This is one I’m familiar with, but the about 1% BMI reduction or 1 point mirrors other studies.
table 3
BMI combined aerobic and resistance group
at the start, 35 BMI, at the end of 6 mths 34.2 BMI, a reduction of 0.8%
table 2
The A1c was reduced from 7.4% to 6.5%, a reduction after 6 mths of 0.9%
here they lost 1-1.5kg
Main results
The 43 studies included 3476 participants. Although significant heterogeneity in some of the main effects’ analyses limited ability
to pool effect sizes across some studies, a number of pooled effect sizes were calculated. When compared with no treatment, exercise resulted in small weight losses across studies.Exercise combined with diet resulted in a greater weight reduction than diet alone (WMD - 1.1 kg; 95% confidence interval (CI) -1.5 to -0.6). Increasing exercise intensity increased the magnitude of weight loss (WMD -1.5 kg; 95% CI -2.3 to -0.7). There were significant differences in other outcome measures such as serum lipids, blood pressure and
fasting plasma glucose. Exercise as a sole weight loss intervention resulted in significant reductions in diastolic blood pressure (WMD -
2 mmHg; 95% CI -4 to -1), triglycerides (WMD - 0.2 mmol/L; 95% CI -0.3 to -0.1) and fasting glucose (WMD - 0.2 mmol/L; 95%
CI -0.3 to -0.1). Higher intensity exercise resulted in greater reduction in fasting serum glucose than lower intensity exercise (WMD -
0.3 mmol/L; 95% CI -0.5 to -0.2). No data were identified on adverse events, quality of life, morbidity, costs or on mortality.
Yeah, I don’t think anyone is arguing about exercise being "good’ for diabetics. The first study is mildly interesting, in that combined aerobic and resistance had slightly greater effects on reducing A1c than one or the other, but the actual differences aren’t very high.
I think this is one of those “overthinking things” positions where more data (and studies) isn’t actually useful to most people. “Exercise is good for diabetics,” and “combined aerobic and resistance training are slightly better than aerobic or resistance on their own,” is sufficient. I don’t know if the BMI reduction is relevant, unless someone is purely interested in weight loss. IN which case, “consistent exercise results in slightly greater weight loss than no exercise” is sufficient.
exercise is generally good for you, but it won’t affect your weight or A1c very much. Nor will general dieting. the recommended ‘eat less move more’ high carb low fat
like T2, I think overweight T1 need to reduce the insulin load, reducing carbs and adding fats for energy does this
That’s not what the study you linked says. It quite clearly suggests that exercising three times a week does reduce A1c, and that combined aerobic and resistance reduces A1c more than aerobic or resistance alone. They aren’t insignificant effects either (.4% to more than 1% reductions). Here’s the relevant text:
Adjusted absolute hemoglobin A1c values decreased significantly in the aerobic training group compared with the control group (change, −0.51 percentage point; P = 0.007) and in the resistance training group compared with the control group (change, −0.38 percentage point; P = 0.038). In the combined exercise training group, hemoglobin A1c values changed by an additional −0.46 percentage point compared with the aerobic training group (P = 0.014) and −0.59 percentage point compared with the resistance training group (P = 0.001).
Exercise is good for you. Exercise is good for diabetics. This shouldn’t surprise anyone!
would you like to read my post again?
(still referencing the combined aerobic and resistance group)
“table 2
The A1c was reduced from 7.4% to 6.5%, a reduction after 6 mths of 0.9%”
I don’t see how it is possible to gain weight if you are a careful patient with type 1 diabetes. I was ultra thin and athletic when I was diagnosed at 14, and although I gained weight with height as I grew, I was still extremely thin when I stopped growing at 18. But since then, since I always had to pay close attention to controlling my diet and was always conscious of insulin requirements, I would have been put immediately on notice if I was eating enough to raise my insulin and weight, so I would have made a correction. Diabetics should be protected against the gradual slide into obesity which affects people with normal physiology, since they eat unconsciously and can drift upwards without noticing it. In my own case, a side-effect of diabetes has been that I am now, at 65, the exact same weight I was when I was 18, which was very thin, and even my old clothes from those days still fit (if I was willing to wear them).
Having to eat extra calories and take extra insulin to treat highs and lows (something non-diabetics don’t have to do)
Being told in my mid-20s that I could (and I quote) “eat whatever you want now” because I was using a pump (worst advice ever, especially to a young adult)
Falling out of exercise due to major issues with my feet and ankles (I’ve needed orthotics since birth, apparently, and didn’t get them till I was almost 30)
Starting a medication for another autoimmune condition that caused me to rapidly gain 25 pounds (and I still need this medication)
Getting no help from the medical community on how to lose weight, because they just aren’t trained in that area (and I don’t have thousands to spend on a private service)
As an aside, I find it frustrating when people who have never had problems with weight make these types of comments. That’s like someone who has never used insulin saying, “I don’t understand how you can possibly go low if you are careful!” People have different physiologies, genetic makeups, and life circumstances. If maintaining a healthy weight were as simple as “being careful” then we wouldn’t be in a situation where a majority of the population is overweight or obese, including a majority of people with Type 1 diabetes.
I wish that these conversations around weight control and weight loss could be dominated and directed by people who were actually living with the experience or had already gone through the journey. Unfortunately, many choose not to disclose the fact that they are overweight for fear of negative judgement.
Hi there, I am quite lean too, always on the verge of being underweight and I would be very happy if I could gain some weight. Let me repeat that: I want to gain weight. Anyone, any endo or dietician who would put me on notice for gaining a few kilograms is crazy. My daily carb intake might be considered insane by some here and still I fail to gain weight. My diet isn’t particularly low fat either - I don’t bother looking at the fat content of food at all. Eating lots of carbs doesn’t make BG management easier, but I don’t see any other way to prevent weight loss. So I would like to gain weight in order to be able to eat less and make BG management easier.
We don’t have normal physiology, that’s why we’re so thin. I don’t believe it has anything to do with my diet and therefore I don’t feel the need to berate my fellow diabetics who gain weight despite paying much more attention to their diet than I do.
I find that in my own case, the intrinsic variability of insulin needs is so extreme that the only way I can stabilize things adequately is to weigh all the food I eat and eat exactly the same food at exactly the same time every day. I would have to make a conscious decision to readjust these parameters if I wanted to gain weight, and I’ve never had any reason to want to do that, though once, on the first day of classes, a student in the front row in a course I was giving whispered to her friend, “He’s so skinny he looks sick!”
I also weigh myself regularly, since that is a good way to check for diabetic renal disease without bothering with a creatinine test, since fluid weight gain is a sign the kidneys are not processing urine as they should. But the only way to make this weighing informative is to eat the same thing all the time so as not to gain non-fluid weight.
The only variable is the amount I have to eat to correct lows, and that does induce some variation, but I have more or less worked that into the daily caloric intake allowed.
These habits come from the way diabetes was treated when I was first diagnosed in 1966, and I was put on an assigned ration of calories of carbohydrate, protein, and fat, and never allowed to stray from it. I was starving all the time and dreamed every night of nothing but food, since the diet was way below the normal consumption of an ordinary teenage male. I suspect that the Joslin’s Clinic, which kept me on that cruel diet, might have been secretly trying to give me some compensatory longevity advantage, since experiments with mice in the 1950s had shown that if they were placed on a starvation diet when young, they lived longer. It may also have been because old ideas die hard, and since it was necessary to starve diabetic children in the pre-insulin era, and that time was only 40 years after it, somehow they still felt starving diabetic children was a necessary treatment.
I’m guessing you’re not a female. I can weigh myself every day and fluctuate by five pounds just from hormones… There are lots of other reasons one might gain weight aside from kidney disease. I definitely would not replace getting an annual kidney check with just weighing myself.
Well, I’m not crazy, so of course I don’t rely on weight alone to determine what is going on with renal function. But since I’m not going for a creatinine test every month, ensuring that there are no surprising weight gains is a good way to monitor things informally in the mean time. The urine output is declining is sometimes too subtle to notice.
Yes, this. Also changes in female reproductive hormones both across the cycle and the lifespan means that for many women, there is no general set amount of food/dosing etc that would both result in consistent insulin regimens and weight results. Plus, my appetite shifts dramatically with all of that, and while I could try to completely ignore that and force myself to eat the same thing regardless, I don’t think that would be good for my own wellbeing. My cycle effects have also shifted as I’ve aged (so it’s not just something I can master and be done with), and I just can’t wait (/sarcasm) for the even greater erratic results I’ll get when I eventually enter perimenopause. So @Seydlitz, you may want to refrain from presuming anyone else’s physiology is at all like yours.
I’ve found success by exercising in the morning, right after waking. This helps battle (and even eliminate) any dawn phenomenon (DP). I can be in the 80-90 range at the start of weight training, be up in the 120’s by the end of a 30 minute workout, and then back down to 100 before I get to work. I don’t consume any carbs before the workout because the DP prevents any hypos. Without the exercise, DP typically gets me into the 140’s before breakfast if left untreated.
Of course women’s weight will fluctuate with the menstrual cycle, but I’m just saying that if you weigh all your food, eat the exact same food at every meal, eat at the same times every day, and always keep the same level of activity, you just won’t find that you gain weight over time. I have had to change my total caloric consumption a few times because of lower caloric requirements with age, so I now eat about half as many calories as I did at 18 (1300 instead of 2500), but those adjustments have been few and far between. If I didn’t manage the blood sugar levels at all, since otherwise there would be too many variables to keep track of dose requirements.
But this simply isn’t true. It may be true for you, but it’s not true for everyone. You are taking your own personal experience and making blanket assumptions that everyone else’s body is identical to yours. Furthermore, eating exactly the same foods at every meal and sticking to exactly the same schedule every day are no longer recommendations for people with Type 1.
My point was beyond that—that our insulin needs can fluctuate so dramatically that strictly regimented eating may not be nearly as helpful in producing replicable outcomes or a reasonable thing to ask of ourselves (given hormone-induced variability in hunger).
Sure, and many people value having more flexibility in their life than this, as well as being able to have a wide range of experiences with their food. Food brings pleasure and has cultural and social meaning for many people, and many diabetics have to balance that with health needs, but that word balance is key for many of us. Would my diabetes be easier control if I ate in a completely monotonous fashion? Maybe. Does it sound worth it to me? Nope. Also worth noting that strictly weighing and controlling everything you eat doesn’t work for some folks, because for them, it’s a stepping stone to disordered eating, or part of it. Food and eating is complicated for lots of people, for lots of reasons.
Well, as long as the conservation of mass-energy theorem still holds good, you simply cannot gain weight (other than by retaining water) if you hold both energy intake(calories are a measure of energy) and energy output constant. Where would the additional weight come from? Absorption from the atmosphere?
I understand that for most people eating as entertainment is important, and the sociologist Bruno Bettleheim has written about the significance of eating freely as something which is psychologically good. However, since I really need to stabilize every variable I can in order to maintain even a moderate degree of control over my spontaneously shifting insulin requirements (e. g., 2 units for dinner in September, 15 units for exactly the same dinner in June), I just forget about eating as recreation, and concentrate on other things. Eating becomes completely automatic, ritualized, and invisible.
