Advice for Trish

Healthy Living Physical Activity
1

I have found that the lower my bmi the better my control is of my diabetes. I am looking to attain the lowest possible which includes lifting and eating right!!

Hey Trish, I hope you don't mind, but I think your statement is an absolutely perfect discussion forum posting and I will pry transfer this directly to a blog post because I think it has a lot of great topics in it.

You've hit on both long-term and short term goals, which is a PERFECT way to get started! You need to know where you're going before you can start the process of getting there. Too many people just aimlessly go to the gym without goals other than "lose weight" or "get skinny" and that is the main reason they fail. They want quick results from really non-specific measurements, like weight and BMI.

I'm going to list what I think are your goals and change them a tick to make them more specific, but not changing your outcomes.

Long-term - Lowering BMI
I think this a great way to start, but I think there is a better measure than BMI. I personally think that BMI is a terrible measurement of anything. I have pry less than 10% body fat but I have a BMI of 28, meaning that I am technically overweight. BMI only takes into account weight and height. It doesn't account for the amount of muscle you will gain when you start lifting and burning off the fat. Rather than lowering your BMI, I would change this long-term goal to lowering percentage body fat and increasing percent lean body mass as I think this is a much better measure of your goals since you can lose a bunch of fat, gain muscle, increase your insulin sensitivity (even in type 1) and decrease your A1C. A lot of gyms out in there in the nether have really nice scales which will give you your percentage body fat, lean body mass and water weight. It usually cost $5-10 per time to use them, but if you make it a point to measure once per month, it's not that big of a expense and it will give you a great way to measure how you are doing.

Short-term - Eating right and lifting weights

GREAT GOALS! I think these are two of the best goals you can have, add some cardio into this equation and you are set for success. Since you are a diabetic, you already understand the importance of eating correctly. This is one of the instances where being a T1DM patient is actually beneficial. You understand how to count carbs, you understand the importance of insulin sensitivity and you are motivated to keep yourself healthy. All of these things are very challenging things to teach a non-diabetic or a type-2 diabetic. Sorry for calling out the type 2's but in my experiences, in the gym, work and umpiring baseball, some T2 really don't get it and want the easy way out rather than working to manage their disease in the early stages while it is still possible.

The next step is deciding how to lift weights, free vs machine, sets vs circuit, high reps vs high weight, short rest vs recovery, multi-joint high intensity vs isolation, plyometric vs static, ect... It can be very challenging to pick a workout that fits you and your specific needs. I struggle with this ever 6-8 weeks when I need to change up my workout so that I don't plateau. Two of the best resources I have found are bodybuilding.com and Muscle and Fitness Magazine. I like bodybuilding.com for multiple reasons. They have a great forum and bodyspace is a great resource. I also almost exclusively order my supplements from them, see other discussion pages for supplement discussions. I like M&F because they have great articles about nutrition and workouts that can be very general and long term or body part specific (focus on improving my back or increase bench).

Finding a GOOD personal trainer is always a great option. Too many of them are just in it to make some money and have a one size fits all workout. They want you to come to them 3 times/week and pay each time while not really getting the most out of you. Some are great at this, other are just making a buck. Do your research, I've lifted along side both types. Sports specific ones are usually the most dedicated rather than the gym sponsored ones which tend to suck and make you try to buy the gyms waters, drinks and supplements. Rather than just giving you good nutrition advice and telling you to bring a bottle of water.

To be able to create a specific lifting regiment for anyone, you have to know certain things. Experience in the gym including current lifting and cardio training status, current or old injuries including arthritis, any medical conditions that could limit exertion (heart, lungs, asthma, blood pressure, neuropathy, brittle diabetes, hormone levels (testosterone, oestrogen, hypoglyaemic unawareness, ect.) and stuff like that. That's why it's really important to get a complete physical from a doctor along with blood work before starting anything new, just to make sure there isn't anything that could drop you in the middle of a workout.

I don't know much about your current activity in the gym so I can't be specific about what you should do. That being said I think with your pretty good A1C, pump therapy, goals of decreasing % body fat, increasing % lean body mass and better control of your blood sugar. I think that starting out with a circuit training workout, with moderate rest times 3 days per week and moderate cardio 2 days per week (fast walking or an elliptical machine) would be great. I am trying to find a good general circuit workout, but it might take me a bit. I have a lot that are designed to break plateaus or for cutting in bodybuilding, but not a lot for a good cardio kick.

2

Hey i appreciate the advice. I am a type 1 diabetic and have been for 25 years. I am now 37 years old and keeping good control of my diabetes has gotten more difficult over the years. I have been on a pump for 12 years now and have realized there is alot more on the pump than i ever utilized. i work out 5 days a week with 2 days rest. I use 3 days for weight training which i usually start out with 10 minutes on the elliptical to warm up, one day of yoga class and one day of cardio exclusively. I do belong to a gym and have tried meeting with a personal trainer there twice now but unfortunately i seem to have more knowledge than they do from the amount of research i have done and just being a type 1 for so many years. I struggle with my blood sugars post workout, i workout in the evening and tend to find myself dropping at times during the night it is just not consistent enough to make a permanent change, so if i have a very heavy workout i usually drop my basal to 75% for about 6 hours which seems to help. I have never had a body fat test done but i am also considered to be obese because i am 5’6 and 155 pounds but do not seem to have an extreme amount of fat on my body. My goal is not really to lose weight but just to be in the best physical shape that i can be.

3

That helps a lot. I agree with the personal trainer thing. Same problem I had with nutritionists. They either know sports nutrition or diabetic nutrition, with not much crossover.

I am in the same boat with the post workout latent-onset hypoglcaemia (LOH). I have the same problem. Mine usually drops hard right at 2 hours post workout (30-60 pts in 15-30 min). Unfortunately there isn’t an easy fix for it except put some long digesting food in your system. Do you eat after your workout? Intaking protein, 15 g of rapid sugars and some long digesting carbs (granola bar) can help to prevent a huge drop. The best way to get this is a protein shake, gummy bears and a granola bar; glass of chocolate milk and some cottage cheese; or a peanut butter and jelly sandwich with whole grain bread. All of those will essentially do the same thing.

I think you’re on the right track with working out. I didn’t mean to blog about only losing weight, just kind of turned into rambling lol.

4

No big deal i know where you are coming from. I also went to see a nutritionist about a year ago and it was a big waste of my time. She really did not tell me anything that i did not already know and she could not answer any of the questions that i had. She of course said that we could make another appointment and she could research my questions but i feel it is just as easy for me to do that myself. Somebody else has recommended a book to me by Sheri Colberg that deals with athletes and Diabetes. Have you found any information out there that has helped you? I am going to try the protein shake before my workout with the granola bar and see if that helps. Thanks for the tip.

5

I found the book Nutrient Timing by John Ivey to have good information on nutrition, but you need to adapt it for insulin use. They recommend following a training session immediately with a protein shake and then eating a meal within 2 hours. That might actually be a way of dealing with the LOH.



ps. Sheri Colberg also has a website with quite a number of articles.

6

take the protein shake after your meal.

7

Yes thank you i have been on the website and it seems to be very specific to diabetes. I will also check out that other book.

8

Why would you take the shake after the meal? If your blood sugar drops 2 hrs after workout, don’t you need to have that protein in your system where it can work over the next 4 hours or so when you need it?

9

I’d like to put in a plug for my favorite source of weight lifting advice, the infamous Mark Rippetoe. I could never have learned to squat without his material, in particular the book Starting Strength. All the help I got from trainers in the gym was being taught to quarter squat in the smith machine on a bosu ball. To this day, I get taunted by the trainers, “don’t squat like that you will blow out your knees.” There is also a forum with lots of advice from the community that follows his teachings. And if you want advice directly from the man himself, you can join his forum, but be warned you better have read his book, he has a wicked tongue and does not tolerate fools.



Personally, I have sought to strength train, as opposed to bodybuilding or powerlifting. I am an old man, I’ll never compete in either sport, but I will make myself healthy and fit. I focus on compound lifts, squat, deadlift, presses, cleans and rows, with a range of accessories to support that core. There are probably only a handful of people in this community who will actually compete, but there is a huge number who would see great benefit from the training. And as Mark Rippetoe says, “Strong People are Harder to Kill, and Generally More Useful!”

10

thanks i will take it after

11

Sorry, mean to say after workout (i was cooking dinner when I wrote this) with your post workout meal.

12

Amino acids are necessary for muscle recovery and will fuel the muscles better than straight glucose. So if you have protein in your system after your workout, your muscles will have that and not completely depend on glucose, which will decrease the LOH.

13

I understood, thank you…

14

I am going to give it a try, i have a couple of varieties of whey protein shakes i will see what happens.

15

I agree wholeheardtedly about including a protein source in your post-workout recovery and meal. Just for clarification though:

You’re saying that the protein is a better energy source than the glucose? If so, how so?

My understanding is that after your workout, there are two things going on.

First, you’ve worked the muscle that then will require repair for growth. Amino acids, either free form or from protein, supply the building blocks for muscle growth. This is also an anabolic process so it does require energy that can come from fats, carbs, or protein. My undersanding is the fuel source used will depend a lot on what is provided. I always thought that, for muscle building purposes though, it doesn’t make much sense for the body to prefer protein over carbs to supply the energy, sacrificing the building blocks for growth over cheap, easy to burn carbs.

Second, you also need to replace any glycogen stores you’ve lost. Again, if your purpose is to grow muscle mass and strength you also want to include protein, but I’ve always relied on a pure carb source for glycogen replacement.

Either way though, I am definitely more concerned about maintaining my BG. For whatever reason, full meals do seem to work better for me than just correcting LOH with carbs,

16

I agree. I pry should have been more specific in this post or linked over. Look at my other discussion post for my postworkout meal. I take in around 60 g of mixed carbs (quick and long digesting) along with 70+ g of mixed protein (whey (rapid) and casein (long duration 4-7 hours). I still have LOH, but it’s not as bad when I intake only high levels of carbs. That being said I’m training for powerlifting and my diet pry would not work for someone training for a marathon where high levels of glycogen are necessary.



Your muscles will prefer the amino acids for rebuilding the muscle after you damage it (protein synthesis requires AA), rather than glucose which provides the energy for the machinery (ATP). So neither are best, they support each other.



Glycogen is great, if you are trying to replace that immediately then your plan is perfect. Unless I am planning on doing cardio later in the day, I prefer not to. I prefer to let my glycogen recover steadily throughout the rest of the day, be depleted at night and then have a very large breakfast to prepare for the day. This helps to keep my BG as a more constant levels with multiple small meals rather than large spikes at meal times.



We all know our diabetes is completely individualized. All we can give are hints to each other. Even pro bodybuilders have completely different food and lifting patterns, it’s just what works best for your body.



My diet works great for when I am trying to slowly gain lean body mass while trying to keep my body fat at a moderate level (~10%) and a good average BG (90 day ave 83 - a1c 5.4).



When I switch to a cutting phase diet, then when its gets ugly…

17

I love that saying!

I should have titled the group something different, I think I’m scaring people off with it. Should have put it more generic about working out, but I wanted to try to find some other people who are intense about their lifting regimens.

You have a great workout set. Essentially the same thing I do!

18

Understood and makes complete sense. I rarely, if ever, just take a carb load after a workout. I’ve always done complete meals with various proportions of protein and carbs over the years for the reasons you mention, and, it’s just better for my BG control.

I trained as a sprinter though, so maintaining my glycogen stores was a a close second as a priority while I was competeing. I was very competitive but I always seem to have issues towards the end of a hard week of training and, in my mind anyway, I always felt like I was at a slight disadvantage because of my broken glucose regulation. I never did find a diet that I thought was completely right.

Anyway, great numbers and great work!

19

In my experience with college football and lifting if you’re exhausted at the end of the week, but not on a daily basis, you should add some extra protein at night. Cottage cheese, cheese sticks or casein protein are great sources because they digest really slowly, provide fuel while you sleep so your body can focus on recovery rather than using energy stores to make more fuel.

20

No worries Trish, I think we’re the same body type! I’m also 5’6" & weigh between 150-160 pounds depending on the day of the week! My friends can never seem to guess my weight as I am a lot of muscle it seems. My Endo always tells me to lose weight b/c she just looks at my BMI, not my body fat %. I’ve stopped staring at the scale & simply go by how my jeans fit when it comes to weight control. I tried out a personal trainer for a month but quit since he couldn’t keep up with my diabetic eating schedule & insulin needs. Man, if I could make a living from being a specialized T1 physical trainer I’d do it in a heartbeat!

I also have issues with my dropping BG’s at night even if I work out at 8AM that day. It seems to bottom me out around midnight… just enough time for me to fall asleep & then wake up in a cold, shaky sweat with a BG of 40. My sugars are also random so it’s difficult to figure out the best temp rate without going too high or low in the morning. Maybe one day I’ll figure it out.