Anne L. Peters, MD: Hi. I'm Dr Anne Peters. I am here today with Dr Bruce Bode to talk about exercise as part of the treatment for diabetes. Let's start the discussion. You and I both take care of lots of athletes. How do you teach someone how to take care of a person who is taking insulin?
Bruce W. Bode, MD: As you know, exercise is an insulin sensitizer; it makes insulin work better. In type 2 diabetes, you always want to get your patients to walk because it improves insulin action. In type 1 diabetes, they don't make insulin, so they need to take insulin to survive. You have to balance the insulin with their food intake. When they exercise, you're going to need less insulin because they will have improved insulin action and sensitivity.
For people with type 1 diabetes who want to exercise, and especially those who want to get into extreme exercise like running a marathon, you have to help them and guide them. You have to balance the insulin with glucose levels. You have to have the right amount of insulin and match it with carbohydrates as best as you can. The rule of thumb is that you always start exercise when your glucose level is above 90 mg/dL and preferably don't start exercise if your glucose level is above 250 mg/dL because that means you are relatively insulin-deficient.
Pediatric Type 1 Diabetes Mellitus
COMMENTARY
How to Counsel Type 1 Diabetes Patients Who Exercise?
Anne L. Peters, MD; Bruce W. Bode, MD
DisclosuresJune 23, 2015
Anne L. Peters, MD: Hi. I'm Dr Anne Peters. I am here today with Dr Bruce Bode to talk about exercise as part of the treatment for diabetes. Let's start the discussion. You and I both take care of lots of athletes. How do you teach someone how to take care of a person who is taking insulin?
Bruce W. Bode, MD: As you know, exercise is an insulin sensitizer; it makes insulin work better. In type 2 diabetes, you always want to get your patients to walk because it improves insulin action. In type 1 diabetes, they don't make insulin, so they need to take insulin to survive. You have to balance the insulin with their food intake. When they exercise, you're going to need less insulin because they will have improved insulin action and sensitivity.
For people with type 1 diabetes who want to exercise, and especially those who want to get into extreme exercise like running a marathon, you have to help them and guide them. You have to balance the insulin with glucose levels. You have to have the right amount of insulin and match it with carbohydrates as best as you can. The rule of thumb is that you always start exercise when your glucose level is above 90 mg/dL and preferably don't start exercise if your glucose level is above 250 mg/dL because that means you are relatively insulin-deficient.
Medscape Diabetes © 2015 WebMD, LLC
Any views expressed above are the author's own and do not necessarily reflect the views of WebMD or Medscape.
Cite this: How to Counsel Type 1 Diabetes Patients Who Exercise? - Medscape - Jun 23, 2015.
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Authors and Disclosures
Authors and Disclosures
Authors
Anne L. Peters, MD
Professor of Endocrinology, Keck School of Medicine, University of Southern California; Director, University of Southern California Clinical Diabetes Programs, Los Angeles, California
Disclosure: Anne L. Peters, MD, has disclosed the following relevant financial relationships:
Served as a consultant for: Amgen, Inc.; Abbott Diabetes Care; Becton, Dickinson and Company; Biodel; Bristol-Myers Squibb Company/AstraZeneca; Janssen Pharmaceuticals, Inc.; Lexicon; Eli Lilly and Company; Medtronic, Inc.; Novo Nordisk; OptumRx; sanofi-aventis; Takeda Pharmaceuticals North America, Inc.; Thermalin
Serve(d) as a speaker or a member of a speakers bureau for: Janssen Pharmaceuticals, Inc
Received a research grant from: Janssen Pharmaceuticals, Inc; Medtronic, Inc.
Received income in an amount equal to or greater than $250 from: Amgen, Inc.; Abbott Diabetes Care; Becton, Dickinson and Company; Biodel; Bristol-Myers Squibb Company/AstraZeneca; Janssen Pharmaceuticals, Inc.; Lexicon; Eli Lilly and Company; Medtronic, Inc.; Novo Nordisk; OptumRx; sanofi-aventis; Takeda Pharmaceuticals North America, Inc.; Thermalin; Medscape
Bruce Bode, MD
Associate Professor of Medicine, Emory University School of Medicine; Atlanta Diabetes Associates, Atlanta, Georgia
Disclosure: Bruce W. Bode, MD, has disclosed no relevant financial relationships.