An individual requires physical activity for overall well-being. However, a person with diabetes needs to work out to keep his sugar levels in the safe range. Gyms are the ideal place for a diabetic person due to the wide range of equipment’s available. However, there are certain aspects to be thought of when a diabetic person plans to gym.
The Benefits of Gym
Since weight gain is one of the major factors for Type 2 Diabetes, exercising should be part of your daily routine. In fact, people already diagnosed with diabetes have controlled their sugar levels by including physical activity in their lives.
Reduces stress and anxiety
It is a fact that sugar levels can be affected due to different emotions. Experiencing different emotions like anger, frustration and fear are common in diabetes. This leads to stress and anxiety causing fluctuations of sugar levels in the body. In fact, it has been found out that HbA1c levels are associated with stress, anxiety and displeasure. Exercising alleviates stress and tension and helps to boost up energy, both physically and emotionally.
Promotes better sleep
According to a research, people who don’t sleep well are likely to develop diabetes or heart complications. Sleep plays an important factor in managing sugar levels. In fact, it causes a spike or decrease in sugar levels. The interesting part is that not only lack of sleep affects the blood sugar; too much sleep can also cause fluctuation in the sugar levels.
Improves insulin sensitivity
Exercising has been known to have a positive effect on insulin sensitivity. In fact, it is the best method to improve the insulin sensitivity. During exercise, the body burns glycogen, a form of glucose present in the body muscles. The more glycogen is burned, the longer the insulin sensitivity is improved.
To improve the insulin sensitivity, exercising should be regular too. However, also be sure of the physical activities you do to keep yourself active. Different activities affect sugar levels differently. For example, activities such as sprinting can increase the sugar levels at start. However, it comes down if the session is long. By contrast, jogging or brisk walking are likely to decrease sugar levels.
Prevents heart diseases
According to a study, statistically there is no difference between those who were given medications to prevent heart diseases and those who exercised. In fact, people who have suffered with a stroke, physical activity have played a significant role in improving the condition.
The Risks of Joining A Gym
When exercising, diabetics should be extra careful so as to avoid fluctuation in sugar levels. The blood sugar can fluctuate amid, immediately after or even after hours of workout. Therefore, one should know about the various risks involved in joining gym with diabetes.
Hypoglycemia is a condition where the sugar levels are lower than normal. According to the numbers, low blood sugars mean blood glucose level going 70 mg/dl if measuring the whole blood and below 80 mg/dl if measuring plasma glucose.
Longer physical activity usually increases the chances of hypoglycaemia. The blood sugar goes down after a moderate to intense workout session and is often known as the “lag effect” of exercise.
The body uses two sources for energy, sugar and fatty acids. The sugar comes from the blood, liver and muscles and is stored in the form of glycogen. During the initial time, say first 15minutes of workout, most of the sugar for energy comes from the muscles or the blood. After that, most of the glucose comes from the liver. After 30 minutes, the body starts using fatty acids for energy. As a result, exercise depletes the sugar in the body. Even though the body recovers the sugar, it takes around 4-6 hours. The time can go up to 12-14 hours depending on the intensity of the workout.
Even though the former cases are usually common, sometimes the individual can experience hyperglycemia. Your sugar levels tend to increase if your blood sugar was high before workout. As after 30 minutes, the liver starts releasing sugar for energy. However, when the liver starts releasing excess of sugar and the body has too less insulin; your blood sugar levels will rise. In fact, the blood sugar rises if your body is stressed or worked too hard.
Steps you can take to prevent the risks
Always check your blood glucose before working out in the gym to make sure your blood sugar is sufficient and whether you should eat a snack or not.
Limit your workout session to 1-2 per day. Additional sessions can result in hypoglycemia.
Take proper rest on your rest days.
Exercise in gym should be in a time where the body has enough energy for the workout. Therefore, eating a carbohydrate based snack an hour before the exercise.
After your workout session, eat something to replenish the energy that you’ve spent.
In case, you are trying to lose weight you must be careful to ensure you don’t consume more.
Hypoglycemia is associated with physical exertion. Therefore, it is necessary to carry any two of the following in your gym bag:
What exercises should you be doing?
Aerobics is a form of exercise that is continuous and elevates heart rate and breathing. This includes jogging, walking, swimming or cycling. Aim for only 30 minutes of aerobics daily. In case, you find it difficult break it into chunks to feel comfortable. Gyms have aerobic classes for people who want a change in their workout session.
Due to elevated blood levels, the collagen (rubbery stuff that makes the joint move) becomes coated with sugar. This results in formation of sticky nets and losing flexibility. Stretching helps to break up the nets and become flexible. Moreover, stretching also releases dopamine which keeps an individual happy. Stretching is a simple way of improving the blood circulation in the body. This will help in better circulation of insulin to reduce sugar levels. Every gym would have an instructor that can help you for a stretching session.
It is known worldwide that regular yoga can reduce stress, anxiety and even sugar levels. Yoga is a one of the cost-effective keys of diabetes management. Since stress and diabetes go hand in hand, the benefits of yoga in diabetes care is necessary. Not only yoga improves blood pressure levels, it also helps in preventing weight gain which is another factor of Type 2 diabetes. Nowadays, every gym has yoga classes for people who are not able to do aerobics or not use the equipment’s.
Whilst the benefits of exercising have been discussed in various studies, the fluctuation of sugar levels during or post workout should also be considered. Therefore, regular monitoring is necessary for exercising. Moreover, good nutrition, sufficient sleep and relaxation are equally important. Therefore, consult your BeatO diabetes educator for proper nutritional guidance and counselling to manage diabetes.
PCOS (Polycystic Ovarian Syndrome) is a hormonal condition which is common amongst woman these days. According to the recent statistics, one in every 10 women is diagnosed with PCOS. Moreover, it affects the metabolism and hormones becoming one of the major causes of infertility.
Since women diagnosed with PCOS are prone to Type 1 diabetes and moreover face difficulties to conceive, it is necessary to know this syndrome in detail.
What is Polycystic Ovarian Syndrome?
PCOS is a condition which affects the female sex hormones. The female ovaries have follicles which are little, liquid filled sacs that hold eggs. An egg when gets developed and mature is discharged by the follicles to go to the uterus for ovulation. For a lady with PCOS, the follicles group together and form cysts. The eggs get developed yet the grouped follicles don’t break and discharge them.
Thus, ladies with PCOS often have irregular periods or only have it on occasion. Since the eggs are not released, women have a lot of difficulty to conceive.
Symptoms of PCOS
As we discussed what PCOS is and how women diagnosed with the same don’t have regular periods, here are some other classic symptoms of Polycystic Ovarian Syndrome:
Abnormality in menstrual cycle
Anywhere between 21 and 35 days is considered to be a normal menstrual cycle. However, the average menstrual cycle is 28 days with one ovulation when eggs are normal.
Again, no period for more than 35 days is another sign of PCOS.
An irregular period cycle is when either the period cycles are eight or less or when the menstrual cycles are longer than 35 days.
Inability to conceive
Since release of eggs by follicles become difficult in PCOS, women experience difficulty in getting pregnant.
The symptoms may differ from person to person. Some may experience heavy and prolonged bleeding and some experience painful menstruation.
Heavy and prolonged bleeding
The ovaries produce progesterone for two weeks after ovulation. By the end of two weeks, the level of progesterone drops and the lining of the uterus start to shed. This is the case in normal periods. If ovulation does not happen, then the ovaries are unable to make progesterone which leads to thickening of the lining of uterus. Moreover, the calls of the lining might become crowded (hyperplasia, a cause of uterine cancer) which can result in heavy bleeding.
When the uterus is unable to produce progesterone, there is an increase in the levels of androgen, including testosterone. This spike in male sex hormones results in increase of male-pattern hair growth and other male characteristics, such as a deep voice.
Increase in waist circumference
Waist circumference is a measure which helps you to identify the risks associated with excess fat around the waist. A waist circumference of 40 inches or more in men and 35 inches or more in women is related to health problems such as Type 2 diabetes and heart diseases.
Acanthosis nigricans is Darkening and thickening of specific parts of the skin, particularly in skin folds of the neck, armpits, and crotch.
Acne, oily skin
Weight gain or difficulty in losing weight
The relationship between PCOS and Diabetes
One of the major problems in the initial stages of Polycystic Ovarian Syndrome is insulin resistance which happens when the body does not work the way it should. As everyone knows, insulin is an important hormone to control blood sugar levels. When the cell resists insulin, the pancreas then produces more and more insulin to control the sugar levels. It affects the immune system and can trigger Type 2 diabetes, gestational diabetes (diabetes during pregnancy) or pre-diabetes.
Type 2 Diabetes is a condition which is similar to PCOS as the cells become resistant to insulin or insulin produced is inadequate resulting in spike of sugar levels. Even though Type 2 diabetes is preventable through exercise or proper diet, PCOS in itself is a risk factor for Type 2 diabetes. High insulin levels decrease the breakdown of fat and stimulate fat storage, fluctuation in blood lipids such as low HDL-C (good cholesterol) and/or high triglycerides In fact, women diagnosed with PCOS in the early stages are later at high risk of diabetes and heart diseases.
How is PCOS diagnosed?
The diagnosis of PCOS is in several steps.
The doctor will discuss your detailed medical history of menstrual cycle and reproductive history which includes information about birth control that you adopt and the pregnancies if you have had.
Your doctor then would ask you to get a pelvic exam where they will check if you have swelling of cysts in ovary. If the doctor feels the presence of cysts, they might recommend an ultrasound of the uterus.
If the tests diagnose PCOs, the doctor would suggest the blood sugar to be tested to check hormone levels. Since insulin resistance is one of the effects of PCOS, insulin and glucose levels will also be checked.
Can there be a similar treatment?
Treatment varies from person to person on the basis of diagnosis. However, the major requirement is lifestyle changes.
These generally include following a low fat, high fibre, low glycaemic index, healthy eating plan, giving up smoking and doing regular physical activity which can help with weight management and improve insulin sensitivity. A weight loss of as little as 5% can improve insulin levels, acne, ovulation, fertility, reduce excessive hair growth and improve mental health. These lifestyle changes can also assist with managing other risk factors including high blood lipids, blood pressure and hormone levels. In many women the male hormone levels reduce therefore reducing future risks.
Continuous physical activity is a must to keep the body healthy and fight obesity which is associated with PCOS. Exercising also burns excess blood sugar and makes the cells sensitive to use insulin more effectively. This benefits people with diabetes as well as women with PCOS.
Healthy food habits
A balanced diet that gives whole grains, healthy fats, and fruits and vegetables is helpful in managing diabetes and overweight. Include low-fat, low GI foods in your diet plan.
Hormonal birth control makes your menstrual cycle more regular and helps control the rising levels of androgens which results in low growth of hair on face and body.
Smoking leads to cardiovascular diseases that can cause blood clots in women who take birth pills. Since PCOS is treated with birth pills, this can become a major problem. In simple way, smoking inversely affects heart, blood and nervous system.
A balanced diet and physical activity can help ease PCOS-related signs. Reducing weight may bring down your blood glucose levels, enhance the way your body utilizes insulin, and help your hormones achieve target levels. Indeed, even a 10% decrease in body weight can help make your menstrual cycle more normal and enhance your chances of getting pregnant.
Get enough sleep. Sleeping helps to restores the body and contributes in weight loss. Six to eight hours of sleep every night can improve you overall health.
Knowledge about the disease
Not only in PCOS, but in every medical condition knowledge of the disease can make you informative about the risks and help you fight them. By knowing the causes and effects of PCOS and insulin resistance, you can know how to prevent them.
Maintaining blood lipids
In PCOS, the decrease of fat breakdown and stimulation of fat storage fluctuates in blood lipids such as low HDL-C (good cholesterol) and/or high triglycerides. As PCOS can result in cardiovascular diseases in later stages, maintaining the blood lipids is important.
Keeping a track of hormone levels
As PCOS affects hormone levels, keeping a track of the hormone levels is necessary. All the hormones especially insulin and thyroid should be checked quarterly if you have PCOS as it is the most affected.
Nevertheless, particular medicines for the two conditions may supplement or balance rehab tips each other.
For instance, medicines like metformin that is proven to improve insulin resistance may be prescribed to women diagnosed with diabetes. However, metformin might also have side effects if not used in conjunction with recommended lifestyle changes
If you have PCOS or diabetes, it is better to consult your doctor or diabetes educator about which treatment options will work best for your particular situation.
Previously, the amount of carbohydrate intake was considered to be directly related to the blood glucose response to different diets. Because of this, food that was included in the traditional diet plans was on the basis of the amount of carbohydrates. However, the concept of Glycemic Index (GI) has cleared that foods relative to glucose or white bread with similar carbohydrate contents does not have the same effect on glucose levels.
What is Glycemic Index (GI)?
GI is a measurement of carbohydrate-containing foods and their impact on blood sugar. In simple words, instead of counting the total amount of carbohydrate level in food, GI measures the actual impact of these foods on our blood sugar. It has managed to be a key player for prevention and management of diabetes, cardiovascular diseases and even some types of cancer.
Why is GI important?
The Glycemic Index has been able to decrease the risk of cardiovascular disease, prevention and management of diabetes, metabolic syndrome, stroke, depression and cancers of breast, pancreas, colon and prostrate. Hence, diets prepared on the basis of low GI will have food which has low glucose level. For example, kidney beans and lentils have less starch which would be recommended in diets.
How is GI measured?
According to the definition, GI ranks food on an ascending scale of 1-100 by measuring the actual blood sugar released on consumption. On the basis of this, all foods are classified into three general categories:-
High glycemic index foods (GI 70 or above), that induce an immediate rise in the sugar level.
Intermediate glycemic index foods (GI 55-69) that causes an average rise in the blood sugar.
Low glycemic index foods (GI 55 or below) that causes gradual rise in blood sugar.
The Glycemic Index is calculated in two steps.
Typically, any food consumed in whatever size produces 50gms of available carbohydrate. Available carbohydrate is what can be easily digested, absorbed and metabolised by the body. These carbohydrates have a greater impact on the body than general carbohydrates as carbohydrates in general can’t be digested or absorbed easily. Insoluble fibres are a kind of general carbohydrates.
So, the available carbohydrates are equal to the amount of total carbohydrates less total amount of fibres.
After the food is consumed, the sugar levels are checked after two hours and the results are plotted thereafter. The summary of the result is what is called the Glucose “AUC” or area under curve. This shows the immediate impact of food on blood sugar.
In the second step, the food intake for calculation is one of the two relative foods: pure glucose or white bread. Once again, the blood sugar is checked over a period of two hours and the results are plotted. The following results are then compared to calculate the GI of the different food. For easier calculation, the relative food, white bread or pure glucose is given a value of 100. For example, if the research is to find the impact of lentils in comparison to white bread, the results are plotted and the AUC is found out to be 46% for lentils. In this case, the glycemic index for lentils is 46.
Low Glycemic Index Indian Foods
Though the food intake can’t be wholly controlled on the basis of GI, there are certain Low Glycemic Index Indian Foods which can be included to balance the sugar levels.
Chickpeas (28) – It has fibres which can prevent sugar levels to elevate, hence it is a must to be included in diet for diabetics. You can prepare a taste curry for your rotis or prepare hummus for bread.
Broccoli- Also known as ant diabetes super hero, this has high levels of fibres and low carbohydrates and is highly recommended in diabetes.
Apple (38) – As always, an apple a day keeps the doctor away! Apples are filled with fibres and can be used as an alternative for those who have a sweet tooth. Other fruits are papaya, pears and grapes which help in controlling blood sugar.
Dalia/Cracked wheat- More nutritious than white rice and refined flour, dalia has a better glycemic index than both as it has more fibre, vitamins and minerals. It is recommended for those who have diabetes, high cholesterol or high blood pressure.
Bitter gourd (karela) – A compound called charantin in bitter gourd keeps the sugar levels low and has great benefits of controlling diabetes.
Fenugreek (methi) seeds- These have chemicals and fibres that slows the process of absorption of sugar and helps in many ways to cope with diabetes. Soaking few methi seeds overnight and drinking the water in the morning will be the best way to start the morning.
Drumsticks- Again, a great food to manage diabetes. Drinking a glass of this juice in the morning will do wonders!
Raw onions- It has hypoglycemic effects which helps in managing the sugar levels and keeping them in control.
Ragi- It helps in digestion and prevents over eating making you feel full for a long time. Another benefit of ragi is keeping the diabetes under control as it is high in fibres.
Beans- A complete mixture of high quality carbohydrates, proteins and soluble fibre, this is the end of search for a good food item.
Fish- A solution for heart related issues and is also a good meal for diabetes. Meats and fats don’t have GI as they don’t have carbohydrates but proteins.
Whole grain bread- It is found that simply switching from white bread to whole grain has increased the sensitivity to insulin. Next time, don’t forget to read the ingredient and pick the loaf that says “whole grain”.
Barley- Having barley instead of white rice can reduce the blood sugar by 70%.
Nuts like walnuts, almonds and cashews are also low in GI
Brown rice- Though the GI of brown rice and basmati rice is same, brown rice has a lot of fibres and is considered more nutritious.
Why Glycemic Index values are unpredictable?
Though the latest trend of healthy eating is Glycemic Index, there are few things that are still unexplainable. For example, the starch level for pasta noodles and whole grain bread is the same but the GI of whole grain bread is more than that of pasta noodles. This is because the 3-D structure of bread allows the enzymes present in the saliva to break the starch more which gives this result. And hence, it shows a greater Glycemic index.
Also, the GI impacts on the way of cooking. For example, some legumes prevent breakdown of the starch present and therefore has a low GI, unless overcooked. Moreover, if the legumes are converted into flour, the value of GI may tend to increase.
It is suggested that the diet should not be entirely relied on the glycemic index as it may vary for unhealthy food. Also, there are people including athletes who would need food items with high glycemic index as it provides quick dose of glucose during or after competition. Hence, it is necessary to maintain a diet which is according to the needs of a body.
Type 1 Diabetes, it is genetic. Did you expect that you too will be affected like your father and grandfather?
Having Type 1 Diabetes in the family never automatically meant I was going to get it. However, I was aware from around 18 years old, when my father was diagnosed, that there was a greater opportunity of developing the condition. I’m lucky that I was able to see my Father deal with it so well and not let it affect his life dramatically so that when I was diagnosed, I had a good amount of experience to call on as well as a man who could answer all of my initial questions.
Your life in 2011 as compared to 2016.
I don’t think it could be more different. Apart from my ethics and beliefs, a huge amount has changed. A lot of people see diabetes as a life sentence – an incredible weight on their shoulders but I made the choice very early on to let it benefit my life as much as I could. I’ve developed a huge passion for nutrition and physical training, to understand how my body works and to help people as much as I can. It’s strengthened my both physically and mentally and allowed me to meet and work with some amazing people in and out of diabetes which has been incredibly rewarding. If anything, I’m far happier now than I was in 2011, in so many aspects of my life. Without diabetes, I don’t think I’d be where I am today.
Diabetes has given you a life purpose. Is this true?
Yes and no. I’ve always had a life purpose. What diabetes has done is given me a great drive to accomplish things that I wouldn’t have considered beforehand. Once you get that ill, nothing really scares you anymore.
For those who are unaware, diabetes has a honeymoon phase. How was yours?
Great – initially. I basically had diabetes without any of the real complications. I started on insulin for the first two months and eventually was having so many hypo’s that my specialist and I decided to come off it altogether. This was expected to last a couple of weeks but ended up lasting almost 3 years. The difficult period was going back onto insulin which was more a pride thing than anything else. I wanted to prove that diabetics could live without insulin. Obviously a pipe dream but now I see that with or without artificial insulin, I can still achieve all that I want to do.
Insulin & You. Friends or Foe?
Friends. Definitely. It saves my life daily. It allows me to live a somewhat normal life. I am incredibly grateful for it. Hypos are incredibly tough and those who have never experienced one will never truly understand. Having a positive outlook on any auto-immune condition is essentially. You can’t constantly hate it or be angry by it. It’s not going away, you have to learn to get along.
There are so many people in the world without the access to regular insulin medication, I feel that it would be entirely ungrateful of me to complain about it.
You’re are a foodie and have Type 1 diabetes. What’s your secret to enjoying good food?
Learn to cook with real ingredients. Find recipes that you love and enjoy them with friends and family.
Having an excellent relationship with food is important. It’s there to enjoy, keep you healthy and to enjoy. Learn to balance the good with the bad – I usually stick with an 80 good 20 bad ratio. Too many people see food as such a negative thing, that it’ll play havoc with their blood sugars or make them overweight. Tracking is crucial here. You need to eat, there’s no getting around it, so it’s all about making it a positive experience.
Food is food and food is awesome.
Do you ever want to say “I wish I didn’t have Type 1 Diabetes” ?
Sometimes. No-one ever chooses to have an auto-immune condition. However, it’s allowed me to learn the value of my health and develop as a person. It sounds weird, but I think a lot more people would look after themselves better if they really knew how quickly their health can be taken away.
Find a physical activity you enjoy. This is the most important one. Be it football, cycling, the gym, running, swimming.
Constantly. Knowing how your body reacts to physical activity and the food you eat before and after allows you to continue to enjoy and experience the benefits.
Do it with friends. That sense of togetherness is key.
Increase muscle mass and reduce body fat. Learn the basics – an increase in muscle allows for better insulin sensitivity. Find a good personal trainer who understands diabetes and allow them to help you if you have no experience.
Take your time. Too many people throw themselves into 6 days a week of exercise and burn out way too quickly. Start slow and build up to what benefits your life. This is a life long journey, taking a couple of months to ease yourself into anything new will only benefit you long term.
Best recommendations of online resource every diabetes individual should surf or download.
My blog – shameless plug – but I talk about my experiences with diabetes, training, food and nutrition tips as a training nutrition coach. You can find it here: www.thehealthydiabetic.co.uk
Other than that Beyond Type 1 is a fantastic resource and an organisation I do a lot of work with.
If I can do it, so can you. words of wisdom to young man recently diagnosed with Type 1 diabetes.
You are the master of your own diabetes management.
Take your time. It’s going to change your life and there’s no getting away from that but if you educate yourself on leading a healthy lifestyle, track, assess, form good sustainable habits and manage the best you can – you’ll do great.