Calories influence energy levels and body fat.

Protein influences everything from muscle growth, appetite control right through to hormone production.

Fiber feeds the bacteria in our guts which play a role in the health of our immune system.

Carbs influence blood glucose and exercise performance.

Vitamin C protects against the damaging effects of high blood glucose and oxidative damage.

Salt influences water retention.

etc… We could go on forever.

The nutritional components of food serve many different roles within the human body.

This article aims to highlight 5 key nutritional aspects of food which have been shown to improve the action (or sensitivity) of insulin, resulting in improved blood glucose management in people with diabetes.

Before we go into details – it is important to understand a few key terms surrounding insulin and diabetes.

Key Terms

Insulin is a key hormone involved in the use and storage of fuels within the body.

Insulin sensitivity refers to how effective the hormone insulin is at doing its job in the body. This varies between individuals and is reduced in people with diabetes.

Insulin resistance is when muscle, liver and fat cells do not use insulin properly. As a result, glucose builds up in the blood, overflows into the urine and is excreted out of the body, never fulfilling its role as the body’s main source of fuel.

Diabetes is a group of metabolic diseases characterized by different degrees of insulin resistance, where not enough insulin is produced, or the current insulin produced does not work effectively.

Disorders in insulin production and signalling can have widespread and devastating effects on the body’s organs and tissues if left uncontrolled. Therefore, it is important that people with type 1 diabetes (who produce next to no insulin) have an uninterrupted supply of high-quality insulin medication to replicate their own natural insulin production.

Individuals with type 2 diabetes may also need to take medication to improve the effectiveness of their natural insulin production.

In both cases of diabetes, certain lifestyle factors are advised to support medication therapy. Nutrition is one of them.

5 Incredibly Powerful Eating Tips That Boost Insulin Sensitivity Naturally

Consume Foods That Have Been Scientifically Proven to Boost Insulin Sensitivity.

Scientific research has demonstrated foods like vinegar, lemon, lime, walnuts, almonds, green tea, cinnamon, and turmeric have insulin-sensitizing properties. Including nutrient-dense foods like these in your diet may help improve the body’s sensitivity to insulin and ability to store consumed carbohydrates within muscle glycogen stores instead of as fat. That’s why I included all these kinds of foods inside the Ultra Lean and Muscle Building Cookbooks. If you haven’t checked these cookbooks out already, you’re missing out on over 200+ mouth-watering diabetic friendly recipe ideas that will help you get you in shape without giving up the foods you love.

  Consider Supplementing with Magnesium and Vitamin D.

Magnesium and vitamin D have been shown to improve the body’s sensitivity to insulin. Low magnesium levels are common in people with Type 1 and Type 2 diabetes.

Magnesium is an essential dietary mineral and the second most prevalent electrolyte in the body besides sodium. Magnesium has a strong relationship with insulin and thus plays an important role in carbohydrate metabolism _1,2.

Research has shown that subjects who supplemented with oral magnesium improved their fasting blood glucose levels and increased their insulin sensitivity.³

The standard dose for magnesium supplementation is 200-400mg.⁴

Vitamin D is a fat-soluble nutrient essential for human survival.

Vitamin D is known to aid in improving insulin receptor function, prevent islet cell death, as well as improve beta cell function.

Research in both type 1 and type 2 diabetes have shown positive results in that supplementing with vitamin D has the potential to lower haemoglobin A1c compared to baseline.^5,6 Much of this may in part be due to improving insulin resistance.

Individuals with diabetes should get a 25(OH)D blood test to assess their current vitamin D status. The Vitamin D Council recommends a blood level between 50–80 ng/mL year round.

If needed, 1,000-2,000 IU (25–50 mcg) of Vitamin D per day is more than adequate. ⁷

Both magnesium and vitamin D may be consumed via supplements. However, they can also be obtained from food.

Magnesium rich foods include green leafy vegetables, pumpkin seeds, cashews, and broccoli.

Vitamin D is easily received by getting sun exposure daily; however, people who live further away from the equator or experience harsh, cold winters are at a disadvantage and may need an additional vitamin D supplement. Also, foods such as fatty fish like salmon, dairy, eggs, and cod liver oil may be consumed to achieve adequate vitamin D levels.

 Prioritize the Essential Fatty Acids, especially Omega-3.

The human body can synthesize most of its fat needs from the diet. However, there are two essential fatty acids, known as Omega 6 (linoleic acid) and Omega 3 (alpha-linolenic acid) which cannot be produced in the body and must be consumed from food. Both of these fats can be found in plant and animal foods.

Consuming a healthy balance of omega-6s and omega-3s is very important for human health.

However, in today’s modern society many populations at risk of obesity and diabetes have an imbalance in their consumption of omega 3s and 6s, whereby too much omega 6 is consumed at the expense of omega 3.

While both of these fatty acids are essential for good health, the stark imbalance is pro-inflammatory and detrimental to insulin sensitivity. The imbalance is a result of the world’s growing food intake, particularly increased consumption of processed food cooked in processed polyunsaturated fats like sunflower oil.

The first line of defence in rectifying this imbalance involves eating fewer calories and improving energy balance with physical activity. The next step is to increase omega 3 consumption from cold water fatty fish or use of high-quality Omega 3 food supplements.

Ideally, 340-453g (12–16 oz.) of cold-water, fatty fish such as salmon, sardines, and mackerel each week, if personal taste allows for it. Otherwise a good quality fish oil supplement.

 Avoid Trans Fats.

There is nothing positive or healthy about man-made trans fats. They are well established to cause insulin resistance, resulting in a decrease in insulin sensitivity. Additionally, trans fat may increase abdominal fat storage.

Food products that contain trans fat include, cakes, vegetable oils and margarine. Substitute these common cooking products for healthier oils like olive oil, avocado oil, coconut oil or real butter.

Trans fats are mentioned on nutrition labels.

Strive to purchase and consume foods that contain 0g Trans Fats.

Food over Macronutrients.  

Carbohydrates have the greatest effect on blood glucose levels, protein has a moderate effect and fat a relatively small effect.

However, when it comes to mealtimes, we mostly consume mixed macronutrient meals comprised of different food sources.

Think about it. You rarely eat a potato on its own. Rather, a combination of potato (carbs), meat or fish (protein) and a good dab of butter (as fat).

If you keep consistent with the amounts of carbs, fat and protein at meal times, you’ll have a much better chance at working out a reliable insulin to carb ratio.

This is great, but what happens when you make an extreme change and decide to consume a food dominant in one macronutrient? Or, vary the composition of your set meal in favour of a certain macronutrient such as a pepperoni pizza which is super high in fat?

When the time comes, you must be willing to increase or decrease your insulin accordingly. This requires an in-depth understanding of how to dose and spread your insulin for mixed and, or, single macronutrient-based meals.

Dosing your insulin accurately is extremely important for avoiding hyperglycemia and further insulin resistance.

Want to put this learning into practice?

I’ve taken all of these principles and incorporate them into Diabetic Shred Guide – a 112-day fat loss system for men and women living with diabetes. It contains everything you need to know about eating, training and living to get lean. You get weekly meal plans tailored to your metabolism and over 50 challenging workouts.

If you want to learn more about flexible dieting you can check out my body transformation diet and training guides created exclusively for people with diabetes.

Diabetic Shred –  112-day Advanced Body Transformation Guide Built for FAT LOSS.

References

1. Paolisso G, Scheen A, D’Onofrio F, Lefebvre P: Magnesium and glucose homeostasis. Diabetologia33:511–514, 1990
2. Nadler JL, Buchanan T, Natarajan R, Antonipillai I, Bergman R, Rude R: Magnesium deficiency produces insulin resistance and increased thromboxane synthesis. Hypertension21:1024–1029,
3. Mooren FC, Kruger K, Volker K, Golf SW, Wadepuhl M, Kraus A. Oral magnesium supplementation reduces insulin resistance in non-diabetic subjects-A RCT. Diabetes, Obesity, and Metabolism. 2011;13(3);281-284
4. http://www.nap.edu/read/5776/chapter/8#223
5. Aljabri KS, Bokhari SA, Khan MJ. Glycemic changes after vitamin D supplementation in patients with type 1 diabetes mellitus and vitamin D deficiency. Ann Saudi Med. 2010;30(6):454-458.
6. Mitri J, Muraru MD, Pittas AG. Vitamin D and type 2 diabetes: a systematic review. Eur J Clin Nutr. 2011.65(9):1005-15.
7. Example.com The Supplement-Goals Reference Guide

For people with diabetes, exercise has been continuously proven to help improve blood glucose control and subsequently prevent some of the secondary health problems associated with diabetes. Monitoring your blood glucose levels is a crucial aspect of living a healthy life with diabetes, but it can also have a substantial effect on your return to exercise if you have been injured.

If you play sport or exercise regularly, there is a possibility you will get injured.

Let’s face it you’re not superman or superwoman. At some stage in your training career, you will get injured. Injuries occur for a multitude of reasons. It may stem from a performing a repetitive movement over an extended period. In athletes, it may be because of a nasty tackle, too sharp a turn or nasty fall. For a regular gym goer, it could be because of a poorly taught exercise or because you have just pushed yourself too fast, too soon. Athletic injuries are usually musculoskeletal in nature, in that they occur in the soft tissues – muscles, ligaments, tendons – or bone and joints. Occasionally injuries can happen to the nervous system, but this is rare.

It doesn’t matter what the cause, injury forces us to rest, heal up and rehabilitate. Generally speaking, the burden of injury and recovery can be challenging both physically and mentally for people with and without diabetes.

The three stages of injury and recovery:

1. Inflammatory Phase: Soon after injury – sometimes immediately – and depending on the exact cause of damage, the body encourages clotting around wound sites, sends antibodies and white blood cells to fight infection, and provides nutrients, enzymes and oxygenated blood to begin the early stages of the repair process. These various processes lead to heat, swelling and, of course, pain.

2. Proliferation Phase: New blood vessels form and deliver further nutrients to the damaged tissues for repair. The newly formed granular tissue and collagen fibres replace damaged tissue and keep the injured site “strong”.

3. Remodelling/Maturation Phase: The collagen fibres during the proliferation phase aren’t robust enough to put up with the stresses of normal exercise. To increase tissue strength collagen integrates itself along the lines of force/tension to protect weaker areas of tissue that may be susceptible to repeat injury.

Diabetes and Sports Injury Risk

The human body needs adequate rest, nourishment and specific rehabilitation exercise to recover properly. People with diabetes must ensure blood glucose levels are controlled tightly for a full speedy recovery.

Fact: Hyperglycemia causes cell injury.

The effects of hyperglycemia on delaying healing and injury recovery are complicated and well beyond the scope of this short article.

However, one of the most damaging processes is an abnormal increase in advanced glycation end products (AGEs). In layman’s terms, this is when normal protein and lipid (fat) molecules bind to sugar, via a process called glycation. Glycation accelerates when these molecules are overexposed to sugar, especially during hyperglycemia.

A prime example would be when glucose molecules attach to the haemoglobin protein in red blood cells. The longer hyperglycemia occurs in blood, the more glucose binds to haemoglobin in the red blood cells and the higher the glycated haemoglobin. An A1C blood test assesses the percentage of glycated red blood cells in an individual’s circulation.

Once a haemoglobin molecule is glycated, it remains that way.

AGEs can also be introduced into the body via modern day food processing methods such as dry heat(1) or during tobacco smoking(2).

AGEs are well established to contribute to a variety of microvascular and macrovascular complications(3) and play a fundamental role in the complications of diabetes by raising intracellular oxidative stress.

In Layman’s terms,

Sugar makes things sticky.

A simple analogy would be to consider high blood glucose like drinking a milkshake through a straw. On the other hand, normal blood glucose levels (normoglycemia) would resemble drinking a glass of water.

Which fluid would be more challenging to sip through the straw?

The milkshake obviously.

This kind of analogy resembles what happens in the cardiovascular systems of arteries, veins and capillaries when blood glucose levels are high. The blood becomes a slower moving, sticky substance.

With this, you have a less efficient delivery of all the essential components of recovery. Blood cannot get to where it needs to be as quick as it is needed. Not only do we see a slower delivery of nutrients, antibodies, enzymes, etc. but there is also a less efficient removal of waste product from recovering body tissues: dead cells, lactic acid, inflammatory markers and more ^5,6,7.

In the same way, cholesterol can is deposited around the body, so too can sugar. Research has shown that chronic hyperglycemia glucose can slow collagen formation around damaged areas of tissue, which increases the potential for re-injury and further damage  ^5,6,7.

Take Home

The benefits of exercise for people with diabetes are plentiful. However, there is a chance of getting injured. If you do experience an injury, your blood glucose control plays a significant role in determining how quickly you recover and get back in the gym.

Here are three super important tips to implement the next time you’re injured.

1. Invest in a Continuous Glucose Monitor (CGM.) to monitor blood glucose levels 24/7 with ease. You’ll be able to catch and treat hyperglycaemia faster than normal.

2. Unless you are completely debilitated exercise areas of your body that aren’t injured. If your lower body’s injured train your upper body, and vice versa. Sitting on your ass all day isn’t going to do you any favours, and in most cases worsens blood glucose control, adds body fat and leaves you feeling like crap. Do what you can.

3. Be mindful that your energy expenditure won’t be as high. To avoid fat gain, make appropriate adjustments to your diet and physical activity.

References

1. Koschinsky T, He CJ, Mitsuhashi T, Bucala R, Liu C, Buenting C, Heitmann K, Vlassara H. Orally absorbed reactive glycation products (glycotoxins): an environmental risk factor in diabetic nephropathy. J Biol Chem. 1989 Mar 5; 264(7):3674-9.
2. Cerami C, Founds H, Nicholl I, Mitsuhashi T, Giordano D, Vanpatten S, Lee A, Al-Abed Y, Vlassara H, Bucala R, Cerami A Tobacco smoke is a source of toxic reactive glycation products.Proc Natl Acad Sci U S A. 1997 Dec 9; 94(25):13915-20.
3. Goldin et al. Advanced Glycation End Products Sparking the Development of Diabetic Vascular Injury. Circulation. 2006;114:597-605
4. Biochemistry and molecular cell biology of diabetic complications. Brownlee MNature. 2001 Dec 13; 414(6865):813-20.
5. Wyatt, LH and Ferrance, RJ., 2006. The musculoskeletal effects of diabetes mellitus. The Journal of the Canadian Chiropractic Association.
6. Levinger I, Seeman E, Jerums G, McConell GK, Rybchyn MS, Cassar S, Byrnes E, Selig S, Mason RS, Ebeling PR, Brennan-Speranza TC., 2016. Glucose-loading reduces bone remodeling in women and osteoblast function in vitro. Physiological Reports.
7. Bhat TA, Dhar SA, Dar TA, Naikoo MA, Naqqash MA, Bhat A and Butt MF., 2016. The Musculoskeletal Manifestations of Type 2 Diabetes Mellitus in a Kashmiri Population. International Journal of Health Sciences.

Before we discuss creatine and diabetes let’s discuss what creatine actually is and abolish some of the common myths and fallacies around this ever popular sports nutrition supplement.

Quick Fire Myths Dispelled

Q. Is creatine a steroid?

No

Q. Does creatine make you go bald?

No

Q. Does creatine cause cancer?

No

Q. What happens when you stop taking creatine?

Generally nothing.

What is Creatine?

Creatine is a molecule we naturally produce in the body. It is a natural tri-peptide which means it has three amino acids. If you eat a diet rich in animal proteins like beef, fish and dairy you will naturally be consuming creatine

Creatine has profound effects on exercise performance by increasing your body’s availability of Adenosine-Triphosphate (ATP) the body’s primary source of energy, especially when performing resistance based exercise. Increased ATP availability allows you to lift heavier for longer which amplifies your ability to stimulate muscle growth.

Creatine Supplementation = More ATP = More Energy = Greater Training Stimulus

There is also research supporting the cognitive benefits of creatine supplementation in those with depression.

Noted benefit and possible side effects include:

• Increased strength
• Water retention
• Stomach cramping (if insufficient water is consumed)
• Diarrhoea of nausea (if too much consumed)

There is some concern that it could harm the kidney, liver, or heart function. However, a connection between high doses and these negative effects has not been proven.

Q. What is the best type of creatine?

There is a host of different creatines available on the market including Creatine monohydrate, Kre-Alkalyn and Creatine Ethyl Ester.

Which form of creatine is best?

Creatine monohydrate is the best form. It is the cheapest and most researched creatine of the lot.

How Do you take creatine?

There are two approaches to dosing creatine.

Approach 1 – Loading Phase

• 0.3g per kg bodyweight per day
• 80 KG male = 24g (broken up into 5g doses)

Approach 2 – Maintenance

• Supplementing with 5g per day.

Q. Do you need to cycle creatine?

Given the current body of evidence, you do not need to cycle creatine.

CREATINE AND DIABETES

How does the holy grail of supplements fare against diabetes?

The research to support creatine consumption in people living with T2 is relatively large. Unfortunately, there is zero research investigating the effects of creatine consumption in people living with T1 which definitely warrants future research.

Benefits of Creatine in Diabetes

Increased muscle mass and frequent muscle contraction in people without diabetes is known to improve insulin sensitivity and glucose uptake into cells.

Creatine has the ability to improve glycemic control, based on its ability to increase training performance.

Muscle tissue acts like a vacuum and storage house for glucose.

When muscle tissue is contracted such as during resistance training, specific glucose transporters known as GLUT-4 translocate (rise) to the surface of the muscle cell and assist with the disposal of glucose out of the bloodstream and into the muscle cells.

The harder an individual trains the greater uptake of glucose.

It is well established that people living with Type 2 diabetes have a marked increase in GLUT-4 activity following strength training ² which assists in the lowering of blood glucose.

These favourable changes could also be seen in people with Type 1. However, due to a complete lack of insulin production, the liver’s production of glucose can often outweigh uptake and thus lead to hyperglycemia.

Is it fair to say these benefits would be useful in well-controlled type 1 diabetes, especially if the liver’s production of glucose is accounted for with appropriate amounts of injectable insulin?

Maybe so….

Either way, more research is needed.

If you want to learn more about building muscle tissue with creatine, I’ve covered an absolute tonne of useful strategies in my book The Diabetic Muscle and Fitness Guide.

Is creatine safe for diabetics?

One of the main concerns with creatine is kidney trouble.

The underlying theory does make sense. The more creatine consumed, the harder the kidneys have to work to process it. And, since people with diabetes already have an increased susceptibility to kidney disease, especially when poorly controlled, creatine consumption might exacerbate the issue.

In fact, there isn’t one single peer-reviewed study or case report suggesting creatine as the causative factor behind kidney damage, which is a marked complication of poorly controlled diabetes.

Research by Gualano in 2010 studied a man with one functioning kidney who consumed more than 20g creatine monohydrate per day. His remaining kidney failed to show any signs of damage ³.

A significant double-blind trial by Gualano and colleagues in 2011 looked at the kidney function of people with Type 2 diabetes who consumed 5g of creatine/day versus those who consumed a placebo. Both groups performed a mixture of aerobic and resistance based exercise, but neither presented any evidence of kidney damage ⁴.

In a separate study, Gualano and colleagues also noted that creatine consumption could improve overall diabetic control by lowering HbA1C levels ⁵.

Two groups, one consuming a placebo and one consuming 5g of creatine/day, both took part in a mixed exercise plan of aerobic and anaerobic exercise. Those who were consuming creatine found a significant reduction in HbA1C compared to the placebo group within a period of 12 weeks.

It was proposed these beneficial effects were a result of increased GLUT-4 activity and ensuring glucose disposal into cells ⁵.

If you want to learn more about the effects of creatine on the diabetic body before taking it you definitely need to check out the hour-long webinar I recorded with Dr Darryn Willoughby (one of the world’s leading exercise researchers) inside the exclusive webinars section of The Diabetic Muscle and Fitness Training Lab.

If you’re obsessed with building a better body, The Training Lab contains a gold mine of information you will benefit from.

Take Home

People living with T2 can safely consume creatine. Research among people with Type 1 diabetes is lacking and should advocate further studies taking place.

Creatine has demonstrated significant benefits on glucose metabolism when used alongside exercise, raising its potential as a possible nutritional therapy in this population.

For the benefit of your overall care, you must mention it to your medical doctor.

Creatine is a proven supplement. But make sure you’re confident in your blood glucose control before using it. Even the best supplements in the world can’t protect against hyperglycemia.

Interested In Using Creatine As Part of Your Muscle Building Efforts?

Since you have made it to the end of this blog, you are obviously serious about your physique, I’m going to give you an 85% off coupon for what many have coined the most advanced diabetes bodybuilding diet and training programs in the world.

Both of these plans incorporate creatine monohydrate as part of their 112-day diet and training program.

The best thing about it…

For all the information you get, these guides are an absolute steal, at only £13 ($16) each.

IF YOUR GOAL IS FAT LOSS -> GET DIABETIC SHRED   

IF YOUR GOAL IS LEAN WEIGHT GAIN –> GET DIABETIC MASS

References

1. Ritcher, EA and Hargeaves M, (2013). Exercise, GLUT4, and skeletal muscle glucose uptake. Physiology Reviews
2. Holten MK, Zacho M, Gaster M, Juel C, Wojtaszewski JF, Dela F., (2004). Strength training increases insulin-mediated glucose uptake, GLUT4 content, and insulin signalling in skeletal muscle in patients with type 2 diabetes. Diabetes.
3. Gualano B, Ferreira DC, Sapienza MT, Seguro AC, Lancha AH Jr. (2010). Effect of short-term high-dose creatine supplementation on measured GFR in a young man with a single kidney. American Journal of Kidney Disease.
4. Gualano B, de Salles Painelli V, Roschel H, Lugaresi R, Dorea E, Artioli GG, Lima FR, da Silva ME, Cunha MR, Seguro AC, Shimizu MH, Otaduy MC, Sapienza MT, da Costa Leite C, Bonfá E, Lancha Junior AH., (2011). Creatine supplementation does not impair kidney function in type 2 diabetic patients: a randomized, double-blind, placebo-controlled, clinical trial. European Journal of Applied Physiology.
5. Gualano B, DE Salles Painneli V, Roschel H, Artioli GG, Neves M Jr, De Sá Pinto AL, Da Silva ME, Cunha MR, Otaduy MC, Leite Cda C, Ferreira JC, Pereira RM, Brum PC, Bonfá E, Lancha AH Jr., (2011). Creatine in type 2 diabetes: a randomized, double-blind, placebo-controlled trial. Medicine and Science in Sports and Exercise.

Other References – Benefits of Creatine

https://www.ncbi.nlm.nih.gov/pubmed/1…

https://www.ncbi.nlm.nih.gov/pubmed/1…

https://www.ncbi.nlm.nih.gov/pmc/arti…

https://link.springer.com/article/10….

https://www.researchgate.net/profile/…

https://link.springer.com/article/10….

http://journals.humankinetics.com/doi…

http://go.galegroup.com/ps/anonymous?…

http://jap.physiology.org/content/91/…

Here are five very popular myths you might have heard before:

1. Type 1 and Type 2 diabetes are the same.

Fact: Although T1D and T2D are both classified by higher than normal blood glucose levels, the cause, pathology and progression of the conditions are different.

Some would even say they are completely different diseases due to the different defective mechanisms and that they simply happen to share the same consequence of high glucose levels.

 2. People with diabetes must avoid sugar.

Sugar is in every food that contains carbohydrate. Some sugars affect blood glucose quicker than others. Glucose, the simplest form of carbohydrate, will cause a rapid increase in blood glucose, whereas the fructose from fruit will not.

There is no such thing as a good or bad food, just good or bad diets or patterns of eating. A diet dominated by fast-acting carbohydrates at the expense of essential protein and healthy fats will hinder health, body composition and performance.

If you consume sugary-based food within your diet, consider this:

• Medication must cover the quantity of food consumed.
• Overall calorie intake must be respected. Carbohydrates don’t fill us 
up and are often overeaten.
• Essential nutrient requirements for both protein and essential fatty 
acids (omega 3 and 6) need to be accounted for.

3. Diabetes will hold you back in life.

ONLY IF YOU LET IT.

Take pride in getting to grips with your condition. Understand it and do your best. You have a choice in the matter.

The better your control, the better your mind and body will work.

Don’t get me wrong: you might struggle to enrol as the next James Bond. A hypo wouldn’t go down too well under fire; nor is it easy to obtain a heavy goods vehicle licence.

But things are changing: police forces are no longer barring people with diabetes, and some local authorities do allow people with diabetes to hold licenses as taxi drivers, provided their medical records show proof of good control and healthy eyesight.

 4. You can catch diabetes.

Diabetes is an NON-COMMUNICABLE DISEASE (NCD).

According to the World Health Organization Non-communicable diseases (NCDs), are a medical condition or disease that is not caused by infectious agents (non-infectious or non-transmissible)

In other words, you can’t catch diabetes.

Non-communicable diseases (NCDs), are also known as chronic diseases, tend to be of long duration and are the result of a combination of genetic, physiological, environmental and behaviours factors.

The main types of NCDs are cardiovascular diseases (like heart attacks and stroke), cancers, chronic respiratory diseases (such as chronic obstructive pulmonary disease and asthma) and diabetes.

5. Diabetics should buy and eat special ‘diabetic food’.

Here’s my take on specialist diabetic food…

It’s revolting, expensive and encourages regular toilet breaks.

Are you having a laugh, food manufacturers?

Do one!

…All over the place?

Testing is a way of life.

If you fail to test, you lose control. It’s as simple as that.

Since I was diagnosed with type 1 diabetes over 10 years ago there have been massive technological developments in blood glucose meters. Modern day devices are stylish, super convenient and pretty much pain free to use. However, many individuals fail to use their device properly and end up with false readings that jeopardize the management of their diabetes.

Check out these 10 useful tips to increase the accuracy of your blood glucose readings if you still use the traditional finger prick test.

1. If you are struggling to get a blood sample, point your finger downwards and gently squeeze until the tip goes red. This is using gravity to your advantage and pooling the blood. Prick the red area and the sample should be easy to obtain.
2. Make sure your hands are clean to prevent infection of the sample site.
3. Let the blood touch the strip, not your skin.
4. Residue from food or medication may affect test results, which can lead to unnecessary administration of medication and unwanted hypos.
5. Close the bottle of test strips to avoid contamination with dirt or moisture.
6. Use a clean lancet for every test. Re-using the same lancet can increase the risk of infection at your sample site.
7. Rotate sample sites to avoid a build up of scar tissue.
8. Test in public if you need to. Your health is more important than someone’s ignorance or curiosity.
9. If you suspect your meter is wrong, test again, preferably using another meter.
10. Make sure your test strips are used within their expiry date.

YOU MUST TAKE YOUR BLOOD GLUCOSE TESTING SERIOUSLY.

 

It pays to be accurate.

Be fussy about taking your blood glucose. Use the tips above everytime you test.

Accurate blood glucose testing will save your life and give you confidence in managing your diabetss. Also, make sure you carefully dispose of your test strips and lancets. Nobody likes to see these lying around, and it gives people with diabetes a bad name.

This is highly problematic for the diabetic bodybuilder, strength and fitness athlete.

A well-structured self-management plan will focus on the following:

• Insulin therapy – T1D diabetics need insulin every day in order to control the levels of glucose in their blood.
• Blood glucose monitoring
• Calorie controlled diet comprised of predominantly high-quality food choices
• Regular physical exercise (especially if overweight)

Check out this short video blog I recorded. You’ll see how I react when I wake up to a surprising high blood sugar before training.

I discuss my theory for treating HIGH BLOOD GLUCOSE levels around exercise and why every person living with diabetes must obsess over maintaining normoglycemia (normal blood glucose control) if they want to build maximum amounts of muscle.

An ideal watch for any diabetic bodybuilder or fitness enthusiast.

In this article, I discuss 10 of the biggest reasons why blood glucose levels tend to go high in people living with diabetes during exercise. Please bear in mind that Type 1 and 2 diabetes are different and need to be managed differently.

Key factors include: the type of medication, physical activity levels, training volume, muscle mass, other illnesses and susceptibility to life stress.

1. Hypoinsulinemia.

You simply don’t have enough insulin in your bloodstream to facilitate the transport of glucose into target tissues. As a result, your blood glucose levels remain high, increasing the risk of ketoacidosis which exacerbates hyperglycemia.

This may be due to missing a dose, eating too many carbs or uncontrolled glucose production from your liver during times of stress. 

Fix. Administer appropriate amounts of insulin or other diabetic medication specific to your abnormal blood glucose level. Only do this under the close guidance and monitoring of a professional health care team.

2. Prolonged Pump disconnect.

Similar to above. Lack of insulin in the bloodstream means only one thing for the individual deficient in insulin: High blood glucose.

Fix. Ensure you pump is well connected at all times, especially if you’ve spent the day doing manual labour. Be mindful that wearing an exercise belt, for powerlifting and bodybuilding purposes can lead to pump discomfort and disconnect during training, consequently leading to high blood glucose.

3. Malfunctioning needles.

If your needle fails to work, you won’t be able to administer insulin accurately, or even at all.

Fix. Test needle function by squirting out a few units of insulin. If it’s jammed, replace it immediately. Always carry spares. Trust me there is nothing worse than a malfunctioning needle.

4. Overuse of stimulants.

Caffeine, Ephedra, Yohimbine and other popular bodybuilding supplements are stimulants. They stimulate a sympathetic (fight or flight) response within the body, which increases the production of glucose raising hormones.

In those who are deficient or fail to produce insulin, overuse of stimulants can increase blood glucose levels, and, if left unattended, can result in hyperglycemia. This isn’t a good place to be prior to training.

Fix. Measure your blood glucose response to popular stimulants. Bear in mind circulating insulin and physical activity may influence your response. I personally test my response in a fasted state when other variables aren’t as much of an influence.

5. Anaerobic exercise.

High intensity exercise is a stressful form of training which has the potential to increase blood glucose levels because insulin levels fail to rise and compensate for the increased production of glucose raising hormones in someone with diabetes.

It is very well established that diabetics involved in powerlifting and bodybuilding style training increase the production of such glucose raising hormones which increase’ the liver’s production of glucose and limits glucose disposal.

In individuals without diabetes, increased production of glucose raising hormones and hyperglycemia is compensated for by an increase in insulin secretion, usually when exercise is finished.

Fix. Monitor blood glucose closely and correct accordingly with appropriate administration of insulin as and when needed if hyperglycemia were to occur. Failing to respond to high blood glucose increases muscle loss, reduces performance and increases the possibility of diabetic related complications.

6. Very vigorous aerobic exercise.

This includes very tough aerobic exercise like mountain climbing, boxing, martial arts or mountain biking which tend to include intermittent periods of anaerobic work.

Similar to above – elevations in glucose raising hormones increase blood glucose. The diabetic’s ability to achieve glycemic control is hindered without administering the appropriate dose medication.

Fix. Monitor your blood glucose response to certain forms of exercise. Identify when and where blood glucose fluctuates. Observe the patterns and react accordingly as you become increasingly familiar with your body’s response. 

7. Too many carbs.

Carbohydrate from food and drink has the greatest effect on blood glucose levels over any other ingested macronutrient. All carbohydrates are broken down into glucose which enters the bloodstream as fuel for instant use or storage for future use. Glucose is an essential fuel for the body, especially the brain.

One of the hallmarks of diabetes is a difficulty processing carbohydrate. Lower carbohydrate intakes are often suggested as a means of improving control. While this dietary approach may be a legitimate way of improving blood glucose control in sedentary individuals, those who train regularly may need more carbohydrate to fuel their training volume. 

A higher intake of carbohydrate increases the potential for hyperglycemia, especially if insulin secretion is lost.

Fix. Dose accordingly.

Specialist diabetes education courses like DAFNE (Dose Adjustment For Normal Eating) are a great way of managing blood glucose levels in people with Type 1 diabetes. The courses empower people with the necessary skills required to calculate the appropriate dose of insulin needed to accommodate the correct amount of carbohydrate found in meals.

8. Stress.

Physical and emotional stress has the ability to increase blood glucose levels in people with all types of diabetes.

If you want to find out if mental stress is negatively affecting your glucose control, score your stress level on a scale of 1 to 10 (10 being worst) and correlate it with your blood glucose level.

If you’re repeatedly correlating high-stress scores with blood glucose levels beyond where they should be, given your insulin is dosed accurately to food eaten, you will gain a fair idea of how sensitive you are to stress.

This is common concern for diabetic bodybuilders, powerlifters and athletes who compete. The stress of competing can elevate blood glucose levels to the point where performance and appearance (in bodybuilding) is impaired. I recall how sensitive I was to mental stress in my competitive bodybuilding days as a diabetic. Hyperglycemia was a constant battle on show day.

Fix. Your perception to stress is important. Learning to respond instead of react to life’s stress is a good skill to possess, since most of the stress you encounter is self-imposed party tricks.

On the contrary, if you are under real threat, whether it be a lion or ex-wife, relocate.

Too much stress, not enough recovery and you put yourself in a prime position for injury, illness or worse, burnout!

I’ve found mediation and personal development great ways to improve my tolerance to life stress.

9. Infection/Illness.

The stress of illness on the body in conjunction with certain medication can cause blood glucose levels to rise, making them difficult to manage in people with type 1 diabetes.

High blood sugar levels weaken the immune system, while diabetes-related health complications, such as nerve damage and reduced blood flow to the extremities, increase the body’s vulnerability to infection, resulting in the illness and infections getting worse.

Fix. Test your blood glucose levels more often and administer the necessary amount of corrective medication to normalize blood glucose levels. Do your best to stay hydrated and if suffering loss of appetite consider supplementing with essential nutrients notably protein, essential fatty acids and a multi vitamin.

10. Denatured Insulin.

If you leave your insulin lying out in the sun or accidentally freeze it, expect it not to work as well. Insulin is a peptide hormone, comprised of different amino acids. Extreme temperature fluctuations can denature the peptide sequence compromising the structure and function of the hormone.

Insulin that doesn’t function properly will promote hyperglycemia.

Fix. Keep your insulin in a cool, dry, and dark place – simple.

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Most annoyingly it will stop a workout dead in its tracks stealing power, increasing your risk of injury and spoiling your routine.

To get the most out of training, it’s essential to recognise the symptoms of hypoglycemia and how to combat it.

I want to discuss three of the biggest reasons why people with diabetes run into low blood glucose levels during exercise, and at the same time discuss practical hypo prevention strategies.

1. You can’t reduce the glucose-lowering effects of injectable insulin.

Injectable insulin does exactly what it says on the needle: it lowers blood glucose.

Individuals who take injectable insulin run the fine line between taking too much and too little. Too little insulin and blood glucose will remain high, too much insulin and blood glucose plummets.

The greatest risk of hypoglycemia in people using injectable insulin is during aerobic exercise. This is due to the low-stress nature of the exercise which doesn’t bring about an increase in glucose-raising hormones typically produced during higher intensity exercise.

High levels of insulin (hyperinsulinemia) suppress the action of glucose-raising hormones like glucagon, which normally signal the release of stored glucose from the liver into the bloodstream to rectify low blood glucose levels. This abnormal response doesn’t normally occur in the body of a non-diabetic because insulin production is tightly regulated.

Secondly, hyperinsulinemia increases the uptake of glucose out of the bloodstream and into the target tissues, further decreasing blood glucose.

It’s also important to be mindful that injecting insulin into a trained muscle group will lead to faster onset and so increase risk of hypoglycemia. This is an important point to note for diabetic bodybuilders or non-diabetic bodybuilders who inject exogenous insulin.   

Dose accurately. Working out the precise amount of insulin to take is a fine art and requires consistent measurement and evaluation of specific insulin doses to food intake and ever-changing day to day activities.

The more consistent you are with diet, training and lifestyle – the easier it is to pinpoint control.

2. Impaired counter-regulatory response.

Another factor that may contribute to an increased risk of hypoglycemia during exercise is an impaired counterregulatory response during exercise.

This may involve problems with glucagon production, one of the primary glucose-raising hormones, or an impaired response to the hormone from the target organ – the liver, where glucose is stored and released.

Glucagon’s role in the body is to prevent blood glucose levels dropping too low. One of the ways it does this is by acting on the liver, stimulating the conversion of stored carbohydrate (glycogen) in the liver into glucose, which can be released into the bloodstream. This process is called glycogenolysis.

While some individuals with type 1 diabetes may have a sound glucagon response, others may not, especially under hypoglycemic conditions. This compromises the ability for the body to regain blood glucose control.

Then again, too much insulin circulating around the bloodstream is still a concern, as its effect will counteract the glucose raising effects of such hormones, rendering them less of an influence on initiating low blood glucose.

3. Poor timing and not enough carbohydrate.

The amount of carbohydrate needed to limit hypoglycemia is at least partly linked to the timing and dose of the last insulin injection.(1) Going too long without food increases your risk of hypoglycemia, especially if physically active. The body’s muscles end up utilising more glucose (carbs) than the amount being consumed via the diet or produced internally by the liver. The result is low blood sugar.

To avoid this, be mindful of the following:

• Skipping and forgetting meals
• Unplanned physical activity
• Taking too much insulin for the carbohydrate and protein, you consume (the two macronutrients that influence blood glucose)

References

1. Francescato et al. Prolonged Exercise in Type 1 Diabetes: Performance of a Customizable Algorithm to Estimate the Carbohydrate Supplements to Minimise Glycemic Imbalances. PLoS One. 2015; 10(4): e0125220. Published online 2015 Apr 28.