Fitness training: ADA recommends

The American Diabetes Association gives good advice on how to avoid low blood glucose (hypoglycemia) during exercise.

Blood glucose measurement

Timing: Exercise 1 to 3 hours after a meal. Blood glucose is at its highest.

Insulin peak: Don't exercise when your insulin injection is peaking. If using rapid-acting or regular insulin, this means avoiding sports in the first 1 to 2 hours after injection.

Adam Morrison

Insulin absorption: Exercise increases blood flow, which speeds up how fast insulin works.

Duration and intensity: If your activity is moderate to high intensity, or if it's moderate and long, consider decreasing the insulin dose that's working while you exercise.

Blood glucose response: Build up knowledge and experience of how your blood glucose responds to different types of exercise. Monitor blood glucose (BG) often: before, during, and after activity.

Insulin injection

BG stable or dropping: If you are going to be doing demanding exercise for a long time, check your BG 1 hour before you begin, then check 30 minutes before to find out if your blood glucose is stable or falling.

Eating during exercise: you might need to eat during or after sporting activity if you work out hard, or if it lasts longer than an hour.

Length of BG reaction: You can have a blood glucose reaction up to 24 hours after exercise, depending on how hard or long your workout.


Clear, accurate answers to your diabetes questions

1: What is type 1 diabetes (T1DM)?

2: Why is insulin important in the body?

3: What does glucose do in the body?

4: When was insulin invented?

5: Why is low blood sugar a problem?

6: Why is high blood sugar a problem?

7: What causes low blood sugar?

8: What causes high blood sugar

9: Is there a cure for type 1 diabetes?

10: Explain diabetes to a young kid

Diabetes advice

By Alan L. Rubin MD, Type 1 Diabetes For Dummies gives clear, easy-to-understand explanations and advice on living with type 1 diabetes.

This is an excellent choice for busy parents of kids with type one diabetes.

Olympic swimmer Gary Hall Jr.

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Gary Hall talks T1DM

Gary Hall Jr. competed in the 1996, 2000, and 2004 Olympics and won 10 Olympic medals (5 gold, 3 silver, 2 bronze). At 24, as a competitive swimmer, he was diagnosed with type 1 diabetes. Refusing to give up, he went on to become one of America's greatest swimmers. This is his story in his own words.

When I was diagnosed with type 1 diabetes, my first reaction was a desire to collapse. I couldn't believe it. I thought that diabetes was a disease that happened to old people who had neglected their health for years, more years than I had been alive.

A hopeless void filled my inside, and all I could do was sit in disbelief. I was upset. Upset like mad. Upset like disturbed. Upset in every sense of the word. I was furious. I was depressed, dumbfounded, and horrified. I was really scared.

I asked the doctor, What does this mean? An abbreviated explanation was given that diabetes is a disease that affects the pancreas, an organ that monitors the level of insulin within the body.

Diabetes means that the pancreas has been offed. It's dead or dying. The good news is that there have been tremendous steps in treating the disease. The bad news is that you need medicine. Daily. By injection [or pump]. Or you will die.

I was sent to an endocrinologist. It was here that I was informed that my swimming career was over, at least as I knew it.

Exercise is good, but in moderation, which oddly enough was the only way I exercised before. I was desperate. I wanted to lunge at the doctor. I wanted to defy him. I wanted to defy the disease. But didn't know if I could. I had no idea what I was up against.

The endocrinologist actually called my grandmother, as well as my parents, to keep me from going on vacation to Costa Rica. But I went anyway.

I packed up my insulin, my needles, my dog and girlfriend and headed south. I gathered as much information as I could before leaving.

In Costa Rica I did a lot of reading, and it was there that I began to have a better understanding of what diabetes was all about. I often felt destructive. When these feelings came about I would calm myself by swimming in shark-infested waters, hoping for the worst.

At first, all I could read were the horror stories of people who had lost their sight, lost their legs, lost their kidneys and liver to diabetes.

As time passed, I came to terms with my disease. I knew that I must accept the circumstances and deal with it. I had no choice. This was just another to be hurdled.

I returned from Costa Rica with a sense of peace. I immediately sought out a new doctor and was lucky to find the best, Dr. Ann Peters out of UCLA. She was so encouraging.

I was going to give swimming a try. I called my coach Mike Bottom who was up in Berkeley, California. I told him that I wasn't sure if it was going to work. Many times it didn't work. Practice was constantly interrupted with blood tests.

Dr. Peters flew up to Berkeley to monitor and observe. The training went on for a couple of months; in swimming this is considered a very short season. Five months after being diagnosed with diabetes, I won nationals. Not only did I win, but I dropped .0.13 of a second, which is the difference between the gold and silver medal in the Olympics.

It was at this point in my career of life that I realized the opportunity that had presented itself. I realized that I had a chance to encourage millions of people living and suffering with diabetes.

What I had done, and what I could do might offer hope to people of all ages that had experienced that awful diagnosis and the pains that followed, a hope that would somehow alleviate the feeling of helplessness and defeat. If I am able to do that, for just one person, it would be so much more of an accomplishment than anything I achieve in the pool.

By David Hay Jones

With thanks to Sports Illustrated, Olympic Diary, December 2000