Is jackfruit good for type 2 diabetes

Enjoy your vacation well prepared

The syringe equipment and the pen must be protected from sand and dirt; the original packaging, simple plastic bags or boxes are useful. The patient should try to avoid syringing in public because in some cultures people are sensitive to it and misunderstandings may arise. It is best to carry medication and syringes with you in the original packaging during customs control.


Glucose and high-carbohydrate foods are best kept in a closed plastic container that protects them from insects, and the box is stored in the minibar in the hotel room.


What many do not know: The reaction of the blood sugar test strips is also temperature-dependent. Reliable measurement results are particularly important when traveling. As a rule, correct blood glucose testing is only possible at temperatures between 15 and 35 ° C. The meter and test strips should be wrapped in a cool medium, for example a damp towel or item of clothing, or transported in an insulated bag. If the humidity is high, the test strip vial must be closed again immediately after removing a strip so that the remaining test strips are not damaged.


Diabetic with foot syndrome


Special attention is paid to the feet of diabetics, of course also when traveling. You should wear cotton socks, as they absorb sweat better than synthetic fiber stockings, and take comfortable shoes with you, never new or rarely worn shoes, so that there are no pressure points on the feet.


A check for injuries and / or pressure points should be carried out every evening. The patient needs to know that even minor injuries can quickly lead to major skin infections. Diabetics with sensory disturbances in the feet (peripheral polyneuropathy) are not allowed to walk barefoot.


Sport harbors hypo danger


What happens to the metabolism during exercise? During exercise, stress hormones such as adrenaline and cortisol are increasingly released, which ensure that the stressed muscles have enough energy reserves in the form of glucose and fatty acids. The secretion of insulin from the beta cells of the pancreas is reduced. In order to avoid excess sugar, the insulin sensitivity of the muscles is increased in healthy individuals and the glucose influx into the cell increases.


In healthy people, the insulin level falls physiologically during physical exertion, but not in diabetics. In addition, the release of the insulin that has already been injected cannot be influenced afterwards. There are two options: Either he reduces the amount of insulin in advance, usually the mealtime insulin, or eats additional carbohydrates, so-called sports BE's. That is why it is essential for every sporting activity to take with you, in generously calculated amounts, carbohydrates that can be absorbed quickly enough.


Nevertheless, despite all precautionary measures, hypoglycaemia can occur. Their detection is made more difficult by the fact that the symptoms of hypoglycaemia such as sweating, tremors or weakness are misinterpreted as normal side effects of physical stress or are not noticed at all.


In coordinatively demanding sports, for example skateboarding or BMX cycling, low blood sugar levels can impair the execution of movement. Therefore, in case of doubt, more frequent blood sugar checks are also necessary during exercise.


In addition to acute hypoglycemia, there can also be "late hypoglycaemia" hours after exercise. The reason is that it takes several hours to replenish the glycogen stores in the muscles, which can lead to a further drop in blood glucose levels. The risk of late hypoglycaemia increases with long-term sporting activities. This can lead to unnoticed hypoglycemia in the middle of the night. This can be avoided by reducing the basal insulin by 10 to 20 percent in the evening or by having a hearty dinner so that the blood sugar is above 150 mg / dl at bedtime.


Practical approach


Depending on the intensity and length of the planned sporting activity, the short-acting insulin must be reduced by 30 to 50 percent in advance. If this is not possible, the diabetic must take in additional carbohydrates. Drinks containing carbohydrates have the advantage over bread or biscuits that they work much faster and at the same time replenish the fluid balance.


As a rule of thumb, the following applies: For moderate activity (examples: rapid cycling on the flat, Nordic walking at 7 km / h, badminton, table tennis, fast walking), around 1 additional BE is required for every 30 minutes of activity. A BE raises the blood glucose on average between 30 and 50 mg / dl. In the case of a higher load, more is estimated accordingly. One bread unit (12 g carbohydrates) of rapidly absorbable carbohydrates is contained in 12 g grape sugar or 2½1 / 2 tablets of Dextro-Energen®, 6 pieces of glucose (Intact®), 120 ml fruit juice, cola or lemonade or 6 gummy bears. To compensate for hypoglycemia, double the amount (2 BU) is required.


If the blood sugar is below 100 mg / dl during the measurement before the start or after the end of the sporting activity, carbohydrates must be supplied immediately. In the case of long-term stress, for example longer than 1.5 hours, the diabetic should measure the blood sugar in the meantime and react accordingly if necessary.


Patients must refrain from sport if a long-term absolute insulin deficiency has led to increased blood sugar (hyperglycaemia) with a tendency to ketoacidosis. This can be seen from a positive "urine ketone test". In this case, physical activity does not lead to a drop in blood sugar, but rather a further increase with simultaneous acidification of the blood due to incomplete fat breakdown products, the ketone bodies. It is imperative that you wait until your blood sugar returns to normal in order to be able to exercise again.


People who do sport generally have to ensure that they drink enough water. However, this is particularly important in the case of increased blood sugar levels, since at levels above the kidney threshold, more fluid is lost through frequent urination. During infections, where insulin often does not work in the usual way, but rather weaker, patients should refrain from physical activity.


Active despite the insulin pump


Diabetics who are treated with oral antidiabetic drugs, for example sulphonylureas and glinides, do not have the option of adapting the tablet dose exactly to the sport. You need to eat or drink extra carbohydrates (sports BE).


Conditions under insulin pump therapy are comparable to those in diabetics treated with insulin pens. In estimating the planned activity, the patient can lower the basal rate accordingly. How much the insulin delivery from the pump is throttled depends on the type, duration and intensity of the physical activity.


Patients who wear an insulin pump also need to know how to behave if the pump is defective or if it is taken off for other reasons, for example when doing water sports such as swimming, diving or surfing. If the interruption is short, i.e. interrupted for a few hours, the blood sugar must be measured more frequently and, if necessary, corrected with smaller bolus doses. If the insulin pump is frequently taken off for a short time, detachable infusion sets are recommended. They have the advantage that you can put the pump back on without having to put in a new set. Here, too, the cannula must be changed regularly: every one to two days for infusion sets with a steel cannula, every two to three days for sets with a Teflon cannula.


If the insulin pump is to be taken off for one or more days, for example in the event of a defect, the patient must switch to syringes or pens (ICT). This situation is generally associated with an increase in the daily insulin requirement (basal rate plus boluses) of around 10 percent. Intensified insulin therapy with normal insulin or short-acting analogues is recommended before main meals and two to four injections of basal insulin (morning, noon, evening and before going to bed). The mealtime insulin is administered in the same dose as under pump therapy.


Which sports are suitable


Above all, endurance sports, which stress the cardiovascular system and breathing, are recommended for diabetics. This includes, for example, jogging, swimming, gymnastics, cycling and ball games. Here you can usually plan the intensity and extent well so that the reaction of the blood sugar can be estimated.


Team sports, but also setback games such as tennis or squash, are usually difficult to plan in advance. This makes it difficult to assess the effect on blood sugar behavior. Due to the weather conditions, water sports such as surfing and kiting, mountain tours with extreme mountaineering, car races and skydiving can hardly be planned. In addition, the athlete may be completely on his own here. If he has hypoglycaemia, he cannot measure his blood sugar and he can hardly consume any carbohydrates.


Hypoglycemia must also be avoided in trendy sports such as skateboarding or BMX cycling, because even the slightest disturbance in body perception, for example in the sense of balance, or reduced protective reflexes can have far-reaching consequences. Weight training or heavy athletics are not recommended, as extreme blood pressure peaks can occur here. There is a risk of damage to smaller vessels; bleeding may occur at the fundus of the eye.


Until a few years ago it was unthinkable that diabetics would get involved in diving. With appropriate precautions, nothing stands in the way of this today. Since 2000 there has even been a diving school for diabetics in Safaga, Egypt.


Sporting success strengthens


Overall, a physically active, well-trained diabetic, taking into account all the risks, can now practice sports that do not seem primarily suitable, such as diving. In addition to the direct positive benefits on blood sugar and a better control of diabetes, exercise has a beneficial effect on the heart, circulation and blood vessels. Not to mention increased fitness, well-being and an improved quality of life.


Competitive sport and diabetes mellitus: is it possible? If the behaviors carried out are taken into account, the question must be clearly answered in the affirmative (3). Exercise with physical effort to the limit of performance is an important experience for the patient. Successes strengthen the self-confidence of the chronically ill. This can often even compensate for existing psychosocial problems.


Whether a diabetic can participate in high-performance sport should be decided on an individual basis. After all, there are a large number of international top-class athletes who perform well despite and with diabetes.