2011-06-17

Two-a-Day Workouts for Type 1 Diabetics: Lessons Learned

Having undertaken two-a-day workouts for nearly four consecutive weeks now, I would like to share some of what I've learned, in hopes that others can gain from my self-experimentation. While everyone's body and schedule are a little different, I do believe two-a-day workouts are a viable option for any athletically inclined type 1 diabetic.

Because I have been asked the question before, I should clarify: What I mean by "two-a-day workouts" is literally working out twice in the same day - once in the morning, and once in the evening.

Lesson #1: Benefit -- Significant Disruptions are Preferable to Massive Disruptions
Prior to beginning my two-a-day regimen, I was working out once in the late afternoon, for between one to two hours. The rest of my day is spent working in an office, and therefore I am quite sedentary for the majority of my waking hours. This once-a-day explosion of physical activity - typically involving both strength training and cardiovascular exercise - was incredibly hard on my body.

I enjoyed the physical exercise and the condition of my body from the exercise itself. Nonetheless, my blood sugar would typically skyrocket during and shortly after the workout, and then suddenly plummet in the late evening, often subjecting me to a potential overnight low.

Working out twice a day for less total time per workout offers me the benefit of never experiencing an activity surge quite that high. At the same time, my body feels more active throughout the day. That is, rather than only being active in the evenings, I am now active in the morning and the evening. This is a lot closer to "always being active." So, not only is each session less disruptive, but it also feels like more consistent daily activity. This seems to have really smoothed out my blood glucose levels during the day.

Lesson #2: Benefit -- A Tighter Schedule
While some may consider this a bad thing, time is much tighter these days, in a good way. The fact that I must now absolutely rouse myself from sleep between 5:00 AM sharp and 5:15 AM means that I now resist the urge to sleep in a bit. This means my mealtimes are more regular. It also means that my workouts must occur with razor-sharp scheduling precision.

As we all know, but are reluctant to admit, routine is the key to successful diabetes management. Two-a-days really seem to encourage the daily routine.

Lesson #3: Challenge -- Missing a Workout
On the other hand, I am finding that when I miss a workout (either in the morning or the afternoon) it is a bit more disruptive than I expected. My body has become so used to the demands of a two-a-day schedule that when it has to become a one-a-day schedule, my blood glucose levels start to climb high within a couple of hours of the missed workout.

Moreover, this is obviously also true on days that are scheduled to be one-a-days on purpose, such as long run days and rest days.

Granted, this challenge can be easily overcome by managing my diet. Which brings me to Lesson #4...

Lesson #4: Diet is the Great Flex-Factor
The master slack variable in all of this seems to be what I eat. If I miss a workout and eat the same way as though I still had worked out, then obviously my blood sugar will increase. If I eat modestly despite a tough workout, I have a low. I finally seem to be in the same place most diabetics are in general, meaning that both my diet and my insulin intake need to be adjusted based on my needs for the particular day.

Lesson #5: Keep a Broad View
In other words, the more I fixate on whatever happens to be different, the more I throw myself off track. I need to adjust all factors in response to every change, not just make one change and hope for the best.

This is a bit of a paradigm shift for me, because we economists are used to thinking about things "ceteris parabus." The funny thing about diabetes is that it isn't really a ceteris parabus kind of disease. Change something at one stage of the chain, and you impact the entire system.

Therefore, any small change requires a variety of corresponding changes. It's not one thing, it's five things...

Lesson #6: It's Worth It
The most important lesson learned thus far is that the challenges are easily accommodated for, and the benefits are many. I highly recommend two-a-days to active type 1 diabetics. I think it is an excellent strategy for diabetes management.