Exercise and Sport in Diabetes (eBook)

Dinesh Nagi is the author of Exercise and Sport in Diabetes, 2nd Edition, published by Wiley.

Exercise and Sport in Diabetes 3
Contents 7
Foreword to the First Edition 11
Preface to the First Edition 13
Preface to the Second Edition 15
Acknowledgement 17
List of Contributors 19
1 Physiological Responses to Exercise 21
1.1 Introduction 21
1.2 Maximal Exercise 21
1.3 Submaximal Exercise 23
1.4 Endurance Training 23
1.5 Muscle Fibre Composition 24
1.6 Muscle Metabolism During Exercise 25
1.7 Anaerobic and Lactate Thresholds 26
1.8 Fatigue and Carbohydrate Metabolism 28
1.9 Carbohydrate Nutrition and Exercise 29
1.10 Fluid Intake Before Exercise 35
1.11 Summary 38
References 40
2 Exercise in Type 1 Diabetes 45
2.1 Introduction 45
2.2 Exercise Physiology 46
2.3 Insulin Absorption 48
2.4 Hypoglycaemia 50
2.5 Hyperglycaemia 50
2.6 Strategy for Treatment Adjustments 51
2.7 Evaluation of the Intensity and Duration of the Effort 53
2.8 Nutritional Treatment Adaptations 55
2.9 Insulin Dose Adjustment 56
2.10 Conclusions 60
References 61
3 Diet and Nutritional Strategies during Sport and Exercise in Type 1 Diabetes 65
3.1 What is Exercise? 65
3.2 The Athlete with Diabetes 65
3.3 Nutritional Principles for Optimizing Sports Performance 66
3.4 Putting Theory into Practice 66
3.5 Identifying Nutritional Goals 66
3.6 Energy 67
3.7 Carbohydrate 67
3.8 Guidelines for Carbohydrate Intake Before, During and After Exercise 69
3.9 Protein 73
3.10 Fat 74
3.11 Vitamins and Minerals 75
3.12 Fluid and Hydration 76
3.13 Pulling It All Together 81
References 83
Appendices 84
4 The Role of Physical Activity in the Prevention of Type 2 Diabetes 87
4.1 Exercise and Prevention of Type 2 Diabetes 87
References 94
5 Exercise, Metabolic Syndrome and Type 2 Diabetes 97
5.1 Physical Activity in Type 2 Diabetes 97
5.2 Type 2 Diabetes, Insulin Resistance and the Metabolic Syndrome 98
5.3 Effect of Exercise on the Metabolic Syndrome of Type 2 Diabetes 100
5.4 What Kind of Exercise, Aerobic or Resistance Training? 104
5.5 Effects on Cardiovascular Risk Factors 104
5.6 Regulation of Carbohydrate Metabolism During Exercise in Type 2 Diabetes 106
5.7 Effect of Physical Activity on Insulin Sensitivity 107
References 109
6 The Role of Exercise in the Management of Type 2 Diabetes 115
6.1 Introduction 115
6.2 Benefits of Regular Physical Activity in Type 2 Diabetes 116
6.3 Effects on Long-Term Mortality 118
6.4 Risks of Physical Activity 119
6.5 Conclusions 123
References 124
7 Exercise in Children and Adolescents 127
7.1 Introduction 127
7.2 Metabolic Effects of Exercise 128
7.3 Attitudes to Exercise in Young Adults with Type 1 Diabetes 129
7.4 The Firbush Camp 131
7.5 Precautions During Exercise 134
7.6 Summary 138
References 138
8 Insulin Pump Therapy and Exercise 141
8.1 Introduction 141
8.2 Potential Advantages of CSII 141
8.3 CSII Usage 142
8.4 Benefits of CSII over Multiple Daily Injections 143
8.5 Potential Advantages for CSII Use with Exercise 144
8.6 Studies of Response to Exercise in CSII Users 144
8.7 Practicalities for Using CSII with Exercise 145
8.8 Cautions for Using CSII with Exercise 147
References 148
9 Diabetes and the Marathon 151
9.1 Introduction 151
9.2 Guidelines 152
9.3 Personal Views 159
9.4 Summary 160
Bibliography 160
Useful Addresses 160
10 Diabetes and Specific Sports 163
10.1 General Principles 163
10.2 Canoeing 165
10.3 Golf 165
10.4 Hillwalking 166
10.5 Extreme Altitude Mountaineering 168
10.6 Rowing 170
10.7 Soccer and Rugby 171
10.8 Tennis 172
10.9 Sub-Aqua (Scuba) Diving 172
10.10 Skiing 173
10.11 Restrictions Imposed by Sports Governing Bodies 173
10.12 Conclusions 178
References 178
11 Becoming and Staying Physically Active 181
11.1 Recommendations for Physical Activity and Exercise 181
11.2 Essential Attributes of a Physical Activity Programme for People with Diabetes 182
11.3 Preparation for Exercise 183
11.4 Changing Behaviour 188
References 194
Appendix 1: Stretching Exercises 196
Appendix 2: Muscular Edurance Exercises 205
12 The Role of the Diabetes Team in Promoting Physical Activity 213
12.1 Introduction 213
12.2 Educating the Diabetes Team 215
12.3 Exercise Therapist as Part of the Team? 215
12.4 Assessment of Patients 216
12.5 The Exercise Prescription 219
12.6 Patient Education 220
12.7 Motivating Patients and Changing Behaviour 221
12.8 Conclusions 226
References 226
Index 229

"Recommended purchase for diabetic clinics and sports scientists and psychologists." (E-STREAMS, June 2007)

"... an extremely useful resource for any member of the diabetes care team...." (Doody's Health Services)

"A revised edition ... is a practical guide for members of a diabetes care team." (Diabetes Voice, March 2006)

"An important book to be available in any diabetic clinic" (Pediatric Endocrinology Reviews (PER) Volume 3:March 2006)