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Diabetes and Sports - A Winning Partnership?!
Nutrition

17 August 2018

Diabetes and Sports - A Winning Partnership?!

Diabetes and Sports - A Winning Partnership?!

When talking about Diabetes comes to the idea a series of limitations: what can't be eaten, what should not be done, and sport is (mistakenly) included ...


Controlling diabetes is always a challenge, especially type 1 diabetes. However, the stigma associated with the need for insulin injections and the specter of complications of poorly controlled diabetes in sport can lead many people to not exercise.  


Sport is a general recommendation, whether have or not diabetes, and sport is one of the pillars of the triad that make up Diabetes treatment, along with diet and drug therapy.


So let's see what kind of recommendations you should follow to get you to play sports, in a safe and healthy way, in case you have diabetes.


When carrying out any type of physical activity, duration, intensity and specific characteristics of the type of training, should be taken into account. It is also important to measure glucose frequently to find out how the type of exercise influences blood glucose and what adjustments are needed:


• Glycemia <70mg / dL - exercise is not recommended.
• Glycemia 70-99mg / dL - a pre-workout meal is recommended.
• Glycemia between 100-250mg / dL - exercise can be done without a previous meal.
• Glycemia> 250mg / dL - Do not do any type of exercise and measure ketone bodies.



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In insulin-dependent or hypersecreting individuals, physical exercise may cause hypoglycaemia if the insulin dose or the intake of Carbohydrates is not changed.  If values ​​before training are ≤ 100mg / dL, an extra intake of carbohydrate-rich foods, such as fruits, juices, energy bars, or isotonic beverages, should be taken. Do not forget that when exercising glucose consumption increases, so, depending on the activity, the daily intake of carbohydrates should be adjusted, so that the glycogen stores are not depleted. 


When the exercise duration is longer than 45-60 minutes, with moderate or high intensity, the following Carbohydrates needs should be taken into account:
 
• 3-5 training sessions, weekly, for one hour: 4-5g HC / kg body weight / day
• More than 5 weekly one-hour sessions: 5-6g HC / kg body weight / day
• More than 5 weekly sessions of 2 hours: 7-8g HC / kg of weight / day
• More than 5 weekly sessions of more than 2 hours: 8-10g HC / kg of body weight / day


The pre-exercise meal should include foods rich in carbohydrates, along with foods rich in protein. It is advisable that this meal should be 2-3 hours before the start of the activity (breakfast 1 to 2 hours before is sufficient).


If training occurs shortlyafter a meal, there may be a greater likelihood of reactive hypoglycaemia - before exercise check the glucose level and, if it is less than 100mg / dL, take a slow absorption carbohydrate supplement - 15-20g (insulin dependent or hypersecretory).  If the exercise does not exceed 30 minutes there may be no need to eat any food.


After exercise, the replacement of Carbohydrates, preferably with low glycemic index, should be ensured. If glucose is less than 120mg / dL, ingest 15 to 20g of carbs (insulin-dependent or hypersecretory).  The goal is to restore glycogen stores (muscle and liver) as soon as possible to ensure the next day's workout takes place under the best possible conditions and prevents post-workout hypoglycemia.


In the case of hypoglycaemia it is recommended to follow the rule of 15x15 - ingestion of a food that provides 15g of carbohydrates, rapid absorption, and wait 15 minutes until the glucose levels are restored. If not, repeat the process. Food options with 15g of carbs: 1 packet and a half sugar, a glass of fruit juice or isotonic drink, a glucose gel or 2-3 glucose tablets. 


Beware of the type of food ingested to restore glucose levels - foods such as cakes, pastries, cookies, chocolate, etc. in addition to sugars contain a large amount of fat that prevents their absorption - longer until sugar reaches the blood and consequently the symptoms of hypoglycemia remain longer.


A diabetic should always have an emergency kit with them - carbohydrate supplements in case of hypoglycemia - fruit juice, energy bars, glucose gels, tablets...


Thus, since well controlled blood glucose and, as long as there is extra food care, a diabetic patient has more to benefit from the practice of sports than the lack of it.


Any questions about diabetes, always consult your health professional.



By Joana Correira, Nutritionist