Running With Diabetes: What You Need to Know

From diatribe.org

Running is a great form of aerobic exercise, helps reduce the risk of heart disease, and can be a healthy outlet to reduce stress. Read on to discover tips for a successful run.

From jogging laps on the track to exploring new parks with a local run group, running is an accessible form of physical activity for people of all ages. 

Whether you prefer a meditative solo run or challenging yourself in a 5k race, city jogs, or trail runs, there’s something for everyone. Plus, running is low cost and doesn’t require any special skills: all you need is a pair of running shoes and a place to jog safely. 

Eritrea Mussa, diaTribe’s social media manager who lives with type 1 diabetes, chose to start running several years after her diabetes diagnosis because it was inexpensive and accessible. Now, running gives her the chance to boost endurance, develop mental toughness, and build community through a local running club in Dallas, Texas. 

“Everyone knows running is hard, even just getting started,” Mussa said. “But the only way to eat an elephant is one bite at a time. So that's how I see running – you just have to start putting one foot in front of the other.” 

Benefits of running for diabetes management 

Physical activity is a key component of self-care for everyone, especially people who have diabetes. The American Diabetes Association (ADA) recommends getting at least 150 minutes per week of moderate-intensity exercise. If you are running or jogging, this usually means a conversational pace where you’re able to talk in brief sentences. 

But how does running specifically improve your diabetes management and other health measures? 

Improved insulin sensitivity

According to the ADA, being physically active can make your body more sensitive to insulin, helping lower blood sugar for up to 24 hours or more after exercise. In fact, research suggests that higher-intensity aerobic exercise – such as hill runs or sprints – may lead to even greater increases in insulin sensitivity. 

For Grace Choi, a 28-year-old living with type 1 diabetes in New York City, running has been key to addressing insulin resistance. In addition to taking metformin off-label and trying to eat healthier, Choi said running has helped improve her insulin sensitivity. For instance, Choi noticed that her insulin-to-carb ratio improved after she started running.

Better heart health

Running can help strengthen the hamstrings, quads, glutes, and other lower body muscles, but importantly, it also strengthens the heart. 

“The heart is a muscle you have to train,” said Choi. 

A stronger heart is more efficient at pumping blood to the lungs and throughout your body. It can lead to a lower resting heart rate (the number of times your heart beats per minute when you're at rest) and reduced blood pressure.

Running has also been shown to lower triglycerides and increase HDL (“good”) cholesterol. Keep in mind that longer runs generally tend to have larger benefits on heart health than shorter runs.

Given that people with diabetes are at greater risk of developing heart disease, it’s especially encouraging to learn that running can significantly decrease the risk of cardiovascular disease. 

Studies have found that as little as 5-10 minutes of running a day can reduce the risk of death from heart disease. 

Plus, data suggests that running could help stave off early death. In an analysis of over 50,000 people followed for over 15 years, runners lived approximately three years longer than non-runners. 

Boosts mental health 

From experiencing a “runner’s high” to better coping with chronic disease, running has many positive effects on mental and emotional well-being. A 2020 review article comparing many different studies found that runners had reduced depression and anxiety, lower stress, and better moods compared to people who did not lead an active lifestyle. 

“Running has done wonders for my mental health,” Mussa said.

For Robin Arzón, vice president of fitness programming and head instructor at Peloton who lives with type 1 diabetes, mental health and running have been intertwined from the beginning. Arzón got into running after a traumatic incident during college, in which she was taken hostage in a bar in New York City. 

“I go from feeling powerless to powerful when I lace up,” she said. “Once you get into a rhythm, it's really liberating to be able to move one's body like that.”

Beyond improving mental health, research also suggests that regular running can help you establish a healthy sleeping cycle. Likewise, moderate-intensity exercise has been shown to strengthen the immune system, though high-intensity exercise (such as running a marathon) temporarily weakens the immune system. 

Considerations for running with diabetes

While physical activity generally helps to reduce blood sugar, different intensity levels can impact blood glucose in different ways. 

Longer, slower runs tend to cause blood sugar to drop over time. People with diabetes may experience low blood sugar (hypoglycaemia) during, after, or later in the day, or even overnight after exercise. Meanwhile, shorter, faster-paced runs (such as tempo runs) can cause blood sugar to rise. 

Diabetes technology like continuous glucose monitors (CGMs) and automated insulin delivery (AID) systems can greatly simplify blood sugar management during physical activity; for example, some devices can be put into exercise mode to avoid low blood sugar. 

Fuel appropriately 

Choi advised first thinking about what you need for fuel as a runner. Then, think about how to align your energy intake needs with your diabetes management. For runs longer than 90 minutes, experts generally advise consuming 30-60 grams of carbohydrates every hour during the run. 

Many runners use specialized products, such as packets of gels or chewy gummies, though standard fruit snacks, honey packets, or candies work, too. Just be sure you have pockets, a fanny pack, or another way to carry snacks – Choi recommended buying activewear with plenty of pockets. 

Consider insulin on board to prevent hypoglycaemia

As with any exercise, you may need to adjust your basal insulin before you start running to prevent low blood sugar. Be sure to monitor your insulin on board: the amount of insulin that is still active in your body from previous bolus doses. 

Through trial and error, Choi developed a strategy for her runs with her Tandem t:slim X2 insulin pump. While she initially tried using activity mode, she found that this setting dropped her blood sugar too low. So, Choi programmed a specific “run” profile that reduces her basal rate by 75%. For long runs, she makes sure to eat enough carbs beforehand and then boluses for about half the carbs.

Likewise, Mussa adjusts her low alerts to sound at 85 or 90 mg/dL (rather than 55 mg/dL) while she’s in activity mode so that she can address falling blood sugar promptly. 

Some people prefer to exercise “fasted” to avoid dealing with insulin on board. This usually means running first thing in the morning, before you’ve eaten. Exercising first thing can help counter the effects of the dawn phenomenon, which causes blood sugar to rise in the early morning. 

You may need to go through a trial-and-error process like Choi's to determine what works best for your runs. Consult your healthcare provider if you have any questions. 

Monitor blood sugar levels

Before heading out for a run, check your blood glucose so that you know where things stand. If you’re low, it’s a good idea to eat a carbohydrate snack and wait to head out until your blood sugar stabilizes. Likewise, if you’re running high, you may want to start your run right away to begin lowering your glucose. 

CGMs are a game changer for exercise with diabetes, as they show real-time glucose readings. 

Of course, getting diabetes devices to stay attached to your skin while sweating can be tricky – Choi said products like SkinTac or Skin Grip have helped her keep sensors in place. 

Many runners use special GPS watches to track their running pace, and some (like the Apple Watch and Garmin) can also display readings from your CGM. 

“I like having a watch that I can look down and it tells me how my glucose levels are,” Choi said. 

If you don’t have access to a CGM, be sure to check your blood glucose before and after exercising using a blood glucose meter. 

The bottom line

Running is a great way to get aerobic exercise, reduce your risk of cardiovascular disease, and improve mental health. If you’re new to running, start slowly and ramp up gradually to avoid injury. 

“It’s okay to start slow,” Choi emphasized. “The fact that you may not necessarily be able to run a mile to start is perfectly okay. You just have to go and try it.” 

Looking ahead, Choi is excited to race in this year’s New York City Marathon with Team JDRF. “Everyone’s running for the same mission: our finish line is turning type 1 into type none.” 

Ultimately, running can serve as a helpful outlet to reduce diabetes distress and may even help you better manage blood sugar levels and cope with chronic disease. 

“Running is incredibly empowering for someone who lives with type 1 diabetes because there are a lot of circumstances we can't control,” Arzón said. “When you tell yourself, ‘I'm gonna run this run today,’ whatever the distance, and you do it, that is incredible. It’s really confidence boosting.”

Be sure to consult your healthcare provider to come up with an exercise plan if you’re completely new to physical activity. It’s also important to keep in mind considerations for exercising with diabetes, such as monitoring blood sugar to avoid hypoglycaemia. 

https://diatribe.org/exercise/running-diabetes-what-you-need-know 

Understanding the impact of blood glucose levels on birth complications in gestational diabetes

From news-medical.net

The higher the blood sugar level in pregnant women when first diagnosed with diabetes, the higher the risk of complications around and after birth, according to research presented at the 26th European Congress of Endocrinology in Stockholm. For every 5mg/L above the diagnosis threshold, the risk of newborns having low blood sugar levels, or a large birth weight, rises by 9% and 6%, accordingly, while mothers have a 31% higher risk of diabetes after birth. The findings suggest that high-risk women with gestational diabetes should be classified further to limit these complications for both mothers and newborns.

Gestational diabetes -; a condition in which women have elevated blood sugar, or glucose, levels during pregnancy -; affects around 20 million pregnancies worldwide and poses increased health risks for both mothers and their babies. For example, mothers are more likely to develop type 2 diabetes and to give birth to especially large babies who face a high risk of birth injuries or even obesity later in life. Women are diagnosed with gestational diabetes if their fasting (pre-meal) blood glucose levels are above 92 mg/dL in the first trimester or their 2-hour oral post-meal glucose levels (OGTT) in the second trimester is above 153 mg/dL.

In this study, researchers from the Tâmega e Sousa Hospital Center in Portugal analysed data on blood sugar levels and birth complications of 6,927 pregnant women, aged 30-37 years old, who carried one child and were diagnosed with gestational diabetes between 2012 and 2017. The researchers found that for every 5mg/L increase in their blood sugar levels, there was a 9% higher risk of low blood sugar (hypoglycaemia) and a 6% higher risk of large birth weight (large for gestational age) in newborns and a 31% higher risk of maternal high blood levels (hyperglycaemia) after birth.

While it is not surprising that high glucose levels are associated with these adverse outcomes in mothers and newborns, our study shows for the first time how much increase in risk there is with 5 mg/dL of increase in the mother's blood glucose levels when first diagnosed with gestational diabetes."

Dr. Catarina Cidade-Rodrigues, co-lead researcher 

Dr Cidade-Rodrigues continued: "The magnitude of elevated risk can be calculated with our measurements and, in practice, could be used to identify and stratify women at higher risk of developing these complications."

"We now want to evaluate if there is a benefit in further stratifying these high-risk women with gestational diabetes, who will need to be more closely monitored and to whom pharmacological interventions can be carried out appropriately. This may help reduce complications during labour and in newborns and prevent future diabetes in these women."

https://www.news-medical.net/news/20240513/Understanding-the-impact-of-blood-glucose-levels-on-birth-complications-in-gestational-diabetes.aspx 

Study shows outdoor physical activity can combat type 2 diabetes and depression

From diabetes.co.uk

Regularly doing physical activities in natural environments can prevent the development of non-communicable diseases such as type 2 diabetes and depression, new evidence has revealed. 

Research conducted by the University of Exeter has discovered that being active in nature could combat just under 13,000 cases of non-communicable diseases a year in England, saving more than £100 million in treatment costs.

Non-communicable diseases are responsible for nearly three quarters of deaths around the world. Otherwise known as chronic diseases, examples of non-communicable diseases include type 2 diabetes, depression, cardiovascular disease, cancer, chronic lung disease and stroke.

According to the World Health Organization (WHO), there will be around 500 million new cases of non-communicable disease by 2030, if the global population fails to increase their physical activity uptake.

In this study, the researchers examined the benefits of exercising on the beach and in the countryside, as well as in parks in towns and cities.

First author Dr James Grellier said: “We believe this is the first time an assessment like this has been conducted on a national scale and we’ve almost certainly underestimated the true value of nature-based physical activity in terms of disease prevention.

“Although we have focused on six of the most common non-communicable diseases, there are several less common diseases that can be prevented by physical activity, including other types of cancer and mental ill health.”

He added: “It’s important to note that our estimates represent annual costs. Since chronic diseases can affect people for many years, the overall value of physical activity at preventing each case is certainly much higher.”

To maintain good health, adults aged between 18 and 64 should attempt to do a minimum of 150 minutes of moderate intensity aerobic physical activity per week, or 75 minutes of vigorous intensity aerobic physical activity, according to the WHO. Figures show that more than one quarter of adults around the world fail to meet these recommendations.

The research conducted by the University of Exeter has revealed that nature-based physical activity has the potential to combat 12,763 cases of non-communicable diseases. 

Dr Grellier said: “For people without the access, desire, or confidence to take part in organised sports or fitness activities, nature-based physical activity is a far more widely available and informal option.

“We believe that our study should motivate decision-makers seeking to increase physical activity in the local population to invest in natural spaces, such as parks, to make it easier for people to be physically active.”

Read the study in the journal Environment International.

https://www.diabetes.co.uk/news/2024/may/study-shows-outdoor-physical-activity-can-combat-type-2-diabetes-and-depression.html

Eating Disorders Common in People With Type 1 Diabetes

From islandernews.com

Key Takeaways

• New research suggests that 1 in 4 people over the age of 16 with type 1 diabetes also has an eating disorder

• Some may intentionally skip insulin doses, thinking it helps them stay slim

• Doing so can upset blood sugar control and raise the odds for complications

THURSDAY, May 9, 2024 (HealthDay News) -- One in every four people age 16 or older with type 1 diabetes may be struggling with an eating disorder, a new review of data on the subject finds.

Type 1 diabetes is an autoimmune disorder in which the body attacks its own insulin-producing cells in the pancreas, making a person reliant on injected insulin. About 5% of diabetes cases are type 1.

The new study was led by doctoral student researcher Pia Niemelä of the University of Eastern Finland. Her team looked at data from 45 studies involving nearly 11,600 people with type 1 diabetes.

They found that over 2,500 patients -- almost 1 in every 4 -- also exhibited symptoms of an eating disorder.

That's not overly surprising, the Finnish team said, since weight gain is a concern for many people with type 1 diabetes. People with the illness can exhibit symptoms like binge eating or cutting back on food intake, but some also practice a form of disordered eating called "insulin omission."

This practice -- skipping insulin doses -- is thought to discourage weight gain, but it can be very unhealthy.

“Intentional skipping or restriction of insulin doses will lead to weight loss, but this also maintains high blood glucose, throwing the management of diabetes off balance,” Niemelä said in a university news release.

The study found that women with type 1 diabetes were more prone to eating disorders than men, but age didn't seem to matter.

“Eating disorder symptoms are often thought to affect adolescents and young adults," Niemelä said. "However, our meta-analysis shows that adults, too, suffer from eating disorder symptoms, which is why it is important to learn to identify patients with eating disorders."

She stressed that developing an eating disorder can encourage complications and worsening illness in people with type 1 diabetes. Certain screening methods can help doctors pick up signs of eating disorders in patients, however.

The study was published in the April issue of Eating Disorders.

https://www.islandernews.com/lifestyle/health/eating-disorders-common-in-people-with-type-1-diabetes/article_df0670d5-ca92-56e1-a2d7-cd9ed9a22379.html 

Benefits of Strength Training for Diabetes

From diatribe.org

Compelling research has shown that resistance exercises like push-ups, squats, and lunges are beneficial for blood sugar management. Here's how to get started.

Aerobic exercise has always held a prominent role in the recommendations of the American Diabetes Association for the prevention and management of type 2 diabetes. This isn’t surprising because aerobic exercises – like swimming, running, walking, and biking – offer a lot to help manage blood glucose. But is it the best choice for diabetes management? 

Strength training, also called resistance training or weight training, may offer a starting point to enhance the effects of aerobic exercise for those living with diabetes. If you’re new to resistance training, it’s a type of physical activity that requires the body’s muscles to move against an opposing force. It usually involves some type of equipment (like elastic resistance bands or free weights) but can be performed through bodyweight exercises like push-ups and squats.  

“Resistance exercise has not been traditionally touted as a therapy, it’s all about aerobic exercise,” said Dr. Stuart Phillips, a research chair in skeletal muscle health at McMaster University. “In my view, resistance exercise is an exercise form that offers many things – strength, mitigating the loss of muscle with aging – and is beneficial for diabetes also.”  

In the last few decades, compelling research has shown that strength training is as good or better than aerobic exercise for keeping blood glucose levels in check. Because of this and other benefits, Phillips said that resistance exercises should be recommended more often as a primary tool for diabetes management. To better understand the benefits of strength training, let’s take a look at what makes it unique. 

Benefits of resistance exercises for diabetes

Improved insulin sensitivity

Studies have shown that strength training improves insulin sensitivity. How exactly? When you lift weights or do other resistance exercises, you increase muscle size, which allows your body to process glucose more efficiently and decreases its need for insulin.

While aerobic exercise has its own benefits, studies have found aerobic exercise alone doesn’t produce the same level of muscle mass and strength as resistance exercises. This makes strength training a great option if you’re looking to reduce insulin needs.

Better blood sugars

Multiple studies show strength training is as effective (and possibly even more so) as aerobic exercise in helping people with diabetes manage their blood glucose. 

Resistance exercises also appear to regulate blood sugar for a longer period than aerobic exercise; while aerobic exercise lowers blood glucose during an exercise session, the blood sugar-lowering effects of strength training can last up to 24 hours post-exercise. 

Quick and easy

Resistance exercises may be a good alternative for those who find it difficult to reach the recommended 150 minutes of aerobic exercise a week. Studies have shown that only 24% of adults between 18 and 55 and 2% of adults over 65 meet that quota. 

Strength training is time-efficient and can easily be done at home using your body weight (think push-ups) or minimal equipment (like resistance bands or even milk jugs). An extra benefit is that it will help maintain much-needed muscle mass, which people start losing at a rate of 3-8% per decade after age 30 and accelerates by age 60. 

Loss of muscle mass can be detrimental to overall health and further chronic disease risk. Moreover, as people age, declining muscle strength and loss of mobility are likely to reduce our overall physical activity, which can trigger or worsen challenges around glucose management.

The good news is that this trend can be reversed – it’s never too late to rebuild or build muscle.

How to start 

It may sound intimidating, but making strength training part of your day can be easy. The great thing about resistance exercises is they’re versatile; you can create a workout anywhere, any time, no matter your fitness level. 

As with any exercise routine, consistency is key. Training two to three times a week and targeting all major muscle groups is a good way to start. There is no one “ideal” workout, as everybody is different. 

“I am a fan of time-efficient workouts that are generally whole-body, targeting major muscle groups – chest, back, and legs – and are manageable in a short time,” said Phillips. 

Though there are many different types of resistance exercises, here’s a sample routine Phillips suggests. An extra benefit is that no equipment is required. For all exercises, rest for 90 seconds between sets.

• Squats: Three sets of 10-15 repetitions. 
• Push-ups: Three sets of 10 repetitions (on the floor or against the wall)
• Lunges: Three sets of 10-15 repetitions 
• Bridges: Three sets of 10-15 repetitions
• Planks: Three sets of 10-30 second holds

Aim for at least three sets per muscle group, ideally performed twice weekly for 30-40 minutes max each session.

If you’re new to strength training exercises, the first step is learning the proper form. Some excellent online sources include the National Strength and Conditioning Association (NSCA), which has an extensive exercise video library free online, and the Mayo Clinic Strength Training Guide. 

The bottom line

Strength training can be a safe and useful tool for diabetes management – plus it’s quick and can be easily done at home. 

Building muscle through strength training has a multitude of benefits, including improved insulin sensitivity, glucose control, and metabolism. Maintaining muscle mass is also important for older adults (especially those living with a chronic condition) as it protects bones and reduces the risk of heart disease. 

For people with diabetes and other conditions, it’s always a good idea to talk to a healthcare provider before trying a new exercise routine. 

https://diatribe.org/exercise/benefits-strength-training-diabetes