2013-05-27

Diabetes And Exercise: Part IV

Recently, I have been exploring the some personal hypotheses related to human growth hormone (HGH), cortisol, and insulin and glucose levels in the blood stream. What began as a bit of a crackpot theory quickly grew into a relatively deep dive into some aspects of the endocrine system that are not directly involved in the insulin-glucagon-food-sugar cycle that so preoccupies us diabetics. I am still not fully comfortable discussing the information from any standpoint of expertise, and it should always be remembered that I am not any sort of an endocrinologist, not even an amateur one. Nevertheless, I do feel that I have sufficient knowledge of some of these concepts to merit a new installment of my Diabetes and Exercise series.

Anabolism And Catabolism
Metabolism consists of two separate processes that have fancy names, but which are fully intuitive. Anabolism is that part of metabolism that produces growth and generation. Catabolism is that part of metabolism that results in the breaking down of larger things.

A simplistic view of the process would cause a conceptual error. We would like to believe that anything that builds is good, while anything that deconstructs is bad. This is obviously not the case: fuel must be burned in order to produce energy, timber must be cut in order to build a house, and so on. In all cases, building something new involves breaking something else down to some extent or another. So long as we are not dealing with annihilation, we intuitively understand this concept.

So it is with the human metabolism: Catabolism breaks down larger molecules so that energy can be released into the body, anabolism combines energy, hormones, and proteins to produce muscle and tissue growth.

Recall from my "Hunting for Clues" post that HGH, which is primarily responsible for muscle growth, lipolysis, protein synthesis, etc., is produced as a response to strenuous exercise and/or hypoglycemia. Insulin levels therefore also impact the extent to which HGH production occurs.

The way this at least appears to me to work is that blood sugar levels have a tendency to fall when we fast (of course) and when we engage in activities that make use of the sugar in the bloodstream. Once the insulin/glucose ratio tilts to a certain point, HGH production kicks-in. The most immediate reason for this is to stimulate gluconeogenesis in the liver. That is, to keep us alive, HGH sends a signal to the liver to start cranking out the glucose. In a healthy body, this would continue up to the point where more reasonable blood-insulin and -glucose levels are established, at which time catabolic hormones (mostly glucocorticoids, I believe) would be released to send a signal to halt or slow gluconeogenesis and/or metabolize blood sugar.

It is a two-step process, and neither step is more important than the other. It is akin to taking a step with your right leg, followed by a step with your left leg, and thus, walking.

Diabetic Conditions (I Think)
Diabetic bodies being what they are, we are always warding-off conditions of hyperglycemia. Left without insulin injections, our blood glucose would rise and we would ultimately die because of it. This suggests (again, I must reiterate that I am hypothesizing based on my limited understanding of the situation) that diabetics with under-controlled blood sugar levels will also experience lower HGH production (since we will rarely be in hypoglycemic conditions, or even conditions of high blood-insulin levels regardless of blood glucose levels).

Combine this knowledge with the fact that exercise produces cortisol, a glucocorticoid. This means that a diabetic who exercises regularly will experience increased cortisol levels (as a direct stress response to the exercise itself) and increased hyperglycemia as a result of both being a diabetic in general and the fact that exercise also stimulates gluconeogenesis as the natural result of exercise-induced increased respiration.

What we are left with is a picture of a diabetic body under the conditions of strenuous exercise: heightened levels of blood glucose and glucocorticoids combined with inhibited levels of human growth hormone. The body is catabolizing, but not anabolizing. That is, the diabetic body breaks down, but does not build up. If you are a diabetic who exercises regularly, you have probably experienced the feeling that you are wearing yourself down: your muscles burn and feel fatigue for days on end, you're tired all the time, and so on.

The quirk here is that, as we all know, exercise also reduces blood sugar levels and can result in hypoglycemia if we're not careful. Our balance is therefore thrown out-of-whack. We get the worst of all worlds: increased blood sugar and cortisol, but no corresponding regulatory influx of HGH. Whatever hypoglycemia we experience is a result of our injected insulin. Because the body isn't producing that insulin itself [hypothesis alert], it appears that the normal anabolic signals fail to trigger the right way.

Making Use Of This Knowledge
Over the past few weeks, I have been experimenting with my new-found knowledge. There are a few simple things we diabetics can do improve our anabolic profile. Doing so will reduce our blood sugar, reduce the amount of daily insulin required, and hopefully help us all better-regulate our bodies.

First, it has been shown that eating a small amount of protein after every workout results in a slight inhibition of the production of cortisol. I have spent almost a year drinking very-low-carbohydrate (~3mg or so) protein shakes after every workout. The low levels of carbohydrate prevent me from going hypoglycemic before I can get to a safe a place with necessary snacks, while the protein serves to reduce the body's post-workout stress response. I feel much better having had a protein shake after a workout than I do otherwise. It does at least appear to work.

Second, it is extremely helpful to use one's workouts to foster the production of HGH. As I have noted, strenuous exercise stimulates HGH production. The operable word is strenuous. If you are like me, then you have grown accustomed to working out a particular way. For example, I spent whole years of my life going for a daily 10-mile run. Before I was diabetic, this worked okay (although it wasn't ideal). When I became diabetic, however, the daily 10-mile run created conditions in my body in which I was producing copious amounts of cortisol due to the stress of the workout, but the workout was never so stressful as to result in much HGH production. My blood sugar would gradually increase, until I would eventually have to take significant time off running.

In contrast, these days I have taken to dedicating about three days per week to a very strenuous strength-and-plyometrics workout that completely exhausts me, after which I will often go for a modest run on top of that. Such workouts are so strenuous that my body cannot help but crank out the HGH. Yet, because I only do this three times per week, my body never gets so worn-down from exercise that I hurt my muscles, bones, or ligaments. The remainder of the days of the week are spent doing a more traditional cardio workout, like a daily run. This seems to produce the right balance of HGH versus cortisol.

Third, it is very important that an exercising diabetic reaches a state of deep sleep on a regular basis, because it is during this deep sleep that the majority of a person's HGH is produced. Every diabetic who has ever had to stay up at night has feel the awful burning sensation of lacking sleep. That burning sensation is cortisol pumping through the human body: losing sleep is stressful. But the foregone HGH production serves up a double-whammy for the exercising diabetic, further worsening our blood sugar profile.

Conclusion
Considering the above discussion, there are a few important take-aways to be had:

  • Diabetics risk diminished anabolism
  • There are proven activities that promote anabolism in the body
  • Hyperglycemia and cortisol production worsen a diabetic's blood sugar profile, but this is a condition that can be alleviated by engaging in activities that promote anabolism
  • Dedicate three days per week to highly strenuous exercise, such as plyometrics
  • Get plenty of sleep
To put it succinctly, if you're not gasping for breath, then you're not engaging in strenuous activity. You should be gasping for breath for a good thirty minutes solid. Doing so will promote HGH production and improve your blood glucose control.

It should be noted that much of what I have just written applies equally to diabetics and non-diabetics. For diabetics, it is uniquely important, but all of the above principles apply to people who simply wish to enjoy the anti-aging, immunity-boosting effects of natural HGH production.