Timing and some food at the ready is important for diabetics who exercise


September 01, 1992|By Dr. Gabe Mirkin | Dr. Gabe Mirkin,Contributing Writer

Exercise helps control diabetes -- when the diabetic's blood sugar level is neither too high nor too low.

But when the diabetic's blood sugar level is too low or much higher than normal, exercise can cause a diabetic to pass out.

A high blood sugar level means your body is unable to utilize sugar correctly for energy, so it burns extra fat, which causes ketones -- organic chemical compounds -- to accumulate in the bloodstream. The exercise also causes the body to put out large amounts of growth hormone and the body's own natural stimulants, such as adrenalin, which cause blood sugar levels to rise even higher.

The best option when blood sugar levels are too high -- two to three times normal -- is to not exercise but wait until the levels drop, either by adding insulin or waiting until blood sugar levels come down on their own.

Exercising muscles draws sugar from the bloodstream for energy. When blood sugar levels are low, exercise can lower them even further. For a diabetic receiving insulin, exercise can push low blood sugar levels so low the individual may pass out.

Exercising the area of the body, such as the thigh, that receives a diabetic's insulin injection causes the insulin to be absorbed rapidly into the bloodstream. This reaction can cause blood sugar levels to drop too low.

To prevent and treat low blood sugar levels during or after exercise, insulin-dependent diabetics should eat within two hours before exercising and have food available throughout the session. They should not inject insulin into the area over the muscles they will use most during exercise.


Q: What's the best way to lift weights to become stronger?

A: The only way to get stronger is to exercise against progressively greater resistance.

Before you start a weightlifting program, you should be healthy and have medical clearance. Begin by picking the heaviest weight you can painfully press very slowly over a full range of motion, 10 times in a row. Do this every second or third day. Every fourth workout, do a set of 6 to 8 "lowerings" with a much heavier weight than you can lift. You will need two friends to help you.

Author Ellington Darden, in his book "Bigger Muscles," offers some additional tips:

First, lift heavier weights rather than do more repetitions. The only way to become stronger is to increase the amount of weight you lift.

Second, move slowly and maintain good form. The slower you move, the greater the stress on your muscles and the greater the gain in strength.

Third, keep your workouts short and sweet. When you work with very heavy weights, the stress on your muscles is so great that you can't do many repetitions without hurting yourself.

Q: Is it healthier to be a vegetarian or meat-eater?

A: The recent Second International Congress on Vegetarian Nutrition offers a mixed verdict.

Vegetarians are as susceptible to developing osteoporosis, a weakening of the bones, as meat-eaters are. Large muscles are more important to having large bones than any nutritional factor. However, vegetarians may not get enough calcium, also needed for strong bones, unless they eat dairy products.

Since vegetarians usually eat less fat, they are less likely to suffer from heart disease and some cancers. Studies have shown that Vegetarian Seventh Day Adventists have lower incidents of non-smoking-related cancers, particularly colon cancer, than people who eat meat.

But a vegetarian diet during pregnancy may lead to shorter labors and smaller newborns, and small babies have more health problems. Vegetarian children may be smaller than meat-eating youngsters, unless the children consume a lot of vegetable oils to meet their need for fat. Children on a strict vegetarian macrobiotic (low calorie) diet do not grow well from ages 6 to 18 months.

Furthermore, breast-feeding vegetarian mothers produce milk high in methylmalonic acid, a symptom of vitamin B-12 deficiency. These women should supplement their own or their baby's diet with extra dairy products or vitamin B-12 pills.

Even though plant foods can be low in trace minerals, vegetarians do not appear to suffer from trace mineral deficiencies.

Dr. Mirkin is a practicing physician in Silver Spring specializing in sports medicine and nutrition.

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