Diabetes and Exercise
Twelve Tips for Athletes

Follow these twelve tips to manage your diabetes and exercise.

By Nancy Clark, MS, RD, CSSD

1. Exercise is a cornerstone for managing diabetes. You need to learn your body's unique response to exercise by monitoring your blood glucose level, insulin dosage, what and how much food you ate, and type and intensity of exercise for 1-2 months to achieve a sense of predictability.
   
   General guidelines cannot replace intelligent self-observation.



2. Exercise regularly, preferably at the same time each day when your insulin is not peaking. A consistent exercise schedule is very important for good blood glucose control. Be sure to test your blood glucose before and after you exercise to learn how exercise affects your glucose level.


3. Always exercise after eating, when your blood glucose is on the rise. One hour after a meal is a good time; that is when your blood glucose is the highest. Do not start to exercise with low blood glucose. Eat a snack first.


4. Exercise with someone else. This person should know you have diabetes, and know the signs of hypoglycemia (confusion, weakness, excessive sweating, trembling, double vision). If your blood glucose should drop, you might stagger and fall; you want your partner to know what is happening.
   
   Sometimes people with diabetes get mistaken for alcoholics. Also be sure your partner knows what to do in an emergency.


5. Always carry sugar in some form with you. (Glucose tablets and hard candies are popular because they are not messy.) Also carry a cell phone and money for a snack.


6. To best determine your food and insulin needs, monitor your blood glucose under varying conditions: for instance, compare training sessions and competitions, or morning vs. afternoon workouts. You should also redetermine your food and insulin needs when the weather changes from hot to cold.



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7. If you are going to participate in a one-shot bout of high activity (such as an unplanned run or speed session), you should eat some food beforehand and you may want to reduce your insulin. Through experience, you'll learn about your body and what food and insulin strategy works best for you.


8. As an athlete with diabetes, you have an impaired ability to store and mobilize carbohydrates in the right amounts at the right times. Hence, if you are an endurance runner, you should not try to "carbohydrate-load." Rather, plan to eat extra calories during exercise longer than 60-90 minutes.


9. During long-term exercise plan to constantly replace glucose supplies. During a marathon or a long run, you'll want sports drinks or snacks along the route.
   
   Target 240 calories (60 gm carb) per hour. Experiment with different foods (juice, gels, raisins, hard candy, bread) to determine the type and amount of food that settles well and enhances your performance.


10. On a long day trip, such as ultra running, hiking or cycling, eat at least six small meals containing both carbohydrate and protein. Be over prepared with emergency food in case you get unexpectedly delayed. Either bring plenty of extra food for everyone, or explain to your friends beforehand why you are unwilling to share the food.


11. Drink plenty of fluids before and during exercise to prevent dehydration. If your urine is a dark color and a small volume, you are dehydrated and need more fluid. Carry a water bottle with you to easily enhance your fluid intake.


12. Because exercise has a lingering effect, you should eat more than usual after you stop exercising. Otherwise, you may experience hypoglycemia that night or even the next day.

Copyright: Nancy Clark, MS, RD, CSSD
Nancy Clark's Sports Nutrition Guidebook (2008), Food Guide for New Runners and Food Guide for Marathoners are available at her website.

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