Training with diabetes: you have to consider this as a fitness trainer!

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In 2020 there were over 37 million diabetics in America – and the trend is rising, recording to CDC National Diabetes Statistics Report.

Diabetes mellitus, or colloquially sugar disease, is one of the most widespread diseases. As a fitness trainer, you are confronted with this quite often.

That’s why it’s important as a trainer to know what diabetes mellitus is, how to organize training with diabetes and what to observe generally.

Training with diabetes – Types of Diabetes

There are many different types of diabetes. The most common is type 1 diabetes mellitus and type 2 diabetes mellitus.

There are also numerous other types of diabetes.

Examples of this are gestational diabetes and LADA.

As a fitness trainer, you will mostly work with people who have type 1 or type 2 diabetes.

These two and LADA will be discussed in more detail in this article.

Carbohydrates and Insulin

To understand diabetes, it is important to know how carbohydrates are metabolized or digested in the body.

If we eat carbohydrates, they are broken down by digestion into simple sugars in the form of glucose.

The glucose enters the blood, and the blood sugar level rises. Since the body wants to keep the blood sugar level constant, it wants to utilize or store the sugar.

To do this, the pancreas releases the hormone insulin.

This insulin enters the bloodstream and acts like a key to the cells. The glucose thus enters the cells and is either used directly or stored.

This causes the blood sugar level to drop again. So far, so good.

Type 1 diabetes

Type 1 diabetes is rarer than type 2 diabetes. About five percent of people with diabetes have type 1.

This type of diabetes describes a complete lack of insulin. The pancreas no longer produces insulin.

Type 1 diabetes usually occurs in childhood and adolescence.

Cause

Type 1 diabetes is an autoimmune disease. Antibodies destroy cells in the pancreas that are supposed to produce insulin.

Why the antibodies attack at all has not yet been fully clarified scientifically.

Treatment

Type 1 diabetes can not be cured. Accordingly, type 1 diabetics have to inject insulin for the rest of their lives. This is the only way an increased blood sugar level can be lowered again.

Type 2 diabetes

Type 2 diabetes accounts for more than 90 percent of all diabetic diseases.

This is what happens most often. However, there is initially enough insulin in contrast to type 1 diabetes.

The disease begins when the insulin can no longer fully fulfill its task and work – also called insulin resistance.

To compensate for this reduced effect of insulin, the pancreas simply releases more insulin at first.

This can go well for a few years, but at some point, the pancreas can no longer secrete enough insulin and keep the blood sugar level constant. Type 2 diabetes develops.

Although the body releases an enormous amount of insulin, at some point, the amount of insulin is no longer sufficient to regulate the blood sugar level.

Here, too, it can happen over time that the body no longer produces any insulin, and, as with type 1 diabetes, you have to inject insulin.

Cause

There are several reasons for its creation. Above all, obesity, poor nutrition, lack of exercise, genetic factors, and a generally unhealthy lifestyle (including stress) should be mentioned.

LADA diabetes (intermediate form)

LADA stands for “latent autoimmune diabetes in adulthood.”

Translated, this means delayed, autoimmune-related diabetes in adults. It is a special form of type 1 diabetes.

However, type 1 diabetes almost always develops in childhood. LADA diabetics, on the other hand, are mostly over 30 years old.

It is assumed that around ten percent of diagnosed type 2 diabetics suffer from LADA diabetes.

Cause

Similar to type 1 diabetes, LADA diabetes is autoimmune. Here, too, antibodies are formed, which destroy the insulin-producing cells.

However, the destruction process takes much longer and is more insidious than in type 1 diabetes.

Like type 1 diabetes, it has not yet been possible to explain why the insulin-producing cells are attacked clearly.

Treatment

In the beginning, the main thing to do is change your diet. In addition, drugs are often used.

As the disease progresses, insulin injections are often necessary. As a reminder, type 1 diabetes requires insulin injections from the start.

The second part of articles about diabetes and weight loss: Insulin resistance & weight loss: symptoms, causes, consequences, test, and the right diet

Training with diabetes – Symptoms & Side Effects

Symptoms

Diabetes mellitus can cause a variety of symptoms.

The following are examples:

Heavy water loss
thirst
fatigue
The sweet smell of urine (a lot of sugar in the urine)
The smell of acetone from the mouth (similar to nail polish).

In particular, people with type 2 diabetes have had no symptoms for years.

Exercising with diabetes

When training with diabetics, both the positive effects of sport and the risks must be considered. About diabetes, training primarily has positive effects on type 2.

Type 1 will never be able to do without insulin injections anyway. Nevertheless, training, sport, and exercise are also healthy for type 1 diabetics, and they can benefit from the other numerous advantages.

Diabetes in itself does not prevent you from the top athletic performance! If you watch your blood sugar level, you can train normally.

For example, the former weightlifter and Olympic, European, and world champion Matthias Steiner have type 1 diabetes.

Positive effects of exercise on type 2 diabetes

Training can increase insulin sensitivity again. As a result, less insulin is needed to transport the same amount of sugar into the cells. If you already have to inject insulin, you can reduce the amount accordingly (of course, in consultation with the doctor).

The risk of blood vessel diseases decreases again.

Glucose uptake increases again.

Losing bodyweight becomes easier (obesity is the biggest risk factor for type 2 diabetes).

The blood sugar concentration drops during physical exertion. Part of the glucose can be reused directly.

Risks of exercising with type 2 diabetes – Training with diabetes

To have enough sugar in the blood, the standard value for diabetics is 130-200 mg/dl before training. This avoids getting into hypoglycemia.

Especially beginners should measure the value regularly. It is recommended to measure it before, during, and after exercise.

In this way, those affected know how the values change during training and can better discuss how to proceed with the doctor.

Hypoglycemia (low blood sugar)

Hypoglycemia is significantly more dangerous than hyperglycemia and can be fatal. If the blood sugar value before training is below 60 mg/dl, you should not do any sport.

If you notice that your blood sugar level is too low and you are already injecting, you should reduce the insulin dose before training or add more carbohydrates.

If aggressive behavior or sweating should occur during training, the trainer or the person concerned should not think twice about whether it is high or low blood sugar but should immediately supply fast carbohydrates (e.g., in the form of glucose).

So you are on the safe side and avoid the dangerous hypoglycemia.

As a person with diabetes, you should also pay attention to the afterburn effect. After training, the cells are still insulin-sensitive. Injecting the normal dose of insulin that you would have taken without exercise would be too much in this case.

You should measure again before training and going to bed because the afterburn effect does not only have to be present after training but can also have an effect in the evening or the next day.

Hyperglycemia (high sugar)

One speaks of high blood sugar when the value is over 250 mg/dl. You should also stop training and consult a doctor if necessary.

Training recommendations

A combination of strength and endurance training can be recommended. The exact training design, of course, depends on various factors:

age
General fitness
Current sporting load or movement
the severity of the diabetes
preferences

Concerning strength training, the following recommendations can be given:

Slowly “touch”
2-3 times a week
full body workout
10-20 repetitions
Training in the submaximal, not the maximal, range

Of course, the training should still be challenging and not too easy. This is the only way to expect positive signs of adaptation.

With regard to endurance training, the following recommendations can be given:

Slowly “touch”
2-3 times a week
No short and intensive loads (e.g., interval training)
20-30 minutes

The 20-30 minutes are set quite far down, as this is a better way to avoid hypoglycemia. With more training experience and better fitness, you can increase endurance training both in scope and frequency.