I recently had the privilege of speaking with a truly world class athlete who happens to also have diabetes.
And when I say world class, what I mean is that at various times in his life he has been better in his event than any other athlete in the world.
With me being a diabetes educator and him being a world class athlete with diabetes, there were many questions I wanted to ask but had to limit it to only a few as time was short.
What was so interesting to me is that many of the answers he gave me were not what I would have expected.
As an example, this athlete (I will keep him nameless) trains an average of 4-8 hours a day.
He may workout sometimes three times per day with some sessions lasting as long as two to two and a half hours.
I was wondering what strategy he used to keep his blood glucose level from going to low during the workout.
He told me that he purposefully allows his blood glucose level to elevate to slightly over 200 mg/dl.
, before his workout begins and will avoid his mealtime insulin.
He said this results in him not feeling the greatest during the first part of his workout, however, it helps keep him from dropping too low.
He will also stop and eat something during the workout on occasion if he feels like he needs it.
I want to point out, and stress, that this is what seems to work for him, and that I am not endorsing this for everyone or anyone.
I would bet that he settled on this regimen based on his own trial and error and in conjunction with his doctor and diabetes care team.
What was really shocking to me was how his blood glucose responded to the physical and mental stresses of competition.
He told me that just before competition he was OK with his blood glucose level being around 150 mg/ dl.
, however, within several minutes after finishing his competition his blood glucose levels had actually risen several hundred points.
There is no doubt his competition was extremely vigorous.
A frequent result of extremely vigorous exercise is an increase in blood glucose levels, however not usually to the tune of 200 to 300 points.
It is well known that in the liver, glycogen is converted to glucose and then released into the circulation during exercise.
This is normal.
It is also known that in the face of danger or stress, good or bad, and excitement, the liver will release glucose into the bloodstream.
In the case of this world class athlete, the physical stress, in addition to the emotional excitement and stress of competing against the best in the world, causes such a release of adrenalin, that large amounts of glucose are then released from the liver into the blood causing a very significant rise in blood glucose.
At this point the athlete would need a corrective dose of fast acting insulin to get his blood glucose back down to more reasonable levels.
After dealing with many athletes over the years, ranging from barely active to high caliber, I have found that the emotional stress alone, of competition is sufficient to raise blood glucose levels dramatically.
Non-intense, non-competitive activities are likely to have far less influence on raising blood glucose levels.