Thursday, January 12, 2012

See ya on the ski slopes...


Unlike what most considers to be “normal”, our bodies were not designed to sit at a desk all day. Our bodies where designed to move and to perform physical work. Regular physical activity eventually causes an adaptation which makes us physically stronger, fitter and generally healthier.

Exercise also makes our body more sensitive to insulin. Essentially, it helps the insulin do its job (move glucose from the bloodstream into the cells to provide energy) much more efficiently.

With Type 2 Diabetes, insulin resistance is a big part of the problem, therefore becoming more active is also a big part of the solution. With Type 1 Diabetes, physical exercise is also important. By increasing insulin sensitivity, the Type 1 gamer requires less synthetic injected insulin to control blood glucose levels. Less medication is always better and by decreasing insulin dosages, you also increase the likelihood of getting doses right. Less medicine = smaller mistakes, whereas more medicine = bigger mistakes. A Type 1 gamer can however never eliminate all injected insulin, since unlike Type 2 Diabetics, their bodies have lost the ability to produce their own insulin. Increasing insulin sensitivity is good in that it makes it much easier to avoid high blood sugars. When the Type 1 gamers physical activity level goes up, the injected insulin begins to work much more efficiently in avoiding high blood glucose values which are the cause of long term health problems associated with the disease.

As good as this all seems, there is also one “drawback” to physical exercise for a Type 1 gamer and that is putting them at risk for hypoglycemia (low blood glucose). One of the differences between Type 1 and Type 2 Diabetes is that in “adult-onset” (Type 2) Diabetes, the patient is mostly not susceptible to hypoglycemia (low blood glucose) since the mechanisms in their bodies working to prevent this are still working. Hypoglycemia is a constant and immediate threat for all Type 1 gamers with possible outcomes being unconsciousness or even death if untreated. Hypoglycemia can creep up almost unexpectedly with little signs or symptoms until it’s too late. Playing in the snow and jumping on her trampoline are the activities that drop Adele’s blood glucose the most.

This coming weekend, Adele and I will be spending a day on the ski slopes downhill skiing. Even if the physical effort required is less than cross-country skiing, it still requires a significant level of physical effort that will surely send Adele into hypoglycemia if I don’t back off on her insulin. That is the part of the equation that is 100% certain. Determining exactly how much insulin I need to back off is the tricky part…

Adele’s test kit in my jacket (close to the body to avoid freezing) and some simple, fast-acting sugar are a must during all of our ski runs as well as hourly blood glucose checks to see if the reduced dose of insulin is enough or too much. Then, a few extra blood glucose checks during the night to make sure the delayed insulin sensitivity doesn't make Adele go low up to 24 hours after all the extra exercise.  All that work, worry and vigilance to do what most non Type 1 gamers do without even thinking twice… Is it worth it? Imagining Adele’s big smile coming down the hill as I write this… you bet it’s worth it.

5 comments:

The Diabetic Camper said...

I am camping this weekend and have to think about all sorts of ways to keep my test kit, and pump from freezing. I even sleep with them in my sleeping bag at night.

Diabetes311 said...

Agreed. Exercise is a dual edged sword!~ I love to ski and am fortunate to go often. I spend a good deal of time "testing" and retesting in the lodge. For those of us that are not "young" anymore its an excuse to rest! I find that anything that causes an adrenaline rush, etc brings my blood sugar up. Never a dull moment with the big D. Take good care and have a safe and happy trip making memories together!

Anonymous said...

Exercise has an enormous effect on blood sugars in our case and it is worth it. But since just simple walking reduces basals substantially and causes lows for her, I am glad she is not an extreme athlete by nature. She does skate, bike and exert herself but not for hours and hours a day like some kids do. Call me a coward but I am grateful she is not more athletic than she is. She usually gets a moderate amount of exercise most days. On days she has been more active, it is usually problematic. This is a very hard thing to accept about Type 1; that they can't just exercise without loading up on carbs before during and the whole night after. Much more difficult to manage an extremely athletic child who engages in sports hours daily. Whatever they want to do, you must help them do it but, yes, exercise is a double-edged sword.

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Sarah said...

I hope this went very well, we're heading to the slopes soon with the boys and I think the anticipation of what "could" happen is making me much more anxious than I need to be.