Aikido and Diabetes
I have been reading and trying to learn something around here for several months, and thought I would introduce myself, and ask for a little input.
I train in Iwama Ryu Aikido at Capital City Aikido in Montgomery, Al. Started training in February.
I am curious as to whether there are any other Type 1 diabetics who train. I have been struggling with managing the impact of training on my diabetes for several months now, and was hoping that there might be some people who are a little further down the road, and might be able to give me some pointers.
I am specifically interested in strategies for managing blood sugar levels during seminars, and other occasions where training lasts longer that 1-2 hours.
Any and all input is welcome!!
After 2 years of being on medication, I was able to get the diabetes under control enough to deal with it through diet and exercise but I can still feel a crash on the way every now and then. I'm Type II myself so the situation isn't quite as pressing but I've learned to keep a little snack in my bag for emergencies.
I used to train with a woman who was on a insulin pump. She still wore it when she trained (don't ask me how), and she had been training for at least 10-years.
Is this something you can ask your doctor about?
I have problems with low blood sugar, and find having some almonds before class helps ward off blood sugar drops. Maybe you would like to try that. It seems to work well for me.
best wishes on this, Rachel
More power to you on getting your Type 2 under control. I think, in many ways, managing type 2 is probably harder than managing type 1--for the very reason that its not "as pressing" as you mentioned.
My doctor and I have spoken a couple of times regarding aikido and bloodsugar control. My blood sugar is *very* well controlled, under normal circumstances. when i start exercising, my metabolism seems to cut on like a light switch. sugar goes up for about an hour and a half and then starts dropping.
the real problem is in longer than normal training, and in my sugar dropping in the middle of the night--about 7 hours after training.
My doctor is very helpful, and very knowledgeable...but there are some lessons that only seem to come from living with and dealing with having diabetes.
Thanks again for the responses!!
My ex-husband was a type 1 diabetic. He had to keep a bar of chocolate by the bedstand in case of a precipiteous blood-sugar drop. Exercise would definately make problems for him, and he had to carry food with him wherever he went. Can you have something on the side of the mat in case you start feeling a drop? I am sure any sensei would be fine with that, in particular if they know of the problem (I take it you've told your teacher about having diabetes).
I keep candy bars in my bag that I bring with me to the dojo. My sensei is aware of the diabetes, and very supportive-both of my training, and of my taking care of myself while i train.
We will be training for several hours on Saturday, and i will certainly try eating some nuts or other protein before we get started to see if that helps any.
The waking up in the middle of the night is the *most* frustrating part. shaking and a cold sweat at 2 in the morning twice a week gets old quick. it has gotten a little less frequent lately, but i know i still have a lot to learn about managing it effectively, especially since there is so much variance in the intensity of the training from dojo trip to dojo trip.
Re: Aikido and Diabetes
Just a small nit: "Iwama Ryu" is an overloaded term that I don't, personally, use. In the strictest sense, it's an organization or collection of organizations that came about due to situations that we in the U.S. don't have. Do a web search on "Iwama Ryu Scandanavia" or "Iwama Ryu Europe" for more information.
Through the Takemusu Aikido Association, we're part of the Aikikai just like the USAF, ASU, AAA, CAA, etc.
Stylistically, as we discussed last night, we have a mixed heritage but focus on the Iwama "style" or what I think of as "the Iwama pedagogical method".
As far as the diabetes go, if you went a little slower vice training like a banshee the way you do, it might lessen the impact. ;)
Seriously, I've thought about shortening classes, taking breaks, etc. to make things better for everyone. Drop me a line about what works and what doesn't.
Thanks for picking the Nit.
I am clearly a man with MUCH to learn.
I didn't realize there was another way to train. :)
I'm not sure I am satisfied with that trade off.
Holmes how many times a day do you check your bloodsugar ?
If you really want to get it it under control
check 4-6 times a day.
That way you will know how motion and food
and the different types of insulin interacts,
eating rye-bread 4 times a day will give
your bloodsugar a basic stability from which you can start calculating your other meals.
The problem that correct insulin/bloodsugar balance presents ,is that to keep your bloodsugar around 7,5 you will get close to the "shockarea" and a little excersise will
tip the balance,and the the counterreaction sets in and then it gets complicated as the counter reaction raises the blood sugar considerably.
Keeping the bloosugar higher will keep you from "shocking" but it will be detrimental
to your body (especially the organs).
If you need sugar fast , fruit-juice is the fastest - the sugarmolecules are the smallest
and will absorb imidiately .
Chocolate is slower working but a good
steady factor - especially dark chocolate.
When you start to sweat and get dizzy the conterreaction is in progress and can't be reversed,I know it's hard to avoid but if you can ( by checking your bloodsugar )your body will not be as strained (?) as when the bloodsugar's raising up and down.
I hope I make sense.
i check about 5 times a day.
my sugar during the day, and on nights i dont train, is usually between 75-90. my past 2 3 month averages have been 5.7 and 6.1.
there is a significant increase in my bloodsugar level during training, followed by a signifigant drop after training. also, when training more than 2 or so hours, the sugar begins to drop, and is very difficult to get back up until i have gotten off the mat.
i can tell when my sugar starts getting below 70. the sweaty and shaky really only happens in the middle of the night-while i am asleep. my body reacts and wakes up once my sugar hits around 45.
i am interested in the rye bread though. could you tell me more about that?
My son has had type 1 diabetes for 10 years. He's not taking aikido, but we've learned over the years that if he does a lot of exercise during the day we're going to have to set an alarm clock for around 2AM -- better to wake up to the alarm, test and eat than to sleep til you're so low you get shaky and feel awful.
When he gets consistent about when and how much he exercises, my son can "calibrate" himself to know how he reacts -- then, he tests his blood right before going to sleep and if it's not ridiculously high (adrenaline does that, sometimes) he eats "enough" extra food
to keep him from going low later. But until we get it all figured out or if his activity level or time is changing, the overnight alarm is the only safe way. One problem with letting yourself go too low too often is that you can become desensitized to the lows so you don't feel them -- at least, that's what they warned us about in Joslin Diabetes Center in Boston.
He got an insulin pump last year, and it's been great. He doesn't have severe lows anymore.
I'm going to try setting the alarm to see if I can't get it to wake me up before my sugar does. Sounds like that might make things easier.
I'm glad the pump has worked so well for your son. My doctor and I have spoken once or twice about the pump, and his feeling is that if you don't mind shots, and have managed to get pretty tight control of your blood sugar, then you don't really gain anything from the pump.
Having some first hand knowledge, how do you feel about this?
I'm 25, and was just diagnosed 2 years ago. It's been a bit of a steep learning curve--especially since I started Aikido, with different schedules and activity levels different days of the week.
Thank you so much for taking the time to write!!
Hi again !
When I Was in Portland last year I noticed
that it wasn't possible to get the kind of rye-bread that we have in Denmark,your version was more like a brown version of white-bread.
But maybe you'll be able to bake it yourself.
What I mean is a bread containing much fiber and kernels (?).
This bread dissolves slowly and steadily and
therefore by eating like 2-3 slices 4 times a day there will a steady bloodsugar development,then if you know in advance that you're going to exercise,you can eat accordingly like 2 hours in advance (rye-bread) and you will know that there is a steady sugar supply instead of going for fruit or candy.
A half hour walk is approximately 2 slices of rye-bread.
Then just before training and after you could
eat some fruit or chokolate.
But I'm very glad to hear that you check your bloodsugar often,that ís the way !!
Some people with type 1 diabetes have psychological problem doing it,because the always feel guilty of not living right and so they check once a week ,that doesn't work !
thank you for the information. you wouldn't happen to know where i could find a recipe for the kind of bread you are talking about would you? as is, i am trying to snack up before bed, with varied results. i would like to try something a little more steadily broken down. i can certainly see the potential benefit.
i have tried to avoid eating before training. i have found that a blood sugar level of 70-80 before training turns into 130-140 halfway through training, with no food. my initial assumption had been that snacking before training was a good idea. after a couple of classes with sugar soaring from 70 before to 190 during, i decided that was not the best course.
rye bread before bed, though, sounds like its worth trying out.
Hi again !
I don't have a recipe in english but I'll
try to find one and make a translation,
There is a tricky thing to bodily motion espcially Aikido (lots of body to ground movement),there are pockets of insulin where you inject and by training you kind of massage these pockets causing extra insulin to be freed after training,which can result in "shocking" at night,so checking bloodsugar
after training and before sleep is a good idea,to see if something happening.
I have assumed you're an american,if I'm wrong please accept my apologies !
You are correct.
I am American. Any help with the recipe would be greatly appreciated.
Also, i noticed the picture under your name. Can i assume that you are a guitarist? I was a jazz guitar major in college, so meeting a fellow diabetic, aikidoka, guitarist is interesting to me.
Hi again !
Guitarist yes - diabetic no !
My experience comes from living with a type 1
diabetic,and being the objective one - and the one who had to witness all the shocks
and helping out especially checking bloodsugar,this is where it comes from.
Doctors told my then-girlfriend that she had a year left to live.
That was in 1988 - guess who's still alive ?
Blind though - I hate doctors who hand out deathsentences !!!
The only time I was wrong when I accidentally
put salt instead of sugar in a glass of milk
,"shocking" people are not rational and you have to be a bit pushy : Come on drink it !
thankfully I found out what was wrong .
Before they let my son have a pump, his Joslin team had us talk in depth with the doctor, nurse, dietician and a psychologist -- and this is when they already thought he'd be a good candidate!
It's important to be realistic about what you expect, and you have to be good about testing your blood and counting your carbohydrates and remembering to give yourself insulin etc etc -- once you're feeling "normal," it's easy to get lazy and start ignoring things and then your control get worse instead of better.
Pre-pump, his control was OK: A1C 6.8 - 7.5 (6.8 was more recent), but with big swings from around 23 mg/dl (not all that often, but he felt horrible then) or more often 45 and up to 350 and the occasional 400 (that was whenever he went swimming in REALLY COLD water, or sometimes for no reason at all that we could find -- maybe the shot went into a calcified spot or somesuch).
He now has to carry pump supplies with him instead of just his meter and glucose. Now his belt pouch also contains batteries, spare infusion set and skin prep stuff. And we have insulin handy as well as syringes in case something ever goes wrong with the pump. And of course he still has glucagon nearby, just in case.
He tests his blood 5-8 times/day.
Always -- well, usually -- before and
after exercise, then before bed if he's
exercised (actually, he usually tests
just before bed anyway, since if he's lowish then he eats something) and of course before meals.
Benefits of the pump:
He doesn't have any severe low bs anymore
He can eat whatever he wants, whenever he wants -- he just has to remember to
find out how many grams of carbohydrates he's eaten and must push the button to give himself enough insulin
He doesn't have to eat unless he's hungry -- used to have to eat snacks every 2 hours, more or less, since he had long-acting insulin working
It's more convenient when he's eating out, since he can eat anything and then can just push the button to dose himself with insulin.
He thinks it's cool that he's a cyborg.
He disconnects the pump when doing something very active that might break it (it's rugged, BUT ...). That means while he's doing the activity he's not getting the basal drip of insulin the pump give him between meals. When he's done, he decides whether to dose himself
with as much insulin as he missed while disconnected or whether he thinks the exercise will make that insulin unneccessary. (Remember, exercise not only uses more blood sugar, it also makes you use insulin more efficiently.)
I'd said earlier that adrenalin makes his blood sugars go up -- maybe that's why yours go up in class. Your liver dumps stored sugar to make sure you've got the fuel for your "fight or flight," but you need insulin to get it into your cells where it belongs. We've seen his go WAY up if he gets a real adrenalin rush. (Then it seems he goes low later, when we think it must be that his liver gets refilled with more stored sugar.)
He's 14 now, and has had diabetes since he was 3. So it's probably easier for him, since it's all he remembers.
I don't know how much detail everyone on this thread's interested in. Feel free to email me if you've got questions you think are too detailed for the forum.
Interestingly, a different young teen with diabetes just joined the weekly jujitsu class my aikido Sensei teaches.
The first class he came to, he didn't bring any sugar source with him and didn't test his blood. He was OK, but is more careful now. We'd had it drilled into us at our training at Joslin right from the start that it's important to test before and after exercise and that you'll probably need to eat an extra 15 grams of carbohydrates for every 30 minutes of hard exercise (and that seems true for my son), so it was a big surprise to see a diabetic who didn't seem to know anything about that. I put glucose in the dojo's first aid kit, just in case.
Thanks for all the information. That is the first time I have had anyone give me a guesstimate of the ratio between extra carbohydrates and exercise. I know I will have to do some experimenting, but 15 carbs/ 30 minutes is at least a place to start.
Thanks to all who have responded so far. I can't tell you how much I appreciate the input.
I wish I had noticed this post last week, but such is life.
I'm 27 and I've been Type I diabetic for 11 years now, and a student of Aikido for about a year and a half.
You're original post included a call for help on how to handle your blood sugars during seminars. Unfortunately, I can't really provide much guidance since I did such a horrible job controlling my own sugars during the only seminar I've attended. My sugars were basically high all weekend. I think it was the combination of excitement, sleep deprivation and over compensation of (perceived) insulin reactions that caused my blood sugars to be higher than I would have liked.
I'll try no to repeat much of what's already been said, lot's of good stuff in this thread.
Insulin pumps.. I've considered them from time to time, but I don't think I want one. This is just my personal preference.
I find that my Aikido training noticibly affects my metabolism/blood sugars for about 1 to 2 days. I end up taking less insulin for the same blood sugar/food intake than if I have not trained.
For snacks to keep with me, I prefer single serving cookie packages over chocholate etc, mostly because the cookies don't melt in the Florida heat.
To avoid waking up in the middle of the night, I check my blood sugars before I go to bed. If I've correctly controlled my blood sugars, I usually need to eat something before bed. This is also dependent on what I've eaten for dinner, if I've had pasta, the complex carbs seem to help keep my blood sugars up over night. On nights that I have pasta, I'll usually have some garlic bread and a glass of milk or some other less complex/more simple carb so that my body is processing some of that while I'm training.
As for variance in training, I've found I can somewhat control my training intensity on a particular night. On the nights I attend the beginning/intermediate classes and my sugars were low/controlled before dinner, I'll seek out complete beginners that are more likely to slowly walk through the techniques. If my sugars are high and I need to burn some extra off, I'll seek out the more advanced students and attack more vigorously. On advanced nights, if I need less of a workout, I'll find the older generation of Aikido students and attack in a committed, but less vigorous fashion.
Before this gets too long, here's my treatment program:
Wake up: Insulin 16 units of Humulin Ultralente and X units of Humalog Regular insulin.
Mid-morning: usually a snack or three depending on blood sugars
Lunch: Check sugars if I feel I need to, and eat lunch accordingly
Dinner: X units of insulin based on dinner and excercise for the evening.
I'm 5 foot 6.5 inches tall and I've weighed around 145-155 lbs since I was diagnosed with diabetes. The key to blood sugar control for me is balancing Food/Insulin/Excercise, and you'll gain experience with what works for you. Ultimately, you are responsible for what goes in your mouth and for me at least, anything that has calories raises my blood sugars (go look at the nutrition facts labels on all that "sugar free" candy at the supermarket, what a load of garbage that label is!). When I'm eating sushi/chinese I end up taking 2 extra units of insulin because that's what I've found I need to do to keep my blood sugars under control. When I'm excercising vigorously, I'll take 2 units less than my normal scale, otherwise I end up having to eat too much food or stop excercising to eat.
Ultimately, for me blood sugar control ends up being a game of timing. For me, I picture my blood sugars as either rising or falling depending on when I've eaten, how much excercise and food etc, so when I'm having an insulin reaction at 8:00 a.m. and I'm not eating lunch until 11:30 a.m., I'll eat more than if I'm having an insulin reaction at 10:30 a.m. If the night before, I trained really hard in the advanced class, I might need to eat 3 servings of some M&M's to get me to lunch. If I haven't excercised as much the night before, I might have something sugary with around 200 calories given the same time of my insulin reaction. The best thing that helps me keep control is eating regularly at consistant times.
Sorry, this is a bit long, Hope this helps, if you want, I could tell lots of stories (my freshman year roommate at college was diabetic).
John S. Murray
I am happy to report that after 2 VERY vigorous hours of training Monday night, followed by 75 *extra* carbohydrates to compensate for the exercise at supper, my Tuesday morning blood sugar was about 105. The next step is to maybe alter my dinner insulin dose so that I don't have to scarf down so much extra food, but it was a good start.
I appreciate all of the advice, and any more that might be added.
I thought I'd mention some other stuff, that I don't recall seeing posted. You've probably heard most of it elsewhere.
First, when I was at college, I was amazed at how much of an effect a seemingly small amount of exercise had on my blood sugars. Just walking to campus and from class to class helped keep my blood sugars down.
Second, you'll probably notice that stress causes your blood sugars to be higher. This would be both emotional stress and stress on the body like sleep deprivation or illness.
Hrmm.. to avoid straying too far off topic, we'll make an Aikido reference. If I'm only training weapons, since there isn't really any rolling type ukemi, I usually only take 1 unit less of my before dinner insulin.
Oh, the other side of waking up at 2:00 a.m. in a cold-sweat insulin reaction is waking up at 2:00 a.m. to go to the bathroom because your blood sugars are too high.
Also, no matter how well you think you're doing at managing your blood sugars, you'll find times when your sugars are higher or lower for no apparent reason. Stuff happens, if you pay attention, your body will remind you.
Well, got to run, good skill (not good luck, it's mostly up to you) with your diabetes management. Your posts don't sound like you're depressed about the fact that you have diabetes, but if you are, the way I look at it, 100 or 150 years ago, I would be dead by now so I'm thankful for that.
Hi Holmes and others,
I saw your post asking for strategies for aikido training longer than 1-2 hours. I read the replies with interest.
I have diabetes type I since 8 years and I train in aikido since 2 years.
Diabetes is an individual disease. What works for one person may not work for another. Everyone will have to learn by trial and error.
I am a bit different case compared to other people with type I, because I am a LADA type (Latent Auto-immune Diabetes in Adults) and my body still produces some insulin of its own. So what works for me may not work for other people with type I.
I take 4 insulin injections a day. I discussed the insulin pump with my specialist, but he was of the same opinion as your doctor was (If you manage a tight control of your blood sugar level by injections and your HbA1C is small enough then you don't gain much by an insulin pump).
Different individuals have a different sensitivity to insulin (E.g. This sensitivity partially depends on your weight. Overweight people tend to have a lower sensitivity. It also depends on the amount of physical exercise you get during a day). This explains why different individuals require different amounts of insulin for the same amount of carbohydrates. It may vary a factor 10.
I recently learned that your sensitivity to insulin varies within a 24 hour period. Most people are more sensitive during morning and afternoon and less during the evening. But some individuals show a different graph of sensitivity. If your sensitivity to insulin varies, so does your personal ratio of units of insulin per amount of carbohydrates. So what works in the morning may differ from what works for dinner.
I attended aikido summer school (in Netherlands, Europe) twice. The last summer school took 5 days with one training session on the first day and one on the last day and two training sessions per middle three days. Each training session takes 3 hours. I compensated for this larger amount of exercise by decreasing the amount of insulin, both my ultrafast insulin (humalog) and my slow insulin (insulatard). My teacher informed the sensei of the summer school, so I was given permission in advance to leave the tatami any time during the training session (in order to take care of my blood sugar regulation). Normally, an aikidoka has to approach the sensei and ask permission to leave the tatami.
On a regular week night I take 10 units of slow insulin. At the end of the first and last day I took 8 units of slow insulin. At the end of the three middle days I took only 6 units of slow insulin. Each training session was preceeded by a meal (either breakfast or lunch). I decreased the amount of ultrafast insulin for each of these meals, taking 3 units instead of 4 units. I took roughly the normal amount of insulin (both ultrafast insulin (humalog) and fast insulin (actrapid)) for dinner, sometimes rounding down the amount (varying between 7 and 13 units).
I had one hypo half way during a training session (I always hope to avoid that). It was 3.3. mmol/l = 59.4 mg/dl. I treated that one by eating 8 tablets of "dextro energy" (dextrose), slightly more than I would normally for a 3.3 mmol/l, and taking a small break of 5 to 10 minutes. I usually ended with low sugar levels after the second training session on the day, sometimes a minor hypo. I treated those primarily by decreasing the amount of insulin for dinner. I always measured my blood sugar level just before going to sleep. My blood sugar levels just before going to sleep were lower than usual, but not by much. I experienced one blood sugar level below 6.0 mmol/l = 108 mg/dl; it was 4.9 mmol/l = 88.2 mg/dl. I treated that one my eating a mandarin (6 gr carbohydrates). The standard advice is too eat 15 gr carbohydrates when your blood sugar level is below 8.0 mmol/l = 144 mg/dl just before you go sleeping. I adapted the advice for my individual case.
Physical exercise has about 24 (and for some people 48 hour) effect on your blood sugar level. After the physical exercise itself, your body tries to replace the (used up) sugar in your muscle cells. That gave me the idea to try out decreasing the amount of slow insulin after a day with physical exercise (after discussing it with my specialist).
This decreasing the dosis of insulin (instead of one or more timed intakes of carbohydrates) works fine for me.
I apply this strategy to a regular training session (either 1 hours and 30 minutes, or 2 hours) as well. My regular aikido training session is in the evening. So that implies planning my dinner before my training session, taking less insulin for dinner and taking less insulin after training session just before going to sleep. I do not eat any extra food if possible, though I always carry an apple and "dextro energy" with me. Roughly one out of 20 training sessions I experience a hypo during the training session (and eat "dextro energy"), so it works fine. Occasionally, I have a hypo after the training session and eat either the apple or "dextro energy".
With respect to stress. Most people with diabetes experience an increase in their blood sugar level as a result from stress, but some experience a decrease. For some people the increase is temporary and will be followed by a decrease in the blood sugar level. For other people the blood sugar level remains high after increasing. Given these three scenarios, every individual with diabetes should find out for him/herself how he/she responds to stress (and handle it accordingly).
I recently attended an educational weekend on the insulin pump. They advised me to decouple the pump during an aikido training session. They also advised not to decouple the pump for more than 90 minutes. If a pump is decoupled for longer than 90 minutes then one should consider taking an insulin injection. I think one gets better control of one's diabetes when one continues to wear the pump during an aikido training. So, what is the best place to attach the pump during an aikido training? Is there any experienced aikidoka who uses an insulin pump who can tell me?
With kind regards,
Re disconnecting the pump for over 90 minutes: you don't need to take an injection, you can just reconnect the pump for long enough to give yourself a dose of insulin (either what you'd have gotten during the time the pump was disconnected, or you could do something fancier if you knew from past experience that you'd need more or less).
My diabetic son's taking chanbara not aikido and it's just an hour long, but since it's vigorous and physical (as is aikido) he always disconnects his pump. When he does something very active and lasting for a few hours, he always takes breaks every 90 minutes or so to reconnect the pump briefly and give himself insulin.
You disconnect the pump not just to keep from getting insulin while exercising but because it's an expensive piece of equipment (US$5000 but health insurance often covers most of it) and you don't want it broken. Also, if something gets caught on the tubing and yanks the pump's infusion set out of you (it doesn't hurt), you'd have to stop and put in a new one before you'd be able to get more insulin via the pump and that would be inconvenient.
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