Diabetes & Exercise – Expert Tips to Manage Diabetes DURING Aerobic Exercise with Dr Rob Andrews
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Dr Rob Andrews talks about diabetes & exercise – Expert Tips to manage diabetes DURING aerobic exercise with Dr Rob Andrews
Paul Coker: Hi. Paul Coker here from 1BloodyDrop.com. On the previous video, I was talking with Dr. Andrews about how you manage your diabetes before aerobic exercise. In this video, I’m with Dr. Andrews, and he’s going to be sharing with us how you manage your diabetes during aerobic exercise. Just for those that haven’t seen the first video, Dr. Andrews, could you just give us a quick introduction of your phenomenal expertise in diabetes and exercise?
Dr. Rob Andrews: I’m Dr. Rob Andrews. I’m a physician who works with people with diabetes in a district hospital, in Taunton. As well as taking care of people who’ve got type 1 diabetes, I see people who are coming up to do sporting events, such as marathons and things, or people who are doing sports at an elite level, and try and give them advice to help them manage their blood sugars before and during and after. To aid with that, we have a research programme that’s run through the University of Exeter that we try and answer questions to make that advice better with time.
Paul Coker: Thanks, Rob. The work that you’re doing is just incredible, and I know that I’ve benefited from it. By us sharing some of your knowledge on this video, I’m hoping that we can get some of your fantastic knowledge out to a much wider community, so thank you for joining us today.
Dr. Rob Andrews: Sure.
Paul Coker: The previous video, we were talking about how you manage your diabetes before you do aerobic exercise. In this video, I’d like to talk about what you should do to manage your diabetes during aerobic exercise, or rather what you should do, what the research suggests is a useful strategy for managing diabetes during exercise. Because, of course, what works for me may not work for the next patient. I think there’s an element here where I can find a method that works for me, and somebody else could try that exact same method. It wouldn’t necessarily work for them, and they would need to refine it.
Dr. Rob Andrews: Yeah. I think you’re right. Exactly what you said is is that it’s very personal what works for certain people. One way of changing the variance that some people see with … Sometimes people find if they do the same exercise, they get a different response each time they do the exercise … is to think about whether it’s worth doing it fasted. We know from research that if you do your exercise before breakfast in the morning, that actually the response you get with whatever exercise you do for you is pretty consistent.
Whereas, if you’re exercising at other times of the day, there’s lots of other things going on, stress of work, when you last ate, when you last took your bolus insulin. That means that you could have a very varied response even though you think you’ve cracked it one time, having done it before. That’s one tip that I would say if you want to try and decrease your variance is think about whether you do that fasted.
Paul Coker: Okay. That’s really interesting because if you look at all of the sports material out there, everybody tells you, “Oh, you should be loading with food before you exercise,” and so actually exercise fasting is not recommended in the mainstream literature. Now, how much science is based on the mainstream literature, I honestly don’t know. But I find it absolutely fascinating because my preferred strategy for going for a run is to get up first thing in the morning and run before breakfast.
For me, personally, I experience a severe amount of insulin resistance in the morning because of a variety of hormones that are flying around in my body. Actually, going for a 30-minute run, I actually manage to negate all of those insulin-resistant hormones without having a huge dose of insulin. That means that I am then going through the whole morning period and getting to lunchtime without going hypo. Whereas, if I try to manage those insulin-resistant episodes with increased insulin, by lunchtime, I am battling hypoglycemia. For me, I find it an essential part of my diabetes management tool kit.
We’re going on a slight tangent here, so I’d like to actually talk about what you actually do during an exercise session. Doing it in a fasted state is one strategy, but, of course, my own opinion would be you need to make sure that you’ve got fast-acting carbohydrates around in case you do go hypoglycemic. If you’ve not eaten for the last 12 hours, you may be at risk if you’re on the running machine for 20 minutes. I think that that, for me, would be one thing I would recognise from my own experiences. What other recommendations would you have?