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Diabetic Athlete’s Handbook: Your guide to peak performance

Dec 22, 2008
 

SheriSheri Colberg Ph.D. has written a new book based on her experiences as an athlete and diabetes patient. The Diabetic Athlete’s Handbook: Your guide to peak performance is reviewed this week by Shannon Hart, PharmD Candidate University of Florida College of Pharmacy

Diabetic Athlete’s Handbook: Your guide to peak performance
Shannon Hart, PharmD Candidate 2009
University of Florida: College of Pharmacy

Were you an athlete back in high school and college, then about the time you wanted to start training for that triathlon, you are diagnosed with type 2 diabetes?  Or have you had type 1 diabetes since you were a small child and now everyone in school is joining the track team, signing up for football or basketball and you think you can not join because you think you will have trouble keeping your sugars under control?  There are many people out there in your same situation, except the main difference between them and you is you are going to discover the Diabetic Athlete’s Handbook, written by Sheri R. Colberg, PhD.  As an athlete and diabetic herself for over 40 years, Dr. Colberg has used her practical experiences as an exercise physiologist and a professor at Old Dominion University in Norfolk, Virginia to write hundreds of articles and author numerous books.  She is also involved in research specializing in exercise and diabetes, is a professional member of the American Diabetes Association, and is on the board of directors of the Diabetes Exercise and Sports Association.     

This book is divided into two main sections.  The first section provides the basics of exercise, regulation of blood glucose, and balancing the two based on the different intensities of exercise.  It also provides information on diet, supplements, glucose monitoring, sport psychology and injuries.  The second section becomes more specific as it focuses on recommendations of adjusting diet and medication to achieve optimal glucose management while incorporating various levels of physical activity as you participate in any of almost 100 different sports.  Throughout the book, there are profiles the author put together from a wide range of athletes from many different countries who responded to a questionnaire she had posted on her website.  From a 96-year-old senior Olympian world record holder to a 22-year-old professional surfer and everywhere in between, the profiles detail the type of diabetes, the greatest athletic achievement, current glucose control method, training tips, the typical daily and weekly training and diabetes regimen, and a great little story of a special moment in which diabetes had an effect on them as competitive athletes.

As you go through the chapters, the book progressively gets more detailed.  Chapter 1 describes the basics of diabetes and the difference between resistance and aerobic exercise.  Chapter 2 and 3 discuss the effect exercise has on blood sugars and the balancing act needed when dealing with insulin and other medications.  Nutritional aids and an athlete’s diet are discussed in chapter 4, while chapter 5 contains guidelines for exercise and blood glucose monitoring.  Chapters 6 and 7 close out the book’s first part by containing important information about the psychology of being and athlete and preventing and treating general athletic injuries as well as diabetic specific injuries and problems.

Chapter 8 begins the more specific sport related section of the book by discussing general adjustments that are usually made to diabetic medication and insulin.  Each chapter contains groups of intensity related sports with changes in diet and insulin alone, as well as in combination, based on athlete examples.  Intensity of exercise, duration of activity, and other effects are also taken into consideration.

At the end of the book, there is an appendix which contains a list of diabetes and athletic organizations with addresses, phone numbers, contacts, and web sites for each one.  The second appendix is a list of diabetes, sport, and nutrition web sites.  Each site listed also has the organization associated with it, in addition to a brief description of what is found on that specific site.

I found the numerous tables and charts in the book are very useful.  One table in particular stands out.  The following is a table in chapter 2 which indicates the amount increase of general carbohydrate needed for endurance sports based upon the intensity of the sport and the blood sugar before exercise.

General Carbohydrate Increases for Endurance Sports

Duration

Intensity­1

Blood sugar before exercise in mg/dl (mmol/L)

 

 

<100 (5.6)

100–150 (5.6–8.3)

150–200 (8.3–11.1)

>200 (11.1)­2

15 min

Low

0–5

None

None

None

 

Moderate

5–10

0–10

0–5

None

 

High3

0–15

0–15

0–10

0–5

30 min

Low

5–10

0–10

None

None

 

Moderate

10–25

10–20

5–15

0–10

 

High

15–35

15–30

10–25

5–20

45 min

Low

5–15

5–10

0–5

None

 

Moderate

15–35

10–30

5–20

0–10

 

High

20–40

20–35

15–30

10–25

60 min

Low

10–15

10–15

5–10

0–5

 

Moderate

20–50

15–40

10–30

5–15

 

High

30–45

25–40

20–35

15–30

90 min

Low

15–20

10–20

5–15

0–10

 

Moderate

30–60

25–50

20–35

10–20

 

High

45–70

40–60

30–50

25–40

120 min

Low

15–30

15–25

10–20

5–15

 

Moderate

40–80

35–70

30–50

15–30

 

High

60–90

50–80

40–70

30–60

180 min

Low

30–45

25–40

20–30

10–20

 

Moderate

60–120

50–100

40–80

25–45

 

High

90–135

75–120

60–105

45–90

Notes: The recommended quantity is given in grams of rapidly absorbed carbohydrate. One fruit or one bread exchange equals 15 grams of carbohydrate.
1Low-intensity activities are done at less than 50%, moderate activities at 50 to 70%, and high- intensity activities at 70 to 85% of heart rate reserve.
2For blood sugars above this level, or when ketones are present, an additional dose of rapid-acting insulin may be required to reduce these levels during an activity, and the recommended carbohydrate intake may be higher than actually needed.

3Intense (near-maximal), short-duration exercise may actually cause blood sugar levels to increase.

This table can be used in conjunction with the table in chapter 4 which lists recommended sports drinks, gels, and other carbohydrate sources with the carbohydrate content in grams per serving, bar, etc.  Other tables include comparisons of continuous blood glucose monitoring systems, common overuse injuries including symptoms of and treatments for, and diabetic medications and how they work. 

Those are just a few of the many tables included in this easy-to-read, easy-to-comprehend book.  Diabetes is a complex, chronic disease and although it is a well known fact that that diet and exercise is of great importance in managing this disease, there is a lack of easy to understand books that also have the information necessary to actually put the dreams of being an athlete into motion.  This book provides that information in an organized manner that flows effortlessly through the sections and chapters.  Using the index in the back, finding specific sports related or diet information is made simple.  Just remember, whether you are the daily yoga enthusiast, the weekend warrior, or the hard-core professional Olympic triathlete, this book is the one in which all diabetics would benefit from to help manage their diabetes while enjoying the sport of their choice!  I would also suggest visiting Dr. Colberg’s Web site, shericolberg.com, to find more information about exercising with diabetes through articles, blogs, books, and more.

www.diabetesincontrol.com