How to replenish carbohydrates reasonably when exercising with diabetic patients?
The carbohydrate intake and blood glucose control during exercise are very critical. It is necessary to ensure the energy required for exercise, but also to prevent hypoglycemia. Therefore, we must consider the intake time of carbohydrates (before exercise, after exercise, and day and night rhythm For influencing factors), the quality and quantity of carbohydrates (different carbohydrate types, and overall dietary matching), of which 1 diabetic patients have more obvious blood sugar fluctuations during exercise. Today we will explore type 1 diabetes patients How to supplement the compound.
Determine the amount of carbohydrate compounds according to the strength of the exercise
How much carbohydrates should be consumed in patients with type 1 diabetes during exercise, and blood glucose control and exercise itself need to be considered. In essence, how much carbohydrates need to be supplemented before exercise, neutral and exercise depends on the patient’s blood glucose level, type and strength of the movement, and the level of insulin in the blood.
Type 1 diabetic patients with blood glucose stability (7-14 mmol/L), low blood ketone body (<1.5 mmol/L) or urinary ketone negative or mild positive can exercise. Before exercise, if the blood glucose is <5.0 mmol/L, it is recommended to supplement 10-20g of glucose. The blood glucose is between 5.0-6.9 mmol/L.
The replenishment of carbohydrates in exercise involves the duration of movement, blood glucose value, and the amount of insulin (height or low) of the body. According to the patient’s movement intensity and duration, the recommended amount of carbohydrates during exercise was given.
Related studies also emphasize that in the case of exercise, a large amount of carbohydrates must also be adjusted, otherwise the insulin dose should be adjusted. Otherwise, the intake of these carbohydrates can lead to a significant increase in weight during the entire exercise process. When a long period of endurance exercise is needed, the maximum amount of glucose absorption of glucose is 1.2-1.7g/min. Therefore, in the long-term high-intensity exercise, the corresponding gastrointestinal side effects, or the relatively insufficient energy, for Patients with type 1 diabetes also have low blood sugar risk. At this time, the type of carbohydrate needs to be considered.
The quality of carbohydrates and blood sugar
Carbohydrates are divided into monosaccharides, dip sugar and polysaccharides. Solo sugar, also known as “simple sugar”, is the basic unit of carbohydrates. It can no longer be hydrolyzed. Monosaccharides also include glucose, fructose and galactose. Polysaccharides include starch (straight starch and branches starch), glycogen, dietary fiber, etc. Different carbohydrates have different digestion and absorption rates, so the impact on blood sugar is also different.
The blood glucose generation index (GI) is used to reflect the impact of food on blood glucose. Gi ≤ 55%of them are called low GI foods, 56%-69%are medium GI foods, ≥70%are high GI foods, while glucose GI is the GI is a glucose GI is the GI is the GI is the GI is the GI is the GI is the GI is the GI is the GI is the GI is the GI is the GI is the GI is the GI is the GI is the GI is the GI is the GI is the GI is the GI is the GI is the GI is the GI is the GI is the GI is the GI is the GI is the GI is the GI. 100%, can quickly lift sugar. What type of carbohydrates to choose in exercise also pay attention to. In order to prevent hyperglycemia in exercise and prevent hypoglycemia after giving prevention after exercise, it is recommended to choose low GI foods. When hypoglycemia occurs, you should choose foods that can quickly raise sugar, such as Glucose (GI is 100%) to quickly improve blood sugar.
Why choose low GI carbohydrate: there is a cross -study conducted for 8 patients with type 1 diabetes showing that taking 75g low GI carbohydrates for the subject 2 hours before the 45 -minute running machine running (GI = 32) or high GI carbohydrate -right spin sugar (gi = 92), and the increased blood glucose of isopacyone sugar is only half of the right spin sugar. During the 3 -hour rest time after exercise, intake of isterite The sugar group is still 21%lower than that of the right rotary sugar group. In the later stage of exercise, the isopacyone group has lower carbohydrates and higher lipid oxidation rates. It is recommended that patients with type 1 diabetes intake low GI food before going to bed. Such foods will not significantly increase blood glucose levels, and have a long -lasting blood sugar effect, which can prevent hypoglycemia after exercise. However, it is still necessary to use rapid sugar to correct hypoglycemia in exercise.
Other glucose alternatives such as fructose and other glucose have different effects on insulin: glucose can be preferred by the body, especially skeletal muscles and brains, and lactose and lactose need to metabolize in the liver. Therefore Essence Therefore, the use of fructose in exercise can promote further blood glucose. Cructering before exercise may provide certain metabolic benefits for athletes and patients with type 1 diabetes because the blood sugar benefits caused by it. Fructose is converted into lactic acid, glucose, and lipids in the liver, and finally becomes glycogen and releases blood or stored in the liver.
Note: The intake of fructose should not be too much. Do not exceed 50 grams at a time. Individuals may need to be as low as 25 grams, otherwise it will cause gastrointestinal discomfort. In addition, long -term intake of a large amount of fructose is not conducive to health. It is found in rodents that a large amount of fruit sugar can cause insulin resistance of liver and extra liver tissue, producing obesity, type 2 diabetes and hypertension.虽然，在人类中还没有强有力的相关证据，但是已有的证据表明长期高果糖摄入会导致血脂异常并损害肝胰岛素敏感性，不过该研究是针对久坐人群，针对运动员的研究则显示The opposite conclusion.
Blood glucose effects of other nutrients: In addition, other nutrients in the diet will also affect the absorption of carbohydrates, thereby affecting the level of blood sugar. For example, a mixed diet containing different numbers of fat, protein and dietary fiber may affect carbohydrates, intestinal insulin absorption, and peripheral insulin sensitivity. Diets containing a large amount of protein or fat compared to diets rich in carbohydrates can delay blood glucose reactions. Therefore, the ADA guide recommends that if patients with type 1 diabetes consume high protein or high -fat diet, insulin levels need to be adjusted. Protective compound scheme for long -term endurance exercise
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Patients with type 1 diabetes can also challenge themselves and do some ultra -high -intensity exercise, such as marathon long -distance running, Iron Man’s three competitions, hiking and long -distance off -road skiing. It can only be carried out in the case. During the exercise, it is necessary to monitor and adjust the food intake in time, and supplement different amounts of carbohydrates according to the strength of the exercise. However, due to the large differences in individuals, there are currently no standard suggestions between patients with type 1 diabetes patients and carbohydrate intake. Table 2 lists the intake suggestions of types of non -1 diabetes patients for reference only.
In addition to blood glucose management, type 1 diabetic athletes also need to consider multiple factors, such as dehydration, electrolyte imbalance, glycogen exhaustion, gastric discomfort, and acid -base balance disorders.
