning that it slows down absorption of carbohydrates you eat (making insulin able to better keep up in a non-diabetic person). It also has other effects around the body, but that is the main one contributing to the “symlin lows” I mentioned. Sheri
Dr. Colberg,
The following questions was posed by a type 1 pt. at our clinic. I’d be interested in hearing your response. Thank you. Cara Walcheck
I have a question about protein intake in the context of weight training.
It is said to consume higher amounts of protein (40% of total calories) to aid in the muscle recovery process. I am currently doing half that amount (20%)
because of the info I’ve found on diabetics and protein intake. What is your recommendation on maximum protein intake? And, more specifically, are there
any issues with supplementing with whey protein (I am currently taking 1 scoop per day; within the confines of my current 20% intake)? I’d like to up my protein, but am concerned
about kidneys.
Also, post-workout, it’s recommended to ingest simple carbs (dextrose) to spike insulin, helping to carry protein nutrients to the recovering muscles. Is this
something I can do? I was planning to mix some dextrose in with my whey protein shake (post-workout) and then take some insulin to cover the dextrose.
The protein recs for people with T1 diabetes are not any different than for the general population for the most part. It is usually fine to consume somewhere in the range of 10-35% of calories as protein. There is no evidence that a high protein diet (within that range) causes a deterioration in kidney function, and it’s even debatable if it does when ESRD is present. In any case, athletes don’t need huge amounts of protein for weight training. The max is about 1.8 grams/kg of body weight each day, which would more than be covered by the 20% range. Whey protein appears to be okay for individuals with T1 diabetes, but again, you just don’t need that much. As for post-workout spikes, it’s debatable as to whether that is necessary. Eating a balanced snack after a workout would suffice, or having some low-sugar yogurt, etc. The current rec is about 4:1 (carbs:prot) as a post-workout snack, but it doesn’t need to be that much to be effective. Also, it really doesn’t have to be dextrose. In any case, I would not recommend having to take more than 1-2 units of Humalog/Novolog post-workout because you don’t want to have to worry about having later-onset hypoglycemia. Sheri Colberg, PhD