Exercis uy Kids –.ppt

Exercising with Type 1 Diabetes Dr. Sheri Colberg Sheri R. Colberg, Ph.D. Old Dominion University Norfolk, Virginia “Diabetic Athlete” - An Oxymoron? No! There are many diabetic athletes worldwide competing even at elite levels Chris Dudley (NBA basketball) Jay Leeuwenburg (NFL football) Kris Freeman (U.S. XC ski team) Gary Hall, Jr. (Olympic swimming) Many others have run marathons, done triathlons, and competed in every type of sport and physical activity Goals of Exercise Management Prevention of hypoglycemia during and after any physical activity Rapid management of hypos caused by exercise Prevention of hyperglycemia and DKA Optimal athletic performance Effects of Low BG on Exercise Early, rapid-onset fatigue Potential loss of coordination Reduced endurance Decreased performance What Is Optimal BG for Exercise? Varies, but most athletes perform best with BG levels of 80-180 Some start out higher, but few lower Fuel Use and Acute Effects of Exercise on BG Control Exercise Energy Systems The way energy is produced and used during an activity affects BG use Three distinct energy systems exist: Immediate (phosphates, or ATP-CP) Lactic acid system (rapid glycolysis) Aerobic (oxygen) Their use is a continuum and depends on exercise type, duration, and intensity Exercise Energy Systems Fuel Use during Exercise For most exercise, carbs are main fuel: glycogen (~80%), BG (20%) Fuel Use during Exercise BG uptake into muscles occurs 2 ways: Insulin-mediated Contraction-induced These two mechanisms act separately, but additively using GLUT4 Thus, active insulin levels affect BG response to exercise by ? BG more Glucose Transport into Muscles Insulin Levels and BG Response If active insulin levels are high, then BG ? during extended activity If insulin is deficient and ketones present, BG usually ? during exercise Check for ketones if BG250 mg/dl and has been elevated for a while Exercise if ketones are none, but take corrective insulin (~50%) if 250 mg/dl Insulin Levels