DIABETICS BENEFIT FROM SPORTS PARTICIPATION

- by Dr. Robert C. Martin

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Approximately 16 million people with diabetes live in the United States. Of those 10% are type 1 or insulin-dependent, which means they must supply insulin to their bodies to control their blood sugar levels. The other 90% are type 2 or non-insulin-dependent that must take medication to stimulate or increase the production of insulin from their pancreas. Wider recognition of the benefits of intensive diabetes management is a recent phenomenon, but there has long been a philosophy among diabetes specialists to advise patients to become more physically active in hopes of improving their diabetes control and enhancing their quality of life. It has been well established that the development of type 2 diabetes can be significantly delayed by exercise and by maintaining an active lifestyle. In the last 20 years the incidence of both types of diabetes has increased. Many researchers feel this may be related to a decline in exercise participation. During physical activity, exercising muscles significantly increase their use of oxygen and of sugars from the liver as well as triglycerides and free fatty acids. Circulating hormones control the levels of these muscle fuels. Insulin is the primary hormone that ensures the proper level of sugar in the bloodstream. In a healthy person insulin is produced at regular intervals regulating sugar levels throughout exercise. With diabetes, exercise activity places a more vigorous challenge on muscle metabolism and blood sugar can quickly get outside normal limits, therefore diabetics must follow proper steps to exercise safely. Whether you have diabetes or not physical activity carries many benefits. There are obvious social benefits to exercise and sports participation: peer relationships developed and enhanced by shared experiences, enhanced self-esteem and confidence from mastery of a skill, learning about teamwork, character, and courage, etc. Specific health benefits associated with exercise, such as lower blood pressure and resting heart rate, lowed cholesterol and lipid levels and improved cardiovascular fitness are all magnified for diabetics who participate. A study published in the Archives of Physical Rehabilitation showed that with exercise, diabetics can significantly reduce their risk of health problems related to diabetes, such as heart attack, stroke, diabetic retinopathy (a deterioration of eyesight) and blood vessel damage. To participate in sports or exercise safely diabetics should start with a visit to their doctor. This is particularly important for people with Type 1 diabetes. A thorough understanding of the nature of the training, practices, and competition is necessary to craft a plan for safe and productive training and optimal performance. Some factors to consider are:

• How many hours and what kind of activity will be endured;

• What times of day and on how many days per week it will be done;

• Whether there are provisions for giving extra carbohydrate if hypoglycemia (low blood sugar) occurs;

• Whether the coaches and trainers support the athlete’s efforts to participate.

Given a thorough preparticipation evaluation, it is possible to tailor diabetes care to allow for very active sports participation, including extremely difficult events, such as an ironman triathlon. In addition, advances such as newer more effective types of synthetic insulin along with insulin pumps - that reduce or do away with the need for frequent insulin injections - have made any sport possible for patients with diabetes. Sports and exercise offer benefits to everyone especially diabetics, get out and get started.