Frequently Asked Questions

Here you’ll find detailed answers to the most frequently asked questions. If you still can’t find your answer, please feel free to ask in the comments, which are active on all of the site guide posts. I’m always updating and adding to this page.

Diabetes Questions

Diet Questions

DIABETES QUESTIONS

Q. Is insulin an advantage to diabetic bodybuilders?

No. People with diabetes need insulin or they will die. Diabetes is a catabolic (muscle wasting) disease if uncontrolled. Insulin is necessary for organising the use and storage of fuels within the body, especially carbohydrate.

Many people get confused and believe the fallacy that people with diabetes using injectable insulin are at an advantage because it’s used/abuse as an ergogenic aid in hard-core bodybuilding.

Diabetics do not have an advantage because they use insulin  Read this article for a more in-depth explanation on the topic. Insulin, Diabetics and Bodybuilding

Q. Can you build muscle quicker if you are diabetic?

No you can’t. Deficiencies in insulin production and/or poor action (insulin resistance) result in problems with the body’s ability to process glucose and build muscle.

It is fair to say that a poorly controlled person with diabetes has LESS chance of building muscle. This can be counteracted by tight control, frequent strength training, adequate rest and a calorie controlled protein rich diet.

Q. Can diabetics get ripped?

Yes. It’s just a matter of knowing what to do and being consistent. The following factors need to be respected when it comes to getting ripped with diabetes, Energy

Intake – Calorie intake via food and drink  Energy
Expenditure – Via Physical activity and set exercise

Training Stimulus – Highly Specific to muscle gain
Recovery – Rest and Stress management
Robust diabetes management to avoid health complications, muscle breakdown, unwanted fat gain and dips in training performance.

Q. Which is better pump or injections?

Insulin Injections require a physical injection. While modern pens are easily stored, quick and painless to administer. Some people struggle and find insulin injections time consuming, embarrassing and intimidating.

Insulin pumps
, are battery powered devices that slowly infuse insulin into the body. They are well suited to patients who have trouble managing their blood glucose levels or don’t like to use needles.

There are many benefits to using a pump over needles including:
  • More flexible living: Less hassle of injecting in public.
  • Precise dosing: Pumps can dose insulin to the nearest .025, .05 or.1 of a unit –meaning less chance of overdosing and going low.
  • Finer tuned adjustment: During periods of stress, illness, growth and
  • Menstruation.
  • Measurement of data: Pumps sync an abundance of blood glucose readings and behaviour over smartphone and computer. This allows for accurate assessment and review of treatment strategies.One of the biggest problems with pump users is mechanical fault or the pump being physically ripped off or wearing it during sex. The optimal dosing strategy for insulin has not been identified and will likely depend on personal preference.

Q. Is there a cure for diabetes?

Not currently. They’re working on it. Your main focus now should be educating yourself and striving to achieve perfect blood glucose control.

Q. What do I do with my used needles and test strips?

Respect others by keeping your environment clean. No one likes to see used needles or test strips lying around, including public places.

This gets people with diabetes a bad name.

Also, respect your bin man by using a sharps disposable box.

Q. Can diabetes affect my sex life?

Yes, it can. Poorly controlled diabetes can reduce the quality of your sex life, and your partners.

Ensure you’re well hydrated and blood glucose levels are in acceptable range before engaging in sexual activity. Sex is a form of exercise, so do yourself a favour and have hypo prevention strategies to hand, just in case.

Low sex drive, impotence, cramping and bad breath are all signs of poorly controlled diabetes.

Q. What is the first thing I should do when I feel my blood glucose going high?

If using a finger prick test. Clean your hands first, test and then correct as needed. If in doubt, test again – even if this means using another meter. Technology isn’t always perfect.

If you’re using CGM, simply correct.

Q. What do I tell people if I’m taking a low and don’t have money to buy something?

If you don’t ask you don’t get. Simple. Respect your health, your family and quality of life. You’ll find the majority of people you ask will want to help. At the same time, you should always be prepared for hypos.

Whether it means keeping lose change for a vending machine or carrying around glucose for rapid treatment.

If you’re using CGM, simply correct.

Q. Which is worse Type 1 or Type 2?

No type of diabetes is worse than the other. The most important thing for both types is to keep the blood glucose level in normal range.

For people with Type 1 that means the key focus is on taking all insulin and balancing it with food, exercise, and lifestyle.

For Type 2 there is a heavier focus on weight management but can also include taking medications and insulin.

Being fully educated and empowered is essential – you can do this by clicking HERE.

Q. As long as my HBA1C is good I’m healthy, right?

Not 100% correct. Hba1c is the most valid measure of long term health risk for both Type 1 and Type 2 Diabetes. The aim is to keep HbA1c at or below 6.5% (48 mmol/mol) to ensure lowest health risk.

That being said there is growing evidence that if your glucose levels are very variable, with lots of highs and lows, this can independently increase risk of cardiovascular disease.

If you achieve an HbA1c of less than 6.5% (48mmol/mol) but at the cost of frequent hypoglycaemia, this can impact on memory and will prevent you from driving.

Being fully educated and empowered is essential – you can do this by clicking HERE.

Q. If I inject insulin into a muscle what happens?

Injecting insulin into a muscle can lower blood sugar down quicker than if injected in fat tissue. Generally, it is not advised.

However, there may be a time and place for this, especially if correcting a very high blood glucose reading or if you have extremely low levels of body fat.

Q. If I inject insulin into a muscle group will it make it grow quicker?

No.

Q. How do I keep my pump and CGM secure? They keep falling off!

Kinesiology tape or Grif Grips are useful for keeping technology like pumps and CGMs secure during extreme activities and training.

Q. What popular supplements can interfere with diabetes management?

Decrease Blood Glucose
– Chromium.
– Alpha Lipoic Acid
– Cinnamon

– Other insulin mimetics (lowers blood sugar)

Increase Blood Glucose

 – Caffeine
– Other stimulants like ephedra.
– Niacin.

Q. What medications interfere with diabetes management?

Increase Blood Sugar
– Barbiturates.
– Thiazide diuretics.
– Corticosteroids.
– Birth control pills (oral contraceptives) and progesterone.
– Catecholamines.
– Decongestants that contain beta
– Adrenergic agents, such as pseudoephedrine.

– The antipsychotic medicine olanzapine (Zyprexa).

Decrease Blood Sugar

 – Bactrim (an antibiotic)
– Beta-blockers.
– Haloperidol.
– MAO inhibitors.
– Metformin when used with sulfonylureas.
– Pentamidine.
– Quinidine.

Q. Do popular painkillers like Aspirin or Ibuprofen affect blood sugar levels?

There is currently no evidence to suggest so.

Be mindful of using too many pain killers and NSAIDs (non-steroidal anti-inflammatory drugs) as they can reduce the anabolic responses to strength training when overused

Q. Why does my blood glucose increase after weight training?

One of the main reasons resistance training increase blood glucose levels is due to the Increased production of counter-regulatory stress hormones such as cortisol and growth hormone.

These hormones serve to mobilise fuel and increase blood glucose levels. Other process like the Cori cycle and gluconeogenesis also play a large role. However, that is way beyond the scope of this short answer. I talk about them in detail in my book!

In healthy individuals, the temporary rise in blood glucose levels is compensated at the end of training by normal insulin production. This keeps blood glucose levels in range. But people with type 1 diabetes fail to produce enough insulin to bring blood glucose levels back down to normal levels, which results in hyperglycemia if insulin medication isn’t administered.

Q. Why is my blood glucose high when I wake up?

This may be due to one of the following reasons,
– Pump disconnect or insulin pen problems.
– You didn͛t take enough bolus for your pre bed meal.
– Your basal insulin is not working (out of date, bad batch)
– Lack of basal insulin
– Stress.
– Particular medications

Q. I go to bed with a normal blood glucose reading and keep waking up with a hypo, why is this?

There is too much circulating insulin in your system. You may have trained the evening prior and consequently the insulin mimetic effects of exercise have caused you to go hypoglycaemic. Pump malfunction may be another issue.

Q. Is it ok to run my blood glucose levels high to lose fat?

No. This isn’t the right way to lose body fat and look great. Long term hyperglycaemia will dramatically increase your risk of diabetic related health problems, including:
– Cardiovascular disease
– Nerve damage (neuropathy)
– Kidney damage (nephropathy)
– Eye damage (retinopathy)
– Foot damage
– Muscle Loss
– Reduced Immune Function
– Skin conditions
– Hearing impairment
– Alzheimer’s disease

Q. Is it true my body doesn’t absorb fuel when I’m high? Surely, I can eat whatever I want then?

Yes and then a strong NO.

When your glucose level goes above 10mmol/l (180mg/dl) from eating whatever you want or missing insulin, your kidneys have to work hard to get rid the excess glucose, by flushing the excess out via the urine.

It is true the energy from this glucose is not available to the body; however, every time your glucose level goes high there is damage done to the small vessels in your body.

If this happens repeatedly for a prolonged period of time, you can develop serious health issues with your eyes, kidneys, feet and all other major organs.

Being fully educated and empowered is essential – you can do this by clicking HERE.

Q. What should I do if my blood glucose is high before I do cardio?

If your blood glucose is high pre-cardio, consider taking half (or less) of your usual correction dose and assess 25 minutes into training.

A full correction dose might stimulate a hypo.

Q. What should I do if my blood glucose is low before I do cardio?

Consume an adequate amount of carbohydrates to bring blood glucose back into range. Cardiovascular exercise has the tendency to lower blood glucose, thereby having the potential to amplify the hypo.

Short bouts of High Intensity Interval Cardio can increase blood glucose levels. But the nature of the cardio after may lower blood glucose back down again. Defeating the purpose.

Q. What should I do if my blood glucose is high before I weight train?

If your blood glucose is high pre-weight training, consider taking your usual correction dose and assess 25 minutes into training.

Strength training has the potential to increase blood glucose levels. Taking less than your normal correction dose may not account for the blood glucose rise that often accompanies this form of stressful training.

Q. What should I do if my blood glucose is low before I weight train?

Consume a liquid carbohydrate sports drink. This acts fast and won’t bloat you like a solid food meal.

The amount of carbs to consume need will largely depend on the severity of your hypo. Weight training can increase your blood glucose levels, accommodate this when eating and avoid over treating your hypo with too many carbs, which will inescapably drive you into hyperglycaemia. Or, A short bouts of High Intensity Interval Cardio can increase blood glucose levels. The strength training that follows may increase blood glucose further and get you back into safe range. 15-30 secs on with 45-60 sec active recovery. I personally use bike and row sprints. The severity of your hypo will largely be down to how much insulin is circulating in your system.

The more insulin, the more sever the hypo. Subsequently, carbohydrate may be needed.

Q. Can people with diabetes compete in bodybuilding or powerlifting?

Yes, they most certainly can.

Check out my own personal story or those who are part of Team Diabetic Muscle and Fitness

Q. Can I smoke if I have diabetes?

Avoid smoking or passive smoking at all costs. The research behind smoking’s detrimental impact on human health is colossal.

Be mindful nicotine patches can decrease blood glucose levels.

Smoking will also knock your appetite. Not a wise move for people with diabetes looking to build muscle and strength.

Q.How I know how much bolus insulin to inject?

Base your bolus dose of insulin for a set meal on how your blood glucose will sit three to four hours after the meal. Your bolus insulin dose should be based on the following key factors:

1. Type of food.

2. Pre-meal blood glucose level.
3. Proximity of exercise or stressful events.
4. Proximity of substances that raise blood glucose.
5. Digestion issues.

Q. What are the best tips to manage my diabetes when I go on holiday?

Check out these 3 awesome travel tips to manage your diabetes fitness efforts when travelling abroad.

Q. As a competitive male or female bodybuilder/physique athlete, how do you test blood glucose or inject insulin if covered in tan? Surely this will be unhygienic?

If you’re a competitive diabetic bodybuilder/physique athlete and need to wear artificial tan on competition day, injecting insulin can be difficult. Avoid injecting through tan, as this is extremely unhygienic.

I apply a plaster to an unexposed area of my glutes then peel off and on, as and when needed to inject.

Q. Does Insulin use in non-diabetic bodybuilders increase muscle mass?

No. A study by Tommelen et al. in the European Journal of Endocrinology found that exogenous insulin administered systemically(whole body) does not increase muscle protein synthesis in healthy, young adults.

Q. What are the cons of using injectable insulin?

Hypoglycaemia, a common side effect of injectable insulin use. It brings a number of problems.
1. It can result in you eating unnecessary calories at times when you may not even be hungry. This increases the potential for fat gain, especially if the hypos are frequent.
2. If you suffer regular Hypos. The issue of ͚hypoglycaemia unawareness͛ can diminish your counter regulatory responses and body͛s ability to recognise hypos. Thus increasing the chances of going extremely low and possibly losing consciousness.
3. Hypos reduce mental alertness which increases the chance of injury when training.

DIET QUESTIONS

Q. What is the best food to treat a hypo?

A liquid glucose sports drink.

Q. Are special diabetic foods better for you?

No. They are a rip off, high in calories and generally taste awful.

Q. How do I know the waiter hasn’t confused my drink with a non-diet full sugar version?

When in doubt ask, and if you have your blood glucose monitor with you test a small sample. A diet soft drink will have no detectable glucose whereas a non-diet drink will be flagged as high.

Q. Do sugar alcohols increase blood glucose?

Although slow to act, sugar alcohols can raise blood glucose levels. As a general rule, I count 50% of the sugar alcohol grams from total carbohydrate.

Q. Can diabetics eat carbs?

Yes, they can, provided they meet an individual’s calorie targets for their specific body composition goals. Carbohydrate intake must also be covered with the appropriate amount of insulin.

Q. Can Type 1 diabetics eat a ketogenic diet? Is it the best way to get lean?

Yes and then No. It is possible for a person with Type 1 Diabetes to follow a Ketogenic diet, but it is essential they clearly understand the difference between nutritional ketosis and diabetic ketoacidosis. Nutritional ketosis is purposeful choice by the individual, where the diet is very high fat (70-80%), there is low but adequate circulating insulin, the blood glucose level remains in normal range, the blood ketone level ranges between 0.5 – 3.0mmol/l, and blood ph level is normal. Diabetic ketoacidosis is where there is inadequate circulating insulin, the glucose level is very high, the blood ketone level is usually >5.0mmol/l, and the blood ph is low. In practical terms it is challenging for a person with Type 1 diabetes to remain in nutritional ketosis for a long time.

This is because they may have to treat hypos with glucose, and their body does not have the auto regulation of insulin levels to deal with peaks and troughs of stress hormones. The most recent metabolic ward studies by Kevin Hall’s Group at NUSI have shown clearly, the most important factor for getting lean is being in a negative energy balance consistently, irrespective of macronutrient profile.

Considering the challenge of staying in nutritional ketosis with t ype 1 diabetes, you may get more value in focusing on consistent negative energy balance.

Q. What is the best diet for diabetic fat loss?

All popular fat loss diets involve calorie restriction. The best diet for fat loss is one that you can stick to over the long term.

The easier it is to stick to, the easier it is to reduce your body fat to a desired level. Large calorie deficits can result in loss of energy, more hypos, muscle loss, reductions in exercise performance and undesirable changes in body chemistry.

Overly restricting certain food groups can prove socially awkward and drive you insane.

Q. Are there any bad foods people with diabetes should avoid?

There is no such thing as a bad food.

It simply boils down to dose and frequency. Too much bad food will inevitably lead to fat gain or problems with blood glucose.

Q. Is it ok to get drunk with diabetes?

Personal preference.

Getting drunk frequently is not healthy or wise. When drunk you can jeopardize blood glucose management, increase risk of injury and consume unwanted calories.

Q. Are low calorie, zero carb spirts the best option to drink over wine, beer and alcopops?

Not necessarily. Although spirts may be low in calories, they can get you drunk quicker. When drunk, food choice tends to go out the window along with common sense.

Be mindful it’s easy to mess up your diet and miscalculate medications the drunker you get. Wine, beer and cocktails can be drunk. They just need to be covered with the right amount of insulin (especially if they contain carbs) and fall within your calorie needs.

Q. What is the best protein sources for people with diabetes?

Animal sources like meat, dairy and eggs are superior for stimulating protein synthesis compared to plant sources.

Q. Do I need to do a detox diet?

No. There is no convincing evidence to support the use of detox diets for fat loss or cleaning the system. Your liver does that for you. Detox weight loss products are also overpriced.

Don’t waste your time.

Q. Can I eat carbs after 6pm and not gain fat?

Yes, you can eat carbs after 6pm and not gain fat. You only gain fat when you over consume calorie from carbs, or any other nutrient for that matter. Ensure the carbohydrate are covered with adequate insulin.

Q. Will carbohydrates make me fat?

No. Too many calories will

Q. Do I need to carb cycle?

No. Carb cycling is much like any other dietary strategy; it is a tool that has value if used in the right circumstances, and if it enhances your dietary staying power towards your goals.

The most important factor for success is consistent energy surplus for bulking, and consistent negative balance for leaning. Carb cycling can be more challenging for people with type 1 diabetes because you are changing the macronutrient profile massively from protein dominant to carb dominant. This can be done but requires your bolusing strategy to be versatile.

To become versatile and make this easy, learn how to become a Bolus Wizard at DMF… Click HERE

Q. Is too much protein bad for your kidneys and liver?

Only if have underlying kidney/liver issues.

Q. Is it better to drink water from a glass bottle?

Not unless the container is contaminated.

Q. How much water should I drink daily?

Aim for 3 + litres daily. Your hydration needs will increase during hyperglycaemia or exercise as your body will excrete both electrolytes and water faster than normal. Use a container or water bottle to measure tour fluid intake across the day. This includes anything that is liquid, like coffee, tea, and diet beverages.

Q. Can I add salt to my meals?

Yes but only if eating healthy. People with diabetes have the same recommendations as the general population for salt intake, to keep to 6g per day.

Contrary to popular belief, most of the salt in the diet comes from processed and dried food, not from adding it at the table. If you eat a real fresh food and very little processed, you can probably add a little at the table. However if you eat a lot of processed food, adding salt on top has a good chance of increasing your blood pressure. If you are an athlete who sweats a lot, you may need to increase your salt intake to hydrate effectively.

The best options are to season with using herbs, spices and lemon juice.

Q. Can I drink diet soft drinks?

Yes. They are low in calorie and carbs. Supporting fat loss and diabetes management. The health issues with aspartame are a fallacy. The dosages used in current research are done using animals and are not realistically replicated to human models.

However, diet soft drinks are high in carbonic acid, which is bad for your teeth.

Q. How many coffees can I drink per day?

Personal Preference
I generally don’t recommend any more than 4 per day. Bear in mind coffee can increase your blood glucose levels. B Cut off your coffee habit later in the evening as consuming to much within 4 hours of bed can negatively affect sleep (muscle recovery).However, diet soft drinks are high in carbonic acid, which is bad for your teeth.

Q. Can I add sweetener to my tea/coffee?

Yes. It is low in calorie and carbs. Supporting fat loss and diabetes management.

Q. Do I have to eat organic food? Is it better than non-organic food?

No. There is little data to support the majority of organic food claims.

However, some people have claimed to feel less guilty when eating‘ organic’ type foods. Placebo does have a powerful effect.

Q. Do I have to eat breakfast? Is it the most important meal of the day?

No. Good nutrition that promotes health, muscle and physique is a 24 hour sport, and the main issue is eating a good quality diet over the day, rather than getting hung up on one meal.

Some people feel great with no breakfast, whereas others need it to thrive.

One thing a person with Diabetes must consider is medication and insulin timing. If you are on a mixed insulin regimen then breakfast is essential, as it maybe if you are on a Sulfonylurea such as Gliclazide.  It is best to educate and empower yourself to be able make safe and effective decisions, do this by joining DMF HERE

Q. Do I need to eat every 3 hours?

No. Good nutrition that promotes health, muscle and physique is a 24 hour sport, and the main issue is eating a good quality diet over the day, rather than getting hung up eating every three hours.

If you have all the foundations covered and are after maximal muscle building or maintaining muscle mass when leaning, there may be a some value in consuming protein every three to four hours.

To empower yourself with the foundations and learn how to apply more advanced dietary strategies.

TRAINING QUESTIONS

Q. Can I wear a powerlifting belt if I have a pump?

Yes. You can wear a powerlifting belt if you have an insulin pump, you just need to think about where you site the cannula.

The safest place is on the side of the buttocks, as it is out of the way of the belt and there is ample fatty tissue to insert the cannula.  The upper abdomen is an option but there is usually much less fatty tissue and you risk cannula blockage.

Q. When is the best time to do cardio? Is fasted cardio better than fed cardio for fat loss?

The best time to do cardio is at a time that suits you, and when your blood sugar is in range. Doing cardio while having a hypo isn’t wise. Also, instead of doing cardio at set times (which can prove awkward). Use a step counter to assess your level of activity across the day, it is a measure of how active you are after all.

Q. As a female, will I get big and bulky like a bodybuilder if I lift weight?

No. You are not set up hormonally for rapid muscle gain compared to a male.

Q. What is the best form of cardio to burn fat?

A format you prefer and can consistently do on a regular basis.

Q. Can I train abs every day?

If you wish. Just make sure you hit them from different angles. Lateral, Flexion, Rotation, and Extension

Q. What if I’m sore after a workout? Is this a bad sign? Am I injured?

Not always.
Soreness after a training session indicated you’ve pushed your body what it is normally exposed to. This dull pain is termed as Direct Onset of Muscle Soreness (DOMS). Don’t panic. It usually subsides after a few day recovery. In order to recover well you must have appropriate rest and food. You also need to manage your diabetes very well. Hyperglycaemia will jeopardize training recovery and prolong muscle soreness. The better the control in conjunction with good quality food and rest. The quicker DOMS subside.

Q. Do you have to be sore and have a good workout?

No.

Q. Do I have to push myself to complete exhaustion every training session?

No. Never leave the gym feeling damaged, vile or lifeless!
Stimulate don’t obliterate.

Q. When is the best time to weigh myself?

First thing in the morning after using the toilet, without clothes.

Weigh using the same scales every single time to keep things accurate. If you do weight later in the day – keep the time of weighing consistent over a number of weeks.

SUPPLEMENTS QUESTIONS

Q. Can diabetics take protein powder?

Yes. Whey protein is a high quality source of amino acids. Whey protein is only problematic when drank to excess causing fat gain or burden the kidneys of individuals who suffer from underlying kidney disease.

Q. Are supplements really necessary if I’m on a budget?

The most important supplements are:
– Multi Vitamin
– Vitamin D
– Magnesium
– Fish Oil
– Creatine
– Caffeine (if needed)

Q. Do I need to take ‘water’ tablets to help remove water and increase definition? (Dandelion root etc)

No!

Q. Can diabetics take fat burners?

Provided they are commercial. Yes, they can.

However, most fat burners are merely overpriced caffeine tabs with a few added herbs and amino acids. If you do take a fat burner, be mindful caffeine increase blood glucose levels.  Other non-commercial ‘fat burners’ like clenbuterol, or ephedra should be avoided.

Q. Can diabetics take creatine?

Yes, provided their kidney health is in good order and their medical professional is aware. There is a host of research behind creatine use and its role in improving body composition and performance. It’s a healthy supplement to use for well-being, body composition and exercise performance. I talk about creatine and other muscle building supplements for diabetics in my book in far greater detail.

Q. Is there a special type of protein powder diabetics must take?

No. There is no special protein powder for a person with diabetes. You would benefit from choosing a high quality protein powder from grass fed animals.Also you must check the label to see if it has added carbohydrate to the blend. The types of carbohydrate added to gaining powders are usually absorbed quickly and will cause your glucose level to spike.

Q. Do diabetic bodybuilders have to take protein powder to build muscle?

No. Not at all. The bulk of your protein intake should come from high quality animal food sources like meat, eggs, fish, other forms of dairy etc.