In people with type 1 diabetes, weight training before cardio exercise was linked with less severe drops in blood sugar.
MONDAY, Mar. 12, 2012 — It’s a question many workout devotees struggle with: weights before cardio, or vice versa? Now a new report says that for those with type 1 diabetes, it may be better to pump iron before getting on the elliptical or jogging around the block.
The study, published in the journal Diabetes Care, followed 12 active, young (average age 32) people with type 1 diabetes who were already running and doing strength training at least three times a week. In the first of two exercise sessions, the participants ran on a treadmill for 45 minutes, then lifted weights for 45 minutes. For the second session, the order was reversed (weights first, then running). Blood sugar levels were monitored before, during, and after each session.
The researchers found that when cardio was done first, glucose levels tended to drop and remain at low levels throughout the workout. By comparison, doing resistance exercise first was linked to less severe decreases in blood sugar, even hours after working out.
The study was small, and other factors that could have affected blood sugar were not considered. But according to Reuters Health, the findings agree with previous reports showing that aerobic workouts produce a quicker drop in blood sugar than strength training.
Balancing the health benefits of exercise with the risk of hypoglycemia (low blood sugar) can be tricky. During exercise, the body draws on blood glucose for energy — which can lead to those dangerous lows. Signs of hypoglycemia include dizziness, sweating, grumpiness, weakness, or hunger.
If you have type 1 diabetes and workout regularly, what else can you do to prevent low blood sugar besides switching around your exercise routine? The National Diabetes Information Clearinghouse recommends checking blood sugar first before exercising and having a snack if the level is below 100 milligrams per deciliter, as well as testing blood sugar at regular intervals both during an extended workout and after the session is completed. Wearing a medical identification bracelet and carrying food or glucose tablets during your workout are also smart ideas.
Showing posts with label controlling blood sugars. Show all posts
Showing posts with label controlling blood sugars. Show all posts
Wednesday, March 14, 2012
Thursday, January 19, 2012
Weight Loss Is Not The Answer for Preventing Diabetes
Richard Kahn, PhD, who was the chief scientific and medical officer of the ADA for nearly 25 years stated at a conference that, "Community-based weight-loss programs have not been shown to be effective at reducing the incidence of diabetes, so implementing a national program would likely be money down the drain."...
He stated that, "Community programs are ineffective at achieving weight loss."
Kahn -- who now teaches medicine at the University of North Carolina at Chapel Hill -- said that just sustaining significant weight loss, even with intensive dieting, exercise, and coaching, "requires near-heroic measures" in the face of a "very hostile food environment."
He outlined his views in a published paper, in which he wrote that there are two ways to dramatically reduce the toll of diabetes: One is to detect diabetes early and then treat it so effectively that complications from the disease are practically zero. The other is to prevent diabetes before it even happens.
Thousands of public health campaigns are aimed at prevention, and for diabetes, that generally means losing weight. But people have the "fundamental problem" of not being able to maintain weight loss, so preventing diabetes in a person at high risk for the disease is extremely difficult, Kahn said.
His paper looked at diabetes prevention studies, including the large Diabetes Prevention Program, in which patients lost an average of between 4% and 6% of their body weight (but gained about 40% back by the end of the nearly three-year trial). It also looked at the government-funded Look AHEAD trial, which found that intensive lifestyle changes resulted in a major reduction in cardiovascular risk factors, but the effects greatly diminished after four years when many participants gained weight and lost their improved fitness.
Kahn said those studies, along with the Finnish Diabetes Prevention Study -- in which the greatest diabetes prevention benefit occurred in people who lost at least 5% of their body weight -- suggest that "without substantial, sustained weight loss, progression to diabetes will probably resume." Progression to diabetes may be delayed for a few years, but the long-term effects are uncertain, he said.
(However, a preliminary study presented at the American Diabetes Association meeting last year found that a short-term lifestyle modification program for overweight diabetic patients showed long-term benefits for many of the participants.)
"In sum, to date, we have not seen a demonstration of any program that results in a clinically meaningful weight loss that can be maintained for more than two to three years in the great majority of participants and at a low cost," Kahn wrote.
Kahn's remarks preceded those of Kenneth Thorpe, of Emory University, who outlined how the healthcare reform law laid the groundwork for a national, community-based diabetes prevention strategy modeled on the Diabetes Prevention Program.
Kahn said that would be a waste of money. "The main argument is that implementing a nationwide community intervention program is not going to do anything, I believe, except waste resources." He also stated that there are too many unanswered questions about how weight loss works that must be answered before a national program would ever succeed in preventing diabetes in the long term.
"We really need to know what is going on with this complex system we have," he said. "What is going on in our physiology that precludes us from losing weight and keeping it off?" Another issue that prevents people from keeping weight off is the ubiquity of the "cheap, widely available, delicious food that we eat again and again."
He suggested "painful policies" as the solution -- such as raising the price of all food except for fruits and vegetables, and offering financial incentives to people who can keep weight off, while penalizing overweight people with higher insurance premiums.
He acknowledged those aggressive policies likely would be unpopular among members of Congress and doctors. "While we wait for the time when lifestyle modification becomes practical, we might be better served by focusing more attention on improving our understanding of the processes that affect energy intake and expenditure and improving the medical management of diabetes," Kahn wrote.
Those medical management strategies include making an early diagnosis and administering "proven treatments that have been shown to reduce complications of diabetes and extend life," he said.
He added that the best doctors can offer right now is to suggest to overweight patients that losing 4% body weight and keeping it off can reduce the risk for serious complications of diabetes by 15% to 20%.
Health Affairs, Jan. 2012
He stated that, "Community programs are ineffective at achieving weight loss."
Kahn -- who now teaches medicine at the University of North Carolina at Chapel Hill -- said that just sustaining significant weight loss, even with intensive dieting, exercise, and coaching, "requires near-heroic measures" in the face of a "very hostile food environment."
He outlined his views in a published paper, in which he wrote that there are two ways to dramatically reduce the toll of diabetes: One is to detect diabetes early and then treat it so effectively that complications from the disease are practically zero. The other is to prevent diabetes before it even happens.
Thousands of public health campaigns are aimed at prevention, and for diabetes, that generally means losing weight. But people have the "fundamental problem" of not being able to maintain weight loss, so preventing diabetes in a person at high risk for the disease is extremely difficult, Kahn said.
His paper looked at diabetes prevention studies, including the large Diabetes Prevention Program, in which patients lost an average of between 4% and 6% of their body weight (but gained about 40% back by the end of the nearly three-year trial). It also looked at the government-funded Look AHEAD trial, which found that intensive lifestyle changes resulted in a major reduction in cardiovascular risk factors, but the effects greatly diminished after four years when many participants gained weight and lost their improved fitness.
Kahn said those studies, along with the Finnish Diabetes Prevention Study -- in which the greatest diabetes prevention benefit occurred in people who lost at least 5% of their body weight -- suggest that "without substantial, sustained weight loss, progression to diabetes will probably resume." Progression to diabetes may be delayed for a few years, but the long-term effects are uncertain, he said.
(However, a preliminary study presented at the American Diabetes Association meeting last year found that a short-term lifestyle modification program for overweight diabetic patients showed long-term benefits for many of the participants.)
"In sum, to date, we have not seen a demonstration of any program that results in a clinically meaningful weight loss that can be maintained for more than two to three years in the great majority of participants and at a low cost," Kahn wrote.
Kahn's remarks preceded those of Kenneth Thorpe, of Emory University, who outlined how the healthcare reform law laid the groundwork for a national, community-based diabetes prevention strategy modeled on the Diabetes Prevention Program.
Kahn said that would be a waste of money. "The main argument is that implementing a nationwide community intervention program is not going to do anything, I believe, except waste resources." He also stated that there are too many unanswered questions about how weight loss works that must be answered before a national program would ever succeed in preventing diabetes in the long term.
"We really need to know what is going on with this complex system we have," he said. "What is going on in our physiology that precludes us from losing weight and keeping it off?" Another issue that prevents people from keeping weight off is the ubiquity of the "cheap, widely available, delicious food that we eat again and again."
He suggested "painful policies" as the solution -- such as raising the price of all food except for fruits and vegetables, and offering financial incentives to people who can keep weight off, while penalizing overweight people with higher insurance premiums.
He acknowledged those aggressive policies likely would be unpopular among members of Congress and doctors. "While we wait for the time when lifestyle modification becomes practical, we might be better served by focusing more attention on improving our understanding of the processes that affect energy intake and expenditure and improving the medical management of diabetes," Kahn wrote.
Those medical management strategies include making an early diagnosis and administering "proven treatments that have been shown to reduce complications of diabetes and extend life," he said.
He added that the best doctors can offer right now is to suggest to overweight patients that losing 4% body weight and keeping it off can reduce the risk for serious complications of diabetes by 15% to 20%.
Health Affairs, Jan. 2012
Saturday, March 5, 2011
Can Diabetes Be Cured?
Q: I'm 47 years old and was recently diagnosed with diabetes. I'm about 25 pounds overweight and lead a sedentary lifestyle, but I'm starting a diet and an exercise program. Will my diabetes go away if I lose weight, watch my diet, and exercise regularly?
— Mary, Kansas City
A: It is wonderful that you are changing your lifestyle to become healthier! This will benefit you greatly, not only in controlling your blood sugar but also in improving your cholesterol levels, strengthening your bones, and improving your heart function. These changes come with a long list of health benefits, but whether they will allow you to stop taking medicines completely depends on several factors:
The primary cause of your diabetes
The length of time that you had undiscovered, or "hidden," diabetes
The length of time you've had diagnosed diabetes
How well your pancreas is functioning, including how much insulin it is producing, and the extent of insulin resistance associated with excess weight
As you probably know, the cause of diabetes among most adults is twofold. It's caused by insulin resistance resulting from excess weight, and inadequate insulin production in the pancreas. These two causes are also interrelated. Many people whose diabetes is primarily the result of excess weight and insulin resistance can potentially reduce their glucose levels by losing a significant amount of weight and controlling their sugar levels through diet and exercise alone. This assumes that their pancreas is still producing an adequate amount of insulin.
A good number of diabetics, however, have the illness but don't know it for at least five years before diagnosis. This is crucial because over time, the insulin-producing cells in the pancreas decline in function. Often, by the time a patient is diagnosed, a critical number of cells have stopped producing insulin entirely. There is no way to reverse this. If your diabetes is diagnosed early in the disease process, however, aggressive management may help you prevent further loss of function in those cells. This means maintaining your fasting glucose levels below 100mg/dl and your after-meal (two hours after) levels below 140 mg/dl. This is the same for morning and evening glucose levels.
It is also entirely possible for some people to control their blood glucose with diet alone. I have a few patients who have been able to do so. All are producing adequate insulin, have lost weight or are within their ideal body-weight range, and watch their diets.
— Mary, Kansas City
A: It is wonderful that you are changing your lifestyle to become healthier! This will benefit you greatly, not only in controlling your blood sugar but also in improving your cholesterol levels, strengthening your bones, and improving your heart function. These changes come with a long list of health benefits, but whether they will allow you to stop taking medicines completely depends on several factors:
The primary cause of your diabetes
The length of time that you had undiscovered, or "hidden," diabetes
The length of time you've had diagnosed diabetes
How well your pancreas is functioning, including how much insulin it is producing, and the extent of insulin resistance associated with excess weight
As you probably know, the cause of diabetes among most adults is twofold. It's caused by insulin resistance resulting from excess weight, and inadequate insulin production in the pancreas. These two causes are also interrelated. Many people whose diabetes is primarily the result of excess weight and insulin resistance can potentially reduce their glucose levels by losing a significant amount of weight and controlling their sugar levels through diet and exercise alone. This assumes that their pancreas is still producing an adequate amount of insulin.
A good number of diabetics, however, have the illness but don't know it for at least five years before diagnosis. This is crucial because over time, the insulin-producing cells in the pancreas decline in function. Often, by the time a patient is diagnosed, a critical number of cells have stopped producing insulin entirely. There is no way to reverse this. If your diabetes is diagnosed early in the disease process, however, aggressive management may help you prevent further loss of function in those cells. This means maintaining your fasting glucose levels below 100mg/dl and your after-meal (two hours after) levels below 140 mg/dl. This is the same for morning and evening glucose levels.
It is also entirely possible for some people to control their blood glucose with diet alone. I have a few patients who have been able to do so. All are producing adequate insulin, have lost weight or are within their ideal body-weight range, and watch their diets.
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