Dr. Rob Andrews talks about diabetes and exercise – Expert tips to control diabetes DURING aerobic exercise with Dr. Rob Andrews
Paul Coker: Hello. Paul Coker here from 1BloodyDrop.com. In the previous video, I was talking to Dr. Andrews about how he manages his diabetes before aerobic exercise. In this video, I'm with Dr. Andrews, and he's going to share with us how he manages his diabetes during aerobic exercise. Only for those who have not seen the first video, Dr. Andrews, could you give us a brief introduction of your phenomenal experience in diabetes and exercise?
Dr. Rob Andrews: I'm Dr. Rob Andrews. I am a doctor who works with people with diabetes in a district hospital, in Taunton. In addition to caring for people who have type 1 diabetes, I see people who come to do sporting events, like marathons and other things, or people who practice sports at the elite level, and try to give them advice. to help them control their blood sugar levels before and during and after. To help with that, we have a research program that runs through the University of Exeter in which we try to answer questions to improve that advice over time.
Paul Coker: Thanks, Rob. The work you are doing is simply amazing, and I know that I have benefited from it. By sharing some of your knowledge in this video, I hope we can share your fantastic knowledge with a much wider community, so thank you for joining us today.
Dr. Rob Andrews: Sure.
Paul Coker: The previous video, we talked about how you handle your diabetes before doing aerobic exercise. In this video, I would like to talk about what you should do to control your diabetes during aerobic exercise, or rather what you should do, which research suggests is a useful strategy to control diabetes during exercise. Because, of course, what works for me may not work for the next patient. I think there is an element here where I can find a method that works for me, and someone else could try that same method. It would not necessarily work for them, and they would have to refine it.
Dr. Rob Andrews: Yes. I think you're right. Exactly what you said is that it is very personal what works for certain people. A way to change the variance that some people see with … Sometimes people discover that if they do the same exercise, they get a different answer each time they do the exercise … it is to think if it is worth doing it on an empty stomach. We know from research that if you do your exercise before breakfast in the morning, in fact the answer you get with any exercise you do is quite consistent.
While, if you are exercising at other times of the day, there are many other things happening, stress at work, the last time you ate, the last time you took your insulin bolus. That means that you could have a very varied response even if you think you have deciphered it once, having done it before. That is a piece of advice that I would say if you want to try and decrease your variance is to think if you do it on an empty stomach.
Paul Coker: Good. That's really interesting because if you look at all the sports equipment there is, everybody says to you: "Oh, you should carry food before exercising", so, actually, it is not recommended to exercise in the conventional literature . Now, how much science is based on conventional literature, honestly I do not know. But I find it absolutely fascinating because my favorite strategy to go running is to get up early in the morning and run before breakfast.
For me, personally, I experience a lot of insulin resistance in the morning because of a variety of hormones that are flying around my body. Actually, running for 30 minutes, I actually managed to deny all those insulin-resistant hormones without a large dose of insulin. That means I'm going through the whole period of the morning and arriving at lunchtime without quitting. Whereas, if I try to control those insulin-resistant episodes with increased insulin, at lunchtime, I'm fighting hypoglycemia. For me, I consider it an essential part of my toolkit for diabetes control.
We are going on a slight tangent here, so I would like to talk about what you actually do during an exercise session. Fasting is a strategy, but of course, my own opinion would be that you should make sure you have fast-acting carbohydrates in case you get hypoglycemia. If you have not eaten for the last 12 hours, you may be at risk if you are in the running machine for 20 minutes. I think that, for me, would be something that I would recognize from my own experiences. What other recommendations would you have?
Video credits to Paul Coker YouTube channel