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Old 09-09-2008, 02:59 PM   #1
Nancy Caceres
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type 1 diabetes

I have a friend who is over weight and has type 1 diabetes, any advice?
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Old 09-09-2008, 03:10 PM   #2
Justin Shipley
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Re: type 1 diabetes

Just read something in that untouchable of medical literature, Men's Health, that the current anti-diabetes diet is dead-set certain to CAUSE diabetes rather than alleviate or prevent the condition.
Type 'type 1 diabetes' into the search bar of the following website and spend a bit of time perusing some of the dietary facors affecting the condition-www.westonaprice.org/splash_2.htm (w/fs)
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Old 09-09-2008, 03:23 PM   #3
Jared Ashley
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Re: type 1 diabetes

I had many clients with Type 2 and one client with Type 1 Diabetes. My experience was that while type 2 has almost no effect on performance, the impact of type 1 was huge.

My Type 1 guy was hardworking and fairly strong, but he would crash FAST! Start with very, very short workouts (5 minutes is easily enough) and build up intensity gradually. If he starts shaking, the session's over, or at least he'll need to take a longer rest than an non-diabetic. Over time, I was able to work with my client to the point where he could self-monitor his body's response and slow down or rest before he reached the crash point. yes, this meant it took him longer to see results, but in a few months he was able to do a 20-minute workout at an intensity level that would have wiped him out literally in 2 minutes when we started. I say this without exaggeration because that's exactly what happened our first session... he had to quit after 2 minutes. Obviously he needs to take the standard diabetic precautions such as bringing a source of quick sugar as well.
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Old 09-10-2008, 07:08 AM   #4
Marc Mayes
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Re: type 1 diabetes

this topic is huge.

I have a 3year-old with type 1 diabetes. So, I'm very passionate about this.

I would suggest that you learn some basic management for a type 1 diabetic, signs of hypoglycemia and hyperglycemia and how to perform a finger stick glucose test, maybe how to inject glucagon for severe hypoglycemia reaction. There are many type-one-diabetic athletes that manage extreme physical exertion and control of their blood sugar, while breaking records and winning gold medals. So, being type one shouldn't limit your clients goals. check out www.teamtype1.org

There's some information about the Zone and being type-one on the net, and a great support group online called www.tudiabetes.com that cover any topic that could affect a type-one diabetic's life. The Zone would be very benefical to your client, if they can modify dietary behavior.

And here's another great resource: http://www.vcrossfit.com/diabetes-101/
written by crossfitter Kirez Reynolds
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Old 09-10-2008, 08:01 AM   #5
Nick Wilson
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Re: type 1 diabetes

As a type 1 diabetic myself, the general gist I'd offer up is as follows. If you can be more specific about your friend's situation please do and I'll post more if I can help ("any advice" is a rather large topic, and you don't give much detail about your friend).

- Your friend needs to commit to making a lifelong change (or series of changes) if they really want to take control of their condition and reap all the benefits that brings (i.e. longer life, less chance of going blind or having their feet chopped off - you know, little things like that). As stupid as it sounds, it's easy to ignore how important your diabetic control is - I know I was very guilty of this for years. Accept that it's there with you all day, every day, and the best way to make sure you live a long, full and healthy life is to control your diabetes as close to 100% of the time as possible.

- You don't say how overweight your friend is, but I'd say that unless they're morbidly obese (I'm talking 300lbs plus), controlling their bloods should be their main priority. Weight loss will probably come along with better control, but even if it doesn't they're probably better off with excess weight and good diabetic control than normal body weight with poor control.

- Being able to self-adjust dosages is a MUST in my opinion. If your friend isn't already doing this, get them to see their doctor or whoever and get their insulin regime sorted out. It will involve taking background insulin once or twice daily and small doses of short-acting insulin as necessary, normally whenever he/she eats (or using a pump).

- The target blood glucose reading should be around 5 mmol/l (that's about 90 mg/dl if you're American), although if your friend currently has very poor control I'd suggest they set a higher target for the first couple of weeks (maybe about 7.5 / 135) and aim to stabalise at that level; once happy there, gradually aim slightly lower over the following weeks. Contrary to everything I was ever told by doctors, it's actually quite realistic to keep your blood very stable after meals so that you don't get the typical post-prandial spikes; and I believe this is critical in achieving good long-term control. This is really only possible when eating very little carbohydrate (see below).

- Blood monitoring should be done at least 4 times per day, but for the first few weeks test more often. When I finally committed to improving my control I tested about 10-15 times per day for a week or two, to get a very clear picture of what happened to my blood at different times of the day and night and relative to different foods and exercises.

- Eating less carbohydrate made a massive improvement to my control. It's possible to eat any amount of carbohydrate and control your blood glucose levels, but the more you eat the harder it becomes, to the point where I believe you'll never get really good control on a "normal" diet. My level of control correlates almost exactly with how little carbohydrate I eat; under 30g per day is the optimal amount.

- Counter-balancing the above point is the fact that eating so little carbohydrate can be difficult - I struggle to restrict my intake that much. An effective compromise is to eat carbohydrates during and after long(ish) duration exercise. I've found that I can eat large amounts of carbs while hiking, cycling or running long distances without spiking my blood glucose. Having eated carbs during exercise makes it easier to go without them at other times.

- Aiming to eat very few carbs has the advantage of automatically ruling out many crappy foods (e.g. cereals and most processed foods). It will skew the diet towards meat, fish and fats; to that your friend should add non-starchy vegetables in abundance. Strangely enough, this diet then looks very similar to the diet Crossfit recommends...

- Learn how much insulin you need per quantity of carbohydrate. Be precise. For me, it's 1 unit per 7g carbs; don't just round off, try to get it as accurate as possible.

- Bear in mind that protein also has an effect on your blood glucose, as the liver converts some dietary protein into glucose. For me, that means taking 1 unit of insulin per 30g protein.

- Learn how exercise affects bloods. This is non-trivial and non-obvious. For me, I find that long-duration endurance sessions drop my blood quickly, and I need to take in carbs while exercising. However, more intense sessions (e.g. metcons or weights sessions) raise my blood significantly, and I need to inject extra insulin to cover it. This is against all the advice you typically read about exercising, but its not uncommon to find that intense exercise spikes your blood glucose.

- Also bear in mind that regular exercise improves insulin sensitivity. If your friend is sedentary and learns their typical dosages etc., then starts exercising regularly, those dosage requirements are likely to change (i.e. be lowered).

- Read "The Diabetes Solution" by Bernstein; I don't agree with everything in there, but the overall picture is good and it's well worth buying.



I could write pages and pages more, so please post more specific questions if you can. However, to summarise what I've found most effective:

- Commit to changing for the long term
- Monitor your blood regularly
- Cut carbs right back, and eat as natural and healthy a diet as possible (the Crossfit diet is a very good place to start)
- Carbs around long-duration exercise can help make this more bearable
- Get all this in order first before looking at weight - but you may well find that weight loss comes as a side-effect of the above changes anyway. It did for me; I lost 15lbs in 6 weeks, all of it fat, and I wasn't at all overweight to start with.


Hope that helps.

Cheers,
Nick.
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Old 09-12-2008, 12:58 PM   #6
Jerry Maestas
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Re: type 1 diabetes

Nick, a couple of questions for my friend who is Type 1 and just starting out on Crossfit and zone.

1. When you talk about 30 grams carbs, are those simple or complex, and what is your main source of carbs?

2. When he does a real intense WOD, the following day his blood sugar spikes negatively and he has to drink orange juice to bring it back up, would he count the carbs in the OJ? if so, would he just eat non-carb foods for the rest of the day?
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Old 09-12-2008, 03:52 PM   #7
Justin Shipley
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Re: type 1 diabetes

w/fs

http://www.westonaprice.org/moderndi.../diabetes.html
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Old 09-12-2008, 09:00 PM   #8
Diego Piedrahita
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Re: type 1 diabetes

Hi all,

I've been doing crossfit since the summer of 07 and lurking on the boards for a bit, mainly the exercise related ones, until I hit a wall in my training where progress wasn't being made. I then decided to dive into a modified zone diet and saw, and still see, great improvements.

However, this past June my oldest son, age 4, was diagnosed with type 1 diabetes and I started searching thru this nutrition board for any posts about people doing crossfit, eating zone, and with type 1.

Ok, after that lengthy intro, my question is this: my son's endo peds have him on a high carb diet with insulin levels to match. From what I've read in this, and other, threads it seems that a low carb diet is a better way to go (~30gms per day). But, can a low carb diet be applied to a growing child? Should it be? I'm going to be gathering as much info as possible so that I can have a talk with my wife, and then with my son's doctors about my concerns with a high-carb diet. Any info regarding my questions would be greatly appreciated. I'm continuously educating myself, so if I'm mistaken in my assumptions please enlighten me.

Thanks!

-Diego
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Old 09-13-2008, 07:41 AM   #9
Craig Van De Walker
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Re: type 1 diabetes

Not only can a child be on a low carb diet it is sometimes prescribed for epileptic children who even when treated with the best drugs money can buy still have seizures.

Google ketogenic diet for seizures or something like that.

Eskimo kids ate that way until recently

Carb intake is not necessary for health, growth, etc. Good fats and protein are!
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Old 09-13-2008, 08:44 AM   #10
Nick Wilson
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Re: type 1 diabetes

Hi Jerry,

When you're talking about such small quantities, you need to factor in everything you eat. The only food I'd eat as a carb source would be non-starchy vegetables and, very occasionally, some berries. However, if I have a few eggs I'll count to 2g of carbs they contain; if I have a couple of sausages with them, that's probably another 4g or so. It's quite likely that the "non-carb" foods you eat like meat, fish, seeds etc. will actually give you a fair old chunk of your 30g carbs.

However, bear in mind that the overall philosophy is simply to eat "not very much" carbohydrate, and particularly not a lot in one go, because it becomes far easier to maintain stable blood readings. There's nothing magical about 30g, and indeed I don't worry if I stray above that. The general idea is to avoid carb-dense foods (including most fruits) and stick to food that has as minimal an impact as possible.

When it comes to treating hypoglycemia, the idea is to take the correct amount of carbs to correct the hypo but not spike the blood; then to go back to eating as normal. It will mean you'll eat more carbs in that day, but as I say the 30g figure isn't a magical limit for the day; we're just trying to "not each much" carbohydrate. A hypo is an extenuating circumstance, and the carbs you eat to correct a hypo are effectively medication, not food.

If his bloods routinely drop the day after WOD's, he should consider reducing the dosage of insulin he takes which is spiking his blood (e.g. it may be his morning background injection the day after the WOD needs to be dropped by a couple of units; he needs to determine this through careful experimentation). Diabetes is a constant balancing act, and control is infulenced by many things; it's not like taking tables 3 times per day, it's about being in tune with your body and adapting to its needs. Regular hypos in a pattern would indicate to me that the dosage needs to be adjusted to counteract that pattern.

One additional point I'd make is that using dextrose tablets to counteract hypo's is a better idea than orange juice, if only because you can precisely control the amount of carbohydrate you're taking in. It's not a huge deal, but worth considering.



Diego, I'm sorry to hear your son has diabetes. I developed the disesase in my early 20's so I didn't go through it as a child. The main thing I'd say is that I'm not a doctor or medical practitioner, I'm only talking about my own experiences, and I don't want to give you any bad advice. I was never advised to eat how I do; I just did it myself after reading around (much as you're doing) and let my blood work speak for itself. But I don't think it'd be responsible to do this with a child; I'd definitely recommend you discuss and agree any changes to your son's treatment with your medical team (which you're already planning to do).

Treating diabetes in young children is different to adults because children are less able to judge the disease themselves. Generally children eat and take insulin to a fairly rigid schedule, because they simply aren't able to self-assess in the way adults can. Children are also generally set higher targets for their blood sugars, to lower the likelihood of them having hypos.

I'd certainly discuss the ideas with your practitioner. Read up on Dr. Bernstein's "Diabetes Solution" (available from Amazon etc.) and see how they take it. Explain why you believe the conventional high-carb, low-fat diet is unhealthy.

I think you'll have to accept that your son can't necessarily adopt a low-carb regime "full bore", because a large part of eating like that is carefully listening to your body's feedback and adjusting things on a continuous basis. But at the same time, you may be able to move to a lower-carb diet, which will give you many of the benefits (specifically avoiding huge post-prandial spikes) without being at all dangerous.

Good luck with it, I'm really sorry I can't be any more help (although if you'd like me to explain anything further, please do ask).

Cheers,
Nick.

Last edited by Nick Wilson; 09-13-2008 at 08:46 AM.. Reason: Edited to clarify a couple of points
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