Diabetes Mellitus

mrs_divalici0us · **Joined:** Thu Feb 26, 2009 9:49 pm **Posts:** 122

Diabetes mellitus is a condition where glucose or carbohydrate metabolism is dysfunctional. Typically it's dysfunctional due to insulin - the 'gateway' hormone that allows glucose to be transported into the muscle - being absent or the body not responding to it. It can be defined as two differing types depending upon the reason why it is dysfunctional as mentioned.

Insulin Dependent Diabetes Mellitus (IDDM):

This was previously referred to as juvenile type or type one. This is categorised because the individual in question doesn't produce any insulin from the islets of the pancreas. In essence the person eats carbohydrates and the body doesn't respond in a normal way by releasing hormone to shuttle the carbohydrates into the body tissue.

Non Insulin Dependent Diabetes Mellitus (NIDDM):

Previously called adult onset or type two diabetes, this is categorised by the body still producing insulin but the tissue not responding to insulin. In essence the body tissue has changed its locks, so the key that previously opened the gate doesn't work anymore.

Both conditions are seen because the body doesn't handle carbohydrates well and the blood sugars of the individual raise above the levels normally seen within a healthy individual.

The treatment for NIDDM revolves around trying to improve the insulin sensitivity of the individual so that the 'key fits' once again. This is usually accomplished via drugs, exercise and changes in diet.

IDDM is a different issue as the body does not produce insulin and as such the individual with the condition must take insulin, usually in an injection format. Control of the individual's diabetes through insulin is crucial as serious complications can arise from poor control of blood glucose levels including (Kaminski 2006).

Coronary heart disease increases two to four times that of normal individuals.
Stroke increases two to four times that of a normal individual.
Hypertension is present in 73% of those with diabetes.
Retinopathy leading to blindness.
Nephropathy. Diabetes accounts for 43% of new cases of renal disease.
Neuropathy. About 65% of diabetics have mild to severe nervous system damage involving peripheral motor nerves and autonomic nerves, this can lead to amputation of any effected limb (60% of non traumatic amputations in the USA occur because of diabetic complications).
Possible coma through blood sugars dropping to low (hypoglycaemia).

Insulin Injections

Considering this, it is vital for a type one diabetic to control there blood sugar levels as best as possible via the administration of insulin injections to match there carbohydrate intake. Most modern therapeutic modalities for type one diabetics involve the basal bolus technique of insulin administration.

Basal Insulin:

This is synthetic insulin that has been designed in order that it has a slow release and exerts its effects over a 24 hour period. This acts as buffer so that between meals the glucose formed from the liver doesn't cause excessive rises in blood sugar levels.

Bolus Insulin:

This is synthetic insulin which exerts its effects much more rapidly, many of the modern insulin's act over three hour period and begin to work within fifteen minutes of administration.

Incorrect Administration:

With the two types of injection there should be a constant control of fluctuations in blood sugars bringing people back within normal ranges. If the administration of insulin isn't correct to bring blood sugars in line with normal values for the amount of carbohydrates eaten the two situations can occur either

Hyperglycemia:

This is a state in which blood sugars rise above normal levels and the body doesn't get enough energy as the glucose isn't entering the cells rather its staying within the plasma.

Hypoglycemia:

This is a state in which the level of insulin is greater than the amount of glucose and blood glucose drops to dangerous levels. Comas can occur through both types of blood sugar irregularities however those with hypoglycemia run the more acute risk.

Insulin Dosage:

The amount of insulin taken varies from person to person. The amount of insulin taken is usually given as a ratio of units per ten grams of carbohydrates (called a portion). Initially a dosage of one unit for each portion is typical.

Once someone finds the level of insulin they need for the amount of carbohydrates eaten a ratio can be worked out by the rule of 50. The formula is shown below:

Total amount of insulin units daily divided by fifty equals units per 10g of carbohydrates

Another formula can be used to determine a 'correction' dosage or the amount of insulin units needed to bring down elevated blood sugars. For the amount of insulin needed to bring down blood sugars by three mmols the rule of one hundred can be used.

Total amount of insulin units daily divided by one hundred equals the amount of units to reduce blood sugars by three mmols.

Diabetes & Bodybuilding

Control of blood sugars for any diabetic is essential, but even more so for a diabetic bodybuilder.
Blood Sugars Too Low:

If blood sugars become too low a bodybuilder will have two major problems:

They will fatigue early when exercising as they will not have enough energy to complete high intensity workouts.
When dieting they will have to eat more carbohydrates than planned to bring blood sugars back to a healthy level which may increase the total amount of calories consumed.

Blood Sugars Too High:

Running too high presents problems, especially for the diabetic bodybuilder

Adding in exercise becomes a vicious cycle in terms of blood sugar control. If someone is running too high with their blood sugars it means they haven't the amount of insulin on board to bring the energy into the cells, as such they have no fuel for exercise and in response their body pumps out more glucose from the liver.

Because the glucose isn't entering the muscle cell as efficiently as normal then the all that ends up happening is the added glucose just pushes up blood sugars even more.

Because their blood sugars are not being controlled the body will have to resort to other fuel sources, typically this means a catabolic state and amino acids robbed from muscle cells to be used for fuel.

Like the hypogycemic state... a bodybuilder with hyperglycemia will tire faster, as they won't be getting the energy into the cells.

Holding water. Water follows substrates; carbohydrates are hydrophilic substrates so a person will have all their fluid gathering outside the cells rather than pulling into the cell and filling a muscle out. This means that either come contest time or just even in the gym a bodybuilder will look less than optimal.

A second issue is that a hydrated muscle has been shown to be in a better protein synthesis state, so even if they aren't going catabolic they aren't optimal for anabolism.

Conclusion

As can be seen the irregularities of blood sugars presented by being diabetic will affect an individuals bodybuilding goals. Optimal control of blood sugars are essential for muscle gaining or fat loss success, in part two a look at the practical solutions for bodybuilding diabetics will be looked at.

Diabetes Mellitus

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