Diabetes Exercise Physiology 200 – Review

This is part one of what I learned from TeamWILD. It occurred to me that it would be good to review “Diabetes Exercise Physiology 100″ before diving into the 200-level stuff. :-) You might also want to look at my notes from when I read The Diabetic Athlete’s Handbook.

    The kinds of energy (More info)

  • Blood sugar: There’s not a lot of it. It’s used by almost all the cells in your body.
  • Glycogen: There’s quite a bit of it. It’s stored in your muscles, ready to be used when you move around.
  • Fat: This is the most plentiful type of energy you have. It takes a bit more work to convert stored fat to a usable form, compared to glycogen, but it happens when you exercise long enough. (A key part of endurance training is to condition your body to tap into this energy source.)
  • Anaerobic systems: These are fast-acting, short-lived sources of energy for quick bursts of activity. They only last seconds or a few minutes and don’t use glucose or insulin.
    Making blood sugar go up

  • Food raises blood sugar. Specifically, carbohydrates raise blood sugar. All carbs (except fiber) raise it.
  • The liver also steadily releases glucose throughout the day, which can raise blood sugar levels.
    Making blood sugar go down

  • Insulin lowers blood sugar.
  • Insulin lowers blood sugar more during exercise.
    The right amount of insulin

  • Too much insulin can cause hypoglycemia, which is dangerous and potentially fatal.
  • Too little insulin can cause diabetic ketoacidosis (DKA), which can cause dehydration, vomiting, coma, and death.
  • Having too little insulin—not enough to keep your blood sugar from going up when fasting—is different than not taking enough insulin to cover the carbs you ate. In the “too much food” case, you have a surplus of available energy in the bloodstream, but you have enough insulin available to use some of it. In the “under-insulinization” case, your body has to seek a completely different source of energy than blood sugar, and that’s what causes ketones and other badness.
    The relationship between insulin and glycogen

  • To switch from using blood sugar to fat, and to stimulate the liver to release more glucose during exercise, insulin levels in the blood must go down. Higher levels of insulin actually cause the liver to hoard glucose (as it does when you eat).
  • Of course, you also need insulin to move glucose into cells. It’s a balance between too much and too little.
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