Exercise & Diabetes – short spurts or endurance stuff?

Emma Baird  at the start of Ben Lomond
At the start and cheery…

Exercise, as we folks with diabetes are often told, is essential for good management of diabetes. ‘Good’ doesn’t mean easy. The usual disclaimer applies; my experiences are unique to me, but this week’s blog post is inspired by last week’s climb of Ben Lomond.

Ben Lomond is a munro—i.e. a mountain this is higher than 3,000 feet or 914.4 metres. Munro-bagging is the activity where you climb them, stand on the top for a while taking pictures (if it’s not on social media, it never happened, right?) and then telling everyone you know for weeks afterwards.

As Ben Lomond is the munro nearest to where I live, it’s been on my bucket list for ages. My sister in law is a keen walker/hill climber so the two of us set off to tackle the mountain last Monday.

I am fitter than average. My FitBit tells me I’m in the top percentage of people my age and gender when it comes to the VO2 measurement. (If you can explain exactly what this is to me, I’d be grateful.) But climbing a munro? Boy, a different kettle of fish entirely. I didn’t prepare properly and I suffered.

So, here are the lessons I learned…

Prepare, prepare, prepare

Endurance exercise needs far more before-hand and after preparation than short spurts of exercise. I can do half an hour to an hour’s exercise without needing to take extra carbs or adjust my insulin. A mountain is something else entirely.

Stretch, stretch, stretch

Stretch out your calves, quads and glutes thoroughly afterwards. No, do. Mine ached for five days afterwards, particularly my calves which I put down to going up on the balls of my feet as I clambered over the rocks. When I got out of bed on Sunday morning and limped downstairs to the toilet, I went so slowly my FitBit didn’t register the steps.

Eat, you diddy

Eat beforehand. I know, duh. I had food with me but my sister-in-law and I did it first thing so I hadn’t bothered with breakfast.

Test, test, test

Blood sugar at the start – 9.8. One hour in, 13.4. I took half a unit of rapid acting insulin—3.2 half an hour later. In a panic, I shoved in too many jelly babies. At the top I ate a banana and took no insulin. By the time I got to the bottom, my blood sugar had hit the heady heights (appropriate analogy, huh?) of 19. I took too much insulin and by the time I got home, I’d crashed once more.

Oh for the Abbot Free Style Libre, which would have made testing blood sugar levels so much easier and adjustments more likely to be accurate. Some day my star will come and the good people of Greater Glasgow and Clyde NHS health board will see fit to prescribe it.

Enjoy the views

Except, this being Scotland, count on getting to the top and seeing nothing thanks to the thick layer of grey cloud that hovers there. Still, twenty metres down and the views were glorious.

Afterwards, we realised we’d climbed Ben Lomond on World Naked Hiking Day… sadly, everyone else who climbed it on that day hadn’t got the memo either.

All of which brings me neatly to—can you do endurance exercise when you have type 1 diabetes to deal with? People do. There’s the Novo Nordisk team of cyclists for a start. On the other hand, they’ve got a team of dedicated professionals behind them to help with diet and working out what they take insulin-wise. I’m willing to bet too, that they have access to all the latest gear—the continuous glucose monitoring, the pumps and sophisticated feedback they can interpret to work out how to cope with long bike rides.

Our ascent of Ben Lomond took just over two hours and ten minutes (844 calories on the FitBit), and the descent about an hour and forty minutes. It counts as the hardest fitness challenge I’ve ever undertaken, far more difficult than running a half-marathon.

[Talking of running, we were overtaken by two trail runners at one point. Lordy. In awe.]

I don’t know if I would do it again. I’d rather do short bursts of exercise interspersed throughout the day as I know what I’m doing and how it will affect me. I’m a mesomorph body type too. My body favours that kind of exercise as opposed to the endurance stuff. I can walk long distances and often do, but most of the time that’s on flat ground or its hills do not last more than 45 minutes. Hauling yourself up mountains is hard as heck.

With exercise it is easy to forget that there is a level above which there is no point in doing extra unless you are training for a big event or you’re a professional sports man or woman or athlete. I do Pilates for the flexibility benefits, I walk or run for cardio and otherwise I try to move a little throughout the day. That, I think, is enough for me.

What do you prefer—endurance exercise or doing short, intense bursts of it?

 

*Photos courtesy of Jacqui Birnie.

BeTravelFit: Ultimate travel workout

From: BeTravelFit blog:
While I was traveling I saw myself faced with situations in which I didn’t have access to any sort of gym, not even a bar to do Pull-Ups with, hell, not even a damn park bench to do Tricep-Dips on because every single bench in the park was used by loved up couples and other people who don’t work out because they actually do have a social life and other things do to then lifting (what a bunch of losers).
So here’s a workout that you can perform anytime, anywhere, with absolutely no equipment needed – just as promised.
The workout consists of three different circuits with three different exercises in each circuit. The exercises in each circuit are to be performed directly one after another with no rest in between. That way the heart-rate stays elevated over an extended period of time and more calories are burned as a result.

Circuit 1: Upper Body (Chest, Shoulders and Triceps) – To be performed 5 times, 60 secs rest
Hindu Push* up x 5
Diamond Push-Up x 5
Push-Up x amrap (as many repetitions as possible)
Circuit 2: Lower Body (Quads, Glutes, Hamstrings and Calves) – To be performed 5 times, 30 secs rest
Single Leg Box Squat x 10
Single Leg Romanian Deadlift x 10
Single Leg Calf-Raise x 15
Circuit 3: Core (Abs And Lower Back) – To be performed 5 times, 30 secs rest
Oblique Crunch x 10
Crunch x 20
Plank for 60 secs
And there you go, here’s your first full body, zero equipment, bodyweight only workout!
It burns a ton of calories, engages all major muscle groups and keeps you occupied for at least an hour to an hour and a half. Feel free to add extra repetitions or sets to make the workout more challenging as you progress and don’t feel intimidated if you can’t perform as many repetitions as suggested in the routine. Just give it your best shot and you’ll be fine!

 

  • Assume the downward dog position. Move your upper body backwards,  into child’s pose, and then move your head and trunk forwards taking your weight in your arms till you then extend your head up with your trunk in the upward dog position.

When do you stop getting benefits from exercise?

From Danielle Baron’s article in International Medical News 10 August 18

As with many different health interventions, there is a sweet spot between doing enough of it and doing too much of it. Too little, and it is not effective. Too much and you could cause unexpected negative repercussions.  The subject of exercise has been investigated regarding its effect on mental health.

Over 1.2 million USA citizens were asked about their exercise habits and their mental wellbeing between 2011 and 2015 by researchers at the Centers for Disease Control and Prevention.

All exercise types improved mental health but popular team sports were particularly effective in boosting mental health. The optimal duration of exercise was between 30 and 60 minutes a session, three to five times a week.

Sessions of longer than 90 minutes or done more than 23 times a month however, were related to WORSE mental health.

The authors conclude that blanket advice on exercise could be improved by being more specific about the types, durations and frequencies that were more likely to improve mental health and that further studies could be helpful.

Chekroud SR et al. Association between physical exercise and mental health in 1.2 million individuals in the USA between 2011 and 2015: a cross sectional study. Lancet Psychiatry. Published online 8 August 2018. doi: 10.1016/S2215-0366(18)30227-X

My comments: Oh dear! Well, I’ve got the duration right at 40 minutes but I hate team sports (because I’m useless at hand to eye or foot coordination) and I aim to exercise every day, which these researchers considered “excessive”.  Maybe the team sports were more beneficial because of the socialisation aspect as well as the physical aspect. Maybe less than 23 times a month made it something to look forward to and a dopamine hit , “I’ve achieved that” rather than a black mark ” I failed to do my exercise session”   as I tend to think about it. I can see the downsides of exercise addiction reflected in this piece of research. 

The Athletes Guide to Diabetes

There’s a new book out for everyone who has questions to ask about how you exercise with diabetes, and it includes advice about low-carb eating and exercise.

Nearly 300 athletic individuals were included in this new edition, now re-titled The Athlete’s Guide to Diabetes by Shelley Colberg, after answering Shelley’s online survey about their activities and diabetes management. And 15 athletes are included in all-new profiles.

Much of the first half of the book has been rewritten to include low-carb eating, the latest diabetes technologies, new medications, and much more. Tips and best practices to deal with device slippage, temperature extremes, and different activities are included as well.

There is guidance and unique perspectives on 165 sports and activities. More than 80% of the content is entirely new, and the publisher is offering an online CE exam for anyone who needs the credits.

Check it out on Amazon, Barnes & Noble, and Human Kinetics.

Amazon (in USA–but other countries to follow shortly):

https://www.amazon.com/gp/product/B07NMZ1P7Z/ref=as_li_tl?ie=UTF8&tag=drshercolbaut-20&camp=1789&creative=9325&linkCode=as2&creativeASIN=B07NMZ1P7Z&linkId=256f1452429dce96118c121dfba945aa

Barnes & Noble:

https://www.barnesandnoble.com/w/books/1129666399?ean=9781492588733#/

Human Kinetics (publisher site):

https://us.humankinetics.com/search?type=product&q=colberg

Your pulse is an indicator how long you will live as well as your fitness

A study published in Heart reports that your resting pulse generally indicates how fit you are. It also modestly predicts mortality rates from the obvious cardiovascular disease but just as strongly with such things as breast, colorectal and lung cancers. A difference of 10 beats per minute equates to a 10-20% difference in mortality.

Also reported in Neurology, Swedish women had their baseline fitness tested in 1968 by ergometry while cycling. There neuropsychiatric status was checked at intervals since.  Women in the highest fitness group delayed in onset of dementia by 9.5 years compared to the low fitness group and by 5 years in the medium fitness group.

Keep it up Emma, all that running about is doing you good. Meanwhile I’m sitting here typing with my resting pulse at 56. Maybe I don’t need to?

From articles originally published in Minerva BMJ 28 April 18 and 7 July 18

 

 

Public Health Collaboration Conference 2018: Achieving your optimal blood sugar target

Videos of the lectures given at the Public Health Collaboration conference 2018 which was held in May over the royal wedding weekend have now been released on You Tube.

You can see my talk, Achieving your optimal blood sugar target, as well as others, on the link below. There are a wide variety of lifestyle topics discussed. Happy viewing.

 

https://www.youtube.com/results?search_query=public+health+collaboration+conference+2018

#Type1Runs—Race Report

An oxymoron I know—the words ‘race’ and ‘me’ aren’t a natural fit. If what I did on Sunday 30 September could be described as racing, I challenge you to find that tortoise and it isn’t the one that beats the hare.

Anyway, here’s how the Great Scottish Run panned out for me. The annual race is the largest running event in Scotland and this year it attracted 30,000 participants in both the 10k and half-marathon.

I started in the pink wave (i.e. the slow coaches) and the start was snail-like thanks to the sheer numbers. No complaints from me there as a slow start is what every expert recommends.

Kingston Bridge

Running over the Kingston Bridge is something else—it presents the views of Glasgow that turn up in black backdrops on TV programmes, in films and books set in the city. You see the armadillo, the Finnieston Crane, the towering Hilton Hotel and the odd church spire or two, silent monuments to the man-made standing either side of the mighty Clyde.

The run always attracts the elites and the fastest man, Chris Thompson, finished in 1.02.07 with the fastest woman at 1.09.15. There was also a proposal at the finish line and the woman said ‘yes’.

 

As the fastest woman crossed the finishing line, yours truly was still at mile seven chanting the mantra “you can, and you will do this” over and over in a mind versus body competition. Thanks to clever tech, my husband was able to track my progress through the Great Scottish Run app and managed to cheer me on those last 50 metres over the finishing line, two hours and thirteen minutes after I started.

[Instead of missing my triumphant sprint to the end as happened at the last race.]

Diabetes care and exercise

And the diabetes care? Ahem! Everything I did points to how not to train for a half marathon and what not to do on the day. Dear reader, the furthest I ran in training was seven miles, although I had the odd day where I ran twice as per what ultra-marathon runners do in training. I managed to run the whole thing without even a toilet stop.

On the day, I woke up with super-high blood sugars thanks to a roll I’d eaten the night before. Yes, just one lousy bread roll rocketed my blood sugar levels through the night and my first test of the day was 18.6. I took one and a half units of fast-acting insulin and my basal dose, minus two units.

Super-high sugar levels made me wary of eating before the race, but I did have a Trek protein flapjack one hour before. Ping! As the race was about to start, my blood sugar levels went up again to 16.6. I knew I couldn’t start running on that, so I took one unit of fast-acting insulin and crossed my fingers.

Body feedback

I took my insulin pen with me, jelly babies and the FreeStyle Libre sensor—and, er, didn’t use it at all on the way round. I couldn’t be bothered routing around in my little pack to find it, and there is something to be said for relying on the feedback your body gives you. At the seven-mile mark, I decided I’d better eat a jelly baby or two, and at the nine-mile point, I accepted a gel from the SIS stall. From then on, I ate eight jelly babies spaced out for the rest of the run.

Blood test at the end said 8.3, rising to 11.1 an hour later and then plunging to 5.4 half an hour after that, at which point I ate a meal roughly 50/50 protein and carbs.

Lessons for another time? Do more blood tests during the race. Ignore the carb loading advice for the night before (or don’t do it with bread or flapjacks) and watch out for adrenaline. The nerves kicked in an hour before the run and that might have contributed to those high sugar levels, so the next time I might not lower the basal insulin rate as much…

Next time

But wait! There’s not going to be a next time, is there Emma?! Confession—having sworn I wouldn’t do it again, I’ve changed my mind. The Glasgow half-marathon is so atmospheric you can’t help but be swept up in running fever. Crowds cheer you almost all the way round armed with witty signs—my favourite was the one telling us we were getting in good practice for the zombie apocalypse—and the sense of achievement you experience at the end is… Indescribable.

And seeing as I proved I can do a half-marathon without ever running more than seven miles in training, the idea of doing it again next year appeals.