Alissa's Fitness Blog

Alissa's Diabetes and Fitness Blog

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Discussion of Diet and Fitness as a tool to manage Diabetes

 

I learned something new today that I felt is important.  Sharing the kind of information that can help people is the reason why I enjoy blogging.  I provided my endocrinologist with information from my dietician appointment - the diet for the week and carb counting. I provided my weekly blood sugars as well. 

I was asked what I do when my blood sugar runs low.  I told him I eat my staple of two 3 ounce sweet potatoes and that if my sugar was below 50 and doesn’t go up right away, I’ll eat 6 ounces of sweet potatoes.  The Dr. was surprised at my response, saying that all complex carbs(a sweet potato is a complex carb) take longer for your body to digest, which in turn causes glucose to go up more slowly.  In other words, a complex carb is not a good rescue carb.  In all my years of competing, I had been concerned about sugar ruining my competition, yet 15 grams is 15 grams no matter what kind of carbs you put in your body. 

Quick sugars are any simple sugar such as orange juice, glucose tablets, or glucose gels that get in and out quickly.

HYPOGLYCEMIA SYMPTOMS:  Fast heartbeat, fine tremor, sweating, anxious, hunger, headache, irritable, weakness, and fatigue.

HYPOGLYCEMIA REMEDY:

Check blood sugar → low is considered less than 70mg/dl

  1. Treat according to reading
    • Fast-acting carbs 50-59: treat with 30 grams
    •  Less than 50: treat with 45 grams 
  2. Wait 15 minutes for conversion to blood glucose and for symptoms to subside
  3. Re-check blood sugar - if still less than 70 then treat again, according to the new reading

Examples for 15 grams of carbs:

  • 4 oz juice
  • 8 oz milk (1 cup)
  • 1/3 can regular soda
  • 3 square of 4 round glucose tabs
  • 3 round peppermint candies (chew)
From this point, instead of using sweet potatoes I’ll carry some of the advised foods with me at all times.  I do carry glucose tablets, but had been worried the sugar would affect me - not realizing it is better to take them than not.  Always feed your body with a low.  It’s a way of your body telling you that you need to feed it immediately with a quick acting sugar.  

 

Today there was black ice on the roads in Austin which created many accidents and closed off roads.  Despite the weather and bad roads, I was determined to get my work out in.  I was on my way to the gym, but had to turn around and come home. 

Being stuck at home due to inclement weather gives you the unwanted opportunity to eat too much food since the refrigerator is always there! So how do I preoccupy my time and redirect myself to avoid unhealthy foods? Here are some suggestions to make sure you stay fit while staving off cabin fever when bad weather hits! Even though all these activities do not pertain to everyone there is always an activity to preoccupy your time.

My children and I eat healthy and occasionally they have yummy treats. Today we decided to take out a cookbook and make a recipe to eat for our meals.  My children love chocolate pudding. It's an easy and delicious recipe that children and even adults love. Since my daughter and I are diabetic, we buy sugar free. We also enjoy dairy and vegetarian meals, so we chose carb-counting cottage pancakes, homemade applesauce, vegetables stir fried in Pam spray and a turkey meat loaf with baked potatoes, measured and mashed in the food processor.

Later today we will have sugar free hot chocolate and light the fireplace. We have sugar free marshmallows and graham crackers with a few sugar free chocolate chips, counting out with serving size on the bag. My kids love making s'mores, however we limit it to two each for portion control. We will have popcorn tonight watching a movie. These are all great choices.

We have monopoly at home and we also enjoy playing many other family games. Even if you are spending the day on your own, there are card games, cross word puzzles, reading, and movies, amongst other activities.

I’m hungry as I write this - I eat the same meals every three hours per the strict diet for my figure competition. I look at the clock hoping it's another meal time soon because I'm bored and food consumes my mind. So, how do I get through it? Although we are in the kitchen near all the food, having a prearranged meal help keep your mind off of food and even gives you apples or vegetables to snack on. I keep my mind preoccupied using all of the tips I've provided – this is the way to promote a healthy discipline with the foods you consume.

My sugar just dropped low. I blogged previously about low blood sugar and how to stop yourself from binging. I wanted to eat but I remember what Dr. Blevins mentioned (Cravings and Low Blood Sugar an Interview with Dr. Blevins) and it worked. I stopped myself from binging.

Whatever you decide to do, remember your ultimate goal of keeping fit and eating healthy!  I’d love to hear what you do during inclement weather – please scroll down and tell me in the comments section.

 

 

Alissa: A question I’ve been asked, and it’s a problem both myself and my diabetic daughter - when your blood sugar drops low, what do you suggest eating to stop cravings and hunger - because I know for myself and my daughter, that’s we go on a binge and it’s so hard to avoid, what do you suggest for that?

Dr Blevins:  You’re talking about a craving, and when you get low, your body is saying , protect me, I want to survive.  Somehow all of the hunger mechanisms go haywire.  You can talk yourself through it, but logic doesn’t always win out when it comes to craving. 10-15 grams of simple carbs is the advisable amount to take for a low.  The best approach, generally speaking, is to use a finite amount of carb for example three glucose tabs.  Then you can tell yourself I just took in more or less 15 grams and I know that’s going to work.  That’s probably the best approach.  There’s no particular food that’s going to help a craving .  I tell people you can have half a glass of juice which is about 15 grams or you can have a barrel of juice which is a huge amount of carbs, but your sugar’s not going to go up any faster.  And you’re going to end up with this mega high sugar afterwards if you have a lot to drink or eat.  But the trouble is that it is hard because people notice that they’re very hungry and their body is telling them to eat and drink more of that juice.  So if you can be disciplined to use a finite amount like 15 grams, and be confident that it’s going to work, then you just have to talk yourself through it.  There’s no perfect food that raises it and satisfies cravings immediately

Alissa: I see

Dr. Blevins: I do think that using rapidly absorbed carbs is absolutely what you want to do.  Athletes can use gels sometimes when get low when they’re working out. A common one is hammer gel.  That’s a particular brand, there are tons of them. The glucose tablets you get at the regular pharmacy are good for routine use. 


I'd love to hear how you handle cravings when your blood sugar is low.  Please scroll down and make a comment


Alissa interviewed Dr. Blevins, M.D., Endocrinologist, Texas Diabetes & Endocrinology on caffeine and blood sugar.

Alissa:  Does caffeine affect blood sugar and what effect does it have on exercise?

Dr. Blevins:  I’ve seen some studies that caffeine and coffee can be shown to prevent Type 2 diabetes.  It depends on the person, whether they have diabetes or not, whether it affects their blood sugar or not and also it’s very individual.   We’ve seen quite a number of people who have noticed that when they drink coffee by itself, with nothing in it, no creamer, no sugar, no carbohydrate added, coffee fundamentally doesn't have carbohydrates in it, especially people with type 1 diabetes, that their glucose sometimes briskly, not sky rockets, but rises after drinking coffee.  It’s complicated a bit because, in the morning when people drink the coffee typically, the hormones in the body that normally rise, for example cortisol growth hormone, can cause blood sugar to rise too.  So if a person has nothing to eat in the morning sometimes the blood sugar will rise whether they have coffee or not because of the hormones rising in the morning.  Many people experience when they drink coffee, their glucose, their sugar bumps up even more. That’s not everybody.  It’s not a rule – it’s more of an observation. 

Alissa:  If that were the case and somebody realized that the caffeine in coffee was spiking their blood sugar, do you have a recommendation as an alternative form of caffeine?

Dr. Blevins: I think it’s fundamentally the caffeine in the coffee.  Usually when somebody drinks decaf you don’t see it happen, but I think caffeine probably interacts with the sympathetic nervous system a bit and that can sort of push the blood sugar up a bit, and it has that stimulatory affect and that’s what coffee’s all about and I think it acts on the sympathetic nervous system to cause the glucose sugar to go up.

Alissa: It’s been suggested to me as a figure competitor to stop drinking caffeine and coffee because it creates cellulite.  Is that true? Does caffeine cause cellulite?

Dr. Blevins:             No I wouldn't say so.

Please scroll down and make a comment - I'd love to hear what you think!

Watch for the next blog where the interview with Dr Blevins is continued.

 

 

What's in Your Refrigerator?

We often feel time pressured to prepare meals and wonder what to eat during the day.  Sometimes we might feel pressed for time, or lazy, and choose to eat out for many meals. Being that I have a busy schedule, I can relate to the added unnecessary stress we experience over what to eat, did I eat right, or why didn't I eat healthier. As a diabetic who avidly exercises, I make all of my meals in advance (usually  the night before) that is measured and weighed using portion control as well as  carb-counted on the bags and containers I travel with.

When I prepare for my day, I easily pull out the meals I've selected in advance to eat for that day. This allows me to leave the house on time in the morning and starts out on a good note, which makes it easier to eat and feel healthy. 

 

Here is an example of what my refrigerator looks like. 

 

Here is what my meals are for today and here is how I prepare them ahead of time.

 

I also carry two 3 oz sweet potatoes for low blood sugar. For those who are unable to prepare food due to traveling, appointments, or work commitments etc. I recommend using similar choices when dining out and ask for the chef to prepare the food how you request.  If you know in advance where you are going to eat, call that restaurant ahead of time and see if they can accommodate you. I try to order everything steamed and request that it isn't cooked in any butter, oil, or sautéed.   I’d love to hear what’s in your refrigerator – please scroll down and tell me in the comments section


 

How to have a Healthy Sweetheart

It’s estimated that 58 million pounds/$345 million dollars of chocolates will be consumed by Americans leading up to Valentine’s Day.  Let’s not fall into the sweets trap and remember that Valentine’s Day is a special day to spend with loved ones.  Although it's very tempting to find sweet foods and chocolate to eat as a treat, the loved ones I spend this day with, my 2 children, find healthy ways to celebrate. Since my daughter is also diabetic, we plan meals in advance – we went to the grocery store and picked out replacements for unhealthy sweets. We purchased a vegetable platter and vegetables to make into kebabs using vegetarian soy meat.  Below is a list of carb-counted healthy treats we got at the grocery store.  I’d love for you to tell me how you are celebrating Valentine’s Day in a healthy way – please scroll down and make comment.  Have a happy and healthy Valentine’s Day!

Food options

VEGETABLES

  • Asparagus                1 cup = 2 carbs
  • Green Beans           1 cup = 4.14 carbs
  • Broccoli                    1 cup = 5.8-7.3 carbs
  • Cauliflower             1 cup = 2 carbs
  • Red Beets                1 cup = 9 carbs
  • Kale                            1 cup = 6 carbs (loose, raw, cooked)
  • Spinach                     1 cup cooked = 5.7 carbs, uncooked 1.9 carbs
  • Carrot                        3 oz = 8 carbs
  • Cucumber                ½ cup – 1.6 carbs
  • Romaine                      2 cups = 1 carb
  • Celery                       2 oz = 1 carb
  • Bell Pepper             1 Cup 1 whole or 5 mini 1 = 6 carbs

I recommend using a dry measuring cup

 FRUIT

  • Berries(Not strawberriesI)       ½ Cup = 15 carbs
  • Apple (Small)                                  (5 oz) = 17 carbs
  • Banana                                              1 whole = 24 carb
  • Melon                                               ½ cup = 7 carbs
  • Grapefruit                                         ½ cup = 10 carbs

DAIRY

  • Lactaid Cottage Cheese              ½ cup = 7 carbs
  • Fage 0% yogurt                              1 cup = 9 carbs

COMPLEX CARBS

  • Spelt Bread                                     1 slice = 22 carbs
  • Rice Crackers                                  (I use Mary’s) 13 Crackers = 21 carb( .61 each)
  • Black Beans                                     1 cup = 25 carbs
  • Edamame                                         Cooked =1 cup 5.7 = 7 carbs
  • Lentils                                               1 cup = 25  carbs
  • Rice Cakes (originial)                   Quaker 1 = 7carbs Lundbergs 1 = 13 carbs
  • Cream of Rice                                 ¼ cup = 36 carbs
  • Hummus                                           2 TBSP = 5 carbs (1TBSP = 2.5 carbs)
  • Quinoa                                              ¾ cup = 34 carbs
  • Sweet Potato                                 4 oz = 16 carbs
  • Butternut Squash                         1 cup = 21,5 carbs
  • Red Potatoes                              1 oz = 7 carbs
  • Mung Bean Pasta                          2 oz = 6 carbs
  • Rice Tortilla                                   1= 22 carbs ( I buy it at Whole foods see label)

TASTY OPTIONS

  • PB2                                         2 TBSP  = 5 carbs (Not regular Peanut Butter)
  • Unsweetened Chocolate           1 TBSP=  3 carbs
  • Almonds                                  ¼ cup (20 almonds) = 2 carbs
  • Salsa or Pico De Gallo            2 TBSP = 1 carb

A diet and training change that resulted in 2% body fat loss and 2 pounds of weight loss in a week has created hyperglycemia for 5 days.  I have provided my logbook of what consistent high blood sugars look like and how I handled it.  I’m very independent with caring for my diabetes and am familiar with the ratios that have been working up to this point.  My endocrinologist Dr Blevins, says in times like this, that availability is important (Dr. Blevins interview). After my 5 day pattern of hyperglycemia, I followed this advice and made an appointment with my endocrinologist. The result - my insulin was increased to adjust to my new diet and rigorous exercise regimen.    Over the next week, I must closely monitor for a similar consistent pattern of high sugar levels accompanied with weight and body fat loss over the next week and continue the close contact with my endocrinologist.  This is what makes an athlete successful in a professional sport.  

As a figure competitor in training season I'm often asked questions such as what is my hemoglobin A1C or what are my blood sugars on a regular basis or how well regulated am I. The answer to that question is just the same as you or I or anyone else. What I enjoy about blogging is being able to share my experiences from an athlete’s point of view.

 

My diet changes weekly. Some weeks are higher in carbs than others. This week I'm on a low carb depleted diet as preparation getting closer to my show in April. What I have found is that every time my carb counting changes, my basal rate changes. I went from 11 units of lantus 2 weeks ago and experienced two days of low blood sugars so I went down to 9 units of lantus. That seemed to have worked well for me once I found the right amounts. This week I continued on Monday with 9 units of Lantus and I've experienced unexplained high blood sugar.

 

It's very frustrating, upsetting thinking what did I do wrong, and it affects my mood and sleep. What I have realized and learned as part of being an independent diabetic who knows how to properly increase or decrease my insulin, is that my blood sugar changes as I eat less carbs and do more cardio.

 

How do I treat myself independently? A must is wait two days to develop a pattern. Write EVERYTHING down form your carbs that you ate per meal to insulin to carb ratios, to insulin administered and the time of both that meal or blood sugar testing and activity level. After 2 days, you will have a clearer picture of what needs to be changed. Here is my blood sugar logs for the last two days.

 

What changes I have discovered is I need stronger lantus in the morning, so I've decided to increase my basal insulin from 9 units to 10 units. I gradually increase it. If I'm still high the next day, I will increase it to 11 units. One thing to emphasize is never make too many changes at once. If my blood sugars are still high in two days, I know my insulin to carb ratios needs to be changed. This is where I need my doctor’s assistance. I call in with my blood sugars and provide them with my weekly diet. Once I see a consistency, they help me in making changes.

 

I would love to hear your experiences with maintaining blood sugar and hemoglobin A1C with a nutrition plan and exercise – please scroll down and make a comment.

Alissa :             Dave Goodin who is my trainer, has helped me get into shape, and allowed me to be able to compete in figure competitions. Dave, what are some of your titles and tell me about yourself?

Dave Goodin: I have a Master's degree in exercise physiology from the University of Texas. I competed for 32 years in bodybuilding, and the last year I competed was actually in men's physique. Before I was a personal trainer, I was a coach. I coached football, basketball, track, and power lifting so I have been involved in fitness for my entire adult life.               

In terms of titles, I was the first person to ever win the NPC Texas Overall Bodybuilding Championship twice. I have five world championships in bodybuilding, three Mr. Universe titles, and Pro Mr. International. My most recent win was at the 2009 IFBB Masters World Championship.

I've had a really good run in my own competition bodybuilding, but along the way, over the last 20 years, I've trained many, many people for competition, very successful.

Alissa:              Tell me that your shows that you have and the shredder show that I've competed in 2014.

Dave:               The Texas Shredder Classic I started it up in 1998 and we've had it every year since then. It's been bigger every year. Coming up here on April 11th will be the Texas Shredder Classic Sanction with the WNBF. We also have the Texas State Naturals which will be October 24th, 2015, and that will be our sixth year for the Texas State Naturals. 

Alissa:              I've been working with you for the last year. I'm a diabetic, and you've really helped me as a diabetic in training and getting into shape so that I'm allowed to compete. How do you train clients with diabetes differently?

Dave:               In terms of the training, the training is really not different with diabetics. One thing that I do have to do when training a diabetic is to be more cognizant of warning if they're starting to get shaky, if their blood sugar gets too low, and I then handle that appropriately at the time.

Where the difference lies is with the diet. Working with the diabetic who wants to get into contest shape to compete, the important thing is to be very mindful of the types of carbohydrates and the amounts of carbohydrates that they're taking in.

They're taking in relatively small amounts of carbohydrates at a time, and carbohydrates that are lower glycemic so that they're releasing more slowly into the system.

Alissa:              How much cardio should you do in addition to training?

Dave:               The thing I tell all my clients if they want to compete is that you want to do as little cardio as you can while still losing the body fat that you want to lose. Now, for the general fitness client that just wants to be healthier, then I would recommend 30 to 60 minutes of cardio four or five days a week but for our clients who want to compete in bodybuilding, figure physique, bikini, those types of things, the amount of muscle that you carry is extremely important.

The cardio can have an effect of tapping into muscle protein for energy. We want to keep the cardio to a minimum. Generally, I've never had any women that didn't have to do any cardio to get ready for a show. Generally, women have to do more than men. It's just a fact of life.

I've had some men that I was able to train for shows that didn't do any cardio at all and got their body fat down fewer than three percent and were just completely shredded and muscular. Again, like I said, the thing I stress to my clients, do as little as you can get away with while still losing the body fat that you want to lose. 

Alissa:              Post season when for somebody like myself who stops competing goes into a transition diet, and then maintenance. What are your thoughts and how do you advise other people who aren't training to compete but want to go onto a healthy eating regimen or maintain what they look like post season to stay fit and healthy?

Dave:               I would say that your normal person who is not competing, generally, they want to look better during the summertime when they might be going out to the lake or they might be going to the pool. Basically, what I would do for them is basically a bodybuilding or figure competition style diet to bring them down leaner than normal so that they look good at whatever, if it's going to the lake during the summer, going to the pool, or sometimes people will, like I've had ladies that are getting ready for their wedding and they want to look good in the wedding dress.

I'll diet them down pretty much like I do a body builder or figure competitor but it's not as extreme as someone who wants to compete. Their body fat levels don't have to get to unnaturally low levels like competitors do. After the event, after the summer is over or after the wedding is over, the smart way to approach it is to gradually add calories back into the diet very systematically over a period of time, and allow your metabolism to speed back up so that you can increase your calories without dramatically increasing your body fat.

Alissa:              Are some people better at certain types of competitions or is it important to find one's niche?

Dave:              Absolutely, yeah, people have different things that they're good at. Even in the bodybuilding world and I’ll say that encompassing bodybuilding competition, fitness, figure, bikini, men's physique, and women's fit body, that's all those things, come under bodybuilding competition. They require different types of structures.

Someone who is naturally much more muscular would fit better into bodybuilding. For a woman who is smaller and has a harder time putting on muscle but she's shapely, she would do better in bikini. Yeah, you want to take your structure and find if you're going to do that type of competition which division fits you better.       

Not everyone is cut out for bodybuilding competitions. Some people are great runners. They could never look good in a bodybuilding competition but they're good at running or tennis players. What I encourage people to do is find something they like in an athletic endeavor, and stick to that and go all out for that.

In any type of athletic endeavor, no matter what you do, weight training, dieting, and cardio are an integral part of any athletic endeavor and can help you do better.

Alissa:              What is your opinion on supplements?

Dave:               Supplements definitely have a great place, particularly for competitors or any kind of competitive athlete to fill in the gaps in your diet. I've had people who say, “I eat really healthy. I eat vegetables, I eat fruit. I eat chicken and beef. I mix it up and try to cover all the bases,” but still, depending on how long something has been on the shelf, it loses vitamins and minerals so by taking supplements, you can fill in gaps in your diet to make sure that you're optimizing the results of the efforts that you're putting in the gym or out on the track, or whatever kind of training you're doing.

Alissa:              I am an all natural body builder, as I know that that's what your career has been. I don't believe in steroids and I’d never put them into my body. With all my hard effort and training, and diet, I do it completely natural with my supplements being just vitamins. Your show is a WNBF show. Tell everybody what that stands for.

Dave:               The WNBF is the World Natural Bodybuilding Federation which means that every show that is sanctioned by the WNBF is drug tested. Every single athlete has to be drug tested for each show.

Alissa:              What is your opinion on the use of steroids?

Dave:               I advise people not to use them. I think that number one, they're illegal without a doctor's prescription and anabolic steroids, unless you have some sort of muscle wasting disease, no doctor is going to give you a prescription for anabolic steroids. It's risking your health because your endocrine system is so intricately balanced.

If you’re taking anabolic steroids which mimic the male hormone testosterone, your endocrine system is going to adjust your other hormones to try to reach homeostasis. 

Alissa:              Dave, thank you so much for this interview. You have been such an inspiration to me. I really admire you and I can't thank you enough for how you've worked with me so patiently through my diabetes and my fitness training to get me to a place where I wanted to be and all of my accomplishments. You've given me drive and motivation to continue going. I owe it all to you, my accomplishments and how far I've come.

Dave:               It's been quite a pleasure working with you for the past year, and I'm certainly very proud of how far you've come, what you've done in terms of figure but one of the things that I would like to express to your followers who are following your diabetes blog is that not only have you gotten in tremendous shape, but the really cool thing is that through the weight training and the attention to diet, you were able to dramatically decrease the amount of insulin that you were having to take.

For diabetics, it's cool if somebody looks good. That's great but when you can reduce the amount of insulin you have to take, it's much better for your system and that's I think to me the point I would like to drive home with diabetics is that this bodybuilding lifestyle with the weight training, the cardio, and the attention to diet, that it's so good for your health.

There's really nothing better you can do. You have been a prime example that being a diabetic doesn't have to limit you. That doesn't have to limit what you do. Maybe you can't eat desserts all the time and things like that but in terms of what you can accomplish athletically, it doesn't have to limit you.

Living the healthy bodybuilding lifestyle, it can definitely not only improve the way you look but improve your overall health and your dependence on insulin, be able to reduce the amount of insulin that you have to take. I think that's really cool because when you first came in here, you were on the insulin pump.

I don't remember how long it was. Was it like two months that you were able to get off the pump?

Alissa:              Yes.

Dave:               I know that was a really, really big deal for you because that was such an imposition to what you were doing, and you're always having to move the pump around. I thought that was a really awesome deal when you were able to reduce your insulin dependence and get off the pump.

Alissa:              Thank you so much, Dave. I really appreciate this interview and everything you've done to help me. You have given me such motivation and drive to succeed. I look forward to our next training session.

Dave:               Of course. 

I interviewed my endocrinologist, Dr Blevins, founder of Texas Diabetes and Endocrinology in Austin Texas on managing diabetes while training for athletic competitions.  Please leave your comments at the end, I'd love to know what you think!

Alissa:   What is your opinion on professional athletes competing in sports such as myself who live with Type1 Diabetes?

Dr Blevins:          Any athlete or is planning to be one can  pretty much do any sport that exists and it’s very important to do what you’ve done which is to get a team consisting of a nutritionist, a doctor-type and yourself.  You’re the most important part because you’re there every day and you get to observe what happens to your blood sugar with various activities.  You really have to define what’s best based on your own body’s responses.  You have to not only train but be super careful about carbohydrate intake and its effect on your blood sugar.  You’ve clearly had considerable success, which is very impressive.  I think it’s good to have a team.  And every athlete I know of ….has a team. 

Alissa:   I have learned how my body responds to exercise.  How can others learn their body’s response to exercise and managing diabetes?

Dr. Blevins:         You have to learn your own body’s response to exercise.  Some exercises will raise your blood sugar – especially exercises with rapid bursts, some will lower.   Every individual is a science in and of themselves.  Those are the two main concepts.  It’s very individual - there are certain rules, for example with the rapid burst exercises, your blood sugar will go up afterwards.  If it’s more of a distance running or aerobic exercise, where the glucose is dropping, you have to adjust your treatment to accommodate that so that you can compete successfully – You want your blood sugar in a reasonable range.

Alissa: How often do you feel that somebody who is competing like me should be seen by an endocrinologist and followed?

Dr Blevins:  I think close initial contact is reasonable.  If somebody has problems, availability is important, probably once every few weeks.  Once the formula is achieved that works best for you then you don’t have to do it that often.  The most common sport I see are people participating in is marathons, triathlons, things like that.  Make sure your feet are well taken care of, make sure your heart status is known and that you’re able to do that kind of intensive training safely.  It’s a big deal too that people not just jump into something without some degree of assessing whether their blood pressure, feet, heart are all ok.

Alissa:  So being that I’m you’re first fitness competitor athlete and having worked with me over the last year to get me through an accomplishment and learning what my regimen, diet and program, training is it encompasses a whole lot of areas to succeed.  So if somebody else like myself , being I have this fitness blog , were to go and want to compete in a figure or fitness or bikini competition – what would be the advice that you would give them , that I can also help them with .  And what are your thoughts on losing body fat quickly – how does that impact blood sugar.  Those are the key things that I was wondering. 

Dr. Blevins:   I really think the blog is a good idea, because I think when people talk to each other about what their experiences are it really helps.  You can find someone with type 1 diabetes and take their experiences, you know, everyone is going to be different.  You may also find someone’s advice you really don’t want to take – I think you have to be discriminating and careful about it because some things that are good for other people may not be good for you.  I think that comparing notes is really potentially very helpful.  I’ve had a lot of runners talk to each other.  I don’ think you want to go on a radically different diet quickly.  You want to do things gradually and moderately, remembering, after all, that you do have diabetes and you have concerns about your blood sugars and you don’t want to go on a crash diet, no more than you want to start exercising in a crash sort of way.  You want to work your way into it and be careful with yourself and your health. 

AlissaSo like for me, working with the team of people I work with, I’ve been advised that about 2% body fat loss per week and maybe a pound at most a week is advised – for me within a 12 week period.  So really it depends on the person, but right now, my body is at 13% body fat and when I compete it needs to be between 6% and 8%.  I have to stay at 13% right now for the next 2 weeks to build muscle and to stay healthy.  And then after that my diet starts decreasing, reducing carbohydrates, and I’m sure my blood sugars are going to be changed again, so when that happens what  do you suggest to help me self manage?

Dr. Blevins: Your insulin sensitivity can change when you increase your muscle mass and even if you change your fat percent and you have to be very careful and aware that your requirements might change.

Alissa: So what do you do to compensate for that - do you suggest follow-up appointments?

Dr.Blevins:  I think a continuous glucose monitor (CGM) may be very helpful in letting you know.  But close monitoring, careful monitoring, eyes wide open – that’s the bottom line. 

Alissa:  Sounds good thank you very much!