CDC statistics indicate that diabetes is the seventh-leading cause of death in the U.S., with 26 million Americans afflicted with the disease. Type 2 diabetes accounts for 90 to 95 percent of the diabetes diagnosed. Cardiovascular disease, stroke, kidney disease, nerve damage, blindness and foot ulcers are the common complications associated with diabetes. Exercise adds variables to diabetic care. You should consult with your health care providers for appropriate exercise programs and sports nutrition needs.
Type of Exercise
The American College of Sports Medicine (ACSM) states that both aerobic and resistance exercise help to control blood glucose in type 2 diabetics, a key factor in reducing the risk of complications. ACSM recommends at least 150 minutes of moderate to vigorous aerobic exercise and two to three periods of moderate to vigorous resistance training a week. Check with your health care provider for the appropriate physical activities for you.
Hydration
Adequate hydration is crucial to sports performance. Losing as little as 2 percent of your body water can significantly impair your work capacity, according to the International Society of Sports Nutrition (ISSN). Dehydration can concentrate the blood and increase blood sugar. Diabetic patients with neuropathy or nerve damage may have difficulty regulating body temperature and need to be vigilant with replenishing fluids, according to the American Diabetic Association. ADA recommends adequately hydrating your body with 17 ounces of fluids two hours before exercise and frequently drinking fluids during and after a workout.
Hypoglycemia
During exercise, your body maintains your blood sugar with reduced action of insulin. However, type 2 diabetic patients who take insulin or sulfonylureas like glyburide, glimepiride, glipizide, nateglinide and repaglinide may experience therapy-induced low blood glucose, or hypoglycemia. In this case, ACSM recommends intake of up to 15 grams of carbohydrates before exercise if the glucose level before exercise is lower than 100 mg/dl. After-exercise hypoglycemia is also likely in these individuals after intense training sessions. If this takes place, eat five to 30 grams of carbohydrates during and within 30 minutes after exercise to replenish your glucose stores and restore your blood sugar. You generally do not have to worry about hypoglycermia if you are not taking these medications. Nevertheless, keep carbohydrate-based foods such as bread and crackers readily available during and after exercise just in case.
Hyperglycemia
Intense training tends to raise blood sugar and lead to high blood glucose, or hyperglycemia. Although this is generally not a concern for type 2 diabetes, ACSM urges caution and adequate hydration when exercising with a blood glucose level higher than 300 mg/dl. You should avoid physical activity if you have ketosis with a fasting glucose level of more than 250 mg/dl.
Proteins and Fats
ACSM recommends 1.2 to 1.7 grams of proteins per kilogram of body weight for people who are engaged in aerobic and resistance training. In addition, fat should constitute 20 to 35 percent of daily calories. Because of the increased risk of stroke and cardiovascular complications, diabetic patients should consume less saturated fats as found in red meat and butter, and substitute with healthy unsaturated fats such as fish oil and plant oils. If you have kidney disease, you may need to cut down on your protein intake. Check with your health care providers for the appropriate daily protein intake for you.
References
- The American College of Sports Medicine Position Statements; Nutrition and Athletic Performance; March 2009
- The American College of Sports Medicine Position Statements; Exercise and Type 2 Diabetes; December 2010
- The International Society of Sports Nutrition; ISSN Exercise & Sport Nutrition Review: Research & Recommendations; February 2010
- American Diabetes Association; Physical Activity/Exercise and Diabetes; January 2004
