Debate at the ADA: Should Athletes with Diabetes Go Low-Carb, or High-Carb?

By Maria Muccioli and Ross Wollen

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Do you need carbohydrates to optimize athletic performance? Or can athletes with diabetes do even better when they fuel their bodies with protein and fat?

By now it’s clear that the low-carb approach to diabetes has largely gained clinical acceptance, for people with both type 2 and type 1 diabetes (T1D). But some questions remain about when carbohydrate restriction is and isn’t appropriate.

One of those big questions: athletics. It’s long been conventional wisdom that athletes – whether elite professionals or weekend warriors – absolutely need carbs to fuel performance. But when you’ve got diabetes, “carb loading” the night before a big race is a tricky proposition.

At this year’s ADA Scientific Sessions, two experts went head-to-head in a debate on “Carbohydrate Intake and Its Impact on Athletics and Health.”

Read on to hear what happened – and who, in our opinion, won the debate.

The Case for a High-Carb Diet

In his presentation titled “High/Normal Carbohydrate Intake Optimizes Performance and Glycemia,” James P. Morton, PhD argued in favor of a normal-to-high carbohydrate approach for athletic performance and blood glucose management. Morton is a professor of exercise metabolism at Liverpool John Moores University.

Morton focused his talk on the importance of fueling high-energy expenditure for elite athletes, such as those on multi-week bicycle races. He presented some data showing that people who consumed a high-carb load were able to exercise for longer periods of time than those who consumed a placebo solution. Morton pointed out that for professionals, even tiny differences can make the difference between victory and defeat.

As an example, Morton presented a case study of Tour de France winner Chris Froome. In 2018, Froome made a very dramatic comeback on the 19th day of a multi-week cycling race. He ate an incredible amount of carbohydrates that day and the day previous, which Morton believes contributed significantly to his victory.

How do carbs fuel performance? The primary explanation centers around the availability of glycogen (branched glucose molecules) in the liver and muscle. The higher the glycogen levels, the more glucose is readily available to power activity.  Morton also presented evidence that those who eat high-carb delay the point at which they begin burning fat for energy, and claimed that delaying this crossover point was important for top performance in endurance athletes.

In addition, Morton cited personal testimonies from some elite endurance athletes, such as audio of interviews from his podcast, claiming that support of high-carb for athletic performance is “unanimous.”

Unfortunately, little of this presentation had much to do with the unique challenges of athletes with diabetes. And for that matter, its focus on truly elite professionals may be of limited relevance to even the most avid part-time athletes. Morton has never worked directly with athletes with type 1 diabetes, but referred to the opinions of his “friend and colleague” Sam Scott, PhD, a researcher at Novo Nordisk. Scott has plenty of firsthand experience with high-performing diabetic athletes: he works with Novo Nordisk’s inspiring all-diabetes pro cycling team.

Morton invited the audience to read Scott’s recent publication concerning type 1 diabetes, carbohydrate intake, and athletic performance. In that paper, Scott concludes that low-carb diets “represent an effective strategy to improve glycaemic control and metabolic health in people with T1D,” but that their effect on athletic performance is basically unknown:

Despite low carbohydrate training being one of the most widely debated topics amongst athletes, coaches and sport scientists, there is very little published research specific to athletes with T1D.

Some evidence suggests that people with type 1 diabetes might especially benefit from “train low” strategies – basically, limiting carbohydrate intake during regular training, and increasing carb consumption for competitions. Beyond that, however, there simply isn’t enough evidence to make concrete claims.

Leaning on his experience with non-diabetic athletes, Morton concluded:

Regardless of whether you have normal glycemic responses or you have type 1 diabetes, the principle of ensuring high carbohydrate availability should always be upheld, because carbohydrate will certainly make you go faster.

The Case for a Low-Carb Diet

In his presentation titled “Low Carbohydrate Intake Optimizes Performance and Glycemia”, Dominic D’Agostino, PhD argued that because low-carbohydrate diets are optimal for blood glucose control, they are therefore also optimal for athletic performance.

D’Agostino, a molecular pharmacologist, is something of a minor rock star in the keto community. He’s a frequent guest on podcasts and Youtube shows, and has a fair personal understanding of keto athletic achievement: he’s an impressive powerlifter to boot.

D’Agostino started by acknowledging that we do not really know the best level of carb intake for athletes. But in his telling, practices even among the elite are far from unanimous, with athletes experimenting with a variety of strategies, ranging broadly from carb restriction to carb loading.

Many athletes choose a low-carb diet because they like the way that it feels – some claim, for example, that keto results in more consistent energy throughout competition, making them much less likely to “bonk” or hit the wall. But for people with diabetes, the primary point in favor of a low-carb diet is the degree to which it optimizes glucose control.

A very low-carb or ketogenic diet doesn’t just steady blood sugar – it also appears to result in some measure of “hypoglycemic resilience”. This isn’t a small matter for diabetic athletes. Hypoglycemia during exercise or competition won’t just ruin athletic performance: it can be very dangerous.

Not only does ketosis protect against hypoglycemia, he explained, but recent research also shows additional benefits of ketosis, such as reduction of oxidative stress. D’Agostino also noted that increased fat utilization can lead to “glycogen sparing”, and that a low-carb diet does not cause glycogen depletion in the muscle. These features may confer additional athletic advantages.

Photo by Adobe Stock

While Morton’s presentation was largely founded on the assumption that athletes with diabetes are fundamentally like athletes without diabetes, D’Agostino emphasized a different principle:

Normal glycemia is optimal for health, performance and recovery.

Of course, normal blood glucose levels are very difficult to achieve for people with type 1 diabetes, especially during exercise. But the low-carb diet has been validated as perhaps the best method of doing so.

D’Agostino explained that his own thoughts on the subject were formed partially by the experience of his former Ph.D. student, Andrew Koutnik, who lives with type 1 diabetes. Initially, D’Agostino believed that type 1 diabetes was “the one condition that I thought you would want to stay away from low-carbohydrate nutrition,” but Koutnik’s success first convinced him otherwise.

I reached out to Koutnik, now a research scientist at Florida Institute for Human and Machine Cognition.

He stressed that most studies comparing high- and low-carb athletic results show mixed or neutral results; when there is a difference, the difference “is often of little meaningful impact to most individuals engaging in physical activity.”

Dr. Koutnik argues that any nutritional program that doesn’t consider glycemic control is missing the most important factor: “Very few will debate that poor health leads to poor performance. Additionally, few will debate that normoglycemia is likely to lead to better performance than hyper- or hypoglycemia.” Therefore, for the T1D athlete, performance is a “consequence” of health.

Who Won the Debate?

Here are our thoughts:

At a diabetes conference, the focus should remain on diabetes. Although Morton presented some evidence to support the performance benefits of high-carbohydrate intake in elite athletes without diabetes, it’s a mistake to assume that the same benefits would occur in athletes with diabetes, or that they wouldn’t be counterbalanced by the known downsides of high-carb consumption. Glycemic management is a huge issue during exercise, and both low and high blood sugars can have dramatic effects on performance.

exercise woman

Photo by Andrew Tanglao (Unsplash)

Most of Morton’s talk also focused on elite endurance athletes. But what we learn from the best athletes on the planet may not be very useful for the rest of us.

In our opinion, D’Agostino showed a better understanding of the balancing act that athletes with diabetes (especially type 1 diabetes) need to perform.

Even if we accept that carb loading can provide a perceptible boost to serious athletes, we have to acknowledge that those carbs (and any accompanying insulin) also make it more likely for the athlete to experience hypo- or hyperglycemia, which can instantly ruin any sports outing. And the more predictable and stable your blood sugar, the more confident you can be, and the less mental space you’ll have to waste on monitoring and micromanaging glycemic changes. And if a ketogenic diet really does provide some protection against hypoglycemia, that’s just even more reason to choose a very low carb diet.

If you’re actually an elite athlete, maybe carbohydrates can help push you to the peak of performance. But maybe not – the scientific evidence is not overwhelming. For the rest of us, blood sugar control remains of paramount importance. It seems to me that a low-carbohydrate diet is more likely to deliver confident performances and strong athletic results.

What are your thoughts on this debate?

Source: diabetesdaily.com

Two Brothers Take Control of Their Type 2

Peter and Johnny are brothers and good friends of mine, we were lucky enough to meet through our sons. They both have type 2 diabetes, just like their dad did. Just recently, they promised each other to begin taking their health seriously – and the changes they’ve made have been inspiring. I want to share their story.

Peter was diagnosed with type 2 eight years ago, right before I was diagnosed with type 1. Over the years, Peter and I have spoken a lot about our diabetes, and it has been so nice to share information and experiences with someone who “gets it.” I remember one time, we were all at a dinner party, and my continuous glucose meter was reading 49 with an arrow down. Peter understood the severity when most wouldn’t have, and quickly ran to the waiter to get me a coke. It has been nice to have someone to talk blood sugars with, but it became bittersweet when Peter’s brother Johnny was dealt the same fate of a type 2 diagnosis.

I thought it would be great to hear from Peter about his journey and how he started to take it seriously and commit to his health. I also spoke to Johnny about his surprising diagnosis, and how he quickly took action and control of his type 2. These brothers helped motivate and encourage each other, and now both can reap the rewards of their efforts.

Peter, Allison and Johnny celebrate taking control of their diabetes and their health.

Thank you so much for taking the to speak with me today. I thought many of our readers would love to hear how you both have taken care of your health thanks to your type 2 diagnosis. Making lifestyle changes isn’t always easy, but it is well worth the journey. And what a bonus to have your brother right by your side!

It is my understanding that your father had type 2 and eventually became insulin-dependent. Did you understand a lot about the disease growing up? 

Peter: Yes, we were six kids growing up, and my brother Johnny and sister Roula would give my dad his insulin shots 2x a day. They did not come mixed back then, so we had to mix the two vials (N&R) together to give his shot.

Did your father take care of his health? 

Johnny: No, he was first diagnosed at 37 but never took care of his health or made any lifestyle changes until later in life. Unfortunately, because of this, he had a toe amputated because of low circulation. It also affected his vision. He had multiple surgeries for this, and it ultimately lead to heart disease and heart failure. We lost him on his birthday at 71.

Knowing your family history, did you pay close attention to your diet and exercise habits? 

Peter: No, I thought I was invincible and that this disease would not affect me.

At what age were you diagnosed with type 2, and what were the symptoms? 

Peter: I was diagnosed at the age of 37. I really did not have any symptoms, but I had gone for a regular checkup and my blood levels were off the charts, and my doctor sent me to a specialist. The specialist put me on medication, but I was not taking the pills as prescribed, as I felt fine and didn’t want to take any medicine. I was not testing my blood sugar at that time.

How did you manage at first, and what lifestyle changes have you made since? 

Peter: I was in total denial and really did not change anything about how I was eating or going through my day-to-day life. Once I turned 45 and understood the severity and saw how much my blood sugar was rising, I made significant lifestyle changes. I started eating healthier, more vegetables (finally eating greens!), switched my alcohol choices (low-carb beer and lower sugar drinks). I started going to the gym prior to Covid, and then turned to walking.

I understand that recently you started to monitor your blood sugar more frequently and even tried out the Freestyle Libre. What was your experience with the Libre? Did you like being able to monitor your blood sugar all the time?  

Peter: I didn’t believe it! When I saw the numbers I thought they were wrong. I did like the ability to see how what I ate affected my blood sugar immediately, but I was not ready for the Libre until I took control of my lifestyle and lost weight, the full journey to get to where I am now. I feel like it would be better for me now, as it is extremely easy.

controlling type 2 diabetes

Peter before his weight loss

Please tell us about your brother, Johnny, and his surprising diagnosis. 

Peter: My brother happened to come over to my house when I was taking my blood sugar prior to my making healthier lifestyle changes and choices. My numbers were in the mid 200’s, and I thought my glucose meter was broken. My brother said, “Take mine so we can see how it’s working.” His numbers came over double mine at 468 [mg/dL]. We definitely thought the machine was broken until my sister-in-law took her blood sugar (with no history of diabetes in her family). She was at 90. At that point, we knew the numbers were correct, and we both knew that this was the defining moment of the rest of our lives.

What was your initial reaction to this pretty shocking news?  

Johnny: I was in total disbelief – I felt like I was going to die and really took a long, hard look at the life that I wanted and made a lot of decisions on how I needed to make some dramatic life changes.

Had you had any symptoms? 

Johnny: I felt completely fine, however, my wife always said that when I didn’t eat I would be very HANGRY. Snickers commercials had nothing on me, and truthfully when my numbers get too low now, I feel exactly the same. It is something I need to continue to control, to level out my sugar levels.

What were some of the first things you did to better get control of your health and your blood sugars?  

Johnny: I immediately stopped eating all processed carbs. No bread, rice, pasta, beer, sugar, desserts, and milk. I replaced these items with Ezekiel bread, zucchini linguini, almond milk, sugar-free coffee sweetener, and condiments (sugar-free ketchup and BBQ sauce).

Johnny before and after choosing to live a healthy lifestyle.

I know you have both come a long way since you found out you had type 2 diabetes. Can you each tell us a little about your successes? 

Johnny: I was 238 lbs before my diagnosis. By changing my eating habits, exercising every day, walking 2 miles, and working out, I now weigh 194 lbs. I’ve lost two pant sizes and feel like a new person, one that will be around for my family for a long time. And my wife says I’m super sexy now.

Peter: I was 232 lbs when I was first diagnosed, and with all of the changes in my everyday lifestyle, I now weigh 186. I feel like a million dollars and realize I should have made these changes years ago. Life is too short. Make the changes now.

You both should be very proud of yourselves for turning this diagnosis into a stepping stone towards a healthier life. What would be your advice to a newly diagnosed person?  

Peter: Control it now, before it gets out of control.

Johnny: Take it seriously as this life is precious and life is worth living without complications – it only gets worse as you get older. The best part, I feel like I’m 18 again!

Thank you again for taking the time to answer my questions. I am truly impressed with how you both taken on this disease. I know your story will inspire many of our readers!

Source: diabetesdaily.com

Diabetes Self-Care: How I Got Into and Out of a Bad Habit

By Julie Hyland

I was diagnosed with type 1 diabetes in July 2013 at the age of 37. I lost a lot of weight, mostly muscle. Looking back at pics, I looked so sickly but I had so much going on at that time I didn’t notice. I was moving to another state, my father passed away and my son was also moving to a different state, all within a two-month period.

After getting diagnosed, I had a very strong mindset that I wasn’t going to let this disease control me, and I was going to show the world I could do even more now with type 1 than I could do before. I have always worked out and watched what I ate, so I was ready to kick diabetes butt. Well, I gained my muscle and weight back and kept that mindset for about 5 years.

Left: Right after I got diagnosed when I lost all my muscle | Right: After I worked to get my muscle back

Then, I let it get to me. The feeling like I suck when my sugars were high. The fear when my sugars went low. The fear of going to bed and dropping low. The constant stressing and worrying about what to eat, what to drink and what to dose. The anger when I would attempt to work out and drop low. The feeling of being stupid because you can’t figure out this disease. So I stopped working out, and I started eating whatever I felt like. But most of all, I drank.

I have always loved alcohol. It was my best friend. It got me through sad times, happy times, stressed times, anxiety, fear. It was my life. It was there for me…so I thought. I began to drink so much, I now know it was a way of numbing my hatred for this disease. The same disease I said I wouldn’t let affect me. If I was drunk or drinking, I was able to ignore a million thoughts of this disease. This disease I got like winning a bad luck lottery.

Because I was always drinking, I stopped noticing how I looked. I mean, I noticed my clothes not fitting and how I looked in the mirror. But because I would just numb myself more, I was able to overlook it. All it took was one video I saw of me getting out of the pool. I couldn’t believe how I looked. I also started doing yoga at that time and I was in my house thank God, but in one of the positions, I had to lift my stomach up in order to do it…what the h*ll?! Never in my life had I experienced anything like this.

How I looked in May 2020

That day was May 18, 2020. I decided that day I was done drinking and punishing myself for something I had no control over. I quit drinking. I started walking. I got a treadmill and a weight rack, bench and weights. I started working out and eating better.

Because I wasn’t drunk and hungover all the time, I felt great and it began to change how I looked at everything. The scale doesn’t show a huge amount of weight loss, but I’ve lost so far 7 inches off of my stomach. I have gone from a size 12 jeans to a size 6. I have started running and I love it. I dabbled in running about 15 years ago but never could run for long distances and always felt like death. When I started in July 2020 I couldn’t run for even 15 seconds. I can now run 3 miles and not feel like death. I will be running my first 5k at the end of May, which is also my one-year of sobriety month. I am nowhere near where I want to be but I’m so happy and proud of what I’ve accomplished so far. After my 5k, I want to do a 10k and then a half-marathon and so on.

April 2021

If I have any advice about this disease it’s “don’t be so hard on yourself”.

I also wish there would be more information out there about adults getting type 1 and more people talking about it. When I first got diagnosed there was barely any information about adults getting diagnosed. I started a YouTube channel in hopes to help other adults and it’s also a good way for me to get all my worries, stresses and journey out to everyone. I stopped making videos when I was in my funk, but I’ve started back up now. Documenting my sobriety and my running journey and how it all affects my blood sugar. If you are interested and want to follow me along in my progress. You can subscribe on YouTube at imtype.01.

Source: diabetesdaily.com

Losing Body Fat with Type 1 Diabetes The “Right” Way

Within 5 minutes of reading any diabetes blog or perusing through any Diabetes Facebook group, you will probably find more biased, scientifically unsupported diet advice than a poorly thought out midnight infomercial.

“Keto is best!”

“No, plant-based is best!”

“Wrong, apple cider vinegar and intermittent dieting is best!”

With so many opinions and biases, how, as people with type 1 diabetes, can we decide on the “right” diet?

Let’s get this out of the way quickly—there is no one golden way of easy results for everyone. Why? Because everyone is different with different goals and value sets and needs to achieve their individualized quality of life.

So when you are searching for the “right” way, just make sure that you are considering what is right for you in the sense of being able to adhere to it for a long period of time, making sure that it doesn’t make you miserable, and assessing the effectiveness toward your goals. The right way will accomplish those three things for you as long as you continue to put in the work.

The “Right” Blood Sugars

As people with diabetes, we can probably all agree that there are effective and ineffective blood sugars. We can’t be hypoglycemic before an activity as that will likely put us in danger and being hyperglycemic can reduce performance, affect function, and become dangerous as well. So, when it comes to fat loss, is there a “right” blood sugar?

Yes and no.

Of the hundreds of people with diabetes I’ve helped to lose thousands of pounds total, blood sugar management comes first.

If you are chasing blood sugars constantly, your diet will reflect that and your training will likely suffer, resulting in a negative cascading effect, leading away from progress.

I’ve found that we can tend to brush off the importance of getting better with our blood sugars (I’m also talking to myself here), because we want to lose fat and show people how hard dieting is, and prove our dedication to other people. But by skipping blood sugar management, we essentially toss all our hard work into the wind and hope for the best.

If you truly want to progress your physique and performance, you have to start asking the right questions:

  • How is this activity going to impact my insulin sensitivity?
  • Am I checking my sugar enough, especially when I start a new diet or exercise program?
  • Am I taking into account how much insulin on board I have before I exercise?
  • Am I talking with my diabetes management team to make sure that my insulin needs are adjusted with my diet and activity levels?

When things change, things need to change yet we tend to fall into the same rut of diabetes management.

Make sure you take into account your new level of intensity and duration and exercise as well as your caloric intake and specific nutrient intake to make sure that your insulin needs are optimized toward the new stimulus you are giving your body by starting a new exercise or diet program.

Here is a chart from JDRF PEAK showing the different blood sugar trends around varying types of exercise. This can help you plan your management accordingly.

Image credit: JDRF

The “Right” Nutrition Plan

All successful diets in terms of fat loss share one pivotal concept—burning more calories than you consume. For you to optimally lose body fat, you have to be in a calorie deficit regardless of whether you are eating keto, vegan, Whole30, or the “broke college kid diet”. It’s not opinion either, it is just the law of thermodynamics.

In abundance, you gain. In deficit, you lose.

So, the right nutrition plan puts you in a moderate caloric deficit where you aren’t starving or medically unsafe but you are also not eating enough to maintain your current weight (after all, what would be the point of that?).

Now, the right plan also has to account for adherence and not making you miserable.

If you truly enjoy carbs and you can manage your sugars well on a moderate- or high-carb diet while still in a caloric deficit, most likely a keto diet will make you miserable and will not be the right fit for you. While both a high-carb diet and a keto diet could be equally effective at losing body fat when equated for calories, we also must consider the real-life implications of quality of life during dieting.

The right diet is something that you can adhere to while also managing your blood sugars and at the same time putting you in a moderate caloric deficit so that you can continue to progress.

You can individualize your nutrition so that you can adhere to whatever kind of eating preferences you like, as long as you can maintain your blood sugars simultaneously.

Some people prefer low-carb, so that it minimizes blood sugar fluctuations.

Some people prefer high-carb and can still manage blood sugar fluctuations.

Regardless of what you choose, the fact remains that you have to stick with it consistently and you have to follow the rules above.

The “Right” Workouts

Personally, I love lifting heavy weights. Also personally, I hate when a coach tells a client that they have to work out the same way that they do.

There are many successful ways I have helped people with diabetes incorporate new workout programs:

  • Walking and progressing to walking with weights
  • Sprinting and high-intensity interval training (HIIT) workouts
  • Bodyweight and resistance band training
  • Water aerobics
  • Olympic weight lifting and bodybuilding
  • Walking your dog and doing 10 Squats every 5 minutes during that walk
  • Working out does not have to mean going to a gym. You can work out exactly where you are, even if you’re in an office just by standing up and sitting down a few times, despite maybe looking a little awkward.

There are three aspects of working out that are considered important and I try to encourage every person to incorporate each of these aspects into their program to have a more well-rounded approach:

  • Resistance training (added weight or bodyweight exercise)
  • Cardiorespiratory training (walking, jogging)
  • Flexibility (stretching yoga, etc.)

So whether you go to the gym and lift weights, or pick up a gallon of water and press it over your head, walk your dog every day and finish up with some stretching, if you use these three concepts and incorporate movements or activities that you like, you’ll find yourself doing the “right” workouts.

Now, extremely successful workouts involve a concept called progressive overload— that simply means that whatever you’re doing will eventually stop working if you keep doing the same thing over and over without any change or progression.

So my advice? Progress. If you walk 20 minutes every day maybe next week walk 25 minutes one of those days or even add five minutes to every day. If you constantly do the same exercises maybe change up the exercise or add weight or change how many repetitions that you do.

Change requires change.

Progression requires progression.

FitMeT1D Challenge

A Free Solution That Might Be Just “Right”

Over the last four years, I have worked with hundreds of people with diabetes and I found a creative way to build a community for free of just people with type 1 diabetes all working together towards a four-week fitness challenge called the Fit Me T1D challenge.

I provide our hundreds of members a modifiable exercise plan with an easily individualized and adaptable nutrition guide as well as a bunch of extremely helpful tips and tricks around diabetes management.

All of this happens in a private Facebook group and your fellow T1D members help you every step of the way.

It’s fun.

It’s challenging.

And hey—it’s free.

I feel like it’s my duty to give back to my fellow type 1s so if you’re interested in joining, we have our next challenge starting March 22nd. Feel free to sign up for free on FitMeT1D (more info at the link as well).

Source: diabetesdaily.com

Easy At-Home Gym Hacks

We are nearly a year into the pandemic, which has all but frozen life as we used to know it. It has required a shift in thinking, and a transition to doing most everything at home: work, school, and even exercise. Most gyms across the country are either still closed or operating at extremely limited capacity, and many people feel more comfortable working out from the comfort of their own homes until herd immunity is achieved in the United States.

But how can you get a good, full-body workout at home, when time, space, and equipment is limited? These are our top tips.

Keep a Routine

The best workout is the one you’ll do consistently, and that means making your exercise time routine. It should be no different than when you would typically go to a physical gym: exercise should happen during the same time and in the same place every day.

This also helps create boundaries with work and family. If you go to the garage every morning at 6 a.m. for dedicated “gym” time, the kids will soon learn that you’re not available to play then. Alternatively, if you block out 20 minutes at noon every day for a run on your Outlook calendar, your boss is much less likely to schedule impromptu meetings during that time.

Also, it’s important to know yourself. If you’re a morning person and start to fade around dinnertime, don’t wait to get your exercise in after the kids go to sleep. By prioritizing your exercise time and making it routine, you’re guaranteed to make it a habit that will stick.

Set Yourself Up for Success

Adjusting to home workouts does not need to be complicated. You can start small with Youtube yoga and dance videos, high-intensity interval training (HIIT) workouts, and even meditation to deal with stress. Listening to Spotify or Pandora while working out can help bring fresh music to your routine, too.

Accumulating some at-home gym equipment can also keep you stimulated and less likely to become bored.

Michelle, from Madison, Wisconsin, says that she uses the Nike training app religiously, as it helps prevent ennui and always mixes up workouts. The app comes with multi-week programs, including a prescribed series of workouts, nutrition tips, and wellness guidance to help users build healthy habits. Each flexible program is led by a Nike Master Trainer and is created to cater to those working out at home.

Additionally, Michelle recommends Bowflex adjustable dumbbells, which replace 15 sets of weights! The weights adjust from 5 up to 52.5 lbs each. By easily turning the dial you can change the resistance, enabling you to gradually increase your strength.

Ryan, from Albany, New York, uses the Bowflex C6 bike in combination with the Peloton app (which is just $15 per month!). The bike has 100 levels of resistance, just like the Peloton bike, but is half the cost, so you can follow along to Peloton workouts while saving a ton of money.

If you’re not into collecting a ton of equipment but want to build strength and get your heart rate up, simply investing in a kettlebell and a jump rope can be all you need to take squats and lunges to the next level.

If you don’t want to buy all new equipment for your home, see if you can crowdsource some from friends and family. Pool resources together, and share weights, a rack, a bicycle, treadmill, or other equipment, to make assembling an at-home gym more affordable.

Jennifer, from Des Moines, Iowa, says, “My sister lives across town and has a great treadmill in her garage. She works the night shift and I work during the day, so will pop on over to her house to get a run in on cold mornings while she’s still at work. It works perfectly.”

Some people have even had luck renting equipment or even borrowing equipment from their gyms while they are closed due to COVID-19 restrictions. Jessica, from Boulder, Colorado, says. “I emailed my local rec center, and they’ve let me borrow some heavier kettlebells that would have been prohibitively expensive to buy. They let members borrow equipment for 72 hours, which works perfectly to spice up my workout routines.”

exercise accountability buddy

Photo credit: iStock

Find an Accountability Buddy

No one is inspired to exercise all the time. Having a friend or family member checking in with you to make sure you’re meeting your fitness goals can be a crucial nudge to help you stick to your routine. Perhaps you have a weekly check-in call with a friend every Friday to review what you did to get your heart pumping, or you email different workout plans to each other every week to stay motivated.

If you feel safe enough to do so, maybe you meet someone for a walk each weekend, to get fresh air and a change of scenery. Whatever you do, it should help you stay motivated, not hinder your progress.

Even if your accountability buddy isn’t actively trying to improve their fitness or lose weight, they could benefit too: a recent study showed that when 130 couples were tracked over six months, the accountability buddy not actively trying to lose weight had success in some weight loss too, if their partner was on an exercise plan.

Make It Fun!

In this strange time, it’s important to make exercise fun. Have goals and work hard to meet them, but make sure to celebrate your progress, too. Maybe you’re trying to deadlift 150 lbs, lower your HbA1c, do twenty weighted lunges in a row, or run a faster mile.

If and when you meet those goals, celebrate them! This may look different in 2021, but ordering takeaway coffee from a favorite coffee shop, ordering your favorite candle online, or buying a new swimsuit are all well-deserved awards for hard work put in at home.

Working out at home does not need to be boring or uninspired. With these tips, you can keep your fitness levels high, stay motivated, save money, and get healthier, even during the quarantine. Remember to always check with your doctor before starting a new exercise routine.

Have you been working out at home during the pandemic? How is it going for you? What strategies or advice would you give others? Share this post and comment below!

Source: diabetesdaily.com

5 Ways to Make Time for Exercise

Prioritizing yourself isn’t easy. Whether your busy taking care of kids, an elderly parent, hustling at your job, or just life in general, it is sometimes hard to remember to take of yourself. This means getting adequate sleep, checking your blood sugar regularly, eating a proper diet and getting in physical activity. All of which can also help you better manage your diabetes and overall health. But finding the time is not an easy feat.

Here are 5 ways you can make the time for exercise:

Make an Appointment

Just like you schedule meetings, lunch dates, and family functions, your hour of exercise deserves a daily slot too. Once it is on your schedule, you can plan other commitments accordingly, and prioritize your health.

Meal Prep

Many people spend a great deal of time preparing meals for themselves and their families. This can really eat up a good chunk of your free time. Think ahead and meal prep. You can easily prepare an entire week’s worth of meals in just a few hours, freeing up enough time each day to get yourself moving!

Work Within Your Confinements

Making time is easier said than done. And many people work long hours, two jobs, and have other responsibilities that do not afford a lot of free time. Get creative. There are things you can do, some like calisthenics throughout the day to keep your blood flowing. You can also look to invest in a desk bike or an under the desk elliptical. These gems are a worthy investment if you are unable to find time to go to a gym. It will allow you to work and work out at the same time!

Find a Workout Buddy

Staying accountable is a key to success, so having someone there to push you can only help you to achieve your goals. You would be more likely to take a long stroll at 6 am with some good conversation rather than go at it alone. Reach out to friends and see if they’d be interested, I bet you’d be surprised at the response!

Think Big Picture

We are often thinking of others before ourselves, which shows we care. We mustn’t forget the importance of making our health a priority, so we can be around for our loved ones for a long time to come. If you are bogged down with work or consumed with other things, remember health is wealth, and that must come first!

Putting ourselves first isn’t something we easily do, but it is important for our long-term health. A little bit of physical activity can go a long way in managing your diabetes and your overall health!

Have you found time for exercise despite being too busy? What motivates you on a day-to-day basis?

Source: diabetesdaily.com

Mandy Marquardt: Redefining Diabetes Through Racing

Mandy Marquardt is a Track Cyclist for the USA Cycling National Team and Team Novo Nordisk, the world’s first all-diabetes professional cycling team. Their mission is to inspire, educate and empower everyone affected by diabetes. Mandy has been part of the team since 2010 and believes what the team does really makes a difference to the people in our community – racing and inspiring everyone around the world affected by diabetes is something that brings her great joy.

Thank you so much Mandy for taking the time to answer our questions! We know you are an inspiration to many and would love to share your story!

At what age were you diagnosed with type 1 diabetes?

I was diagnosed with type 1 diabetes at the age of 16 while racing and living in Mannheim, Germany with my father.

What were your symptoms?

I surprisingly didn’t have any symptoms that I was aware of and the diagnosis was a shock. There were signs now that I look back at what I thought were some odd incidents. For example, I would take forever to warm up and felt this overwhelming feeling of exhaustion and tiredness frequently. I thought it could have been from the stress of school and training hard.

Along with my type 1 diagnosis, I shortly after found out I have hypothyroidism too, so having that all discovered and learning to get it under control was such a good feeling.

Being diagnosed as a child is hard, how did you handle your diagnosis? Were you quiet about it or were you vocal and welcomed the opportunity to educate?

When I was first diagnosed, I didn’t know anyone else living with type 1 diabetes. While hospitalized for two weeks, a doctor told me I would never be able to compete at a high level again in the sport of cycling. I was heartbroken, but my parents were my biggest supporters, and helped me get back on the bike. I always knew it was my happy place. I started riding again, and just training for fun and told myself, we’ll see what happens.

Joining Team Novo Nordisk in 2010, racing amongst other athletes with type 1 diabetes and learning how to talk about my diagnosis gave me hope.

At what point in your life did you get active with fitness and more specifically, cycling?

I was born in Mannheim, Germany and moved to South Florida at the age of 6. My parents got me involved with the local swim team and I started playing tennis. I picked up running and was interested in competing in triathlons. In 2002 at the age of 10, my dad came across The Brian Piccolo Velodrome, which was a short drive from our home and was a safe place to learn to ride competitively. A year later, my parents and I drove to Texas to compete in the 2003 U.S. Junior Women’s 10-12 Road National Championships and I won two gold medals in the criterium and time trial and a silver in the road race – I was hooked.

I continued to race both the road and track discipline for years. My success on the track has currently led to 18 U.S. National titles and 3 American National Records (records all with type 1 diabetes).

Photo credit: Team Novo Nordisk

At what point did you decide to do it professionally?

After I graduated from the Pennsylvania State University – Penn State Lehigh Valley commonwealth campus in the Spring of 2014, I was invited to a USA Cycling camp that fall.

Afterwards I was invited to go represent the United States at my first UCI Track World Cup in Guadalajara, Mexico. I was so terrified to compete at that level, but now, six years later, I’m right up there with the world’s best, ranked 12th in UCI World Sprint ranking and one step closer to hopefully competing at my first Olympic Games. It’s been a slow and steady process, but if diabetes has taught me anything, it is consistency, patience and resilience.

In June of 2020, I was honored that USA Cycling named me as a member of the Long Team for Women’s Track Cycling. The final selection will be made next year, since the Tokyo Games have been rescheduled for July 23-August 8, 2021.

Did type 1 diabetes ever come in the way of your training or races?

Oh absolutely. It can be a challenge at times and the race doesn’t pause for me. Training and racing at this level, I’ve conditioned and adapted my body to handle the stress and workload, but occasionally the body will do what it wants. Of course, sometimes, it’s still frustrating when my blood sugars aren’t cooperating, like [when]  training and competing at altitude, going through different periods of my training cycle, juggling time zones and everything life throws at me.

I work closely with a sports psychologist and my team’s diabetes educator. Through a lot of trial and error, I’ve found what routine and nutritional habits work best for me and I’m still always learning and improving.

What do you use to help you manage your diabetes? Do you use a pump or do you prefer injections? Do you use a continuous glucose monitor (CGM) to help you monitor your blood sugar levels?

I use a continuous glucose monitor and take injections. It’s helpful to have real-time data around training, racing and traveling to better my diabetes management and performance – getting the most out of my training and recovery. Plus, I want to live a long healthy life, without complications!

Photo credit: Team Novo Nordisk

Photo credit: Team Novo Nordisk

What do you recommend to other athletes when it comes to managing your blood sugars during this type of activity?

Whether competing at a high level or just going out to exercise, always be prepared. I love my snacks! My favorites are the Honey Stinger waffles, performance chews, and protein snack bars! It’s important to be mindful about nutrition and fueling, and incorporating more protein, and eating consistently through the day. Most importantly, be patient and seek resources. My team, Team Novo Nordisk has many great resources and tips on their website too!

I know you are very active within the community, what are some of the things you’ve been up to lately?

I love my cycling career, but I think it’s important to have a balance between my personal and professional life. I recently partnered with Mammoth Creameries, a yummy keto-friendly ice cream founded by Tim Krauss, who is living with type 1 diabetes – it’s a pretty sweet partnership!

I also recently launched my logo and merchandise. The diabetes community has always been inspiring and supportive. I feel that my logo really puts my journey and the connection with the diabetes community in perspective. The blue circle is the global symbol for diabetes – that we are all connected in a special way and my initials subtly share a story that we are all greater than our highs and lows. For my merchandise highlighted with my logo, I wanted to create a wide range of awesome and high quality clothing and products that people can feel inspired and connected with.

Where do you see yourself both personally and professionally in 5-10 years?

Well, currently training hard in hopes of being selected for my first Olympic Team! I’d like to aim for the 2024 Olympic Games in Paris. So, in 5-10 years, I’d love to hopefully be a 2-time Olympian. Personally, I’d like to continue my education and earn my Masters Degree. I have an undergraduate degree in Business Management and Marketing from The Pennsylvania State University – Penn State Lehigh Valley (’14) commonwealth campus. I want to continue to prove to myself what I’m capable of as an athlete and what is possible with diabetes.

What would you say to the children out there, living with type 1 diabetes, who aspire to do great things when it comes to sports and fitness?

Go for it! Never limit yourself and your own capabilities. Use your platform to create awareness and inspire and connect with others affected by diabetes. The Founder and CEO of Team Novo Nordisk, who is also living and racing with diabetes says, “Diabetes only chooses the champions.”

Mandy, thank you for taking the time to answer our questions! We will continue to follow your journey and can’t wait to see more great things from you! We wish you all the best!

Source: diabetesdaily.com

My Running Journey with Type 1 Diabetes

By Mariel Sotelo

I am 43 years old, was diagnosed just before I turned 20 years old.

The doctor misdiagnosed me with type 2. After the diagnosis of my middle daughter, I understood why I was misdiagnosed. She was diagnosed as a MODY 3 and she is now being treated with oral medication. I started with oral medication and three years later, I got married and was planning to grow our family. I started to research insulin pumps. My endocrinologist had no idea about any of the pumps, but he signed off on the paperwork within a few months of me getting pregnant with my first daughter. As she turned one, I found out I was pregnant with my second daughter. After I had my second daughter the weight just piled on from there. After my oldest started school is when I decided to do something about the weight and my sugar. I met the gym owner who is the one responsible for me starting my love/hate relationship with running.

In 2013 we started to train for our first half marathon. It was not an easy thing for me to do. I could not just say I am going out for a run like the rest of them. Why? Because I have type 1 diabetes (T1D) and at first it was trial and error just to figure out how to handle the pump, the blood glucose, and the effort put into it. I always love the idea of having to use less insulin after a run.

marathon medals

Photo credit: Mariel Sotelo

After running a few more half marathons, everyone decided it was time to go to the next level. I was a little scared, but not because of my diabetes. I was scared because everyone was getting faster and it seemed like I wasn’t making any progress. I have continued to run no matter how fast or how slow I am. I know I have T1D and that alone is a hassle sometimes, but I know that a lot of the women that now run in the group say that they started and continue to run because of me! They feel inspired when they see that no matter what, I do not back out from running.

Even COVID-19 did not stop me from completing a challenge I had signed up for back in November of 2019. My first run was completing a half marathon in May which I had to do a week after a 14-day quarantine after contracting COVID-19 from work and having mild symptoms. I have to say, I did have some concerns with my lungs, but I did okay and was able to finish. On October 25th, I completed my 8th marathon which was part of the challenge. On the weekend of November 14th and 15th, I finished my 9th marathon. I ran 14 miles on the 14th for World Diabetes Day and 12.2 miles on the 15th to complete my run.

Diabetes has not stopped me from running! I am not the fastest runner of the group but I always reach the finish line!

Source: diabetesdaily.com

Exercise: Getting Started with Type 2 Diabetes

Everyone knows that if you live with type 2 diabetes, exercise will be beneficial not only for your blood sugars, but for your overall health and well-being. The tougher issue is to know where, when, and how to get started. Learn more about the risks, benefits, and factors to consider when starting an exercise regimen while living with type 2 diabetes. Please note: always check with your doctor before beginning any new exercise routine.

Benefits

The benefits of exercise for people with type 2 diabetes are well-known. Exercise helps maintain tighter blood sugar control, lowers the risk for heart disease and other cardiovascular complications, improves blood pressure levels, strengthens muscles and bones, and helps to improve quality of sleep and the body’s ability to handle stress. According to the CDC, adults should aim for at least 150 minutes of moderate-intensity aerobic physical activity (like walking) or 75 minutes of vigorous-intensity physical activity (like jogging or dancing) each week.

Factors to Consider

The best type of exercise is the type that you’ll do regularly, so a main factor to consider is finding something that you like doing. If you dislike the gym, don’t force yourself into a habit of going. If you love the outdoors, craft your fitness routine around hiking or a morning walk. If you love music, maybe take up dancing. The options are endless, so find an activity that you’ll enjoy, and you’re more likely to stick with it!

Recommended Types of Exercise

  • Walking
  • Jogging/Running
  • Hiking
  • Biking
  • Dancing
  • Weight/Strength Training
  • Pilates
  • Yoga
  • Swimming

Additionally, making a fitness activity a habit is the best way to make sure you do it regularly. Pair a walk while sipping your morning coffee each day, or make a date with a friend each Saturday afternoon for a hike in a local park. Opt to bike to work a few times per week, or go to the grocery store on foot, instead of driving. Creating a habit of exercise is the best way to make sure you stick to a new routine.

Make your fitness routine known by sharing your intentions with family and friends, and get them in on it, too. Having people around who support your new lifestyle will ensure that you keep at it, and they’ll benefit from joining in as well. It is also beneficial to have tech help you out. Read up on the 10 best fitness apps for beginners, and prepare to get hooked on being active, tracking your progress, and meeting measurable goals while getting healthier.

Precautions to Take

If you’re new to exercise, it’s important to ease into it. Start with walking, or simply moving more: take the stairs instead of the elevator, or park farther away from the entrance to the grocery store when you do your weekly shopping. Wear a pedometer or fitness watch to track your steps, and aim to get 10,000 each day.

It’s also important to check in with your doctor or care provider before starting any new exercise routine, to make sure you are healthy enough to begin. Also seek their input and advice on what exercise they recommend for you to get started. You will also want to discuss any potential adjustments to any of your diabetes medications before starting a new routine. Additionally, make sure you have quality shoes for walking and exercising, as healthy foot maintenance is vital for people with diabetes.

Lastly, make sure you’re always prepared for your workout with checking your blood sugar before, during, and afterwards to make sure you’re within your target range, and always carry low snacks and plenty of water with you to make sure you’re staying hydrated and protected from hypoglycemia while exercising.

It’s crucial to set realistic goals for your exercise. Are you looking for more peace of mind? To lose weight? To have a healthier HbA1c? Spend more time outside? Really get a clear focus on what you want to accomplish, and aim your exercise routine around that goal. Remember, start small so you don’t get overwhelmed.

Lastly, make sure you have fun. Exercise is about building healthier habits, getting your heart rate pumping, and enjoying yourself while doing something that’s good for you. If you’re not having fun, you’re not doing it right! Make sure to enjoy yourself, and you’ll find that a healthy exercise routine builds dividends over time.

Source: diabetesdaily.com

Former NFL Player with Type 1 Diabetes Shares His Story

Jake Byrne was diagnosed with type 1 diabetes as a teen, and he didn’t let his condition stop him from pursuing his dreams of playing professional football. He also wrote a book to inspire others with type 1 diabetes to pursue their dreams. We talked to Jake about his journey and the advice he would give to young people recently diagnosed. 

How old were you when you first became interested in football?

Since I was a little kid. My parents are from Wisconsin, and I grew up watching the Green Bay Packers every Sunday. I first started playing football in the 3rd grade.

When were you diagnosed with type 1 diabetes?

I was diagnosed when I was a sophomore in high school; I was 15 years old.

How did your diagnosis affect the trajectory of your football career at the time?

The largest hurdle to overcome was how to manage a new disease with the physical and mental demands the game of football put on someone’s body.

Did you become discouraged about your future?

Yes, the most noticeable change was the sudden weight loss. I lost around 30 lbs. and had to figure out how to adjust to a completely new lifestyle living with T1D.

What worried you the most, and how did you move forward?

How to manage my blood sugar was my biggest worry. Stabilizing my blood sugar to be able to stay in a healthy range for a 2-3 hr. game or practice was such a challenge. There was just not a lot of information or people I knew that could provide helpful insight on how to manage in such an extreme environment. For the most part, it was trial and error that was my method of finding what worked for me.

What was your most memorable football experience?

I have a couple. I never thought I would make it as far as I did in my football career. I always wanted to make it to the NFL, but I set more short-term goals that seemed realistic at the time. The first was after I finally got in a good rhythm with my diabetes and football and was able to play well enough to earn my first scholarship offer from the University of Arkansas. This eventually led to several other offers, which lead to my decision to attend the University of Wisconsin. The second was my Junior year when we beat Ohio State (who was #1 in the country), which lead us to become Big10 Champions earning us an invitation to play in the rose bowl in Pasadena, CA. The third was when I finally got a shot to play in my first NFL game on Sunday for the Huston Texans.

What was the most challenging aspect for you in regard to playing football with type 1 diabetes?

Keeping my blood sugar in a safe range. Lows were always a struggle.

Tell us a little bit about your book. What prompted you to write it? What was the inspiration and motivation behind it?

The inspiration behind the book started when I first received a letter from a young kid who was struggling to convince his parents to let him play football, triggering the feelings around how lost I was when I was first diagnosed. I was looking for some hope and guidance on how to move forward. From that point, I wanted to find a way to share my story to help others that were going through a difficult time overcoming adversity.

*Editor’s note: Jake’s book, “First and Goal: What Football Taught Me About Never Giving Up”, can be purchased on Amazon.

Can you tell us more about how having type 1 diabetes affected your football career experiences and vice versa?

Playing football at a high level is a challenge in itself. Then diabetes adds a level of complexity and discipline on top of that no-one else has to deal with.

Did the training and commitment involved in playing the sport at such a high level translate to more optimal diabetes management?

Absolutely, the amount of physical activity involved in sports like football leaves very little room for error. You can’t take one second off with T1D.

What advice would you give to newly-diagnosed kids and teens who have professional sports aspirations?

Never let diabetes set your limitations. Control your diabetes; don’t let it control you. It all comes down to your willingness to be disciplined in having a proactive approach to their daily routine to match your lifestyle.

Where are you today, and how do you think type 1 diabetes affected your path, overall?

Diabetes taught me very quickly that I had to be very disciplined in everything I do; it ingrained a work ethic and a sense of responsibility that is now part of who I am. That mindset allowed me to chase my dreams to play in the NFL, transition into my career into robotics, and eventually led to an opportunity to work for Locus Robotics as the Director of Customer Success. T1D taught me that through my life that if you work hard and have a thought-out plan, you can accomplish anything you set out to do.

Thank you for taking the time to speak to us, Jake. Your story is sure to be an inspiration to many young athletes with type 1 diabetes. We wish you all the very best in all your future endeavors!

***

Are you a competitive athlete with type 1 diabetes? What challenges have you faced and what advice would you give?

Source: diabetesdaily.com

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